Inspection on 01/07/05 for Mews, The

This inspection was carried out on 1st July 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

Mews, The 16/12/09

Mews, The 12/01/09

Mews, The 30/01/07

Mews, The 05/12/05

Mews, The 14/10/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 The Mews 336 Cowpen Road Blyth Northumberland NE24 5ND Lead Inspector Karena M Reed Unnanounced 1 July 2005 9:30 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. The Mews B53-B03 S60982 The Mews V220925 010705 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service The Mews Address 336 Cowpen Road Blyth Northumberland NE24 5ND 01670 353103 N/A lisadeane@milburycare.com Milbury Care Services Limited 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) Vacant CRH 4 Category(ies) of LD Learning disability (4) registration, with number of places The Mews B53-B03 S60982 The Mews V220925 010705 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 14-10-2004 Brief Description of the Service: The Mews is a purpose built, spacious bungalow situated near to the centre of Blyth . It is in close proximity of the town centre and all its facilities. It is well served by public transport systems. It was built and registered in July 2004. It is registered to provide care to four highly physically dependent and learning disabled young people. Nursing care is not provided. The bungalow is spacious and well equipped with the necessary equipment to meet the physical needs of the people. Service users have their own bedrooms and en suite facilities are shared bteween two service users. The residents of the service have access to a landscaped garden with raised flower beds. The Mews B53-B03 S60982 The Mews V220925 010705 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over 2 and a half hours. A partial tour of the premises took place and a sample of records were inspected as well as other records. Records included:3 care plans, the fire log record, the accident book, admission/discharge register, complaints record. I spoke to the senior support worker who was on duty and the two other support workers at the time of inspection. I also spoke to one resident who was in the house , another resident and support worker were at college. What the service does well: What has improved since the last inspection? What they could do better: Individual contracts between the home and the resident need to be completed and signed when a resident is admitted. This contract should state the service provided by the home to make sure a person who comes to live at the home is fully aware of the services provided to them and what their fees are paying for. A care plan required updating to take account of changed needs of the service users and to detail the extra support required from staff. Shared moving and handling equipment and overhead ceiling tracking equipment leading to shared en suite facilities needs to be reviewed in order to allow flexibility and promote choice and freedom for highly physically dependent people. The Mews B53-B03 S60982 The Mews V220925 010705 Stage 4.doc Version 1.20 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Mews B53-B03 S60982 The Mews V220925 010705 Stage 4.doc Version 1.20 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 The Mews B53-B03 S60982 The Mews V220925 010705 Stage 4.doc Version 1.20 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4,5 The process followed in the home ensures that potential residents are provided with details of the services the home provides which helps them to make an informed decision about coming to stay in the home. The service user guide is very informative and welcoming. Service users care records showed the home receives comprehensive information when a referral is made. The information assists the home to carry out their detailed assessment prior to agreeing to admit people into the home to ensure that the home can meet their needs. Records were available and staff spoken to stated there is a comprehensive training programme to ensure that staff are equipped with the necessary skills in order to meet the needs of the residents. EVIDENCE: Inspection of records for three residents showed that full assessments had been carried out prior to their admission. A relatively new resident confirmed that they had visited the home and received full information about the way it was run before moving in for a trial stay. The resident was also very happy with the care and attention received. Residents have the opportunity to visit the home as many times as they choose to decide if they wish to live there. This may involve tea time visits, day and overnight stays and can be accelerated to the pace of the residents. Records showed a new resident was currently being introduced to the home and coming for some daily visits during the week. The Mews B53-B03 S60982 The Mews V220925 010705 Stage 4.doc Version 1.20 Page 9 Staff spoken to said they receive training to assist them to meet the various needs of the residents as individually as possible. New staff follow the LDAF, Learning Disability Framework as part of their induction. The Mews B53-B03 S60982 The Mews V220925 010705 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9, There are very good arrangements in place to ensure that residents’ care needs are met. Service users are well supported by staff and the necessary levels of support are provided due to the detailed care plans that show the level of care and support that staff need to provide. Comprehensive risk assessments are carried out to assist residents to lead as fulfilled lives as possible and they are well supported by staff to take