Inspection on 12/09/05 for Midway (5)

This inspection was carried out on 12th September 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

Midway (5) 18/01/07

Midway (5) 07/06/05

Midway (5) 06/09/04

Midway (5) 17/05/04

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Insight - Eastchurch

Southfields

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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 5 Midway Walton-on-Thames Surrey KT12 3HY Lead Inspector Christine Bowman Unannounced 12 September 2005 : 11.00am th 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. 5 Midway H58 H09 S13512 Midway V248837 120905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 5 Midway Address Walton-on-Thames Surrey KT12 3HY 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) 01932 23501 Welmede Housing Association Ltd Mrs Marie Denise Farouk CRH - Care Home 6 Category(ies) of LD - Learning Disability (6) registration, with number of places 5 Midway H58 H09 S13512 Midway V248837 120905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 - The age/age range of the persons to be accommodated will be 35 - 64 years. Date of last inspection 7 July 2005 Brief Description of the Service: 5 Midway is a care home for 6 adults with learning disabilities, and is located on a private road within walking distance of Walton on Thames town centre. The home is a large detached house with a parking area to the front of the building and a large secluded garden to the rear. All the bedrooms are single occupancy and there are bathroom and toilet facilities on each floor. On the ground floor there is a large sitting room, a separate dining room, a large fitted kitchen and a well equipped utility room. Midway provides homely and comfortable accommodation for the residents. Welmede Housing Association is the registered proprietor of the home and the staff are employed by the North Surrey Primary Care Trust. 5 Midway H58 H09 S13512 Midway V248837 120905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second inspection for the year commencing in April 2005 and ending in March 2006 and should be read in conjunction with the first report for a more complete description of the service. It was an unannounced inspection, which started at 11.00 am and was completed by 3.30pm. One resident and a member of staff were present initially and they led a partial tour of the premises. The home was clean, tidy and well kept, the garden was well tended and there was a cheerful display of potted plants by the front door and vegetables and herbs were growing in the garden to the rear of the house. The other residents returned from rambling and a shopping trip and two of the residents allowed their rooms to be inspected. The deputy manager was interviewed and four members of the care team were spoken with briefly. Records, policies, training logs and care plans etc. were inspected and lunch was taken with the residents. Communication with the residents was difficult as some did not speak at all and some residents used single words and sounds to express themselves. Resident’s views could not be sought directly, but were gained from observation and interpreted by the staff. 5 Midway continues to provide a homely, comfortable and caring environment for the residents who live there. What the service does well: 5 Midway is good at encouraging and empowering the residents to live fulfilling lives. Holidays, which were being prepared for when the last inspection took place, had been taken and the residents had enjoyed a variety of entertainment at the seaside, the deputy manager stated. There were some excited squeals when the holidays were being discussed. Birthday celebrations had also been enjoyed with a meal in a restaurant and chocolate birthday cake. The resident who had just had a birthday was humming, ‘Happy Birthday,’ to herself and making happy sounds as she ate a piece of her cake. Even though there had been some changes in the staff team, there was good teamwork in practise and evidence of a thorough understanding of the needs and wishes of the residents. A wide variety of training opportunities are available to the staff, who are actively encouraged to develop themselves professionally. 5 Midway H58 H09 S13512 Midway V248837 120905 Stage 4.doc Version 1.40 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. 5 Midway H58 H09 S13512 Midway V248837 120905 Stage 4.doc Version 1.40 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 5 Midway H58 H09 S13512 Midway V248837 120905 Stage 4.doc Version 1.40 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) 2 Continuous assessment of the resident’s needs inform the staff, who empower and enable them to live fulfilling lives. EVIDENCE: All the residents have lived in the home from the time their long stay hospitals closed and will remain in the home as long as their needs can be met here. There had therefore been no vacancies or prospective service users. Current resident’s files showed that their needs were assessed on a regular basis and interviews with key workers provided evidence of the resident’s wishes and aspirations being adhered to. 5 Midway H58 H09 S13512 Midway V248837 120905 Stage 4.doc Version 1.40 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 and 10 The resident’s needs and personal goals are reviewed and their care plans updated to reflect the new opportunities available to them. Key workers support the residents in making decisions about their lives and encouragement is given to the residents to take an active part in the running of the home according to their wishes. The confidentiality policy could be simplified to inform the staff of when information may be shared and the consequences of unauthorised breaches. EVIDENCE: Care plans were reviewed on a three monthly basis and resident’s files showed that they were updated regularly and written in the first person. Discussions with key workers revealed that they were involved in all meetings and arrangements for the residents they were responsible for and that they actively sought new experiences for those residents who appreciated them and kept alive memories for residents for whom the past was important. 