Inspection on 26/06/07 for Millerbank

This inspection was carried out on 26th June 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 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Millerbank 08/03/06

Millerbank 27/10/05

Millerbank 01/03/05

Millerbank 05/08/04

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

CARE HOME ADULTS 18-65 Millerbank 27 Carlton Road Burnley Lancashire BB11 4JE Lead Inspector Unannounced Inspection 26th June 2007 09:30 Millerbank DS0000009507.V334541.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 Millerbank DS0000009507.V334541.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. Millerbank DS0000009507.V334541.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Millerbank Address 27 Carlton Road Burnley Lancashire BB11 4JE 01282 423686 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) Tranway Associates Limited Miss Kelly Anne Isherwood Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places Millerbank DS0000009507.V334541.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service must at all times, employ a suitable qualified and experienced manager who is registered with the Commission. Date of last inspection Brief Description of the Service: Millerbank is a care home registered to provide accommodation for six younger people, aged 18 to 65, with mental health problems. Tranway Associates Ltd own the home, and the Responsible Individual is Mr Ian Smith. Ms Kelly Isherwood is the registered manager. The home is an older type property close to Burnley town centre and service users therefore have easy access to the town’s facilities. There are 2 single bedrooms and 2 shared bedrooms. None have an ensuite. The home aims to provide a structured environment and routines, which endeavour to meet the needs of individuals, and encourage self - development and independence. There is a statement of Purpose/Service user Guide, which is given to all prospective residents/relatives. This written information explains the care service that is offered, who the owners and staff are and what the resident can expect if he or she decides to live at the home. The fees at the home are £500 per week. There are no additional costs. Millerbank DS0000009507.V334541.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit undertaken over a period of approximately 6 hours on the 26/06/07. The Inspector spoke to the manager; three care staff, and two residents. As part of the inspection process the inspector used case tracking as a means of assessing some of the National Minimum Standards. The process allows the inspector to focus on a small number of people living at the home. All records relating to these persons are examined and the rooms they occupy are looked at. Before the visit the manager completed a survey form, which provided information about how the home is run and what services are available. Residents and relative views were sought which helped in looking at how the home operated and was meeting National Minimum Standards. Comment cards had been sent out before the visit to residents and relatives and four were returned giving their views on what it was like living at the home. Records of two members of staff were also examined. A tour of the premises was undertaken. Examination of the homes documentation, policies and procedures formed the basis of the inspection process. What the service does well: There was good and useful written information about how the residents are supported and what they had agreed to do each day in order to improve and develop their lives. One resident spoken to said, “I have been attending college for woodwork and painting which I like to do”. Millerbank has comprehensive and easy to follow recording systems of the residents care needs, general health and reviews of care ensuring daily events are accurately recorded and residents health needs are continually monitored. Observation of staff talking to and supporting residents was excellent ensuring relationships develop and the manager and staff are aware of resident’s needs and how to support them. It was clear following discussion with the manager and staff they know what each resident likes and dislikes are and when there is Millerbank DS0000009507.V334541.R01.S.doc Version 5.2 Page 6 a problem and can deal with it. One staff member said, “With a small home and staff team we know each other well and are able to support the residents in what they want to do” There is a small staff team that has not changed a lot ensuring stability, development of good relationships, a mutual understanding of the needs of individuals and good communication to ensure the persons feels listened to and are respected. Comments from residents included, “The staff are very good”. And, “I speak to my key worker who I get along with”. A staff member spoken to said, “We Get along fine ”. Training opportunities for staff is good, with access to training courses excellent which helps staff develop their skills and provide a good service. Staff spoken to said, “Yes any training I want to do the manager is very supportive”. Another said, “Very good training opportunities”. There is a qualified mental health nurse employed at the home who has the skills and experience to help and support the residents if needed. A comment from a member of staff said, “Its good to have a qualified nurse on call”. What has improved since the last inspection? What they could do better: The application form for employment must be updated to request a full employment history with any gaps explained to ensure the safety and protection of the residents. Examination of staff application form only requires a five year history of any gaps in employment. Millerbank DS0000009507.V334541.R01.S.doc Version 5.2 Page 7 Some communal parts of the home for example the hallways and residents doors should be redecorated to provide pleasant surroundings for the people to live in. 