calculated risks as necessary. Service users are encouraged to be involved in decision making and they are encouraged to communicate and make their views known other than verbally. EVIDENCE: Inspection of the records for a recent admission showed that an assessment had been carried out prior to their admission, this was combined with information received from the care manager’s assessment of the resident’s care needs. The resulting care plan recorded detailed information about the health, medical and social needs of the service user and the amount of staff intervention required in order to provide support. Inspection of a care plan for a resident recently discharged from hospital required updating. It did not detail food intake prior to admission to hospital The Mews B53-B03 S60982 The Mews V220925 010705 Stage 4.doc Version 1.20 Page 11 nor the support required within the resident’s care plan after her return, although there was a district nurse’s medical care plan. One service user’s care plan detailed the necessary support to use a communication board to articulate their views and wishes. The Mews B53-B03 S60982 The Mews V220925 010705 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,16,17 The Home encourages and provides good support to enable service users to access and participate and use community facilities wherever possible eg leisure, health, spiritual, social, educational needs. Social activities and meals are both managed creatively and provide daily variation and interest for people living in the home. Visitors are made welcome or staff support residents to maintain contact with family and friends as they wish. EVIDENCE: The service users care plans looked at demonstrated that, residents, whatever their level of need are assisted to enjoy a more independent lifestyle. Staff assist and support residents to acquire skills and become more self sufficient in aspects of every day living. Service users all pursue their own individual hobbies and interests e.g Snoezellen, Jacuzzi, swimming, reflexology, aromatherapy, attending music concerts, shopping etc. The resident spoken to confirmed that they are involved in the running of the home and involved in making decisions about their lives. Residents records also provided evidence that all residents are consulted and asked their opinion and encouraged to make decisions. The Mews B53-B03 S60982 The Mews V220925 010705 Stage 4.doc Version 1.20 Page 13 A four week menu is in operation. Menus are made accessible in pictorial format if required, in order to increase the choice and involvement of residents. The Mews B53-B03 S60982 The Mews V220925 010705 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20 There are excellent arrangements in place to ensure that residents’ health care needs are met, care plans outline the needs to ensure that the staff team are fully informed and aware of the support they need to provide. The medication system does not fully follow community pharmacy guidelines with regard to the storage of mediaction. EVIDENCE: Attention was paid to service users’ dignity and privacy and staff were seen to act respectfully at all times. The care plans and case records inspected contained relevant individual plans of care detailing care and support required for some complex needs. Records showed when service users had seen health professionals eg doctors, community nurses, etc. Staff receive medication training before they administer medication. Advice was given in accordance with community pharmacy guidelines, about the system to be established for the administering and recording of any controlled drugs, in case they were ever prescribed. Discussion took place about the use of rectal diazepam by staff in an emergency to meet the assessed medical needs of guests. It is acceptable to carry out this procedure if training is provided to staff by a qualified district nurse and if stringent policies and procedures are in place for its use for the protection of service users and staff,and also if the appropriate insurance cover is in place. The Mews B53-B03 S60982 The Mews V220925 010705 Stage 4.doc Version 1.20 Page 15 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) 22,23 There is a suitable complaints procedure. Residents and their relatives have confidence that they can raise any issues and know that they will be dealt with. EVIDENCE: The home has a complaints procedure. There have been no complaints about the home since the last inspection. The resident spoken to confirmed that they would raise any issues of concern with the staff team. A procedure for responding to allegations of abuse is available. The person in charge informed me that staff are to be given training in Adult Protection. The Mews B53-B03 S60982 The Mews V220925 010705 Stage 4.doc Version 1.20 Page 16 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) 24,25,26,27,29,30 The bungalow is comfortable and homely and well maintained with good quality furnishings and décor. It was built to a high specification and the building is large and there is ample space for service users to enjoy internally and externally. There is an excellent standard of hygiene. It is well equipped with specialist equipment as required by residents to meet their physical needs, but the equipment and system for sharing does not lend itself to flexibility and promoting the choice and freedom of individual needs. EVIDENCE: A tour of the premises was undertaken and a small number of bedrooms viewed. Service users have their own bedrooms , en suite facilities are shared between two bedrooms. Bathrooms are equipped with specialist bathing and lavatory equipment