Inspection on 02/08/05 for Millenia House

This inspection was carried out on 2nd August 2005.

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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Millenia House 08/08/06

Millenia House 17/01/06

Millenia House 21/09/04

Millenia House 12/05/04

Millenia House 27/01/04

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Polesworth Group Friary Road

Polesworth Group Pooley Heights

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Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

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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 WV2 4PP Lead Inspector Joy Hoelzel Unannounced 2 August 2005 09:00 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. Millenia House E56 S17188 Millenia House V242452 UI 020805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Millennia House Address 10 Needwood Close Goldthorn Park Wolverhampton WV2 4PP 01902 621010 01902 621010 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) Mr George Dixon George Dixon Care Home with Nursing 10 Category(ies) of Learning Disability - 10 registration, with number of places Millenia House E56 S17188 Millenia House V242452 UI 020805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21 September 2004 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 Mr 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, cooking skills and caring for their own private space. All bedrooms are single occupancy complimented by communal lounge and dining areas. Millenia House E56 S17188 Millenia House V242452 UI 020805 Stage 4.doc Version 1.40 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 2nd August 2005 and is the first of the statutory inspections for 2005/06. Nine people are resident at the home; staffing numbers are at the agreed levels. The owner was on the premises together with two registered nurses, two care support workers, one cook and one handyman. A tour of the premises took place, one service users care plan was examined in depth, together with supporting documents and discussions were held with six service users, visitors, staff and the owner. What the service does well: What has improved since the last inspection? What they could do better: Attention must be given to the factual details included in the statement of purpose and service user guide. Both documents should be reviewed at regular intervals, amended and readily available. Millenia House E56 S17188 Millenia House V242452 UI 020805 Stage 4.doc Version 1.40 Page 6 A more proactive approach to the social, recreational and therapeutic activities may enhance the life style of some service users. Regular supervision and support given to staff would benefit the service users living at the home and may create an improved and more effective staff team. 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 E56 S17188 Millenia House V242452 UI 020805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Millenia House E56 S17188 Millenia House V242452 UI 020805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,5 Although no new service users have been admitted to the home recently, the home has an appropriate admissions policy in place should the need for it arise EVIDENCE: The home has a statement of purpose and service user guide setting out the information about the service. However, the documents were not easily accessible and did not include the current information or contact details of Commission for Social Care Inspection. It was recommended that copies of both documents are easily accessible, given to all current service users and discussed at the next service user meeting. The clinical manger stated that there had been no new admissions since the inspection in September 2004. Observation of a service users care plan evidenced that a pre admission assessment had been obtained prior to admission. One service users care plan did not include a signed contract/statement of terms and conditions/licence agreement. The registered nurse explained that the document might have been archived. A signed copy was evidenced in another service users care plan. Millenia House E56 S17188 Millenia House V242452 UI 020805 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9 The service user plans are comprehensive and updated at appropriate intervals ensuring that individuals’ needs are met EVIDENCE: All service users have an individual plan of care that is updated and reviewed at least monthly. A formal review is conducted at six monthly intervals together with an annual multidisciplinary review. The care plan of each individual need details the identified problem, the desired outcome and the nursing interventions that are needed. One service user plan inspected, detailed the interventions and procedures needed in the event of aggressive behaviour and unplanned absences from the home. The plan had been signed and dated by the service user and member of staff. One care plan indicated that a service user has difficulties managing finances, a detailed plan had been drawn up with clear guidelines on how to support and assist the service user in this area. At the time of the inspection one service user talked about the advocacy support he was receiving. Two service users were discussing the days’ activities with staff and deciding what to do in the afternoon. Millenia House E56 S17188 Millenia House V242452 UI 020805 Stage 4.doc Version 1.40 Page 10 Risk assessments are included in the care plan. One service users plan included a detailed smoking risk assessment; the action needed to reduce the risk had been discussed and agreed with the service user. Millenia House E56 S17188 Millenia House V242452 UI 020805 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15,16,17 Service users are helped and encouraged to keep in contact with their families and friends 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 manager explained that due to the complex and challenging needs of service users, at times it is difficult to maintain good relationships with the local educational establishments. A therapist and tutor have been recruited since September 2004 and are assisting and encouraging service users with developing and maintaining practical living skills. The nurse in charge explained that activities are at a minimum due to the summer holidays. Records indicate that activities are arranged for a Wednesday for four service users and include drawing and relaxation. Millenia House E56 S17188 Millenia House V242452 UI 020805 Stage 4.doc Version 1.40 Page 12 One service user stated that staff assists him to keep his room clean and tidy and to attend to his own laundry on a weekly basis. One service user care plan included the information of finding paid employment; the nurse in charge discussed the difficulties with this due to the degree of the person’s disability. During the morning of the inspection there was little evidence of any planned therapeutic activity happening. Care staff were standing at the front of the building observing service users having a cigarette, other service users were listening to music or in their rooms. One service user stated that he usually watched television as there ‘is not much else to do’. He stated that he visits the local social club maybe twice a week with other service users and staff. The nurse in charge stated that service users go into Wolverhampton shopping, are enrolled on a fitness programme at Bantock Park, and go to the local pubs and clubs. The nurse in charge discussed the support given to two people who developed a personal relationship whilst living at the home. The two people confirmed during conversations, that the staff are very supportive