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. Millerbank DS0000009507.V334541.R01.S.doc Version 5.2 Page 8 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 Millerbank DS0000009507.V334541.R01.S.doc Version 5.2 Page 9 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): 2 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The admission and assessment process is clear and precise to make sure the care needs of the residents are met. EVIDENCE: The records of two residents were examined and had comprehensive assessment information recorded in detail to ensure a thorough care plan could be developed. The written assessments seen confirmed there is involvement of the residents other professionals and where possible relatives, so that everybody who needs to be is involved in the best interest of the residents. A comment from a relative said, “They provide good care for my son and have all the information to do that”. One resident said, “I was given trial visits before coming here”. Staff spoken to had a clear understanding of how the assessment procedures work and are part of the process so that they know how to meet the individual needs of the residents being admitted. One staff member said, “The manager assesses any new residents”. Discussion with staff, the manager and examination of documentation confirm residents are admitted to the home when a comprehensive assessment has been carried out by the manager so that the every person knows that they will be able to meet individual needs and ensure they will be well cared for and Millerbank DS0000009507.V334541.R01.S.doc Version 5.2 Page 10 able to reach there potential. A staff member spoken to said, “We all get involved in the admission process so we are aware of any the needs of residents”. Millerbank DS0000009507.V334541.R01.S.doc Version 5.2 Page 11 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): 6,7,9.Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are helped to make decisions, which supports them in their day-today lives, whilst taking into account risks. EVIDENCE: Two resident’s records were examined and included detailed information about their personal, social, emotional, welfare and healthcare needs to ensure staff know exactly what is needed to provide and promote good quality care to the individual. One survey returned from a resident said, “Planning my weekly days on my care plan helps”. Residents confirmed that they made their own choices in certain aspects of their life, such as going to college, what activities and hobbies to pursue. Resident’s comments included, “I can do what I want to do by structuring my weekly plan”. And, “I choose my activities with staff”. Millerbank DS0000009507.V334541.R01.S.doc Version 5.2 Page 12 Records examined confirmed risk assessments have been updated and regularly reviewed to ensure residents independence and living skills are developed in line with there care plans. A resident said, “I go out on my own to college”. One member of staff spoken to confirmed “All risk assessments have been updated”. Millerbank DS0000009507.V334541.R01.S.doc Version 5.2 Page 13 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): 12,13,15,16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Opportunities for development and community participation are addressed in the care plans, to ensure residents have opportunities for personal development. EVIDENCE: As the home is relatively small, the manager and staff are aware of making sure individual lifestyles are reflective of their needs. This is achieved through recognising individual need, and ensuring support to achieve recognised goals that have been identified on care plans. All were encouraged to learn domestic and living skills, such as shopping and cooking their own meals. One resident is aiming to live independently in the community in supported accommodation. When spoken to he said, “I have been at college learning joinery and painting and decorating”. Another resident spoken to said, “We help cleaning up and cooking”. Millerbank DS0000009507.V334541.R01.S.doc Version 5.2 Page 14 Residents have a range of activities available to them, which included television, music, videos and board games, as well has community based activities, for example trips out to the cinema, shopping and Blackpool. At the time of the visit the residents were going on a day trip to Manchester. One member of staff spoken to said, “I take them in the mini bus they wanted a day in Manchester”. A resident said, “I am looking forward to going”. Menus examined are balanced and interesting. Meal times are set although flexible enough to accommodate preferences. Details of individual preferences and dietary needs were recorded on the resident’s care plan. Residents eating habits and weight are monitored to ensure there health and welfare needs are met. The manager said, “Staff have received food hygiene training”. This was confirmed through examination of staff training documentation. A resident spoken to said, “We help with the shopping and cooking and choose what we like to eat”. Millerbank DS0000009507.V334541.R01.S.doc Version 5.2 Page 15 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): 18,19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents health care is taken seriously and needs are closely monitored ensuring health issues are met. EVIDENCE: There is evidence the home has good access to specialist healthcare services in individual records examined, for the benefit of residents using the service, so that their healthcare needs are met and welfare continuously monitored. The records are well maintained and provide evidence the home works closely with the resident, their family if possible and other professionals so that the staff know all about the specific needs of the individual. The “assertive outreach team” was used at times for additional help and support. A registered mental health nurse was employed part time and supported the residents if required. A member of staff spoken to said, “Its good to have a professional mental health nurse on the staff team”. Staff spoken to had a good knowledge of the individual needs of residents, including their individual preferences, their specific medical needs and their personal choices and preferences. A resident commented, “My keyworker is aware of what I need”. Another said, “I went through my daily programme with staff they are good”. Millerbank DS0000009507.V334541.R01.S.doc Version 5.2 Page 16 Medication practices have been improved and resident’s medication records case tracked were looked at closely ensuring they are protected and there health is maintained. The manager said, “We have improved our policies in relation to medication”. There has been staff training in areas of equality and diversity so that they understand the need to make sure no individual is disadvantaged due to any cultural difference. One staff member said, “We have covered diversity issues in our induction training”. Walking around the building it was clear staff understood respect and dignity for the residents by knocking on bedroom doors before entering. A member of staff said, “It’s a good habit to get into”. Millerbank DS0000009507.V334541.R01.S.doc Version 5.2 Page 17 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. The arrangements for recording and reporting of complaints are good ensuring people feel listened to. The manager and staff have good knowledge and understanding of safeguarding adult