Inspection on 20/06/05 for Marion House

This inspection was carried out on 20th June 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Marion House 11/07/08

Marion House 26/07/07

Marion House 27/06/06

Marion House 24/01/06

Marion House 09/11/04

Marion House 04/05/04

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 Marion House 40 The Avenue Moordown Bournemouth Dorset BH9 2UW Lead Inspector Stephanie Omosevwerha Unannounced 20 June 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. Marion House D55 S3961 Marion House V233480 200605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Marion House Address 40 The Avenue Moordown Bournemouth Dorset BH9 2UW 01202 521985 01202 519002 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) Prospects Mr Franco Monteregge CRH (PC) -Care Home Only 8 Category(ies) of LD - Learning disability (8) registration, with number of places Marion House D55 S3961 Marion House V233480 200605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 9th November 2005 Brief Description of the Service: Marion House is a large detached house in a quiet residential district of Bournemouth known as Moordown. The local area includes a wide range of shops, churches and community services, and is served by local bus services. The home accommodates up to eight adults of both sexes who have learning disabilities and some additional disabilities such as visual impairment. Each resident has their own bedroom, seven are on the first floor and the eighth on the ground floor. A Day Opportunities service is attached to the property but is separated from the care home by a locked door and has its own entrance at the rear of the property. The home comprises of a lounge, a dining room, a quiet room, a laundry and a kitchen. There are three bathrooms with toilets, three shower rooms with toilets, and two other separate toilets. Outside there are attractive grounds that include a fountain, sensory garden and pergola. The home is staffed 24 hours a day and there is a designated key worker and support key worker for each service user. The home is a part of the PROSPECTS organisation and the registered provider is the Chief Executive of that organisation, based at the Head Office in Reading, Berkshire. PROSPECTS has been involved in the support of people with learning disabilities since 1975 and operates various services across the U.K. It is an organisation rooted in Christian principles and the ethos of the home reflects this. There is however no requirement for anyone to engage in religious activity whilst they are supported by PROSPECTS. Marion House D55 S3961 Marion House V233480 200605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an unannounced inspection of the home and took place over 5 hours. It was carried out as part of the planned inspection programme for care homes undertaken by CSCI. During the inspection all communal rooms were seen and a sample of 4 service users bedrooms were viewed. The inspector also had the opportunity to speak with 5 residents, 2 members of care staff, the acting team leader and a volunteer. A sample of records was checked including staffing records and rotas, medication records, communication book. The inspector took into account information contained in the regular monthly reports sent to the Commission by the Responsible Individual. Residents generally expressed a great deal of satisfaction about their care and spoke positively about the food, their rooms, and the staff. Comments included, “I like living here”, “the staff are really nice” and “its (the food) perfect”. One resident did say “sometimes other residents upset me”, however discussion with the acting team leader assured the inspector strategies were in place for dealing with disagreements between residents. Members of staff were also enthusiastic about the home, enjoyed their working environment and felt able to make a real contribution to the quality of service. What the service does well: Marion House has a Christian ethos that places a high importance on creating a caring environment where service users are treated with dignity and respect. Service users are confident about speaking out and feel able to express their views, which is an indication that their rights and choices are encouraged and promoted. The home has a thorough recruitment procedure and a commitment to training ensuring an effective staff team is in place. There is good communication between members of staff and systems are in place such as a communication book, handover sheets and a daily diary to ensure service users’ individual and group needs are met. Marion House is attractively decorated and comfortably furnished providing a homely setting for service users to live in. Service users are able to choose the individual style of their own bedroom e.g. one service users bedroom is decorated in their favourite football team’s colours. The home is committed to providing a good quality service and regularly reviews all aspects of its performance through a comprehensive programme of self-review and consultation, which includes seeking the views of service users, staff and relatives. Marion House D55 S3961 Marion House V233480 200605 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: 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. Marion House D55 S3961 Marion House V233480 200605 Stage 4.doc Version 1.30 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 Marion House D55 S3961 Marion House V233480 200605 Stage 4.doc Version 1.30 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) 2. The home has a stable group of residents whose needs and aspirations are recognised and supported by the staff team. Procedures are in place to ensure thorough assessments of prospective service users’ needs would take place in the event of any vacancy occurring in the home. EVIDENCE: There have been no new admissions to the home since 2000. There is a policy and procedure in place that clearly sets out the homes admission procedure. Local authorities fund all service users and assessments were provided prior to their admission to ensure their needs could be met. Discussion with service users confirmed they had been consulted about moving to the home and had chosen the home for specific reasons, e.g. “my mum was living in Bournemouth, I didn’t like living too far away.” There have been some recent changes to the staff team, however, discussion with members of staff confirmed they all received induction training that followed the Learning Disability Award Framework (specifically designed for those who work with adults with learning disabilities). The induction training also included getting to know residents’ individual support needs and how to recognise them to ensure consistency of care was provided. Marion House D55 S3961 Marion House V233480 200605 Stage 4.doc Version 1.30 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) 7 and 8. Practice in the home ensures service users are facilitated to make decisions about their lives and individual choice is promoted. EVIDENCE: Discussion with residents indicated