and designed to provide maximum assistance to service users. Bedrooms are well decorated and individually furnished and personalized. Observations during inspection and from conversation with resident and staff that it is not practical for residents to share the overhead ceiling tracking moving and handling equipment that links between bedroom and bathroom as residents are impeded and disturbed eg when the moving and handling equipment is used to assist someone to bed. The two residents are disturbed The Mews B53-B03 S60982 The Mews V220925 010705 Stage 4.doc Version 1.20 Page 17 during the night and early in the morning depending upon the needs of the person who requires the equipment. Obviously it cannot be used by two people simultaneously therefore one service user has to wait until they are able to use it. They may not therefore be able to get up when they want, or go to bed when they want. The Mews B53-B03 S60982 The Mews V220925 010705 Stage 4.doc Version 1.20 Page 18 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) 32,35 The staff have an understanding of the residents support needs. This is evident from the positive relationships, which have been formed between staff and residents. There are training arrangements in place, which means staff are given a grounding in the areas they need to know to provide good care and enhance their personal development. EVIDENCE: Examination of staff rotas and discussion with the person in charge and a member of the staff team provided evidence that the numbers of staff are as follows: 7.30am- 3.00pm 3 3.00 pm- 10.00pm 3 There are currently two staff vacancies that have almost been filled. The necessary checks are being carried out prior to the workers being appointed. When these are filled there will be a full complement of staff. Agency staff are used in order to cover vacant hours. At weekends four staff members are on duty in order to provide a 1-1 ratio to residents. During the week some residents attend college where they are accompanied by a staff member to also provide 1-1 support. The manger’s hours are included in the above. The Mews B53-B03 S60982 The Mews V220925 010705 Stage 4.doc Version 1.20 Page 19 Approximately twenty hours are supernummary. Staff also carry out food preparation, cleaning and laundry. Staff stated that they enjoyed working in the home and were observed to be kind, caring and respectful to residents. Staff stated that they receive induction training. Where new inexperienced staff are employed, they work as an extra member of the shift, which is good practice. 22 of the care staff team have now achieved an NVQ2. Staff confirmed that they also receive advice and /or training in other areas, such as challenging behaviour, values and rights of people with learning disabilities. The Mews B53-B03 S60982 The Mews V220925 010705 Stage 4.doc Version 1.20 Page 20 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) 37,38,40,41,42. The manager is new into post, and she will be introducing systems and procedures to ensure the well running of the home and to ensure the safety of residents and staff. EVIDENCE: A new manager has been appointed to manage the home. She is waiting to be registered as manager. She is also studying for the Registered Manager’s award which should be completed by December 2005. The fire log book indicated that fire safety checks are not being carried out routinely, no entries had been made since 29-5-2005. Only one signature was evident in the residents personal allowance register. The positive comments of residents and staff give confidence that the manager provides good leadership throughout the home and promotes a philosophy of involvement of residents and staff. The Mews B53-B03 S60982 The Mews V220925 010705 Stage 4.doc Version 1.20 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 3 3 2 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 2 x 3 3 Standard No 11 12 13 14 15 The Mews 3 3 3 3 x Standard No 31 32 33 34 35 36 Score x 3 x x 3 x Version 1.20 Page 22 B53-B03 S60982 The Mews V220925 010705 Stage 4.doc 16 17 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x x 2 2 2 x The Mews B53-B03 S60982 The Mews V220925 010705 Stage 4.doc Version 1.20 Page 23 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. 2. Standard 20 5 Regulation 13(2) 5(1)c Requirement To adhere to pharmacy guidelines for the recording and storing of medication To provide a an accessible contract between the home and resident outlining services provided. To carry out the necessary fire checks within the prescribed frequency. Timescale for action July 5th 2005 September 2005 July 31st 2005 3. 42 23(4)c(iv) 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. 4. 5. Refer to Standard 20 30 5 42 41 Good Practice Recommendations To think about possible administration of rectal diazepan by staff. To establish a database to ensure staff training needs are uodated as required. Individual contracts between residents and the home need to be formalized and signed. A system needs to be established to ensure that the staff are given training in moving and handling skills, fire safety, first aid, infection control and food hygiene. The personal allowance register should contain two signatures, one of the service user where possible. B53-B03 S60982 The Mews V220925 010705 Stage 4.doc Version 1.20 Page 24 The Mews The Mews B53-B03 S60982 The Mews V220925 010705 Stage 4.doc Version 1.20 Page 25 Commission for Social Care Inspection Northumbria House Manor Walks, Cramlington Northumberland NE24 5ND 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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