Inspection on 04/05/07 for Milehouse Lane (25)

This inspection was carried out on 4th May 2007.

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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Milehouse Lane (25) 26/05/06

Milehouse Lane (25) 09/11/05

Milehouse Lane (25) 22/04/05

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 Milehouse Lane (25) 25 Mile House Lane St Albans Hertfordshire AL1 1TF Lead Inspector Bijayraj Ramkhelawon Unannounced Inspection 4th May 2007 11:30 Milehouse Lane (25) DS0000019467.V339597.R01.S.doc Version 5.2 Page 1 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 Milehouse Lane (25) DS0000019467.V339597.R01.S.doc Version 5.2 Page 2 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 Stationery 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. Milehouse Lane (25) DS0000019467.V339597.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Milehouse Lane (25) Address 25 Mile House Lane St Albans Hertfordshire AL1 1TF 01727 835413 01727 835413 FP Telephone number Fax number Email address Provider Web 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 Services Limited Marie O`Flaherty Care Home 7 Category(ies) of Learning disability (7), Learning disability over registration, with number 65 years of age (7), Physical disability (3) of places Milehouse Lane (25) DS0000019467.V339597.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home may accommodate up to 3 people with physical disability on the ground floor only (when associated with a learning disability). 26th May 2006 Date of last inspection 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 managers 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. The current fees charged are £ 1187.08 - £ 1711.10 per week. A copy of the Statement of Purpose, Service User Guide and the most recent CSCI inspection report is available from the care home. Milehouse Lane (25) DS0000019467.V339597.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 4th May 2007. One inspector carried out the inspection, which took part of the day. Feedback from people living in the care home and staff was received. Care plans, staff files, records of medicine administration and management, complaints and compliment records, fire safety, health and safety records, policies and procedures and other relevant documents were examined. A tour of the premises was also carried out. At the time of the inspection, there were seven people in the home and the majority of them were attending to their day activities outside the home. Three of the people living in the care home were spoken with. What the service does well: What has improved since the last inspection? The Statement of Purpose and Service User’s Guide have been updated so provide up to date information about the service. Risk assessment for people with epilepsy has been undertaken to ensure that they receive the right intervention and care. Staff have attended training in epilepsy and adult protection so that they are aware of the right procedures to be followed. A record of the outcome of complaints investigated was being kept to provide an audit trail. The broken window on the 1st floor bathroom has been replaced. Milehouse Lane (25) DS0000019467.V339597.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Milehouse Lane (25) DS0000019467.V339597.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Milehouse Lane (25) DS0000019467.V339597.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1-5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information about the care home is available and included in the Statement of Purpose and Service User’s Guide. Comprehensive assessments have been carried out for each person living in the care home in respect of their needs and aspirations with regular reviews undertaken. EVIDENCE: The majority of people living in the care home were admitted when the home first opened. People visit and ‘test drive’ before any decisions for placement are made. Comprehensive assessments of each individual’s needs were undertaken and ‘whole life’ reviews that include ‘person centred plans’ were held annually. Each person has a written contract and terms and conditions of stay. Milehouse Lane (25) DS0000019467.V339597.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6-10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans were detailed and included information on all assessed health care needs, social needs and risk assessments. People were supported to make decisions about their lives and participated as fully as possible in all aspects of life in the home; their views were listened to and acted upon. People were treated with respect and assisted to make choices about their lives and to participate in community activities wherever possible. Confidentiality was respected and safeguarded and records securely stored. EVIDENCE: Care plans examined provided evidence that service users were assured that their assessed needs and aspirations were identified and met. Care plans were reviewed regularly and reflected people’s changing needs. Each person has an annual ‘whole life’ review which was ‘person centred’. A weekly individual activity programme was devised and included attending day centres and other community facilities. People were encouraged to take part in decision-making Milehouse Lane (25) DS0000019467.V339597.R01.S.doc Version 5.2 Page 10 and to be involved in the domestic chores of the home. One service user showed an interest in birds and has obtained a collection of finches, which were accommodated in a well-kept finch cage in the lounge. Policies and procedures in relation to confidentiality were in place and these were included in the induction-training programme for staff and in ongoing training. The records relating to the people living in the home were securely stored. Milehouse Lane (25) DS0000019467.V339597.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11-17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the care home were encouraged and enabled to make choices in relation to their food, clothes and activities to optimise their abilities in developing their skills. They were also encouraged and supported to pursue social and leisure activities as stated in their individual care plan. EVIDENCE: Individual’s personal development was promoted by engaging in planned day care, social and leisure activities. A weekly programme of individual’s activities for mornings and afternoons were displayed on the notice board. People are encouraged to maintain contact with their relatives and those who are important to them. Milehouse Lane (25) DS0000019467.V339597.R01.S.doc Version 5.2 Page 12 There are yearly holidays or trips according to people’s preferences. Summer holidays were being planned for this year. Community activities recorded included trips to the cinema, pubs, restaurants, bowling and other places of interests. A six weekly rotational menu was in place. The dining area was comfortable and reasonably spacious. Milehouse Lane (25) DS0000019467.V339597.