they were able to make decisions about their daily lives. Examples included one resident had recently been shopping to choose some new clothes, one resident said they preferred a shower in the morning and another said they could have a bath whenever they wanted, service users said they could spend time pursing the activities of their choice either in the privacy of their rooms or the communal areas of the home. Service users are now fully involved in essential lifestyle planning and each holds all the information about their care and support needs in a file “All about me” which they keep in their rooms. The home operates a keyworker system and a member of staff explained the role and responsibilities that included ensuring the service users needs and wishes were taken into account. The keyworker supports the service user with their personal finances if appropriate. All service users have their own bank accounts and lockable safes in their rooms. It was recommended at the previous inspection that a second member Marion House D55 S3961 Marion House V233480 200605 Stage 4.doc Version 1.30 Page 10 of staff countersigned service users financial records. A member of staff confirmed this had now been implemented in the home and the inspector also noted this guidance to staff had been discussed and recorded in the staff meeting minutes. Service users are encouraged to access advocacy services and several residents have independent advocates. They are also involved in 2 local advocacy groups and a regional advocacy group facilitated by PROSPECTS. There was evidence that service users are consulted and able to participate in the daily running of the home. Regular residents meetings are held in the home. Service users also have the opportunity to attend part of the staff meetings. There was a recommendation made at the previous inspection that service users should be given a choice about attending and should be offered the choice of being supported by another service user/advocate if appropriate. Service users confirmed they could now attend in pairs or their keyworker could speak on their behalf if they wished. Marion House D55 S3961 Marion House V233480 200605 Stage 4.doc Version 1.30 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) 16. The home’s ethos creates a caring atmosphere where service users’ rights and responsibilities are respected and promoted ensuring residents are encouraged to fully participate and contribute to the daily running of the home. EVIDENCE: Service users are encouraged to participate in the daily routines of the home and there are kitchen and dining room rotas so service users are clear about their responsibilities. Observation on the day demonstrated this as one service user laid the tables ready for the evening meal and another service user had gone out shopping for groceries. Service users privacy is respected and staff knock before entering resident’s bedrooms. This was further demonstrated by a member of staff asking service users’ permissions before showing the inspector their bedrooms. Service users were observed to have unrestricted access of all communal areas of the home and on their return from day time activities some choose to spend time in the communal areas whilst other sought the privacy of their rooms. The inspector also noted staff fully interacting with service users and it was clear they had an excellent rapport treating residents with dignity and respect. Marion House D55 S3961 Marion House V233480 200605 Stage 4.doc Version 1.30 Page 12 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) 20. The systems for the administration of medication are good with clear and comprehensive arrangements in place to ensure service users medication needs are met. EVIDENCE: The home has a comprehensive policy and procedure concerning the administration of medication. All staff receive mandatory induction training in administering medication but it is usually the most senior staff on duty that takes the responsibility for medication. The home’s medication record file was analysed and this contained all the up-to-date information about each resident’s health needs and their current medication is listed including information about what the medication is taken for and any contraindications. There was evidence of good liaison with the local pharmacy that provide medication to the home in a monitored dosage system. The pharmacist prints out a description of the medication so they can be easily identified. Records concerning the administration of medication were well maintained and accurate. There were clear procedures in place to cover any absences from the home e.g. staying with relatives. Marion House D55 S3961 Marion House V233480 200605 Stage 4.doc Version 1.30 Page 13 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. A complaints booklet is in place but needs amending to include additional information. Residents feel confident in articulating their concerns and there was evidence that these are taken seriously and acted on in the home. EVIDENCE: A complaints booklet was available, although the member of staff was not sure if it was the most up-to-date version. Some minor amendments were required to ensure that full accurate information was given e.g. CSCI contact details, reassurance that the complainant wouldn’t be victimised and the timescale for dealing with complaints in the home. Service users confirmed they knew how to use the complaints system and there had been one internal complaint since the previous inspection. One service user told the inspector “sometimes other residents upset me – I get low”. This situation was discussed with the acting Team Leader who was fully aware of the issues and informed the inspector strategies were in place for dealing with incidents involving potential disputes between residents. It is acknowledged that a group of people living together are not always going to get on and Marion House have worked hard to reach compromises to avoid confrontations between residents. Examples included providing Sky TV in one resident’s room, distracting residents by taking them out or getting them involved in an alternative activity, using different areas of the house to ensure service users have adequate space/privacy to pursue their personal interest/hobbies. Marion House D55 S3961 Marion House V233480 200605 Stage 4.doc Version 1.30 Page 14 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. Marion House is well maintained and decorated to a high standard providing service users with a comfortable, attractive and homely environment. EVIDENCE: During the inspection, the lounge and dining room were observed. These were found to be light, bright and comfortably furnished. Both rooms are large in size and the dining room has a further separate seating area providing service users with additional choice of communal space. The entrance hallway had been redecorated and one resident had purchased new curtains for their bedroom since the last inspection. A sample of four service users’ bedrooms was viewed. These have furniture, fittings and