Inspection on 17/01/06 for Millenia House

This inspection was carried out on 17th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Millenia House 08/08/06

Millenia House 02/08/05

Millenia House 21/09/04

Millenia House 12/05/04

Millenia House 27/01/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Millenia House 10 Needwood Close Goldthorn Park Wolverhampton West Midlands WV2 4PP Lead Inspector Joy Hoelzel Unannounced Inspection 17th January 2006 10:00 Millenia House DS0000017188.V275780.R01.S.doc Version 5.1 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 Millenia House DS0000017188.V275780.R01.S.doc Version 5.1 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. Millenia House DS0000017188.V275780.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Millenia House Address 10 Needwood Close Goldthorn Park Wolverhampton West Midlands WV2 4PP 01902 621010 01902 621046 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) Mr George Dixon Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Millenia House DS0000017188.V275780.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd August 2005 Brief Description of the Service: Millennia House is a care home providing accommodation, personal and nursing care for nine adults with a learning disability and mental ill health. It is privately owned and managed by George Dixon. The home is located in the Goldthorn area of Wolverhampton, close to shops, pubs and other amenities. The two storey converted building provides a domestic-like setting in which service users have the opportunity to develop everyday living skills such as participating in personal laundry and caring for their own private space. All bedrooms are single occupancy complimented by communal lounge and dining areas. Millenia House DS0000017188.V275780.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over three and a half hours on Tuesday 17th January 2006 and is the second of the two statutory inspections for 2005/06. Nine people are resident at the home; there have been no new admissions to the home since the previous inspection in August 2005. Staffing numbers are at the agreed levels. The owner was on the premises together with one registered nurse, two care support workers, one cook and one handyman. A tour of the premises took place, one resident care file was randomly selected and examined in depth, together with supporting documents and discussions were held with three residents, staff and the owner. What the service does well: What has improved since the last inspection? The three requirements made at the previous inspection in August 2005 have all been complied with. Formal recorded supervision for all levels of staff has commenced; procedures must be in place to maintain the continuity of the meetings at regular intervals. Some areas of the home have been redecorated and carpets replaced. Millenia House DS0000017188.V275780.R01.S.doc Version 5.1 Page 6 New procedures and documentation for individual care planning are being introduced using the person centred planning approach. 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. Millenia House DS0000017188.V275780.R01.S.doc Version 5.1 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 Millenia House DS0000017188.V275780.R01.S.doc Version 5.1 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 the following standard(s): EVIDENCE: This set of standards was not inspected on this occasion. Millenia House DS0000017188.V275780.R01.S.doc Version 5.1 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 the following standard(s): 7 The new documentation currently being introduced for planning the care of each individual will ensure that all staff have the required information to make certain that care needs can be fully met. EVIDENCE: One resident case file was randomly selected for inspection. The file contained information and assessments dating back to 2001. The care plan for the effective management of a physical health problem was formulated in March 2005, with the last review dated 13/07/05. Other information relating to this care plan is recorded in various other books and files. The case file included clear instructions for dealing with potential and actual challenging behaviour and a missing persons procedure. The registered nurse demonstrated a sound knowledge of the resident’s health and welfare and was able to find the documentation relating to the resident when requested. With so many different files, books and recording documents currently used it was difficult to follow the care process. Later on during the inspection the registered provider stated that the care plans/files are being reorganised, new documentation relating to person centered planning is being implemented. The new documentation relating to Millenia House DS0000017188.V275780.R01.S.doc Version 5.1 Page 10 the same resident was completed with the resident in November 2005 with a review date of February 2006. The registered provider was unable to state exactly when the new documentation and planning process would be fully operational but stated that it would be functioning shortly. An office on the ground floor is presently being decorated and prepared for the safekeeping of the case files. Millenia House DS0000017188.V275780.R01.S.doc Version 5.1 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 the following standard(s): YA 12,16 Very limited social, recreational or therapeutic activities are arranged; there is little evidence to suggest that service users views are being sought or that the activities are in any way stimulating. EVIDENCE: The registered nurse explained the difficulties with accessing educational and occupational opportunities for the residents due to their own motivation and abilities, but also the problems experienced with the local educational establishments. The case file evidenced that staff assist with household chores each week; support is given for dealing with personal laundry and cleaning. One resident attends a Skills For Life cookery course weekly. The staff at the home provides all meals, drinks and snacks, there is no provision or facility for residents to make their own drinks or refreshments. Although the care plan inspected documented that the resident was previously able and supported to make his own breakfast, he is now unable to do so because of the lack of the provision. Millenia House DS0000017188.V275780.R01.S.doc Version 5.1 Page 12 There was little evidence to suggest that any therapeutic activity is organised for residents on a daily basis, apart from the arranged laundry and cleaning schedules. During the inspection residents were observed to be very lethargic and seemingly uninterested in the happenings of the day. One resident stated that he wasn’t ‘doing anything’ today but on Thursdays he went into town to ‘hang around’. Two residents were sleeping in the lounges during the morning, one resident was going out to visit relatives and another had gone out early and arrived back at lunchtime but stated that he had already eaten. One support worker was assisting a resident with household chores and the other support worker was busy cleaning windows. The nurse in charge stated that residents continue to access the