Inspection on 22/04/05 for Milehouse Lane (25)

This inspection was carried out on 22nd April 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Milehouse Lane (25) 04/05/07

Milehouse Lane (25) 26/05/06

Milehouse Lane (25) 09/11/05

Milehouse Lane (25) 09/12/04

Milehouse Lane (25) 06/07/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Mile House Lane 25 Mile House Lane St Albans Hertfordshire AL1 1TF Lead Inspector Hazel Wynn Unannounced 22 April 2005 14:00 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. Mile House Lane I52 s19467 Mile House Lane v222733 200405 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Mile House Lane Address 25 Mile House Lane St Albans Hertfordshire AL1 1TF 01727 835413 01727 835413 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) Milbury Care Service Limited Care Home 7 Category(ies) of LD LD Learning Disability - 7 registration, with number LD(E) LD (E) Learning Disability - over 65 - 7 of places PD PD Physical Disability Mile House Lane I52 s19467 Mile House Lane v222733 200405 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: This home may accommodate up to 3 people with physical disability on the ground floor only (when associated with a learning disability Date of last inspection 22nd April 2005 Brief Description of the Service: 25 Mile House Lane is a large detached domestic style property in a residential area to the south of St Albans. It has been converted for use as a residential care home and offers single room accommodation for up to seven adults with learning disabilities. Three of the bedrooms are located on the ground floor and are suitable for wheelchair users. Shared facilities include a large domestic kitchen, L shaped lounge and a conservatory. The home does not have a lift and the four service users on the first floor must be fully ambulant. There is a fully assisted bath with overhead hoist tracking on the ground floor and a shower room on the first floor. Staff members have their own sleep-in room with en-suite WC and shower unit. The manager’s office is on the first floor. The front of the house is for car parking, and the large garden at the rear is suitable for wheelchair users. The home is close to one of the main roads leading to the centre of St Albans. It is within walking distance of a public house/restaurant, local shops and public transport routes. The home has its own transport for regular runs to and from the various day centres, for shopping trips and excursions. Mile House Lane I52 s19467 Mile House Lane v222733 200405 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place during the afternoon and early evening of the 22nd April 2005 and found that the majority of the standards were met. There was one requirement for a registered manager to be appointed, the appointed manager has applied to the Commission for Social Care Inspection (CSCI) but needed to reschedule a cancelled interview appointment. The home had a very relaxed atmosphere and was clean, tidy and fresh. and Service Users appeared very well cared for. The home is able to demonstrate its commitment to meet the requirements of the Care Standards Act 2000 and the National Minimum Standards. The manager supported the inspector to carry out her duties in a positive and professional manner The inspector was able to interact with five of the Service Users and observe activities in process. Staff on duty presented with good morale. The inspector also met with the operations manager who was at the home carrying out his monthly audit of the service. What the service does well: What has improved since the last inspection? The home has worked hard on building good relationships with neighbours and the Service Users benefit from neighbourliness. The proprietors have been working in consultation with the CSCI on compiling a Practice Manual, which will ensure there are good and consistent guidelines in place. The proprietors are holding a Regional Annual Conference for their Managers, this will provide a team building exercise and a time for celebration during the overnight stay at a hotel; this will aid the morale of the homes managers. In turn the manager stated that she will look at ideas to ensure her team feel that they too have Mile House Lane I52 s19467 Mile House Lane v222733 200405 stage 4.doc Version 1.30 Page 6 been recognised and have a valuable contribution to make in the way forward. Service Users will benefit from these endeavours to create unity in the staff team. 