Inspection on 08/08/06 for Millenia House

This inspection was carried out on 8th August 2006.

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

Millenia House 17/01/06

Millenia House 02/08/05

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

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 Key Unannounced Inspection 8th August 2006 11.25 Millenia House DS0000017188.V306779.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 Millenia House DS0000017188.V306779.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. Millenia House DS0000017188.V306779.R01.S.doc Version 5.2 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 Mr George Dixon Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Millenia House DS0000017188.V306779.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th January 2006 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.V306779.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection is the first of key inspections for 2006/07 and took place over three hours on Tuesday 8th August 2006. It was conducted by one Commission for Social Care Inspection regulation inspector. Twenty four of the forty three National Minimum Standards for Care Homes for Adults (18-65) were inspected on this occasion. Nine people are resident at the home; there have been no new admissions to the home since 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. A recent application has been received for the registration of a small flat for accommodation purposes a tour of the flat was undertaken during this inspection. What the service does well: What has improved since the last inspection? What they could do better: 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. Staff training and development needs must be identified with the relevant courses being initiated. Millenia House DS0000017188.V306779.R01.S.doc Version 5.2 Page 6 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.V306779.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 Millenia House DS0000017188.V306779.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA 1, 2 Quality in this area is good. This judgement has been made using available evidence including a visit to this service. The home provides a brochure and resident guide that clearly sets out the objectives and philosophy of the service and provides good clear information about the home. EVIDENCE: The home has produced a comprehensive and extensive brochure and resident guide detailing all aspects of the service provision. The owner stated that the brochure is available to interested parties. The home has had a stable client group with no new admissions since August 2005. The case file of a resident selected for inspection contained full details of the pre admission assessments carried out by the home and other healthcare professionals prior to making the decision to move in. Millenia House DS0000017188.V306779.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA 6,7,9 Quality in this area is good. This judgement has been made using available evidence including a visit to this service. Staff are sensitive to the individual needs of each service user and meet these in a professional manner. EVIDENCE: The care plans of all the residents have been completely reviewed, each person has been fully involved with developing an individual care programme using the person centred approach framework. The manager stated that the plan of care is reviewed at six monthly intervals and immediately before the specialist review of the care programme approach for people with mental health difficulties. All care plans and relating documentation are stored in one of the two secure offices. The manager explained that at any time the resident is able to access his or her own care plan and has the opportunity to invite relatives or representatives to the regular reviews. One resident spoke about the forthcoming planned review and of the outcomes expected. The plan of one resident was inspected and contained a comprehensive assessment for independent living and social skills assessments. The person in Millenia House DS0000017188.V306779.R01.S.doc Version 5.2 Page 10 charge gave a knowledgeable account of the assistance this person requires with money management and the weekly recreational activities that are organised. In addition this person attends a local community centre each week for a course on relationships and communication organized by a psychologist. One resident discussed the plans for the future and the aspirations for arrangements for independent living. The manager was fully supportive and discussed this and the possible alternatives that may be available. Risk assessments are undertaken and include the action necessary for reducing the risk or possible injuries. The resident is again fully involved with this process and an agreement is drawn up between the home and the resident on risk management. Throughout the inspection, residents were observed to be discussing and conferring with staff about various options about the day’s activities, making a decision, and undertaking the activity. Millenia House DS0000017188.V306779.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA 12,13,15,16,17 Quality in this area is good. This judgement has been made using available evidence including a visit to this service. The service has a strong commitment to enabling residents to develop their skills, including social, emotional, communication, and independent living skills. Individuals are supported to identify their goals, and work to achieve them. EVIDENCE: The manager explained that due to the potential challenging behaviours of some of the residents it is not always possible for inclusion at the local further education establishments. Some residents though do attend the local day centres and have the opportunity for training in social and household skills. One resident has recently declined to attend the day centre for training in money management. Staff at the home have now taken over this training and are supporting and guiding this person to manage finances on a weekly basis. All residents are actively encouraged to access the facilities in the local community. Many visit the shops on a daily basis and outings to the local pub continue where residents enjoy a game of pool and a drink. Millenia House DS0000017188.V306779.R01.S.doc Version 5.2 Page 12 The manager stated that two residents have joined the local drama club and were involved in a recent production of a play. One resident goes to football training weekly. One resident is currently on a family holiday, and another person spoke of his plans to go and visit family and friends over the weekend period. Two people have developed a personal relationship, staff continue to be very supportive in maintaining this relationship and offer guidance in healthcare promotion. All residents have a key to their own bedrooms, have a responsibility for housekeeping tasks and are supported with cleaning their rooms and attending to their own laundry. The care plans have an agreed programme for dealing with these chores. All meals and drinks are provided by the staff at set times during the day. Small fridges have been provided in some bedrooms for the cold storage of drinks and snacks. Residents stated that the food was ‘good’. The midday meal that was prepared by staff looked well cooked and appetising. The home has recently been divided into two living units; each unit has a dining and lounge area. The residents are encouraged to use these facilities but are also at liberty to access other areas of the home should they so wish. Millenia House DS0000017188.V306779.