Inspection on 15/06/05 for Middle West

This inspection was carried out on 15th June 2005.

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 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

Middle West 15/05/07

Middle West 10/01/06

Middle West 20/12/04

Middle West 07/07/04

Similar services:

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Middlewest Carlton Road South Godstone Surrey RH9 8LE Lead Inspector Lisa Johnson Unannounced 15 June 2005 12.45 pm 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. Middlewest H58 S13719 Middle West V233117 150605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Middle West Address Carlton Road South Godstone Surrey RH9 8LE 01342 893804 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) Mr Jonathan Georges Esparon & Mrs Winifred May Esparon 7 Woodroyd Gardens, Horley, Surrey, RH6 7LP Mrs Winifred May Esparon Care Home (CRH) 10 Category(ies) of Learning disability (LD) 10 registration, with number of places Middlewest H58 S13719 Middle West V233117 150605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 The age/age range of the persons to be accommodated will be: 18-64 YEARS of whom one person may be over 65 years of age of female gender category LD(E) 2 Of the 10 service users accommodated in the home up to 4 service users of either gender may have a Physical Disability within catergory PD as a secondary condition to their primary condition of Learning Disability 3 Conditions attached to maximum height of service users accommodated in first floor bedrooms. Date of last inspection 20 December 2004 Brief Description of the Service: Middlewest is a care home supporting ten adults who have learning disabilities. Middlewest is a detached chalet bungalow located in a semi-rural lane within a private residential estate. Although the home is in an isolated location it has its own transport. South Godstone village is within short distance and the home is able to access other towns such as Redhill, Horley and Caterham. Communal space in the home is spacious and icludes lounge, separate dining room, kitchen and a large conservatory. There is a separate utility room. Bathroom and toilet facilities are on the ground floor with a wheelchair accessible shower room. Bedrooms are mainly on the ground floor and there are both single and double rooms. There is a shared bedroom, single bedroom and bathroom on the first floor accessible by a steep, narrow staircase. Middlewest H58 S13719 Middle West V233117 150605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes first inspection for 2005/2006. The inspection was unannounced which meant that residents and staff were not aware that the Commission for Social Care Inspection were visiting. The inspector arrived at 12.45 pm leaving at 5pm. The first part of the visit consisted of the inspector touring the home, followed by a discussion with the Home Manager looking at the requirements made from the last inspection. Records were also sampled including the homes Statement of Purpose, service user guide, complaints policy, care plans and risk assessment. A number of policies and procedures were sampled including medication records, menus and health and safety policies. Staff personal files were sampled to check that the recruitment procedure for staff is correct. The staff training and development records were sampled to ensure that they are receiving the correct training to undertake their job appropriately and to ensure that they are receiving supervision sessions from their manager. The inspector spent time speaking to some of the service users and two members of staff. The inspector would like to thank the service users and staff for their time and hospitality during this visit. What the service does well: The atmosphere in the home was found to be welcoming, warm and friendly. Positive interaction was observed between service users and staff providing evidence of good relationships. Each service user has an activity programme in place and a range of activities is available for service users to access. Service users have opportunities to attend external day care facilities such as attendance at local college courses and workshops. Service users participate in social activities such as shopping, meals out, attendance at church, going to the pub, organised outings and an annual holiday. The home is managed well and record keeping is maintained to an effective standard. A comprehensive statement of purpose is in place accurately describing the services that the home is able to offer. The home offers a detailed induction programme to all new staff. Middlewest H58 S13719 Middle West V233117 150605 Stage 4.doc Version 1.30 Page 6 The inspector was informed that a self advocacy group is being held weekly over eighteen weeks and is being coordinated by the Royal Association for the deaf. 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. Middlewest H58 S13719 Middle West V233117 150605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Middlewest H58 S13719 Middle West V233117 150605 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2 ,3, 4 &5 Adequate information was available that would assist prospective service users make an informed choice as to whether the home would be a suitable place to live. Contracts were in place and assessments are completed prior to new persons being admitted to the home. Trial visits to the home were made available for new service users. EVIDENCE: The statement of purpose is comprehensive in describing the services that the home is able to offer. There is a clear admission policy and an assessment is completed before any service user is admitted to the home. The home is able to offer any prospective service users and relatives the opportunity to visit and trial periods in the home are available. Contracts are in place in the form of a statement of terms and conditions. A complaints procedure is in place and available in the service users guide. Middlewest H58 S13719 Middle West V233117 150605 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8, 9 & 10 Individual care plans are in place and these included risk assessments. Service users