Inspection on 10/09/07 for Mendip House

This inspection was carried out on 10th September 2007.

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 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

Mendip House 30/11/06

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 Mendip House Somerset Court Harp Road Brent Knoll Highbridge Somerset TA9 4HQ Lead Inspector Jane Poole Unannounced Inspection 10th September 2007 2:30 Mendip House DS0000067302.V348818.R01.S.doc Version 5.2 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 Mendip House DS0000067302.V348818.R01.S.doc Version 5.2 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. Mendip House DS0000067302.V348818.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mendip House Address 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) Somerset Court Harp Road Brent Knoll Highbridge Somerset TA9 4HQ 01278 760555 01278 760747 janet.smith@nas.org.uk Vanessahalfacre@nas.org.uk National Autistic Society Mrs Janet Ceylan Care Home 9 Category(ies) of Learning disability (9), Physical disability (9) registration, with number of places Mendip House DS0000067302.V348818.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30/11/06 Brief Description of the Service: Mendip House is a large detached bungalow situated in the extensive grounds of Somerset Court, which is owned by the National Autistic Society who remain the registered provider. As part of Somerset Courts Modernisation Programme each previous accommodation area that formed Somerset Court, has now become a separate registered service. The home was registered with the CSCI on 16/06/06 and is registered to accommodate nine services users. The fees at the home range from £1231 to £1680. per week. Additional charges are made for personal items and services such as hairdressing, aromatherapy, toiletries and holidays. Mendip House DS0000067302.V348818.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of this inspection visit was to inspect relevant key standards under the Commission’s ‘Inspecting for Better Lives 2’ framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are: - excellent, good, adequate and poor. The inspection was carried out over a 5.5 hour period. The inspector was able to meet with staff and service users, view records, tour the building and observe care practices. Some service users were unable to express their views but appeared relaxed and comfortable in their environment. Prior to the inspection the manager completed an Annual Quality Assurance Assessment (AQAA) and 4 members of staff completed comment cards. What the service does well: There is a very relaxed atmosphere in the home with staff and service users constantly interacting with each other. The manager and staff team demonstrate a commitment to genuine service user involvement in the running of the home. Various forms of communication, including pictures, are used to encourage participation and enable service users to make choices. Service users are involved in menu planning, shopping and food preparation. There are various activities available to service users and staff focus on individual interests when arranging social activities. Three service users are planning to attend college when the new term begins. Service users are able to have visitors at anytime and are encouraged to invite family members to social events in the home. Staff spoken to were extremely enthusiastic about their roles and had an excellent knowledge of the people living at the home. They stated that there was a good induction programme for staff and ongoing training opportunities. Mendip House DS0000067302.V348818.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Mendip House DS0000067302.V348818.R01.S.doc Version 5.2 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 Mendip House DS0000067302.V348818.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 & 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes statement of purpose and service user guide gives comprehensive information about the facilities and services offered. No new service users have moved to the home since the last inspection but there are policies in place to ensure that any prospective service users are able to visit the home prior to making a decision to move in. EVIDENCE: No new service users have moved to the home since the last inspection. The manager has produced a statement of purpose for the home, which reflects the services and facilities offered. The service user guide states what is included in the fee. The manager discussed with the inspector her plans to create a more service user friendly Statement of Purpose, which she is currently working on. Mendip House is part of Somerset Court where a major modernisation programme is underway. This will involve looking at all service users to ensure Mendip House DS0000067302.V348818.R01.S.doc Version 5.2 Page 9 that they are living in the right home with people that they are compatible with. The home has policies and procedures in respect of admitting new service users. These involve full assessments of need and opportunities for the prospective service user to visit the home and spend time with staff and other service users. Mendip House DS0000067302.V348818.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 & 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is committed to involving service users in the running of the home and enabling individuals to express their views. All service users have a care plan that sets out their abilities and goals for the future. EVIDENCE: All service users living at the home have a care plan. The inspector looked at two care plans in detail. The plans set out the needs and preferences of the service user, including their goals for the future. Each service user also has a behaviour support plan and risk assessments are in place in respect of certain activities and situations. Mendip House DS0000067302.V348818.R01.S.doc Version 5.2 Page 11 The home is in the process of introducing person centred planning and the inspector viewed the documentation that the manager had devised in respect of this. New documents included pictures and will be completed with the full involvement of service users and/or their representatives as appropriate. This will make them much more meaningful for service users and hopefully lead to more personal care plans. Staff complete monthly summaries in respect of each service user and these highlight significant events. All service users also have a link book, which they take with them each day to their day services placement to ensure good communication between the day services staff and the residential staff. Since the last in section all service users have been asked where they wish these to be stored and their wishes have been actioned. There are regular service user meetings where service users can express their views about the home. Again the inspector noted that pictures were used to enhance communication. Throughout the inspection the inspector was able to observe care practices and noted that staff interacted constantly with service users and choices were offered at every opportunity. Mendip House DS0000067302.V348818.