5 Midway H58 H09 S13512 Midway V248837 120905 Stage 4.doc Version 1.40 Page 10 The log of resident’s meetings showed that the last meeting took place in July and their wishes and responses had been interpreted by the staff, and noted. One resident had requested a bar-be-cue, the majority of the residents had indicated that the holidays had been enjoyable and one resident chose not to participate. The previous meeting demonstrated that the residents had been consulted about the kind of holiday they would like and who they would like to accompany them. The confidentiality policy, which had last been reviewed in 2003, was not a user-friendly document. In order to inform new staff, this policy should be simplified and state clearly under what circumstances confidences may be breached and the consequences of inappropriate breaches. The resident’s personal information was securely stored. 5 Midway H58 H09 S13512 Midway V248837 120905 Stage 4.doc Version 1.40 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) 11,14 and 16 Residents are enabled to engage in opportunities for personal development instigated by their key workers. Residents choose their own lifestyle and are encouraged to take responsibility for their actions in the community in which they live. EVIDENCE: From care plans viewed it was noted that one resident had been re-assessed by the Adult Education Centre to access some of the classes on offer. The resident had been enrolled to participate in line dancing, yoga and fitness classes. A monthly club for people with learning disabilities called the ‘Get Together Club’ is organised by the deputy manager. The resident she is key worker for assists with the organisation by helping with the shopping and setting up the tables. A variety of social events are offered such as discos, tea dances, barbe-cues and parties etc, the deputy manager stated. 5 Midway H58 H09 S13512 Midway V248837 120905 Stage 4.doc Version 1.40 Page 12 Arrangements have been made for two residents, who both like to attend church services, to spend a weekend in Canterbury. They had visited Chichester Cathedral and will be visiting Canterbury Cathedral, the deputy manager stated, and one of the residents will be seeing her sister who lives in the area at the same time. Risk assessments had been completed. The annual holidays had taken place since the last inspection and feedback from the residents meetings, happy sounds made by the residents when the holidays were discussed, photographs and conversations with the staff, who had accompanied the residents confirmed that Hayling Island was very popular. A variety of entertainment had been enjoyed including singing, dancing, bingo, swimming and meals out as well as the sand and the sea. One resident doesn’t like to get up and often has a late breakfast, the deputy manager stated, but on the day he visits the garden centre, he likes to get up early. The staff were observed knocking on the doors of resident’s rooms and waiting for a response before entering. One resident likes to spend a great deal of time in his room listening to music and enjoying his coloured lights and mobiles. Doors of bedrooms and bathrooms are lockable from inside and the staff had access to a master key in case of emergencies, the deputy manager stated. Personal dignity is preserved and bathroom doors always closed when residents are being assisted with personal care tasks. There were many opportunities for the residents to be involved in daily tasks around the home and residents were observed preparing the table for lunch and clearing the table. A member of staff stated that one of the residents likes to help in the garden. Others like to make cakes, help with the laundry and keep their rooms clean and tidy. 5 Midway H58 H09 S13512 Midway V248837 120905 Stage 4.doc Version 1.40 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) 20 and 21 Safe medical procedures protect the residents and forward planning assures them that their wishes will be respected as they grow older, and in the event of illness and death. EVIDENCE: The residents are risk assessed and no-one self-medicates, the deputy manager stated. Life plans include a consent form but residents are unable to sign. The book for recording the collection and disposal of medication was seen and was signed and dated by the pharmacist on each occasion drugs exchanged hands. A metal cabinet attached to the wall was available for the storage of medication and dosages were sealed in a system filled by the pharmacist and accompanied by a MAR chart. These were inspected and completed in a satisfactory manner. Only the staff who had been trained in the administration of medication were permitted to carry out this task, the deputy manager stated. 5 Midway H58 H09 S13512 Midway V248837 120905 Stage 4.doc Version 1.40 Page 14 There had been some replies from relatives with reference to preferred actions in the event of the death of a resident. Training opportunities were available for the staff to book on bereavement courses and local community health support was on offer to assist should anyone suffer from a long-term illness, the deputy manager stated. 5 Midway H58 H09 S13512 Midway V248837 120905 Stage 4.doc Version 1.40 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 and 23 Many opportunities are provided for residents to communicate one-to-one with their key workers, floating support and any other member of staff they choose. Residents are protected by being cared for by staff who are trained in safeguarding them from abuse. EVIDENCE: No complaints had been logged since the last inspection and no Vulnerable Adults Procedures had been instigated. The deputy manager voiced some concern about the jealous behaviour of a resident and the resident’s consequent reactions to others. ‘The staff are aware’, she stated, ‘and the situation will be carefully monitored’. Training logs showed that training in the Surrey Multi-Agency Vulnerable Adults Procedures was regarded as important. Resident’s financial procedures were inspected. The book in which resident’s current balance is recorded is signed by a responsible member of staff at the end of a shift, and handed over to another responsible member of staff beginning a shift, who checks the balance is correct and then signs the record. Balances checked were correct. Individual residents have their own ledger, receipts are kept and logged and the Welmede policy states that two people should sign for cash withdrawals. This had not always happened but, the deputy manager stated that this would be the case in the future. 