are involved in making decisions and were able to participate in aspects of life in the home. Information regarding service users was kept in a confidential manner. EVIDENCE: Comprehensive assessments were available and clear evidence was seen that the individual care plan is formulated on the outcomes of assessment. Two Care plans were sampled and it as evident that detailed action plans are in place to ensure that individual needs are met to achieve positive outcomes. Evidence is available that service users participate in activities in the home, for example in household activities such as being supported to clean their rooms and assisting with housework in the communal areas and this was confirmed by one service user who stated “I make my bed and I enjoy doing dusting”. Makaton sign language is used where appropriate to assist service users in enabling them to communicate. Evidence was seen that detailed risk assessments are in place. A selfadvocacy meeting is held in the home weekly and is coordinated by the Royal Association for the deaf. Middlewest H58 S13719 Middle West V233117 150605 Stage 4.doc Version 1.30 Page 10 A confidentiality policy is available in the home and personal records were stored appropriately. Middlewest H58 S13719 Middle West V233117 150605 Stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12,13, 15 &17 The home is able to demonstrate that service users are given opportunities for stimulation through providing, leisure and recreational activities. Service users are able to maintain contact with the local community. Staff support service users to maintain family links and friendships. The home ensures that service users are provided with nutritious, varied, balanced and attractively presented meals. EVIDENCE: A comprehensive activities programme is in place and a wide range of activities are on offer based on the wishes and needs of each individual. Service users have the opportunity to attend local colleges and workshops undertaking courses such as numeracy and literacy, cookery, pottery, art therapy, relaxation and arts and crafts. At the time of the inspection some service users were leaving to go to an evening pottery class and one service user displayed the items that she makes in her bedroom. Social skills development is encouraged, demonstrated by shopping trips, visits to the pub and meals out. Holidays are arranged for the service users in July. At the time of the inspection some service users had returned from a shopping Middlewest H58 S13719 Middle West V233117 150605 Stage 4.doc Version 1.30 Page 12 trip and a meal at McDonalds. Exercise bikes and a selection of games are supplied in the home. Service users maintain links with their families and friends, which is stated in the homes Statement of Purpose. A varied menu was available and service users are consulted. Meals were of a good standard and were nutritious. The atmosphere in the dining room was observed to be relaxed and unhurried. Positive interaction was observed between staff and service users who were being provided with appropriate support. Middlewest H58 S13719 Middle West V233117 150605 Stage 4.doc Version 1.30 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 standard(s) 18, 19 & 20 The home is able to demonstrate that detailed individual plans are in place that meets the personal and health support needs of the service users. The home ensures that referrals are made to specialists and all service users receive regular health checks. The arrangements in respect of administration of medication would be improved by ensuring that two staff are present when transcribing medication on to record cards and to make available a photograph of each service user on the medication administration card to ensure that the service users safety is protected. EVIDENCE: Care plans sampled demonstrate that physical and emotional needs of service users are considered. Accident records are maintained and these were sampled. Health appointments are clearly documented for example appointments with the GP, chiropody, opticians and dentist and evidence is available that liaison with specialist health care professionals takes place when required. Care reviews were taking place regularly. Individual risk assessments are in place and are detailed; these include risks with regard to safe bathing, ironing and the use of the kitchen. Medication records were sampled and were clearly documented and stored appropriately. Two staff assist with the administration of medication. The homes chemist does not provide the home with printed medication records, which means that the home has to transcribe this on to their own recording Middlewest H58 S13719 Middle West V233117 150605 Stage 4.doc Version 1.30 Page 14 sheet. Therefore a recommendation has been made that that two staff must check and sign to avoid any errors. A further recommendation has been made that an individual photograph of service users should be present on all medication records. Middlewest H58 S13719 Middle West V233117 150605 Stage 4.doc Version 1.30 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 The home is able to demonstrate that service users and relatives views are important and listened to. Policies were in place in respect of complaints and adult protection in order to promote the welfare and safety of service users. EVIDENCE: A clear complaints policy is available and a copy is contained in the Service users guide. There have been no complaints received since the last inspection. A Policy is available in relation to resident’s rights. An updated copy of the local authority multi-agency procedure for the protection of vulnerable adults was present. The home has a whistle blowing policy. Protection of vulnerable adults training formed part of the homes induction and foundation training. Evidence of training was sampled and was available in staff personal files. Some staff have attended external multiagency training. Two staff were asked about their understanding of abuse and they were clear in their responses as to their responsibilities in reporting any observed abuse. Middlewest H58 S13719 Middle West V233117 150605 