local shops and facilities in the area, in addition to going into Wolverhampton. The home has two vehicles to assist residents with attending hospital appointments and occasionally to places of interest. Millenia House DS0000017188.V275780.R01.S.doc Version 5.1 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 the following standard(s): YA 18,20 A robust procedure has been adopted for the safe administration of medication. EVIDENCE: The current care plan did not include any information regarding offering or providing personal support to the resident. The nurse in charge stated that all residents are actively encouraged to shower daily and that support from the staff is offered when a problem is identified. The person centered planning records detailed that this had been discussed with the resident and his likes and dislikes were documented. The home operates a twenty-eight day regime of medication administration using a monitored dose system with some bottles and boxes. The Medication Administration Record charts appeared to be correctly completed and corresponded with the amount of medication in the blister packs. The consent to the administration of medication by the staff at the home has been sought and a signed copy of the consent is filed in the case file. The nurse in charge explained the procedure for the safe administration of medication when the resident is away from the home. The Medisure Domiciliary Dosage System is prepared by the pharmacist for the resident and includes the clear instructions for the administration of the medications. Millenia House DS0000017188.V275780.R01.S.doc Version 5.1 Page 14 Millenia House DS0000017188.V275780.R01.S.doc Version 5.1 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 the following standard(s): YA 22,23 The home has a satisfactory complaints system and there is evidence that residents feel that their views are taken seriously. EVIDENCE: The complaint procedure is clearly displayed at the entrance to the home and has been amended to include the contact details of the Commission for Social Care Inspection. The nurse in charge stated that no complaints have been received since the last inspection in August 2005. Residents stated that they are able to discuss any concerns they may have with the nurses and care staff. Adult abuse issues are included in the induction procedure for all new staff and a whistle blowing procedure is available for staff reference. The nurse in charge acknowledges that training in this area is outstanding. Millenia House DS0000017188.V275780.R01.S.doc Version 5.1 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 the following standard(s): YA 24 The home continues to provide a high quality, comfortable and safe environment for those in residence. EVIDENCE: The home is comfortable, homely and domestic in character, some areas of the home have been redecorated and carpets have been replaced. The nurse in charge explained that there is an ongoing programme of redecoration and refurbishment. In consultation with the local fire officer new fire resistant doors are currently being fitted to the corridor on the first floor. At the time of the inspection the home was clean and tidy. Millenia House DS0000017188.V275780.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA 32,34,35,36 Staff require training in all areas to ensure that they can fully meet the needs of each individual in a sensitive and professional manner. EVIDENCE: The home is staffed with first level nurses, (general, mental health and learning disability), supported with a team of care workers. The nurse in charge demonstrated a sound knowledge of the current resident group and the disabilities, specific conditions and challenges that are associated. Five care support workers have begun training for National Vocational Qualification training at level 2 in care. The nurse in charge explained the induction process for all new starters; the corresponding documents have been completed and are filed in the personnel file. Two staff personnel files were randomly selected for inspection. Both files evidenced a recent criminal record bureau disclosure; only one contained two references and proof of identification. The responsible individual explained that the references and proof of identification that were missing had probably been misfiled as he is in the process of reviewing and revising all personnel files. Neither file contained a copy of the job description, contract or codes of practice. The nurse in charge and responsible individual acknowledged that training in the core topics, specialisms and updates are now outstanding for all staff. Millenia House DS0000017188.V275780.R01.S.doc Version 5.1 Page 18 Formal staff supervision commenced in October 2005 for all levels of staff, the date of the next supervision session has not been identified and so has the potential for not continuing the process every two months. Millenia House DS0000017188.V275780.R01.S.doc Version 5.1 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39, Alternative systems and ways of obtaining residents views are needed to ensure that the home fully meets the stated purpose and objectives. EVIDENCE: The manager stated that regular monthly and six monthly quality assurance audits of the service are carried out. He discussed the difficulties with offering the satisfaction questionnaires to the residents this being due to literacy difficulties, possible dyslexia and understanding the gist of the forms. Residents meetings are held at regular intervals offering the opportunity to comment about life at the home. Millenia House DS0000017188.V275780.R01.S.doc Version 5.1 Page 20 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 X 2 X 3 X 4 X 5 X X 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 3 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 3 32 X 33 3 34 1 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 X 16 2 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X 3 X X X 2 X X X X Millenia House DS0000017188.V275780.R01.S.doc Version 5.1 Page 21 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. Standard YA16 Regulation 12(2)(3) Requirement Timescale for action 31/03/06 2. YA35 3. YA36 4 YA39 The registered person must ensure that a social, recreational and therapeutic activity programme is developed. 18(1) The registered person must 31/03/06 (C)(i) ensure that all staff receives updates and training in the core and specialist topics. 18(2) The registered person must 31/03/06 ensure that systems are in place for all staff to receive formal supervision at least six times a year. 24(1)(a)(b) The registered person must 31/03/06 ensure that an effective quality assurance and monitoring systems are developed and maintained. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations DS0000017188.V275780.R01.S.doc Version 5.1 Page 22 Millenia House Standard Millenia House DS0000017188.V275780.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Wolverhampton Area Office 2nd Floor St. Davids Court Union Street Wolverhampton WV1 3JE 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 Millenia House DS0000017188.V275780.R01.S.doc Version 5.1 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!