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 & 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have opportunities to take part in leisure activities according to their ability and interests. The menu in the home offers a variety of healthy meals and service users are involved in choosing and preparing food. EVIDENCE: The annual quality assurance assessment states that the home have worked hard in the last 12 months to ensure that service users are actively involved in the running of the home and in making choices about how they spend their leisure time. This was evidenced during the inspection. Mendip House DS0000067302.V348818.R01.S.doc Version 5.2 Page 13 All service users attend on site day services 4 days a week and have one day at the home. The inspector met with the service user and member of staff who had an in house day and observed that this is an opportunity for service users to learn and develop independent living skills such as laundry and cooking. There is a range of leisure activities on offer with people going out shopping, to cafes and pubs and taking part in activities around the home and garden. On the evening of the inspection some people watched TV or listened to music and others went out for a walk with staff. Everyone ate the evening meal together and assisted with clearing up afterwards. The previous weekend service users had been fruit picking and made pies for everyone in the home. No service users have paid or voluntary jobs outside the home. Three people have registered for college courses for the coming term. Service users are able to have visitors at anytime and the manager is encouraging service users to invite family members to social events in the home. It was observed that service users were able to spend time in communal areas or in the privacy of their own room. When service users are attending day services they eat lunch in the main dining room, which is used by service users across Somerset Court. This is a refectory style service with all service users making choices about their meal. Breakfasts and evening meals are prepared and eaten in Mendip House. The inspector viewed the evening meal. Staff eat with service users and it was a pleasant sociable occasion with people chatting about what they had done during the day and what they would like to do during the evening. The home has a weekly food budget and service users assist to create a menu and shop for the food required. Staff stated that shopping was not only an opportunity to choose food but also a chance to enhance social skills. Menus seen gave a good variety of healthy meals. Mendip House DS0000067302.V348818.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have access to healthcare professionals according to their individual need. Policies and procedures in respect of medication promote safe practice. EVIDENCE: All service users are registered with GPs and have access to other healthcare professionals in line with their individual needs. All appointments are recorded and these show that people living at the home have access to opticians, dentists, speech and language therapists, chiropodists and psychiatrists. Keyworkers carry out an annual health assessment with each service user and pictures are used to assist people with communication. Care plans give details of the level of support people need with personal care. There are both male and female support staff meaning that service users are able to make a choice able the gender of the person who assists with personal Mendip House DS0000067302.V348818.R01.S.doc Version 5.2 Page 15 care. There are adequate bathroom facilities and everyone has a wash hand basin in their bedroom. The home uses a Monitored Dosage System for medication, currently no service users administer their own medication. All medication is administered by two staff, one member of staff administers and the second witnesses. All staff have received training in this area. Medication is now stored in an appropriate cupboard in the newly formed office giving staff more light and space to undertake the procedure. Medication Administration Records were viewed and found to be correctly signed when administered or refused. Opened creams had not been dated with their time of opening in line with good practice guidelines. Mendip House DS0000067302.V348818.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home have taken reasonable steps to minimise the risks of abuse to service users. EVIDENCE: The home has policies and procedures in respect of making a complaint, recognising and reporting abuse and whistle blowing. The manager has made staff aware of the updated Somerset County Council ‘safeguarding vulnerable adults’ policy. The home has received no complaints since the last inspection and no concerns have been raised with the Commission for Social Care Inspection. During the inspection the inspector observed that service users moved freely around the home and had unrestricted access to their private rooms and all communal areas. The inspector viewed the recruitment files of the two most recently appointed members of staff, these showed that there is a robust recruitment procedure; all staff are checked against the Protection Of Vulnerable Adults (POVA) register before they commence work at the home and all undergo an Enhanced Criminal Records Bureau (CRB) check. Mendip House DS0000067302.V348818.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 27, 28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are involved in making the house a comfortable, homely environment. On the day of inspection all areas were clean and fresh. EVIDENCE: Mendip House is a single storey building set in the grounds of the Somerset Court site. There are a further 4 registered homes on the site and some services are shared. There are no shops or facilities within walking distance and the home is not on a public transport route. All areas of the home are fitted with a fire detection and emergency lighting system. Mendip House DS0000067302.V348818.R01.S.doc Version 5.2 Page 18 There is a large lounge / diner and kitchen and a smaller quiet lounge. Since the last inspection the home has developed the garden area and service users have been involved in planting flowers and vegetables. There is outdoor seating and tables for service users to make use of. There are three bathrooms, one of which has been adapted to meet the needs of a person with physical disabilities. There is also a shower room. Bathrooms and the shower room are not homely in appearance. The manager and staff use pictures and colour charts to assist service users to make choices about décor and furnishings. All bedrooms are for single occupancy, all have wash hand basins and there are shared toilet and bathing facilities. The inspector was able to view a sample of service user bedrooms and all had been personalised to suit the needs and tastes of the individual. Since the last inspection an office has been created which gives staff a private space and also allows for better storage of confidential records. There is a washing machine and tumble drier in the kitchen, that service users can use for personal laundry. There is also a large commercial style laundry on the Somerset Court site. Part of the modernisation plan for Somerset Court will involve all individual homes having improved laundry facilities. All areas seen by the inspector were clean and fresh. Mendip House DS0000067302.V348818.