CARE HOME ADULTS 18-65
Midway (5) 5 Midway Walton-on-Thames Surrey KT12 3HY Lead Inspector
Christine Bowman Unannounced 7 June 2005, 11:00 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. Midway (5) h58 h09 S13512 Midway [5] V231786 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Midway (5) Address 5 Midway Walton-on-Thames Surrey KT12 3HY 01932 253501 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) Welmede Housing Association Ltd Denise Farouk Care Home 6 Category(ies) of LD Learning Disability - 6 registration, with number of places Midway (5) h58 h09 S13512 Midway [5] V231786 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: The age/age range of the persone to be accommodted will be 35-64 years. Date implemented: 1 April 2002 Date of last inspection 6 September 2004 Brief Description of the Service: Midway is a care home for 6 adults with learning disabilities, and is located on a private road within walking distance of Walton of 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 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. Midway (5) h58 h09 S13512 Midway [5] V231786 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which commenced at 1.00pm and took four hours to complete. The service users and staff were welcoming and very willing to assist in the inspection process. All the residents were communicated with, but some residents did not speak. Two residents shared their care plans and commented on life at Midway. They also assisted with a partial tour of the premises and allowed their own bedrooms to be viewed. The manager, and two staff were interviewed and two more staff were spoken with briefly. Records, staff files and some policies were inspected. This was a positive inspection of a service, which caters well for the needs of the residents and provides them with a caring and happy home. What the service does well: What has improved since the last inspection? Midway (5) h58 h09 S13512 Midway [5] V231786 Stage 4.doc Version 1.30 Page 6 The manager is in the process of ascertaining the wishes of the residents in the event of serious illness or death and she has already been in contact with relatives to obtain their views. When this process is completed the outcomes will be recorded in the care plan. A new duty rota has been devised, which showed clearly which staff are available for extra duties should the need arise, and is marked to show when those duties had been covered. All the staff files inspected contained all the information as required under Schedule 2 of The Care Homes Regulations 2001. Although the downstairs bathroom had not yet been refurbished, negotiations have been made to include a separate shower as well as an assisted bath and the home have been involved in the decision- making. The manager stated that the surveyor had visited. The manager is now forwarding information, through a Regulation 37 notification of any accident or incident, which affects the wellbeing of residents, to the Commission for Social Care Inspection Surrey local office. 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. Midway (5) h58 h09 S13512 Midway [5] V231786 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 Midway (5) h58 h09 S13512 Midway [5] V231786 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, and 5 Information available to prospective service users is comprehensive and available in an appropriate form. An individual licence agreement containing a statement of terms and conditions is available in resident’s files. EVIDENCE: The statement of purpose and the service user’s guide are illustrated with photographs of the home, of the residents involved in activities and of the staff carrying out their duties. Both documents are interesting to those who can or cannot read because they tell a story in pictures about going to live at 5 Midway. These documents are bright, colourful and very individual to the home. The service user’s guide is also available in a number of formats such as symbols and on video cassette. Each resident whose file was inspected had a licence agreement and there was a file note to indicate that the resident was not able to sign so the agreements seen were signed by Welmede Housing Association only. If residents are unable to sign agreements they should be signed by a representative on their behalf. Midway (5) h58 h09 S13512 Midway [5] V231786 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 and 9 Arrangements for care planning in this home were good and frequent. Residents were involved in the reviewing of their care plan with support from their key workers and were risk assessed when engaging in new activities. EVIDENCE: Two residents assisted in the viewing of their care plans. One resident repeated the words ‘shopping’, ‘clothes’ and ‘shoes’ in the section of likes and dislikes and later showed her collection of shoes and the clothes she had chosen to take on holiday. Helping with chores was another of her favourite things to do and later she insisted on clearing the table after tea. Both of the residents were aware of who their key workers were and referred to them with shortened names. Care plans were detailed and reviewed every three months, a new review date being set at each review. Included in the care plan were an initial assessment of needs, preferences, social and community activities, hobbies and interests, education, risk assessments, health needs, finances and a licence agreement.
