Inspection on 08/08/05 for Maltings (The)

This inspection was carried out on 8th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Maltings (The) 22/08/07

Maltings (The) 19/04/06

Maltings (The) 28/11/05

Maltings (The) 09/02/05

Maltings (The) 21/07/04

Maltings (The) 04/02/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Maltings (The) Brewers Lane Shelbourne Road Calne Wiltshire SN11 8EZ Lead Inspector Malcolm Kippax Announced 08 August 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Maltings (The) D51_D01_S36134_MALTINGS(THE)_V242894_080805_Stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Maltings (The) Address Brewers Lane Shelbourne Road Calne Wiltshire SN11 8EZ 01249 815377 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Milbury Care Services Limited Allison D Turner Care Home 3 Category(ies) of LD Learning Disability (3) registration, with number PD Physical Disability (3) of places SI Sensory Impairment (3) Maltings (The) D51_D01_S36134_MALTINGS(THE)_V242894_080805_Stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th February 2005 Brief Description of the Service: The Maltings is a detached bungalow situated in a residential area of Calne. The home is run by Milbury Care Services Limited and provides care for up to three people with a learning disability, physical disability or sensory impairment. The home provides domestic style accommodation in a community setting. There are three single bedrooms, one with full en-suite facilities. There is a spacious lounge and a separate dining room and a kitchen. The service users have access to two toilets, a shower and a bathroom. There is a large garden and the home has its own vehicle for trips out. In addition to the manager there is a permanent staff team of four support workers. There are two support workers on duty at all times when the service users are at home. Maltings (The) D51_D01_S36134_MALTINGS(THE)_V242894_080805_Stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was arranged at short notice with the home’s manager. The inspection started at 1pm and lasted for six hours. The three service users were met with, however verbal communication was not possible. The manager and two agency staff members were spoken with. The accommodation was looked at and a selection of the home’s records was examined. The parents of one service user were spoken with during the inspection and another parent has since been spoken with. Allison Turner has been registered as the home’s manager since the last inspection. What the service does well: What has improved since the last inspection? What they could do better: The permanent staff team could not provide all the support that service users need. This will improve with the recruitment of new staff, which should produce a more settled staff team and less dependency on agency staff. The service users’ personal goals should be more clearly highlighted and monitored. This will help to ensure that staff can focus on providing support in areas that will enhance the service users’ quality of life. The accommodation and garden should be developed in ways that will improve the environment for service users. Maltings (The) D51_D01_S36134_MALTINGS(THE)_V242894_080805_Stage4.doc Version 1.40 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Maltings (The) D51_D01_S36134_MALTINGS(THE)_V242894_080805_Stage4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Maltings (The) D51_D01_S36134_MALTINGS(THE)_V242894_080805_Stage4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 and 5 Information about the service is kept up to date, however work should continue to present this in a user friendly format. Terms and conditions are not being agreed by the appropriate parties. EVIDENCE: Written information about the home had been updated following the change of manager. A service user’ guide has been produced in a written and a pictorial version, but neither format is meeting the service users’ needs. Photographs have been introduced used as a means of communication in other areas. The manager acknowledged that further work was needed to make information generally more accessible to service users. It was agreed with the manager that some further information would be added to the written version of the service user’s guide to ensure that this contains everything that is required. There is a block contract between Milbury Care and the funding authority. Milbury Care have produced a terms and conditions agreement for each service user. These are signed by the manager on behalf of Milbury Care. The manager said that keyworkers were able to sign on behalf of the service user. The agreements should be signed by an appropriate person who is independent of the service. Maltings (The) D51_D01_S36134_MALTINGS(THE)_V242894_080805_Stage4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 Service users benefit from the information that staff members have about their personal needs. A lack of clarity about individual goals and progress with achieving these is likely to affect the service users’ quality of life. EVIDENCE: Each service user had an individual plan as part of a system of ‘person centred planning’. A range of forms about daily routines and preferences were completed. The forms were written from the service user’s perspective, which gave a personal account of the service users’ needs. ‘Monthly Summary Sheets’ were completed, which the manager said was the way in which the individual plans were kept under review. These forms include headings, such as Individual Support Requirements and Achieved goals and future planning. The latter included some goals and objectives for individual support but there was a lack of continuity from one month to another. Dates and progress relating to the achievement of personal goals were not consistently recorded. The agency staff members spoken with said that good information was available to them about the service users’ needs. They contributed to the completion of daily record forms, which are used to monitor changes in the service users’ health and welfare. Maltings (The) D51_D01_S36134_MALTINGS(THE)_V242894_080805_Stage4.doc Version 1.40 Page 10 There was a requirement at the last inspection for information to be provided in the service users’ individual plans about the support that they receive with managing their finances. Some details have since been recorded on a form although it was agreed with the manager that further information would be added about the financial arrangements. Maltings (The) D51_D01_S36134_MALTINGS(THE)_V242894_080805_Stage4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 15 and 17 Service users are well supported in their contact with family members. Parents maintain a close involvement however relationships have been affected by changes in the home. The menu takes account of individual needs although service users would benefit from the involvement of a dietician. EVIDENCE: The person centred planning forms included sections on ‘About My Family’ and ‘How I would like my family and friends to be involved in my life’. These showed that service users have regular contact with parents. Details of visits were completed on the daily record forms. One service user’s parents visited at teatime with a friend who gave the service user a haircut. The parents spoken with said that they had seen a number of comings and goings in the management and staffing of the home. This brought with it the need to respond to new ideas and changes in personnel. They said that they were hoping to establish good communication with the home but felt that this had not yet been achieved. The manager said that she is in regular contact with relatives and is looking at the best ways in which this can be maintained. Maltings (The) D51_D01_S36134_MALTINGS(THE)_V242894_080805_Stage4.doc Version 1.40 Page 12 A menu is written for the week ahead. Menus were seen for a four week period and these showed a varied range of meals being served. There was a statement on the menus advising staff of the need to provide one of the service users with an alternative meal when the set one is spicy or acidic. Details of individual meals taken were recorded on the service users’ daily record forms. The manager said that the menus were based on a range of meals that were known to be popular with the service users. Some of the service users’ particular likes and dislikes were recorded in their personal files. The manager said that greater attention was now being given to home prepared food, in preference to convenience and high fat dishes, as part of a more healthy diet. The involvement of a dietician would be helpful in providing a professional view about the content of the current menus and how nutritional and dietary needs can best be met. The tea meal on the day of the inspection was freshly prepared and served to service users in different areas. Maltings (The) D51_D01_S36134_MALTINGS(THE)_V242894_080805_Stage4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed on this occasion EVIDENCE: Maltings (The) D51_D01_S36134_MALTINGS(THE)_V242894_080805_Stage4.doc Version 1.40 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 Milbury Care Services encourage comments about the service although service users are dependant on others to raise any concerns and complaints on their behalf. EVIDENCE: Milbury Care Services has produced a leaflet covering concerns and suggestions. A copy of this was displayed in the service users’ rooms. While this may be useful information for visitors, the written format is not meeting the service users’ needs and is not in keeping with a homely appearance. The home’s record of complaints showed that one neighbour had complained about the high hedges that border the property on one side. The manager said that this complaint was justified but there had been a delay in its conclusion because of difficulties with finding a suitable contractor to attend to the hedges. The parents spoken with said that they had met with the Milbury Care Services Operations Manager in order discuss various matters concerning arrangements in the home. In future they hope to be able to raise any concerns directly with the home. Maltings (The) D51_D01_S36134_MALTINGS(THE)_V242894_080805_Stage4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 25 Service users live in a homely and domestic style environment. However service users would benefit from changes being made to the accommodation and grounds. EVIDENCE: The Maltings is a domestic style bungalow and the accommodation was kept in a homely way. Some of the décor looked dated and the manager said that particular areas, including the hall and dining room were to be redecorated. The manager said that she is also keen for the environment to better reflect the needs of service users. This would include making the accommodation and grounds more easily accessible and using colour and texture in ways that will benefit service users who have a sensory impairment. Two service users in particular were enjoying using the home’s garden. This is spacious and well established, with a sun house and patio areas. However the general upkeep of the garden should be improved. A recommendation was made at the previous inspection that the paved areas in the garden should be levelled so that the service users can access the garden safely. Maltings (The) D51_D01_S36134_MALTINGS(THE)_V242894_080805_Stage4.doc Version 1.40 Page 16 There were three single bedrooms two of which had at least ten square meters of usable floor space. One room, which measured 9.3 square meters was occupied by a person who uses a wheelchair. The person had been living in the room since before the introduction of the National Minimum Standards. As recommended at the last inspection, consideration should be given to enlarging the room for this person. The manager said that the feasibility