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18-21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal support was provided as required and according to individual’s preferences. People living in the care home are not able to retain and administer their own medication due to their complex needs and profound learning disabilities. The management and administration of medicines were generally kept in good order except where medicines are not given the reason for omission is not being recorded. The disposal of medicines also needs improving. Ageing, illness and death would be handled with respect and in accordance with individual’s wishes. EVIDENCE: People’s personal and health care was being provided as set out in their care plans. The progress notes indicated that identified needs were being met and kept under review. Changes in any needs were also reflected in individual’s care plan. None of the people living in the home are able to self-medicate due to individual’s complex needs and profound learning disabilities. The Milehouse Lane (25) DS0000019467.V339597.R01.S.doc Version 5.2 Page 14 administration and management of medicines were kept in good order except it was noted that some medicines were signed as being given but the tablets were still in the blister packs. No records were made as to why these tablets were not administered as prescribed. It was also noted that the pharmacist did not sign for each medicine returned for disposal. Policies and procedures were in place in respect of ageing, dying and death. Milehouse Lane (25) DS0000019467.V339597.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the care home and their families can feel confident that their concerns would be listened and people using the service would be safeguarded and protected. EVIDENCE: Various forms of communication were being used to support service users to air their views. The staff recruitment policies and procedures were robust. Staff have been provided with recent training in safeguarding adults (adult protection). A copy of the complaints procedure is included as part of the Service User’s Guide and a record of the outcome of the complaints investigated are in place. No complaints have been received since the last inspection. However, at present one member of staff was being investigated under the POVA Procedure. Milehouse Lane (25) DS0000019467.V339597.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24-27, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the care home are encouraged to choose individual styles for their bedrooms, which helps to promote their independence. Some issues were identified in the environment, which a planned maintenance programme that includes the renewal of fabric and decoration would allow planning for. EVIDENCE: All rooms are for single accommodation. People’s bedrooms were personalised with individual’s belongings. Staff encouraged people to bring and/or choose their own furniture and can decorate and personalise their rooms, subject to any fire and safety regulations. The premises were safe, accessible, comfortable, reasonably clean and free from offensive odours. Each room has sufficient light and ventilation. The bathroom and toilet provision is sufficient for the number of residents in the home. However, it was noted that there was a long and deep crack appearing on the ceiling of the main lounge (the manager has written since the inspection Milehouse Lane (25) DS0000019467.V339597.R01.S.doc Version 5.2 Page 17 to say that the ceiling has now been repaired). It was also noted that a planned maintenance and renewal programme for the fabric and decoration of the premises was not kept. The carpets on the stairs and corridors were worn and badly stained. The home uses its own transport for people to access local amenities and relevant support services. Milehouse Lane (25) DS0000019467.V339597.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31-36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. An experienced, effective and trained staff team supports the people in the home. The staff recruitment policy and procedure is robust and implemented so as to ensure people are safe. The staff team are well supported by management and formal supervision was provided. EVIDENCE: Staff duty rota showed that there is adequate number of staff rostered on days and nights to meet service users needs. 5 care staff have completed their NVQ Level 2. One has completed the NVQ Level 3 and 2 are currently undertaking this course. Staff were aware of and promoted the main aims and values of the home including the key worker system. Staff confirmed that they have received a job description on starting employment and they undergo a period of induction, which meets the Learning Disability Awards Framework (LDAF), which included working along side a senior care staff. They also confirmed that they do receive formal supervision on a regular basis. Milehouse Lane (25) DS0000019467.V339597.R01.S.doc Version 5.2 Page 19 Staff files examined had all the documents required by this standard. Milehouse Lane (25) DS0000019467.V339597.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37-43 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was well run. The registered manager has implemented a good ethos, provides clear leadership and has a good management approach in the provision of this service. People living in the home can be confident that their views underpin all self monitoring, review and development by the home and that their rights and best interests are safeguarded by the home’s policies and procedures. The health, safety and welfare of people living in and staff are promoted and protected. EVIDENCE: All appropriate written policies and procedures were in place. All records examined were well documented. Staff spoken to confirmed that regular fire drills did take place, which everyone takes part in. A monthly meeting for Milehouse Lane (25) DS0000019467.V339597.R01.S.doc Version 5.2 Page 21 people living in the care home is held where people have a formal time to air their views. All staff completes the statutory training to maintain safe working practices and the home complies with all relevant legislations to safeguard the health, safety and welfare of service users and staff. Staff who handled food have undertaken food and hygiene training. Accidents, injuries, incidents of illness were recorded and reported. The home has a valid insurance cover for legal liabilities to employees, service users and third party persons to a limit commensurate with the level and extent of activities undertaken or to a minimum of £5 million and expires in March 2008. Milehouse Lane (25) DS0000019467.V339597.R01.S.doc Version 5.2 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 Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 3 3 x 3 3 3 3 3 Milehouse Lane (25) DS0000019467.V339597.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection?No 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 YA20 Regulation 13 (2) Requirement Medicines must be given as prescribed and when medicines are not given, the reason for omission must be recorded. The cracked ceiling in the main lounge must be repaired (Since the inspection the manager has written to say that this worked has been completed on 11/05/07). The worn and badly stained carpets on the stairs and corridors must be replaced. Timescale for action 22/06/07 2. YA24 23 (2) (b) 22/06/07 3. YA24 13 (4) (a) & (c) 20/07/07 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 YA20 YA24 Good Practice Recommendations The pharmacist should sign for each item of medicine returned for disposal. A planned maintenance and renewal programme for the fabric and decoration of the premises should be kept. Milehouse Lane (25) DS0000019467.V339597.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Milehouse Lane (25) DS0000019467.V339597.R01.S.doc Version 5.2 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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