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 & 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good training opportunities and regular supervision is available to all staff, which leads to a competent workforce. Recruitment procedures are robust and minimise the risks of abuse to service users. EVIDENCE: The home employs 16 support workers, 7 have a National Vocational Qualification in care at level 2 or above. A further 4 people are currently working towards the award. The inspector was able to speak with staff on duty and four staff completed comment cards prior to the inspection. New staff felt that there was an excellent induction programme which involved basic training in health and safety, autism and the protection of vulnerable Mendip House DS0000067302.V348818.R01.S.doc Version 5.2 Page 20 adults. This is carried out before staff begin working with service users in the home. All staff asked felt that there were good training opportunities within the home. Staff spoken to and those who completed comment cards all stated that they received regular supervision. The inspector viewed a number of supervision records and noted that a wide range of issues were discussed, including training requirements. The manager stated that all staff receive formal supervision a minimum of six weekly but additional supervision sessions are facilitated for anyone requiring additional support. Staff felt that there were always adequate staff on duty to meet the needs of service users. The inspector observed that staff had time to assist service users in a respectful manner and to support people with leisure activities. The inspector viewed the recruitment files of the 2 most recently employed members of staff and this gave evidence of a robust recruitment procedure including appropriate checks and written references. The manager gave evidence that staff are recruited to meet the needs of the specific service user group and is hoping to expand the recruitment procedure to include more service user involvement. Staff spoken to were very enthusiastic about their roles and demonstrated an excellent knowledge of the service users living at the home. All stated that there were regular team meetings and good communication between team members. Mendip House DS0000067302.V348818.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40 & 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed taking account of the views of service users and other interested parties. Records are kept up to date and well maintained. EVIDENCE: The registered manager is Janet Ceylan. She has many years experience of working with people with autism and learning difficulties. She holds the Registered Managers Award (NVQ level 4) She undertakes appropriate training to broaden her knowledge and ensure that her practice is kept up to date. Mendip House DS0000067302.V348818.R01.S.doc Version 5.2 Page 22 Prior to the inspection Janet completed an annual quality assurance assessment as requested by the Commission for Social Care Inspection. The document was well completed and demonstrated a good knowledge of the service and the people living at the home. It showed a commitment to continuous improvement and goals set for improvements were appropriate and realistic. The manager was available throughout the inspection and showed an obvious commitment to seeking the views of service users and other interested parties to ensure that all goals set are in line with the wishes of those living at the home. There are regular staff and service user meetings and minutes seen shown that these were an opportunity to express views and make suggestions, not just an information sharing session. The National Autistic Society (NAS) acts as a corporate appointee for service users at the home and small amounts of money are kept in the home to ensure that people are always able to access personal monies. Clear records are kept of all transactions and receipts are maintained. The NAS has comprehensive policies and procedures that are available to all staff on the NAS intranet and the home keeps hard copies in the office. Health and safety records show that equipment is well maintained and serviced if required. Staff have fire training at least 6 monthly, however it was noted that some night staff had not received this training within the last 6 months. Fire alarms in the home should be tested weekly but this is not always being complied with. Staff receive training in health and safety issues such as first aid, food hygiene and manual handling during their induction period and there are regular updates provided for more longstanding staff. The home keeps the Commission for Social Care Inspection up to date with significant events. An up to date certificate of registration is displayed in the hallway and the insurance certificate, covering the whole site is on display in the general office. Mendip House DS0000067302.V348818.R01.S.doc Version 5.2 Page 23 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 3 2 3 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 3 27 2 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 3 X 2 X Mendip House DS0000067302.V348818.R01.S.doc Version 5.2 Page 24 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 YA42 Regulation 23 (4)[d] Requirement The registered manager must ensure that all staff receive regular training in fire safety. Timescale for action 30/09/07 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 YA28 Good Practice Recommendations The home should refurbish the small lounge to provide a comfortable alternative room for people who prefer a quite area. All prescribed creams and lotions should be dated when opened. Bathrooms should be redecorated to ensure that they provide a domestic homely environment. Fire alarm tests should be carried out every week and recorded. 2 3 4 YA20 YA27 YA42 Mendip House DS0000067302.V348818.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Taunton Local Office Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Mendip House DS0000067302.V348818.R01.S.doc Version 5.2 Page 26 - 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!