décor that reflects the occupants taste e.g. one room was decorated in the colours of the service user’s favourite football team. This was confirmed verbally by service users who told the inspector they chose how their bedroom was decorated and one service user described their room as “beautiful”. Service users said their privacy was respected and staffed knocked before entering their rooms. This was further observed during the inspection when a Marion House D55 S3961 Marion House V233480 200605 Stage 4.doc Version 1.30 Page 15 member of staff asked the residents if the inspector could view their rooms. Observation during the inspection also determined that service users had unrestricted access to all communal areas of the home. Marion House D55 S3961 Marion House V233480 200605 Stage 4.doc Version 1.30 Page 16 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) 32, 33, 34, 35 and 36. A comprehensive and accredited induction programme ensured consistency of care for service users even though there had been changes in the staff team. The numbers and skill mix of staff on duty ensure the home is well run and organised, supporting the assessed needs of service users at all times. The home operates a recruitment procedure, which is thorough and based on equal opportunities ensuring the protection of service users. The home has a strong commitment to training and excellent communication and support strategies in place for staff, meaning service users benefit from a professional, effective and competent staff team. EVIDENCE: During the inspection, there was the opportunity to talk to 2 members of staff, the acting team leader and a volunteer who had been placed in the home by a Christian organisation for several months. The inspector was shown a staff file, copies of the staff meeting minutes and the staff rota. Staff records evidenced that robust recruitment procedures were in place and these were based on equal opportunities. A staff contract was observed specifying the terms and conditions of employment. All appointments are Marion House D55 S3961 Marion House V233480 200605 Stage 4.doc Version 1.30 Page 17 subject to a six-month probationary period. Volunteers and advocates are also subject to CRB checks. There had been some recent changes in the staff team; however, thorough induction training is given to new staff that is Learning Disability Award Framework accredited. A member of staff told the inspector that the induction also included a comprehensive guide to all the residents’ support needs and how to recognise them. They also said that new staff spent time watching/shadowing more experienced members of staff at first to ensure they felt confident prior to working independently with the service users. Members of staff said that they took part in “a lot of training” and examples of courses attended included administration of medication, fire safety, person centred planning. There was further evidence in staff files that qualifications had been obtained in fire safety, medication and first aid. Training was provided internally as well as externally. For example, the use of an in-house questionnaire as evidence of staff competency in administering medication. Analysis of the rota and observation during the inspection demonstrated the home is well organised with satisfactory numbers of staff on duty to meet the assessed needs of service users. The home has a regular team of relief staff who know the service users and understand the way the home works. There are excellent communication strategies in place such as a staff communication book, daily support notes and handover sheets, which ensure individual and collective needs are identified and met. There are regular team meetings once a month that are recorded and actioned, e.g. observation of the minutes evidenced that a recommendation made at the previous inspection to countersign service users financial records has now been implemented. Staff confirmed they had regular supervision sessions and these were recorded and observed on the staff files. Staff spoken with appeared professional, committed and motivated and service users spoke highly about the staff. Comments included “the staff are perfect”, “the staff are really nice” and “the staff are very good”. Marion House D55 S3961 Marion House V233480 200605 Stage 4.doc Version 1.30 Page 18 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) 39. The home is committed to providing a good quality service and regularly reviews all aspects of its performance through a comprehensive programme of self-review and consultation, which includes seeking the views of service users, staff and relatives. EVIDENCE: The home has various methods to ensure service users views are taken into account e.g. residents meetings, residents attending staff meetings, regional advocacy groups, regular keyworker sessions, service user questionnaires. The registered manager has written to relatives for formal feedback on the service and is also available for relatives to contact to discuss any issues or concerns they may have. Staff spoken with said they felt valued and able to make a contribution to service development. The inspector was told the organisation had recently set up a new service in response to requests to support people in the community and members of staff had been able to be fully involved with the Marion House D55 S3961 Marion House V233480 200605 Stage 4.doc Version 1.30 Page 19 implementation of this. In fact the team leader had been promoted to manage this service. Since the previous inspection the home has completed a picture record of some of the successes/improvements in the home that is accessible to the residents in the home. This record provides a measure of some of the achievements the home has accomplished over the past year. The responsible individual visits the home on a monthly basis and Regulation 26 reports are sent to the inspector. These are very comprehensive and provide a detailed analysis of all aspects of the home’s performance. Marion House D55 S3961 Marion House V233480 200605 Stage 4.doc Version 1.30 Page 20 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 x 3 x x x Standard No 22 23 ENVIRONMENT Score 2 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x 3 3 x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x x Standard No 11 12 13 14 15 16 17 x x x x x 3 x Standard No 31 32 33 34 35 36 Score x 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Marion House Score x x x x Standard No 37 38 39 40 41 42 43 Score x x 4 x x x x D55 S3961 Marion House V233480 200605 Stage 4.doc Version 1.30 Page 21 No 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 22 Regulation 22 Requirement The registered provider must amend the complaints procedure to include the following information:- the name, address and telephone number of CSCI, the timescale for dealing with complaints and reassurance that the complainant will not be victimised. Timescale for action 30 September 2005 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. 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