issues, which protect residents from abuse. EVIDENCE: New and improved updated complaints procedures have been put in place to make sure any complaints or incidents both major and minor are properly recorded with investigations and outcomes, evidence of this was provided by the documentation examined to support the new policies. The manager said, “We now have any minor incident recorded which would help us spot any trends in behaviour”. A resident spoken to said, “I know how to complain if I want to”. All resident surveys said they knew who to speak to if they had a complaint to make. Staff have attended training in safeguarding adults through Lancashire County Council. They are also attending training with the Learning Disabilities Award Framework (LDAF), and this has been completed for staff to ensure they have knowledge of abuse issues. One member of staff said, “Yes we do abuse work in National vocational Training (NVQ)”. Millerbank DS0000009507.V334541.R01.S.doc Version 5.2 Page 18 Millerbank DS0000009507.V334541.R01.S.doc Version 5.2 Page 19 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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment is safe and clean maintained to a good standard providing comfortable surroundings for the residents. EVIDENCE: A tour of the building found the home to be clean and tidy and residents are encouraged to help with domestic tasks as part of their life skills plan. One resident spoken to said, “I don’t mind helping with the cleaning”. Observation walking around the premises found the decoration and furnishings are maintained to a decent standard ensuring the residents live in pleasant and safe surroundings. However some communal areas of the home for example the hallways and residents doors should be redecorated to improve the home for people to live in. Bedrooms are individually decorated and furnished well. All rooms had good lighting and personalised by the residents themselves to make it feel homely. Millerbank DS0000009507.V334541.R01.S.doc Version 5.2 Page 20 The home has a laundry facility downstairs with policies and procedures in place to control the risk of infection. Millerbank DS0000009507.V334541.R01.S.doc Version 5.2 Page 21 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): 32,34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Recruitment procedures are robust to make sure residents are safe and protected. Training for staff is good ensuring they have the skills and competences to carry out their roles. EVIDENCE: Examination of two staff files confirmed the recruitment procedures of the home are good. Staff records include, application forms, individual photographs, Criminal Records Bureau (CRB) disclosures, Protection of Vulnerable Adults (POVA) disclosures and references were in place to ensure the residents are protected. All checks had been completed prior to commencement of employment. However the application form for employment must be updated to request a full employment history with any gaps explained to ensure the safety and protection of the residents. Both files examined only requested a five year history of any gaps in employment. Training for staff is good records shows the target of 50 of care staff to complete National Vocational Qualification (NVQ) level 2 in care has been achieved over the year with new staff attending the course. One member of staff said, “I am on the list to do my NVQ training”. Each member of staff Millerbank DS0000009507.V334541.R01.S.doc Version 5.2 Page 22 have there own individual record of training, records were examined to evidence this. And new staff now receive “Skills for care” induction training. Comments from staff spoken to all praised the homes training programme and availability to attend courses to ensure they develop and acquire the skills for the job. Comments included, “Excellent induction training”. And, “Any training we want to do we are supported”. Staff records examined confirmed supervision is taking place to ensure development and any issues can be addressed. Millerbank DS0000009507.V334541.R01.S.doc Version 5.2 Page 23 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, 39 and 42.Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed well and systems, policies and procedures are in place for the protection of staff and residents. EVIDENCE: The registered manager has the necessary skills and qualifications required to support the staff, residents and enable the home to meet its stated purpose and objectives. And shows a commitment to continuously develop the home to ensure the standards are high. One member of staff spoken to said. “She is always keen to help and listen to people”. The management team has developed good systems to gather staff, residents and relative’s views as part of his monitoring of quality to ensure the home is run smoothly and effectively. One relative survey returned said, “They look after my son well it’s a good home”. Millerbank DS0000009507.V334541.R01.S.doc Version 5.2 Page 24 The home has an annual development plan in place in order to continue to develop the home to ensure the safety and comfort of the residents. Regular staff and resident meetings are held and recorded and suggestions are carried out if agreed by both parties. Copies of staff meetings were looked at to confirm this. Examination of records for residents confirmed they are comprehensive, well written and up to date ensuring all relative information is on file. Records of money being handled by the manager for residents were up to date, explaining the reason for any expenditure and the balance of the money that was being retained. Millerbank DS0000009507.V334541.R01.S.doc Version 5.2 Page 25 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 4 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 2 35 3 36 X 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 3 X X X X X 3 Millerbank DS0000009507.V334541.R01.S.doc Version 5.2 Page 26 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 YA34 Regulation 19 (1) Schedule 2 Requirement Gaps in full employment history must be explored and explanations recorded. Timescale not met 08/03/06 Timescale for action 30/08/07 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 Refer to Standard YA24 Good Practice Recommendations The home should ensure the premises are well maintained to provide comfortable, pleasant surroundings. Millerbank DS0000009507.V334541.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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 Millerbank DS0000009507.V334541.R01.S.doc Version 5.2 Page 28 - 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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