with their relationship. All service users have key to their own personal bedroom, it was very evident, through discussions and the tour of the building that staff highly respect and ensure the privacy for all service users. A relative visiting the home stated that she is unable to visit regularly because of the distance from her home but she keeps in contact through the phone. When she visits she is made welcome and is able to see her relative in private if they wish. All meals are provided by the catering staff at set times during the day. Three service users stated they could no longer make drinks for themselves when they wish as the facility for doing so has been removed. Drinks are prepared and served to service users at set times of the day. The owner discussed the reasoning behind removing the kitchen facility, it was recommended that this issue be openly discussed at the next service users meeting and a compromise agreed. The care plan evidenced that nutritional needs are assessed and reviewed, prompt action was taken when one service user was losing weight although observed to be having an adequate diet. Millenia House E56 S17188 Millenia House V242452 UI 020805 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20 The health care needs of service users are very well met with evidence of regular review and of good multi disciplinary working taking place on a regular basis EVIDENCE: The care plan evidences access to health care facilities with regular visits to the G.P., dentist, chiropodist etc and when needed to specialist services, speech therapist, addiction services, clinical psychologists and psychiatrists. The home operates a twenty-eight day regime of medication administration using a monitored dose system with some bottles and boxes. Medication is kept to a minimum with surplus medication returned to the pharmacy. All medications received into the home are documented on the medication administration record sheets (MAR), and these appeared to be correctly completed. The registered nurses administer the medication to all service users; consent for the administration of medication must be sought from each service user and documented in the care plan. Millenia House E56 S17188 Millenia House V242452 UI 020805 Stage 4.doc Version 1.40 Page 14 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 Minor amendments to the complaints procedure are needed to ensure that service users have all the correct contact details. EVIDENCE: The complaints procedure is clearly displayed at the entrance to the home. Details of how to contact Commission for Social Care Inspection at any time during the procedure must be included on the document. Service users stated that they are able to discuss any concerns with the staff at any time. The nurse in charge also stated that service users access the advocacy service if they so wish and indeed do so at times. Millenia House E56 S17188 Millenia House V242452 UI 020805 Stage 4.doc Version 1.40 Page 15 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) 24,30 The standard of the environment is good providing service users with a homely and comfortable place to live EVIDENCE: The home is located in the Goldthorn region of Wolverhampton and is in keeping with the residential area. The two-storey property has been converted to accommodate ten people with a learning disability and mental health problems. It is homely and domestic in character with all areas fully accessible to service users. Limited redecoration, routine maintenance and some replacement of carpets have been carried out since the last inspection in September 2004. During this inspection the premises were seen to be clean and hygienic. Millenia House E56 S17188 Millenia House V242452 UI 020805 Stage 4.doc Version 1.40 Page 16 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) 36 The lack of regular supervision and support given to staff has the potential to disadvantage service users in receipt of the individual care that has been identified. EVIDENCE: The staff supervision records inspected evidenced that staff are not receiving regular supervision with their line manager. This was a requirement following inspections in July 2003, May 2004 and September 2004. At these three inspections a date for full compliance with the requirement was agreed with the nurse in charge. It is evident from inspection of the supervision records that the staff are not adequately supervised or supported to enable them to fully meet the service users needs or their individual goals. A further date has been agreed with the nurse in charge for full compliance with the requiremen, that all staff must receive formal recorded supervision at least six times a year Supervision • • • Millenia House must cover All aspects of practice, The philosophy of care in the home And career development needs. E56 S17188 Millenia House V242452 UI 020805 Stage 4.doc Version 1.40 Page 17 Millenia House E56 S17188 Millenia House V242452 UI 020805 Stage 4.doc Version 1.40 Page 18 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) 42 The premises are run and maintained in a safe manner. EVIDENCE: Records indicate that safety checks are carried out at regular intervals. The temperature of the hot water outlets accessible to service users is now regulated to maintain a temperature at close to 43 degrees centigrade. All portable electrical equipment is safety tested annually. Millenia House E56 S17188 Millenia House V242452 UI 020805 Stage 4.doc Version 1.40 Page 19 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 2 3 x x 3 Standard No 22 23 ENVIRONMENT Score 2 x 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 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x x 1 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Millenia House Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x E56 S17188 Millenia House V242452 UI 020805 Stage 4.doc Version 1.40 Page 20 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 20 Regulation 13(2) Requirement The registered person must ensure that service users consent to medication is obtained and recorded in the individual plan. The registered person must ensure that details of how to contact Commission for Social Care Inspection at any time is included on the complaints procedure. The registered manager must ensure that all care staff receives formal recorded supervision at least 6 times per year. Supervision must cover all aspects of practice, the philosophy of care in the home and career development needs. All other staff must be supervised as part of the normal management process on a continuous basis. Annual appraisals must also be undertaken for all staff members to discuss their job descriptions and future training needs.This must now be a priority requirement Timescale for action 1st October 2005 2. 22 22(7)(a) 1st October 2005 3. 36 18(2) 1st October 2005 Millenia House E56 S17188 Millenia House V242452 UI 020805 Stage 4.doc Version 1.40 Page 21 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. 3. Refer to Standard 1 17 Good Practice Recommendations It is recommended that the statement of purpose and service uers guide is given to all service users and discussed at the next service users meeting. It is recommended that the issue of a service users kitchen facility is discussed at the next service users meeting to reach a satisfactory compromise. Millenia House E56 S17188 Millenia House V242452 UI 020805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection 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 E56 S17188 Millenia House V242452 UI 020805 Stage 4.doc Version 1.40 Page 23 - 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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