Inspection on 24/01/06 for Marion House

This inspection was carried out on 24th January 2006.

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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Marion House 11/07/08

Marion House 26/07/07

Marion House 27/06/06

Marion House 20/06/05

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 Sophie Barton Unannounced Inspection 24 January 2006 12:45 th DS0000003961.V280044.R01.S.doc Version 5.1 Page 1 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 DS0000003961.V280044.R01.S.doc Version 5.1 Page 2 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 Stationery 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. DS0000003961.V280044.R01.S.doc Version 5.1 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 Provider Web 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 for People with Learning Disabilities Mr Franco Monteregge Care Home 8 Category(ies) of Learning disability (8) registration, with number of places DS0000003961.V280044.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th June 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. DS0000003961.V280044.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection has been undertaken as part of the statutory inspection process in accordance with the Care Standards Act 2000. Marion House was assessed according to the Care Homes for Adults (18-65) National Minimum Standards. This was an unannounced inspection on Tuesday 24th January 2006 at 12.45pm to 4.30pm, followed by an announced visit on 26th January 2006 at 3.00pm to 6.00pm. The Team Leader spent time with the Inspector on the first day and answered a number of questions and queries put to her by the Inspector. The Registered Manager was available if requested. A senior support worker was available on the second day, and again answered many queries and questions put to her by the Inspector. As well as examining care files, policies and other records two service users, the day Services Manager and a member of support staff were spoken with on the first day. Five service users were seen and spoken with informally on the second day. The inspector was made very welcome by staff and service users and assisted the Inspector in all aspects of the inspection. Fourteen key standards were assessed at this inspection. One of these standards were assessed as having a significant shortfall, and four with minor shortfalls. Nine standards were met in full with two being exceeded. What the service does well: The home is proactive in ensuring service users are fully consulted about their care and the running of the home. Care plans and resident meetings evidenced clearly that it is a person centred service with service users’ welfare and rights at the centre of all planning. The service users commented that Marion House is “like a first class hotel” and “lovely”. Service users lead an active life, with many opportunities to undertake a variety of activities, training and education. Independent life skills are fully promoted in the day services and transferred to the residential service. In particular the care planning systems are commendable. The Individual Plans are detailed and informative, describing how service users consider their needs are to be best met. Monthly key worker meetings ensure that care planning remains central and reviewed regularly. Each service user has clear records of their routines, ensuring staff are consistent in their caring. The records indicate that privacy and dignity should be maintained at all times. The home is clean and hygienic. DS0000003961.V280044.R01.S.doc Version 5.1 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. DS0000003961.V280044.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection DS0000003961.V280044.R01.S.doc Version 5.1 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 the following standard(s): 5 The home is proactive in ensuring that service users understand and agree with the terms and conditions of residency and consultancy and participation is fully promoted when considering changes. EVIDENCE: There have been no new service users admitted to the home for over 5 years. There are no current vacancies, therefore Standards 1-4 are not applicable at this time. The Inspector examined three service user care files. On each file was a detailed Statement of Terms and Conditions, which had been signed by the service user. The Team Leader explained that she is currently putting information on a tape for two service users who are visually impaired. DS0000003961.V280044.R01.S.doc Version 5.1 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 the following standard(s): 6, 8 and 9 Care planning systems are very effective, person centred and provide for good participation by service users, with staff having good clear guidance on how to meet the individual’s needs and goals. Service user consultation is given a high priority by staff, with service users participating fully in all aspects of life in the home. The systems for risk assessment and management need to improve to ensure that staff are clear about risks to service users and how these are to be minimised. EVIDENCE: Each service user has a care file named “All About Me” which they keep in their rooms and three service users agreed for the Inspector to examine them. These files contain information about the service user’s likes, dislikes, goals, daily routines, personal care and health needs. Each service user also has a detailed Essential Life Plan which is more descriptive and details the service user’s needs and how staff can best meet