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. Mile House Lane I52 s19467 Mile House Lane v222733 200405 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 Mile House Lane I52 s19467 Mile House Lane v222733 200405 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 and 5. This home supports prospective Service Users to make as informed choice as is possible and that a comprehensive assessment of needs and aspirations is carried out. EVIDENCE: Records show that a long transition process is planned to support the service user toward assurance (in as far as is possible) that the choice of home is a good choice. The initial assessment is added to over the transition period to enable a full profile of needs and risk assessments to be compiled. Currently an assessment is in process for a prospective service user. The Service Users’ Care Managers, the team at Milehouse and their respective families, co-work in making the decision that the home appears to be a good choice. The long transition period assists the home to judge, beyond the initial assessment, that it has the capacity to meet the assessed needs. Contracts are with the Local Authority; a copy of this is placed on each Service Users file. Mile House Lane I52 s19467 Mile House Lane v222733 200405 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. The home supports Service Users to make choices within their individual abilities. Service Users are afforded choice as part of everyday living. Through this support Service Users progress and develop both personal and social skills. EVIDENCE: Due to the extremely complex needs of the Service Users, they are supported by significant others to ensure that the assessed and changing needs/goals are recorded on the care plan and kept reviewed. Service Users are supported to make decisions with varying support according to individual needs. The risk assessments contained in the Care Plan folder provide evidence that the Service Users are supported to take reasonable risks to support them towards as individual lifestyle as is possible. A service user was, seen to be, supported to use garden tools to tend a vegetable plot in the garden whilst the inspection was in process and that he received valuing comments from staff for his endeavours. Mile House Lane I52 s19467 Mile House Lane v222733 200405 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) 11, 12, 13, 15, 16 and 17. The Service Users are supported to enjoy a full and meaningful life alongside others in the local community and through holidays and other opportunities. Service Users are benefiting and developing from the support of the home’s care team. EVIDENCE: The Care Plans seen provided evidence that Service Users have set goals and team input to support then in their personal development. The activities evidenced in the records appeared to be age, peer and culturally appropriate. Progress records evidenced that the Service Users utilise the resources of their local community. The complaints records reveal that the team have worked at building relationships with neighbours. Mile House Lane I52 s19467 Mile House Lane v222733 200405 stage 4.doc Version 1.30 Page 11 Family/friends relationships are appropriately encouraged and supported; Records show that family/friends visit regularly and that Service Users are also supported to visit some family members in their own homes. Service Users rights are upheld through policies and procedures, Robust recruitment, staff training and supervision. Evidence was seen that wherever there is any indication for action to be taken, the home does take action using the disciplinary process if necessary. Mile House Lane I52 s19467 Mile House Lane v222733 200405 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) 18,19 and 20. Personal support is provided in accordance with the Service User’s wishes as indicated in the care plan. Physical and emotional needs are met and medication is appropriately managed. EVIDENCE: The Care Plans provide clear guidance to staff in how to provide support to a service user according to his/her preference. Staff were seen to support Service Users in meeting physical and emotional health needs in keeping with the Care Plans for individuals. As is clearly documented in each Care Plan, the Service Users are unable to administer and control their own medication. Policies and procedures are in place and clear evidence was seen of how this is put into practice. Medication Administration Records were seen to be accurate with no gaps. Medication was seen to be appropriately reviewed, administered, ordered and stored. Mile House Lane I52 s19467 Mile House Lane v222733 200405 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. The Service users views are important and responded to in a positive manner by the home’s care team. Service User’s are protected by the homes Policies and procedures. EVIDENCE: The Hertfordshire County Council Adult Protection Procedure is in use and this was seen to be easily accessible for all staff. There have been no complaints since the last inspection; disputes with neighbours have been resolved and relationships have been rebuilt. CRB is obtained and at least two references for each member of staff prior to employment. All other documentation necessary for ensuring the protection of Service Users, through a robust recruitment system, is kept on the staff files. Abuse awareness and all mandatory training is provided on a rolling programme commencing at induction. New staff are required to complete the LDAF programme and if they have not completed this by the end of their probation period, the probation period is either extended or employment is not confirmed. Mile House Lane I52 s19467 Mile House Lane v222733 200405 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, 25, 26, 29 and 30. The home is comfortable, clean, safe and well maintained with sufficient facilities and communal space. Service users have their own comfortable bedrooms and specialist equipment is in place for those who require it. EVIDENCE: The inspector saw that the home is well maintained, comfortable, clean and homely. Records showed that Health and Safety checks are carried out following a comprehensive checklist on a monthly basis. The operations manager was in the process of carrying out an internal audit during the inspection. Service Users’ bedrooms had individual personal possessions. The Service Users are supported to take care of their own room according to the level of support they individually require. The appropriate professionals have assessed Service Users who require specialist equipment prior to the provision of this; evidence of professional input is on file. The home was fresh and clean and good hygiene practice procedures were in place. Mile House Lane I52 s19467 Mile House Lane v222733 200405 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) 34, 35 and 36 The home is adequately staffed (shortfall covered by agency when necessary). The staff understood their roles and receive ongoing training and supervision. The recruitment process is robust. The staff are competent to meet the assessed needs of the Service Users. EVIDENCE: Action is taken where a staff member needs retraining in order to strengthen skills; so that care and support provided is appropriate and of a high standard to meet the Service Users needs. Evidence was seen that the recruitment process is robust; staff files contained the necessary documentation. CRB is retained by head office, the number and outcome of the CRB is sent to the manager. Staff spoken to confirmed they are well supported and receive formal supervision, in which the progress of individual Service Users is tracked; care staff are named keyworkers for individual Service Users. Mile House Lane I52 s19467 Mile House Lane v222733 200405 stage 4.doc Version 1.30 Page 16 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 and 43. There is a competent manager appointed, whose registration application is in process with the CSCI. The home is well managed in accordance with legislation and the Companies policies and procedures. EVIDENCE: Records, staff spoken to, activities in progress and the fact that the home was clean, tidy and fresh all provided evidence that the home is well run to the Service Users benefit. However, the manager is not yet registered but arrangements are in process and an interview date with the CSCI was arranged during the inspection process. Staff spoken to said they were very happy working in the home under the leadership of the current manager. The manager discussed the ethos of the home and the team’s efforts to ensure the home’s ethos benefits the Service Users. Progress records and observations of staff interaction with Service Users, clearly indicated that the homes ethos is put into practice. Action plans are drawn up for any deficits. Mile House Lane I52 s19467 Mile House Lane v222733 200405 stage 4.doc Version 1.30 Page 17 Service user’s views are recorded in the care plan, those who advocate on behalf of the Service Users have input to the care plan. As part of the selfmonitoring process, the care plans and progress made are included in the audit. An audit was in process during the inspection and service user’s goals and quality of life were being monitored. A new practice manual containing policies and procedures has been compiled in consultation with the CSCI and was shown to the inspector. Policies and procedures were in place to safeguard the Service Users rights and best interests. MAR records, Service Users’ financial records and care plan recording, all show that the service user’s rights and best interest were safeguarded and that policies and procedures were being put into practice. A checklist was seen covering health and safety areas requiring regular evidence of monitoring and this had been fully utilised to produce an action plan where appropriate; this, together with records maintained in the Service Users’ files and other records, provided evidence that the health safety and welfare of Service Users is promoted and protected. Mile House Lane I52 s19467 Mile House Lane v222733 200405 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 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 N/A 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 x x 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 x 3 3 x Standard No 31 32 33 34 35 36 Score x x x 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Mile House Lane Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 1 I52 s19467 Mile House Lane v222733 200405 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 YA43 & YA37 Regulation 8 (1) (b) Requirement There must be a registered manager in the home. (It is noted that the application has been made and an interview now arranged). Timescale for action 06.06.05 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. Refer to Standard Good Practice Recommendations Mile House Lane I52 s19467 Mile House Lane v222733 200405 stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire 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 Mile House Lane I52 s19467 Mile House Lane v222733 200405 stage 4.doc Version 1.30 Page 21 - 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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