Stage 4.doc Version 1.30 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, 28, 29 & 30 The home is able to demonstrate that it provides a clean, safe, homely and comfortable environment, for the service users to live in. Appropriate equipment and adaptations were in place where required. EVIDENCE: Service users bedrooms were homely and decorated with personal possessions. Some bedrooms are shared and a steep, narrow staircase accesses bedrooms on the second floor and the manager stated that this is not causing difficulties to the service users living there at present. One bedroom has en suite facilities. There are spacious communal areas. There is a large lounge, which is comfortable and homely. A large dining room is available plus a large conservatory. There are toilet and bathroom facilities on the ground floor with one shower being wheelchair accessible. There is a separate kitchen and a separate utility room, which is accessed through the back entrance of the house. The home has carried out environmental risk assessments. The home was cleaned to a high standard and food was stored appropriately with daily fridge and freezer temperatures recorded. Hazardous substances are stored and locked away safely. Middlewest H58 S13719 Middle West V233117 150605 Stage 4.doc Version 1.30 Page 17 Fire records were sampled; fire drills, alarm checks and maintenance of equipment was taking place regularly. Middlewest H58 S13719 Middle West V233117 150605 Stage 4.doc Version 1.30 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) 31, 32, 33, 34,35 &36 Staffing levels in the home are adequate to meet service users needs and staff work positively with residents to improve the quality of their lives. Appropriate recruitment practices were in place to ensure the safety and protection of service users. Training and development of staff is encouraged. Staff supervision sessions need to take place more regularly. EVIDENCE: It was pleasing to see that three new staff have been recruited since the last inspection. Three staff recruitment files were sampled and detailed job descriptions were in place as well as references and police checks. New staff are undertaking induction training, which is detailed and comprehensive. One new member of staff spoken to confimed that she is working through induction training including protection of vulnerable adults training and that she felt supported in the home. Another staff member spoken to stated that there is good teamwork, staff meetings take place and that there is support to undertake training and development. Mandatory training is updated and staff are supported with National Vocational Qualifications. Details of training and certificates are maintained on staff personal files and individual record books are in place. However it is recommended that an up-to-date record should be made available to record all training dates. All staff receive an annual appraisal and supervision has been implemented. Middlewest H58 S13719 Middle West V233117 150605 Stage 4.doc Version 1.30 Page 19 Records state that no supervision has taken place for six months. A requirement has been made that all staff supervision be updated and a recommendation has been made that a schedule is drawn up for the year to assist the manager in this process. Middlewest H58 S13719 Middle West V233117 150605 Stage 4.doc Version 1.30 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, 39, 40, 41, 42 &43 The home runs well and the manager is providing good leadership. Record keeping is maintained to a good standard. Comprehensive policies and procedures are in place to promote the safety and well being of service users. The manager has implemented a quality assurance system based on seeking the views of service users which will measure the success in achieving the aims, objectives and statement of purpose of the home. EVIDENCE: The home is privately owned and is run by the registered manager and her husband who is also the registered proprietor. Mr Esparon deals with much of the administration side of the home. The home was observed to be open in its approach. Staff confirmed that the management of the home is supportive. A business plan for the service is available and a quality assurance system is in place including a survey of service users views and service user meetings. Comprehensive policies and procedures are available and staff are made aware of them and have to sign them as part of their induction. The provider of the Middlewest H58 S13719 Middle West V233117 150605 Stage 4.doc Version 1.30 Page 21 home has implemented a comprehensive induction programme and health and safety policies are adhered to. Record keeping is of a high standard. Middlewest H58 S13719 Middle West V233117 150605 Stage 4.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 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 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Middlewest Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 3 H58 S13719 Middle West V233117 150605 Stage 4.doc Version 1.30 Page 23 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. 2. 3. Standard 36 Regulation 18 (2) Requirement All staff supervision must be updated. Timescale for action 2 months 15/8/05 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. Refer to Standard 20 36 36 20 Good Practice Recommendations The home should consider two staff being present when medication is transcribed on to medication administration charts. The home should consider implementing a schedule to plan dates of staff supervision. The home should consider implementing a schedule for recording dates of all staff training. The home should consider providing a photograph on each residents medication record Middlewest H58 S13719 Middle West V233117 150605 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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. Extracts may not be used or reproduced without the express permission of CSCI Middlewest H58 S13719 Middle West V233117 150605 Stage 4.doc Version 1.30 Page 25 - 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. 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