Inspection on 24/01/06 for Mckechnie 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 Good. 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Mckechnie House 12/02/09

Mckechnie House 18/12/06

Mckechnie House 06/10/05

Mckechnie House 09/03/05

Mckechnie House 16/08/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Mckechnie House 104 Mill Road Mile End Colchester Essex CO4 5LJ Lead Inspector Pauline Dean Unannounced Inspection 24 January 2006 09:20 th Mckechnie House DS0000017880.V277394.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 Mckechnie House DS0000017880.V277394.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. Mckechnie House DS0000017880.V277394.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Mckechnie House Address 104 Mill Road Mile End Colchester Essex CO4 5LJ 01206 751463 01206 843367 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) Broad Horizons Limited Mrs Jean Brown Fleming Revelle Care Home 2 Category(ies) of Learning disability (2) registration, with number of places Mckechnie House DS0000017880.V277394.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 2 persons) 6th October 2005 Date of last inspection Brief Description of the Service: McKechnie House is an established small care home, first registered in October 2001 for two younger adults with learning disabilities. The registered provider is Broad Horizons Ltd, with Mrs Jean Revelle as the responsible individual/ registered manager. McKechnie House is one of three small care homes, with the same proprietor, located in Mill Road and as they are in close proximity there is interaction between service users and staff. The home is found in a residential area of Colchester, located close to Colchester General Hospital. Close by there are local shops and facilities, with the main town centre offering shopping and leisure facilities a short bus ride away. Accommodation for the two service users is on the first floor, both having single rooms with a wash hand basin fitted. There is a bathroom with bathing and shower facilities and toilet. An office/staff bedroom is also found on the first floor. On the ground floor there is a front lounge and a kitchen/dining area. The property is semi-detached and has gardens to the front and rear. There is some off-road parking in the front garden. The rear garden is enclosed with a paved patio area, decking and a lawn. Mckechnie House DS0000017880.V277394.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place over one day in January 2006. This was the second inspection of the inspection year 2005 to 2006. Throughout the day there was discussion with a senior care staff member who was on duty. Both service users were spoken with during this inspection. No visitors or relatives were present at this inspection. A tour of the premises was conducted at this inspection and some care and staff records were sampled. In addition some of the policies and procedures were sampled and inspected. Fifteen of the forty-three standards were inspected at this inspection; of these eleven were met, with four standards nearly met. All of the twenty-two key standards were inspected over the two inspections of the year. As at the last inspection there is an improvement in meeting the requirements. The shortfalls found were as at the last inspection namely the development of a Service Users’ Guide in a format that would be readily understood by individual service users; staff supervision and the quality assurance and quality monitoring processes. In addition the records relating to Portable Appliance Testing (PAT) were not available for inspection. What the service does well: What has improved since the last inspection? The senior care staff member spoke positively of the support and training offered at Broad Horizons Limited and it was said to be ongoing. Recent training opportunities such as First Aid training and Basic Food Hygiene training was highlighted as examples. Mckechnie House DS0000017880.V277394.R01.S.doc Version 5.1 Page 6 Record keeping within care planning and risk assessments was seen to have improved since the last inspection. Regular reviews were seen within the record keeping detailing action to be taken and planned interventions. As with the other care homes run by Broad Horizons Limited, service users are encouraged to develop friendships between the residents of the other houses and the inspector was told of the existence of such friendships by care staff and a service user. 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. Mckechnie House DS0000017880.V277394.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 Mckechnie House DS0000017880.V277394.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): 1. Clear detailed information, by the way of the Statement of Purpose and the Service Users’ Guide, is provided to placing authorities, prospective service users and their families to enable them to make a choice of whether they wish to be admitted to the home. EVIDENCE: As detailed at the last inspection the home’s Statement of Purpose and Service Users’ Guide have been reviewed and revised and they meet requirements. There is, however, still a need for Broad Horizons Limited to further develop the Service Users’ Guide into a briefer and more accessible format for each individual service user within the home. Mckechnie House DS0000017880.V277394.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 & 9. Service users’ assessed and changing needs are detailed in their individual care plans to help ensure that their personal needs are met. Both risk assessments and risk management strategies are in place to help support residents in their daily living. EVIDENCE: Both care planning files were reviewed and inspected. These were found to be detailed care plans with risk assessments and risk management strategies in place. Following a visit home changes had been noted in some behaviours of a service user. Within the care plan this was clearly documented with management strategies and reviews planned. The involvement of the service user was included in this record keeping with all staff involved in this management of care. Mckechnie House DS0000017880.V277394.R01.S.doc Version 5.1 Page 10 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): 16 & 17. Service users are supported and enabled and their rights are respected and recognised in their daily lives. The home offered a healthy, varied, planned menu, with consideration given to preferences and dietary requirements EVIDENCE: The rights of service users are respected and recognised within the home. One service user has chosen to hold their bedroom key, whilst the second service user does not wish to hold their key. This is detailed within their care plan records. Furthermore, any restrictions in place were also seen to be recorded within their care plans. Planned reviews were noted in these records. As with the other two care homes owned by Broad Horizons Limited, service users are enabled to select either individually or in a group the meals they wish to eat. Records are kept of their selections and how these choices were made. Food supplies are purchased weekly/fortnightly by the registered manager and each home purchases milk and bread daily as required. Both freezers in the home were seen to be full at