of this was being looked at. Service users have the freedom of the home, with the supervision of staff. The manager said that one service user enjoyed helping to make cakes in the home’s domestic type kitchen. Maltings (The) D51_D01_S36134_MALTINGS(THE)_V242894_080805_Stage4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34 and 36 The recruitment procedures help to protect service users from unsuitable staff. Arrangements are in place to support staff members and a recent staff appointment has been beneficial. EVIDENCE: A new permanent staff member started in May 2005. The staff member’s employment file contained evidence of the appropriate recruitment checks and references. The file also had a record of supervision, with dates and outcome. The service users’ parents said that the new staff member’s appointment had helped the staffing situation and been beneficial for service users. There continued to be a high use of agency staff as a result of staff vacancies. The manager said that this would be helped by the appointment of two new employees who would be starting shortly. One of these people is to be in the new position of assistant manager. The agency staff met with said that they worked in the home on a regular basis. They were used to working with each other, although it was usual to work alongside a permanent member of staff. The manager said that this was the usual pattern. They were satisfied with the support that they received and the information they were given about the service users. An on-call system was in place for contacting a senior person outside ‘office hours’. It was seen Maltings (The) D51_D01_S36134_MALTINGS(THE)_V242894_080805_Stage4.doc Version 1.40 Page 18 that the agency staff were familiar with the service users’ needs and their preferred routines. Maltings (The) D51_D01_S36134_MALTINGS(THE)_V242894_080805_Stage4.doc Version 1.40 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 Systems are in place that help to ensure that service users are not at risk. Further improvements will be beneficial. EVIDENCE: Maltings (The) D51_D01_S36134_MALTINGS(THE)_V242894_080805_Stage4.doc Version 1.40 Page 20 The home’s fire log book was up to date. The log book contained a copy of the fire risk assessment that the manager had completed in April 2005. This had produced a recommendation about the fitting of fire doors to replace the existing ones. The manager said that this was now being followed up with the relevant parties. Additional radiator covers have been fitted since the last inspection. One radiator in the bathroom remains uncovered, which the manager confirmed would be receiving attention. The temperature of the hot water is being regularly monitored. A chart in the bathroom attached to one service user’s room was up to date with a record of bath hot water temperatures. A locked cupboard is used for the storage of cleaning fluids and C.O.S.H.H. related materials. A risk assessment file contained records of individual and generic risk assessments. Several of these had been completed by the manager in June and July 2005. Maltings (The) D51_D01_S36134_MALTINGS(THE)_V242894_080805_Stage4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 x x x 2 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 x x x x x Standard No 11 12 13 14 15 16 17 x x x x 3 x 3 Standard No 31 32 33 34 35 36 Score x x x 3 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Maltings (The) Score x x x x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x D51_D01_S36134_MALTINGS(THE)_V242894_080805_Stage4.doc Version 1.40 Page 22 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 1 Regulation 5 Requirement The registered manager is required to amend the service users’ guide to ensure that all the information required in Standards 1.1 to 1.4 are included (this requirement was made at the last inspection and has been met in part) The registered manager is required to ensure that there is a clear reflection in service users’ individual plans as to how benefit payments are made and how service users are supported in managing their finances (this requirement was made at the last inspection and has been met in part) A cover must be fitted to the radiator in the bathroom Timescale for action BY 19/08/05 2. 7 15 BY 31/08/05 3. 42 13 BY 19/09/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 1 Good Practice Recommendations That work continues to produce information, including the D51_D01_S36134_MALTINGS(THE)_V242894_080805_Stage4.doc Version 1.40 Page 23 Maltings (The) 2. 3. 4. 5. 6. 7. 8. 5 6 17 24 24 24 25 service users guide, in formats that best meet the service users individual needs The service user agreements should be signed by the service users or a representative and the registered manager (recommendation made at the last inspection) That the service users personal goals & objectives, and their progress with achieving these, are more clearly identified in their personal records. That advice is obtained from a dietician about the content of the menus and the nutritional needs of individual service users That the use of colour and texture within the home environment is developed in ways that will benefit service users who have a sensory impairment That the upkeep of the garden is improved The paved areas in the garden should be levelled so that the service users can access the garden safely (recommendation made at the last inspection) Consideration should be given to enlarging the room occupied by the person who uses a wheelchair (recommendation made at the last inspection) Maltings (The) D51_D01_S36134_MALTINGS(THE)_V242894_080805_Stage4.doc Version 1.40 Page 24 Commission for Social Care Inspection Avonbridge House Bath Road Chippenham Wiltshire SN15 2BB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Maltings (The) D51_D01_S36134_MALTINGS(THE)_V242894_080805_Stage4.doc Version 1.40 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!