5 Midway H58 H09 S13512 Midway V248837 120905 Stage 4.doc Version 1.40 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) 25and26 The residents benefit from having bedrooms which suit their needs and lifestyles and promote their independence. EVIDENCE: Two resident’s rooms were viewed during this inspection and two were viewed previously. All the resident’s rooms were single occupancy and offered sufficient space to meet their needs. One resident, who spends a great deal of time alone in his room listening to music and watching his television, had coloured lighting installed and mobiles hanging from the ceiling. He had comfortable seating in his room. Other residents had chosen to have their own comfortable chairs downstairs because that was where they wanted to spend their time, the deputy manager stated. Two of the residents whose rooms were seen take great pride in keeping them tidy and clean. One room had a slight offensive odour, the reason for which was explained by a member of staff. All the rooms inspected were in good decorative order and contained personal objects, pictures and photographs of special importance to the occupant. The residents choose from material samples supplied by Welmede when new curtains or quilt covers are required, the deputy manager stated. 5 Midway H58 H09 S13512 Midway V248837 120905 Stage 4.doc Version 1.40 Page 17 There were window restrictors to safeguard residents from accidentally falling out of the windows and the heating system was controlled to protect the residents from burning themselves. 5 Midway H58 H09 S13512 Midway V248837 120905 Stage 4.doc Version 1.40 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 and 36 The residents benefit from being cared for by staff who understand their roles, are competent and supported by senior staff. EVIDENCE: Job descriptions were viewed, and several staff were asked about their role in the home. All those spoken with had a clear view of what was expected of them. Observations also confirmed that the staff understood the needs of the residents and worked together well as a team. Training logs were available but there was no access to the staff personnel files. The manager was on holiday and the key was not available. The guidance and policies provided by Welmede for the staff were well written and clear. As well as the mandatory training, there was evidence of a wide variety of courses available to the staff and those interviewed had either achieved an NVQ qualification, were in the process of completing one or were due to begin in the near future. The staff confirmed that they were supervised regularly and the diary for supervision bookings had clear dates set for these meetings. 5 Midway H58 H09 S13512 Midway V248837 120905 Stage 4.doc Version 1.40 Page 19 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) 39,40,41.42 5 Midway has a system in place to monitor the quality of the service provided to the residents. The staff team have access to clear policies and codes of practice to inform them and ensure the residents are central to all their actions. The resident’s records are stored securely in accordance with the Data Protection Act 1998. Good and frequent health and safety checks protect the residents from harm. EVIDENCE: A quality assurance and quality monitoring system is in the process of being developed and questionnaires completed by relatives over the year revealed a great deal of satisfaction with the service. The Welmede homes also participate in a system in which the managers complete monthly inspections of other services. Copies of these reports are made available to the inspector at the local CSCI office. 5 Midway H58 H09 S13512 Midway V248837 120905 Stage 4.doc Version 1.40 Page 20 Policies and codes of practise were available to the staff in the office and each policy had a checklist to be signed by the staff when the policy had been read. Personal information with regard to residents was stored securely in locked filing cabinets. Health and safety check lists were inspected. Daily checks were made of fire exits, fire blankets, ashtrays, storage cupboards, electrical sockets, gas taps, external security and escape routes etc. These were signed and dated by a member of staff each day and were up to date. Weekly checks were made of the maintenance of fire-fighting equipment, alarms, detectors and the emergency lighting, the safe operation of electrical and gas appliances and water temperatures. Water temperatures were within the acceptable range. Monthly checks included electrical wiring, overloading of sockets or trailing flexes, signs of perishing wood or damp, insecure doors and windows etc. All the checklists were up to date and signed. The deputy manager stated that the Welmede maintenance team were always quick to respond to requests for work to be completed. From the Fire Officer’s report of his annual fire risk assessment, compartmentalisation does not meet the fire regulation requirements. 5 Midway H58 H09 S13512 Midway V248837 120905 Stage 4.doc Version 1.40 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. 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 x 3 x x x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 3 x 2 Score Standard No 24 25 26 27 28 29 30 STAFFING Score x 3 2 x x x 2 Standard No 11 12 13 14 15 16 17 3 x x 4 x 3 x Standard No 31 32 33 34 35 36 Score 3 x x x x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 5 Midway Score x x 3 3 Standard No 37 38 39 40 41 42 43 Score x x 2 3 3 3 x H58 H09 S13512 Midway V248837 120905 Stage 4.doc Version 1.40 Page 22 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. Standard 26 34 Regulation 16(2)(k) 17(6)(ag) 13(4)(b) Requirement The Registered Manager must ensure that residents bedroom is free from offensive odours. The Registered Manager must ensure the staff personnel files are available for inspection at any time. The Registered Manager must ensure that action is taken on the findings of the Fire Officers risk assessment. Timescale for action 12/09/05 Immediate 12/09/05 Immediate 12/09/05 Immediate 3. 42 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. Refer to Standard 10 23 Good Practice Recommendations The confidentiality policy should clearly state when it is permissible for breaches to occur and the consequenses of inappropriate breaches. The registered manager should ensure the staff follow procedures laid down to safeguard residents finances. 5 Midway H58 H09 S13512 Midway V248837 120905 Stage 4.doc Version 1.40 Page 23 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 5 Midway H58 H09 S13512 Midway V248837 120905 Stage 4.doc Version 1.40 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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