these. The service user has monthly key worker meetings. These are recorded and these records showed that DS0000003961.V280044.R01.S.doc Version 5.1 Page 10 service users are consulted about their Plan, and sign the documents. Service users also have a Care Management Care Plan and Assessment. Consultation also extends to other areas of living in the home. The residents meeting minutes seen showed that service users are consulted about activities, food, decoration and furnishings and holidays. Where requested, changes to the home’s routines are decided by service users and reviewed by all. Service users shop for household food and furnishings and can attend staff meetings if they wish to. There have been risk assessments developed for each service user. However the majority of these were written several years ago and many of these had not been reviewed. In discussion with the Team Leader she confirmed that risk assessments are currently being updated and did show the Inspector evidence of this. The Inspector was also shown recent risk assessments that had been completed for a service user going on a holiday. Risks assessments were not kept on service user’s individual files. DS0000003961.V280044.R01.S.doc Version 5.1 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 the following standard(s): 12, 13, 15 and 17 The staff ensure that service users are given every opportunity to lead ordinary and meaningful lives, with links with the community enriching service users’ social, educational and leisure opportunities. The service users are supported well by staff in maintaining appropriate personal and family relationships. The meals in the home are good offering both choice and variety, although service user participation in meal preparation is limited, restricting service user personal development and independence. EVIDENCE: All of the service users have chosen to attend Stepping Stones (the Day Service run by Prospects), and can attend all day or for specific sessions only. The Inspector met with the Manager of this Day Service and spoke to the service users about their day opportunities. The Inspector was informed that two service users undertake work experience (in a school, mother and toddler group, and at a community centre). The service also runs a café (Marions Kitchen) which is in Moordown and the service users work day shifts there. DS0000003961.V280044.R01.S.doc Version 5.1 Page 12 Other service users are part of a gardening project, recycling project and attend sessions at the local community centre (music sessions). Service users are supported in attending church if they wish, go for walks, and go swimming. The Inspector was also shown a list of trips service users went on in 2005 and some of these were day trips to London, Marwell Zoo, going on a river cruise and going on holiday to Butlins. One service user did state that although he had been taken to a Football match a while ago he would like to attend again, but is waiting for staff availability. All service users confirmed that they are supported to see family and had friends outside of the home. One service user showed the Inspector a photo album that staff had helped him put together of friends and family. A Resident meeting record showed that service users discussed the timing of meals, and choosing special meals and takeaways. The Team leader confirmed that all service users participate in meal plans and go shopping with a member of staff for food. The Team leader also confirmed that service users are encouraged to make their lunches and prepare food. However one service user stated that they do not cook their meals as they are not allowed to. Another service user stated that they used to help but don’t anymore and another service user stated that he doesn’t want to help with meals. DS0000003961.V280044.R01.S.doc Version 5.1 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 the following standard(s): 18 and 19 The staff have a very good understanding of the service user personal care support needs, with daily routines recorded well, promoting consistency and maximising privacy, dignity and independence. Health monitoring recording and planning was limited in places, which could potentially leave some health needs to be unmet. EVIDENCE: The care files seen showed that daily routines were recorded in detail, allowing staff to have clear instruction on how to meet the service user’s personal care needs and acknowledging their preferences. These records also showed that service users are encouraged to be as independent as possible with their own personal care. Service users confirmed that they go and buy their own clothes and personal shopping. They also have a ‘development day’ where they can have 1-1 support from their key worker to go shopping. There is a clear record made of the service users’ health needs. However the Inspector found no evidence on some service users’ files of when they had been for routine dental, optical, audio tests or psychiatry appointments. Identified risks to health had also not been recorded appropriately as a risk assessment, and for one service user his care plan had not been updated to include recent health changes. DS0000003961.V280044.R01.S.doc Version 5.1 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 the following standard(s): 22 and 23 The recording of complaints in the home is not consistent, leaving some complaints unsatisfactorily addressed. The home has satisfactory and detailed Protection of Vulnerable Adult (POVA) guidance for staff, ensuring service users have better protection from abuse. EVIDENCE: The Inspector was given a copy of the home’s complaints and POVA policies and guidance. These documents were detailed and appropriately informed staff of correct procedures to follow. The complaints procedure has been made user friendly, but there is a continuing need to make it suitable for service users who are visually impaired. The Inspector examined the Incident book, the Complaints Log and ‘In House Issues’ book. In the latter book it detailed two complaints made by a service user. This had not been written in the complaints log, and the complaints procedure not followed. The complaint written in the complaints log did not evidence whether the service user was happy with the outcome of the complaint. In discussion with a member of staff they were clearly able to articulate the procedure to be followed if they suspected abuse to a service user. The Team leader confirmed that staff are instructed in POVA procedures in staff meetings. The member of staff confirmed that service users are informed of abusive behaviour, their rights to protection etc at Advocacy Forums, key worker meetings and that they had all done some awareness training in this area. DS0000003961.V280044.R01.S.doc Version 5.1 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 the following standard(s): 30 The standard of cleanliness within this home is good providing service users with a hygienic and comfortable home. EVIDENCE: The Inspector had a tour of the premises during this unannounced inspection. The kitchen, bathrooms and communal living areas were clean and free from any offensive smells. The staff confirmed that there are infection control procedures, with separate hand washing areas, and guidance followed in the preparation and storage of food / meats. There is a separate laundry area with impermeable walls and flooring. DS0000003961.V280044.R01.S.doc Version 5.1 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: None of these standards were assessed at this inspection. Please refer to the previous inspection report dated June 2005 where standards 32 – 36 were assessed as being met in full. DS0000003961.V280044.R01.S.doc Version 5.1 Page 17 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 42 The safety and welfare of service users is being put at risks due to the failure to maintain health and safety checks and servicing. The home has also failed to carry out some fire precautions action. EVIDENCE: The Inspector examined the fire precaution records, health and safety files and spoke to two members of staff about health and safety within the home. Checks of fire equipment had been maintained satisfactorily and staff had undertaken fire training at appropriate intervals. There is a fire risk assessment of the home, although this was limited in detail. A recommended action to prevent fire had not been actioned by the home’s manager. Fire drills had not been undertaken in the evening or early morning when there are less staff on duty and service users are in their bedrooms. The Inspector noted that a fire door was propped open. The home had clear policies in relation to health and safety practices. DS0000003961.V280044.R01.S.doc Version 5.1 Page 18 Water temperature checks are taken weekly. The Inspector noted that the records showed that the temperature in the shower room had been above 43 degree centigrade for 5 weeks, and could therefore scald a service user. PAT testing had been undertaken in 2005. However there was no evidence presented to the Inspector to show that the electrical systems or boiler and gas appliances had been checked / serviced. Risk assessments for safe working practices could also not be found by the inspector. DS0000003961.V280044.R01.S.doc Version 5.1 Page 19 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 Standard No Score 1 x 2 N/a 3 N/a 4 N/a 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 x 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 x 33 x 34 x 35 x 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 x 3 2 x LIFESTYLES Standard No Score 11 x 12 4 13 3 14 x 15 3 16 x 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 x x x x x x x 1 x DS0000003961.V280044.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement The registered Manager must ensure that the health and welfare of service users is maintained, by ensuring gas and electrical appliances are services appropriately. Identified fire hazards must be removed. Fire doors must not be propped open. Action must be taken immediately when water temperatures are too high. Timescale for action 1 YA42 13 30/03/06 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 2 3 Refer to Standard YA9 YA17 YA19 Good Practice Recommendations Risks to service users should be recorded appropriately and reviewed at six monthly intervals. Service users should be given the opportunity to prepare and cook their meals. There should be a clear record made of when service users attend routine health checks and specialist health DS0000003961.V280044.R01.S.doc Version 5.1 Page 21 4 YA22 5 YA42 appointments. The Registered Manager should ensure that all complaints are recorded appropriately in the home’s complaints log. There should be a record made of whether the complainant is happy with the outcome of the investigation. There should be a fire drill undertaken in the evening / early morning. There should be risk assessments completed on all safe working practices. DS0000003961.V280044.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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. 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