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA 18,19,20 Quality in this area is good. This judgement has been made using available evidence including a visit to this service. The personal and health needs of residents are very well met with evidence of regular review and of good multi disciplinary working taking place on a regular basis EVIDENCE: The case files contain the information on the amount of personal care required by the individual although the manager stated that most people only required occasional prompting to attend to their own personal hygiene. The case files evidence access to health care facilities, with recording of 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 being returned to the pharmacy each month. All medications received into the home are documented on the medication administration record sheets (MAR), and these appeared to be correctly completed. Millenia House DS0000017188.V306779.R01.S.doc Version 5.2 Page 14 The registered nurses administer the medication to all service users. No one living at the home currently has responsibility for the administration of his or her own medication. Millenia House DS0000017188.V306779.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA 22,23 Quality in this area is good. This judgement has been made using available evidence including a visit to this service. The home has an open culture, which enables residents to express their views, and concerns in a safe and none blame environment. EVIDENCE: The home has recently revised and updated the information on the complaints procedure and is included in the brochure and residents guide. A copy is also displayed on the notice board at the entrance to the home. The manager confirmed that no complaints have been made or referred to the other agencies for action. The Commission for Social Care Inspection have not received any complaints or concerns directly since the previous inspection in January 2006. The manager explained that any concerns by the residents are taken seriously and acted upon swiftly. The residents stated that they would see a member of staff if they had any difficulties or concerns. The manager and staff demonstrated a good knowledge in adult protection issues and policies and procedures are available at the home for reference when required. Small amounts of resident’s cash are kept in the office for sundry expenditure. All transactions are recorded and signed for by the staff member and the resident. Millenia House DS0000017188.V306779.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA 24,30 Quality in this area is good. This judgement has been made using available evidence including a visit to this service. The home provides a physical environment that is appropriate to the needs of the residents who live there. EVIDENCE: The home is comfortably furnished, well maintained and homely. Ongoing maintenance and replacement of the fabric continues on an as needed basis. The carpet in the first floor lounge is marked with a spillage of paint. The fire doors on the first floor have been installed in line with the recommendations of the local fire officer following the visit in January 2006. One resident stated that he had been helping out with the gardening and found this enjoyable. The gardens are well maintained and accessible to residents, seating areas have been provided. The laundry is well equipped with domestic type appliances; residents are encouraged to deal with their own washing and ironing. At the time of the inspection all areas of the home were very clean, tidy and hygienic. Millenia House DS0000017188.V306779.R01.S.doc Version 5.2 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 Quality in this area is adequate. This judgement has been made using available evidence including a visit to this service. The service has a good recruitment procedure that clearly defines the process to be followed which ensures the delivery of good quality services and for the protection of individuals. Inconsistencies in the provision of staff training and supervision have the potential for staff not fully meeting the residents’ needs reliably. EVIDENCE: The brochure and residents guide details the skills and experiences of staff at the home and includes registered nurses, (general, mental health and learning disability), and a team of care staff trained to National Vocational Qualification level 2. The manager and nurse in charge demonstrated an in depth knowledge of the current resident group and the challenges that are associated with the disabilities and specific conditions linked with a learning disability and mental ill health. Other staff spoken with also had a good understanding of the residents’ individual needs. Personnel files inspected contained documentary evidence of identity checks, criminal record bureau disclosures and other information needed in the recruitment of suitable staff. All job descriptions have been recently reviewed and revised. Millenia House DS0000017188.V306779.R01.S.doc Version 5.2 Page 18 The person in charge stated that training in the core and specialist areas have been facilitated for staff. It was not possible to evidence this as the personnel file contained only a certificate for fire training in April 2006; a training matrix is not operational. The annual appraisals however contain an identification of the training and development needs. The nurse in charge confirmed that formal supervision for all levels of staff continues. The supervision record of the staff member selected for inspection contained a record dated April 2006 a further date had not been identified. Other supervision records had not been fully completed by the supervisor, signed or dated. Millenia House DS0000017188.V306779.R01.S.doc Version 5.2 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): YA 37,39,42 Quality in this area is good. This judgement has been made using available evidence including a visit to this service. The Manager has the required qualifications and experience and is competent to run the home. He works to continuously improve services and provide an increased quality and stable life for residents. EVIDENCE: The registered manager is a first level nurse with the skills and experience to successfully manage the home. He is supported with a team of knowledgeable staff. The manager was observed to have an excellent rapport with the residents, all appeared to be well at ease and comfortable with each other. The manager discussed the continuing developments in research based best practice and spoke passionately of the role of advocate that he offers to the residents. Regular quality assurance monitoring continues with satisfaction questionnaires offered to residents at intervals. Due to the difficulties with dyslexia and understanding of written information, effective monitoring of residents satisfaction is monitored through the daily informal conversations and Millenia House DS0000017188.V306779.R01.S.doc Version 5.2 Page 20 discussions and with observation of any changes in the behavioural patterns presented. Staff and residents meetings continue at regular intervals, the meetings are minuted and a date for the next meeting is arranged. Monitoring of the health, safety and welfare of residents through safe working practices continues with the necessary weekly, monthly and annual checks being carried out, recorded and any actions identified followed up. Millenia House DS0000017188.V306779.R01.S.doc Version 5.2 Page 21 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 2 3 X 4 X 5 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 3 STAFFING Standard No Score 31 3 32 X 33 3 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 3 X X 3 X Millenia House DS0000017188.V306779.R01.S.doc Version 5.2 Page 22 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 YA35 Regulation Requirement Timescale for action 30/09/06 18(1)(C)(i) The registered person must ensure that all staff receives updates and training in the core and specialist topics. Previous timescale 31/03/06 not fully met 18(2) 2. YA36 The registered person must 30/09/06 ensure that systems are in place for all staff to receive formal supervision at least six times a year. Previous timescale 31/03/06 not fully met RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA24 Good Practice Recommendations It is recommended that the carpet in the first floor lounge be replaced. Millenia House DS0000017188.V306779.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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.V306779.R01.S.doc Version 5.2 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. 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