the time of the inspection. Within the current service user group there are no special diets. Takeaway meals are enjoyed by the service users who told the inspector of their favourite meals at home or out. Mckechnie House DS0000017880.V277394.R01.S.doc Version 5.1 Page 11 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): None of these standards were inspected in full at this inspection. EVIDENCE: All of the above key standards were inspected at the last inspection. None of these standards were inspected in full at this inspection. There was however some discussion with a senior carer, who confirmed that service users access healthcare professionals as needed. Records held in care planning files confirmed this. Mckechnie House DS0000017880.V277394.R01.S.doc Version 5.1 Page 12 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): None of these standards were inspected in full at this inspection. EVIDENCE: All of the above key standards were inspected at the last inspection. None of these standards were inspected in full at this inspection. The inspector was told however, that there had been no complaints or adult protection concerns since the last inspection. Mckechnie House DS0000017880.V277394.R01.S.doc Version 5.1 Page 13 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): 24, 28 & 29. McKechnie House provides a safe, homely and pleasant environment, which was clean and comfortable. EVIDENCE: McKechnie House continues to offer a bright, clean and a homely environment. The premises are of a domestic type and are in keeping with the local community in a residential area. Decoration and maintenance is ongoing. Since the last inspection, the hall, stairs and landing have been decorated and new carpets have been fitted. New kitchen worktops and cupboards are to be fitted. Furnishings and furniture are of good quality throughout the home with service users influencing the selection of bedroom and living room furniture. Shared communal space comprises of a lounge and a kitchen/dining room. Night staff choose to sleep in the lounge at night and secure storage for their belongings is found in the first floor office. Within the home there is no specialist equipment or environmental adaptations for these are not required for the current service user group. Mckechnie House DS0000017880.V277394.R01.S.doc Version 5.1 Page 14 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): 32, 33 & 36. Staffing levels and skills are appropriate to the needs of service users. There is a need to introduce regular recorded supervision sessions for care staff to ensure that service users are supported and protected. EVIDENCE: As stated at the last inspection, Broad Horizons Limited has introduced Learning and Disabilities Framework (LADF) Training for all care staff. Staff have completed courses entitled the Safe Practitioner, Communication and Abuse Awareness training. National Vocational Qualifications (NVQ) training is also encouraged and progressed. 100 of care staff at McKechnie House have obtained a NVQ level 2 qualification in care. The senior care staff member on duty said that they hoped to obtain funding and start NVQ level 3 in care training. Staffing rotas and staffing levels were inspected and these were found to meet requirements. Consideration is given to the Department of Health Residential Forum Guidance. Records evidenced that staff supervision had commenced. The need however to plan regular recorded supervision meetings is highlighted. New supervision record sheets have been introduced into the home. The home is advised of the need to ensure that this record keeping enables the care home to meet requirements as listed in the National Minimum Standards – Standard 36.4. Mckechnie House DS0000017880.V277394.R01.S.doc Version 5.1 Page 15 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): 38, 39, 40 & 42. Staff and service users are well supported by the home’s manager, who is hands-on and part of the care team in the home. They benefit from competent and accountable management of the home. An effective quality assurance and quality monitoring system is still required. The home has reviewed and revised their policies and procedures to help safeguard service users’ rights and best interests. Records required to protect service users’ needs were found to be in place and the majority of safety certifications sampled were found to meet requirements helping to ensure the safety and welfare of service users and staff. EVIDENCE: From discussion with a senior carer, the management approach in the home was said to be open and positive. Record keeping and management planning evidenced this and involvement of senior care staff was encouraged. Whilst quality assurance surveys have been used in the past, it is understood that a new stakeholder survey is to be sent out to service users’ families and Mckechnie House DS0000017880.V277394.R01.S.doc Version 5.1 Page 16 their social workers soon. Following this, there would be a need to analyse the responses and implement an annual development plan for the home. Safety certifications were sampled and inspected. Records relating to fire drills and smoke detector checks were seen and found to be in good order. Safety certification of the electrical systems within the home was inspected and they were found to be current and meet requirements. Whilst records were seen on individual appliances of Portable Appliance Testing (PAT), a record of all appliances tested and the outcome of these tests could not be found on the day of inspection. Mckechnie House DS0000017880.V277394.R01.S.doc Version 5.1 Page 17 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 2 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 3 29 3 30 X STAFFING Standard No Score 31 X 32 3 33 3 34 X 35 X 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X X X 3 2 3 X 2 X Mckechnie House DS0000017880.V277394.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? Yes 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 YA36 Regulation 12 (5), 18 (2) Requirement Timescale for action 10/02/06 2. YA39 3. YA42 The registered person must ensure that staff receive support and supervision to carry out the job as detailed in the National Minimum Standards for Care Homes for Adults (18 - 65). 24(1) The registered person must ensure that there is an annual development plan for the home, based on a systematic cycle of planning-action-review, reflecting aims and outcomes for service users. (This is a repeat requirement. Previous timescales of 07/02/05 and 25/11/05 were not met.) 13, 16, 17 The registered manager must ensure so far as is reasonably practicable the health, safety and welfare of residents and staff. This is with particular regard to the Portable Appliance Testing (PAT) records. 10/02/06 10/02/06 Mckechnie House DS0000017880.V277394.R01.S.doc Version 5.1 Page 19 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 YA1 Good Practice Recommendations The Service Users’ Guide should be summarised in a clear and accessible format and addressed directly to service users in terms that can be easily understood by them. Mckechnie House DS0000017880.V277394.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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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