Midway (5) h58 h09 S13512 Midway [5] V231786 Stage 4.doc Version 1.30 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15 and 17 The home provides opportunities for residents to be involved in community life according to their assessed needs, encourages interaction with family and friends and involves residents in the organisation of their home and the planning of their meals. EVIDENCE: In the morning a group of residents had been leaflet dropping for which they receive a small remuneration. The Geesemere day and leisure centre is run by the North Surrey Primary Care Trust and provides work and activities to residents, from art and craft, pottery and woodwork to simple jobs such as packing. All residents attend for at least a day each week. In the afternoon four residents went out to spend some time in a sensory room and returned looking very relaxed. Other activities in the community include going to church, two residents like to attend each week and some of the neighbours now recognize them and greet them, the manager stated. Swimming, going to the cinema, 10-pin bowling,
Midway (5) h58 h09 S13512 Midway [5] V231786 Stage 4.doc Version 1.30 Page 11 rambling, shopping for food and personal items, horse riding, boating and trips to the pub are just some of the many activities on offer to the residents, the manager stated. Photographs in the statement of purpose and the service user’s guide showed residents involved in those activities. It was reported that very soon the annual holidays will begin and the residents of 5 Midway will be going to the seaside in two separate groups. A resident had been out to buy new clothes to take and was very pleased with her new swimming costume, as she held it up she was smiling. Quality assurance questionnaires sent to relatives of residents had been returned recently and confirmed that the home was highly thought of and praised the staff for their commitment and care of the residents, also mentioned was the appreciation of relatives of their inclusion in events organized by the home. A member of staff stated that relatives are always invited to review meetings. One resident was also indicating that there were friends from other Welmede homes they like to meet with. Shopping for food is popular, a member of staff stated and residents like to choose the food. The meals are cooked by the staff with help from the residents, and on the day of the inspection the meal was chicken pie with chips and fresh vegetables. The meal was plentiful, hot, tasty and well presented. As the residents ate around the dining room table with the staff, one resident was humming a happy tune. The staff were attentive to the needs of the residents, helping them to help themselves to drinks, gravy and more food, and mindful of support to prevent accidents when help was offered with clearing the table. Midway (5) h58 h09 S13512 Midway [5] V231786 Stage 4.doc Version 1.30 Page 12 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 and 19 Personal support is offered in a way that preserves the dignity of the residents and good care plans, reviewed frequently ensure that physical, emotional and health needs are met. EVIDENCE: A resident confirmed that the staff respect their privacy by knocking on the door of their bedroom and also smiled and nodded their head when asked if they felt comfortable receiving personal care, as stated in the care plan. From the body language and happy sounds the residents made when the names of their key workers were mentioned, they appreciated the relationship. Everyone is registered with a GP, either the local one or the family one and as evidenced in the resident’s files, appointments are made with specialists such as dentists, chiropodists and opticians. The services of psychologists, physiotherapists, speech therapists and dieticians, were reported by the manager to be available at the North Surrey Primary Care Trust. Midway (5) h58 h09 S13512 Midway [5] V231786 Stage 4.doc Version 1.30 Page 13 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 Safeguards were in place to protect residents. The complaints procedure in the service user’s guide is very clear and the staff attend training on Adult Protection Procedures. EVIDENCE: The close working relationship the two key workers have with each resident and the one to one floating support time offered to individuals means that there is opportunity for staff to be aware if a resident has any worries or concerns. There are also residents meetings both at the home and for the region. The complaints procedure in the service user’s guide is written in combination of key words and picture symbols and is easy to understand. No complaints were reported to have been received by the home since the last inspection. Midway (5) h58 h09 S13512 Midway [5] V231786 Stage 4.doc Version 1.30 Page 14 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) 24,27 and 30 This is a fundamentally safe and comfortable home, which could benefit from refurbishment in some areas. EVIDENCE: The premises are suitable for the needs of the residents providing wellproportioned shared living areas and single bedrooms. There is sufficient space for residents to be together or to spend time alone. The entrance hall, office and dining room are in need of redecoration and the curtains in the dining and sitting rooms are looking a little faded and worn and need to be replaced. Although the downstairs bathroom has not yet been refurbished, a surveyor has been in and the colours and equipment have been chosen. In the corner of the office is a basin for hand washing, which was reported as being no longer used more space could be made available if it was removed. Midway (5) h58 h09 S13512 Midway [5] V231786 Stage 4.doc Version 1.30 Page 15 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) 33,34 and35 There are good recruitment procedures in place, appropriate training is accessible and an effective team of care staff has been built up. EVIDENCE: Staff records indicated that vetting procedures were good and induction training begins with a three-day course of core skills. Throughout induction new staff have a ‘buddy’, who teaches them about the different means of communication employed by the residents, the manager stated. Training is available through the North Surrey Primary Care Trust, which is subcontracted by Welmede Housing Association to provide the staffing for the home. The staff team work in shifts of early or late and there are three people on duty except at night when there is a member of staff on waking night duty. It is commendable that the home covers all absences from a bank of their own staff and do not employ agency staff. To support the person on night duty, there is a person sleeping-in in one of the other Welmede homes a few streets away. Throughout the inspection the staff team were attentive to the residents and able to interpret their needs and wishes. There was warmth and
Midway (5) h58 h09 S13512 Midway [5] V231786 Stage 4.doc Version 1.30 Page 16 understanding in the relationships observed between the staff and residents and the staff were subject to spontaneous hugs by the residents. Midway (5) h58 h09 S13512 Midway [5] V231786 Stage 4.doc Version 1.30 Page 17 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 and 42 Leadership in this home is good, resulting in high staff morale and enthusiasm. Residents are safeguarded by good health and safety procedures. EVIDENCE: The manager has been in post for two years and has an open, positive and inclusive management approach. This was verified by the staff interviewed during the inspection. There were no health and safety issues. Midway (5) h58 h09 S13512 Midway [5] V231786 Stage 4.doc Version 1.30 Page 18 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 4 x x x 3 Standard No 22 23
ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 x 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 2 x x 2 x x x Standard No 11 12 13 14 15 16 17 x 3 4 4 3 x 4 Standard No 31 32 33 34 35 36 Score x x 4 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Midway (5) Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x 3 x h58 h09 S13512 Midway [5] V231786 Stage 4.doc Version 1.30 Page 19 Yes 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 YA27 Regulation 23(2)(j) Timescale for action The ground floor bathroom is to Immediate be refurbished with consideration 7/06/05 taken into account for the increasing age of the residents. An action plan to be sent to the CSCI local office outlining the plans. This was a requirement from the previous inspection and must be complied with. The entrance hall, dining room 7/07/05 and office are in need of redecoration Requirement 2. 3. 4. 5. YA24 23(2)(b) 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 YA24 Good Practice Recommendations The curtains in the sitting and dining rooms are looking faded and worn and it is recommended that they be replaced. Midway (5) h58 h09 S13512 Midway [5] V231786 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection The Wharf Abbey Mill Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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