Inspection on 27/10/05 for Millerbank

This inspection was carried out on 27th October 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Millerbank 26/06/07

Millerbank 08/03/06

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 Mrs Pat White Unannounced Inspection 27th October 2005 10:00 Millerbank DS0000009507.V261424.R01.S.doc Version 5.0 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.V261424.R01.S.doc Version 5.0 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.V261424.R01.S.doc Version 5.0 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 Ltd 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.V261424.R01.S.doc Version 5.0 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. 1st March 2005 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 owned the home, and the Responsible Individual was Mr Ian Smith. Ms Kelly Isherwood was the registered manager. The home is close to Burnley town centre and therefore offers easy access to the town’s facilities. The home aims to provide a structured environment and routines, which endeavour to meet the needs of individuals, and encourage self - development. All the service users had regular ongoing contact with the Mental Health Services multi disciplinary team (MDT) through placement assessments, on going reviews and individual contacts with practitioners. A wide range of policies and procedures, which complied with the Care Homes Regulations 2001 and the National Minimum Standards for Younger Adults, underpinned the care at Millerbank. Service users enjoyed a range of activities, which were regarded as rehabilitative, such as physical out door pursuits, holidays, social activities and shopping outings. They were also expected to carry out household chores in order to enhance everyday living skills. Service users were encouraged and supported in the pursuit of college and educational opportunities. The home received the Investors in People Award in August 2003. Millerbank DS0000009507.V261424.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. SUMMARY OF THE INSPECTION ON THE 27/10/05 This inspection was an unannounced inspection, the purpose of which was to assess important areas of life in the home that should be inspected over a 12 month period, to check the legal requirements and recommendations from the previous inspection and to check any other matters which came to the inspector’s notice. The inspection took 6 hours 30 minutes, and comprised of talking to service users, looking round the home, looking at service user’s care records and other documents, and discussion with the registered manager, Kelly Isherwood. A member of staff was spoken with. There were 5 service users in the home at the time of the inspection. Four service users spent time in conversation with the inspector; one refused. Some of their comments are included in the report. Comment cards were left for service users and relatives to complete and return to the CSCI. Two from service users and one from a relative, were completed and received prior to the writing of the report. Note. This summary is particularly aimed at service users, and the home should ensure that the full report is widely available to all those who are interested. What the service does well: Ian Smith and Kelly Isherwood (the management team), made sure that Millerbank was the right place for service users to live, by meeting them before they came to live there and finding out about their needs. Service users spent time in the home before going to live there. This made sure that the staff working in the home knew what they needed to do to support people. The written information about service users’ needs was detailed and useful. There was good and useful written information about how the service users should be supported and what they had agreed to do each day in order to improve and develop their lives. Service users were encouraged to do as many things for themselves as possible and to choose what they wanted to do and where they wanted to go. Millerbank DS0000009507.V261424.R01.S.doc Version 5.0 Page 6 Service users stated that they appreciated the support and help given to them by the staff. One resident stated that he had been “surprised and pleased” by how much support he had received. Millerbank has consistently offered the service users very good opportunities to improve and develop themselves, such as educational and leisure activities. The routines of the home were also beneficial to the service users and as one service user said they “gave structure and purpose to the day”. The meals and food served at Millerbank has been consistently praised for being healthy, appetising and enjoyable. The home and the service users benefited from strong and consistent management, and from a manager who is determined to improve the standards in the home Millerbank provided the service users with a safe, pleasant and homely environment. What has improved since the last inspection? What they could do better: All the legal requirements and good practice recommendations from the previous inspection had been met. None were made at this inspection. Millerbank DS0000009507.V261424.R01.S.doc Version 5.0 Page 7 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. Millerbank DS0000009507.V261424.R01.S.doc Version 5.0 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.V261424.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 & 4 The admission procedures, including the pre admission assessment and trial visits to the home, assisted prospective service users to make a decision about whether or not they would want to live at Milerbank, and whether or not their needs could be met. The home was meeting the needs of the service users who appreciated the improvement in their lives and the support from the staff. EVIDENCE: The admission procedures, including the procedures for assessing prospective service users’ needs and prior visits to the home, helped to determine whether or not a placement at Millerbank would be appropriate. The inspection methods showed that the service users’ emotional, psychological and physical needs were being met. The registered manager ensured that these needs were met according to relevant clinical guidance, and that staff had the necessary knowledge and skills. Any restriction on choice and freedom were part of the care plan, and agreed with the multi disciplinary team. Service users spoken with indicated that they felt their needs were being met. One stated that he would like his trial placement to be made permanent. Three others stated that they felt their lives had improved since living at Millerbank and that they appreciated the opportunities available to develop. Millerbank DS0000009507.V261424.R01.S.doc Version 5.0 Page 10 Two service users had come to live at Millerbank since the previous inspection. The inspection methods indicated that they had both spent time in the home on introductory trial visits. Millerbank DS0000009507.V261424.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 The written information about service users in the care plans was detailed and comprehensive, and assisted staff in understanding service users’ needs. Service users were assisted in making choices, and taking risks, to promote independence. EVIDENCE: Millerbank DS0000009507.V261424.R01.S.doc Version 5.0 Page 12 All the service users had detailed and comprehensive care plans that provided useful information for the staff. These care plans included the “Care Programme Approach” assessments and care plans, and the “Proposed Package of Care” completed by the management team. They described detailed individualised procedures for service users and described any restrictions on choice and freedom that were agreed through the multi disciplinary team, for example alcohol consumption, home leave and going out alone. This was based on risk assessments. There was evidence that the service users were involved in the development and regular reviews of their care plans. Service users confirmed that they made their own choices in certain aspects of their life, such as going to college, what activities and hobbies to pursue. One service user was benefiting from being encouraged to pursue his interest in music. One service user was learning how to manage his finances. Staff enabled service users to take responsible risks, such as going out alone and restricted consumption of alcohol (see above). There were procedures for unauthorised absences from the home. Millerbank DS0000009507.V261424.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Service users benefited from a wide range of opportunities for personal development, including educational and leisure activities. The routines of the home gave useful structure and purpose to service users’ time, whilst also allowing individuals choice and taking into account their preferences. Service users appreciated and benefited from meals that were healthy and enjoyable. EVIDENCE: Service users were encouraged and supported in their personal selfdevelopment through educational, community and leisure activities. Since the last inspection two service users had become independent enough to leave Millerbank to live in supported accommodation. Three of the present service users attended college courses. Regular visits to the gym were encouraged. Service users’ links with the community included going to pubs, shopping, the cinema and restaurants. Two service users had been to London, on their own, to stay with a relative. A one weeks holiday was included in the contract price, and this year service users had been to Minehead. Those spoken with said they had enjoyed this Millerbank DS0000009507.V261424.R01.S.doc Version 5.0 Page 14 time. One service user stated that it had been a long time since he had enjoyed a holiday. Service users spoke in positive terms about the routines and activities at Millerbank and felt that they “were good for them”. One service user stated that they gave him a “structure and purpose to the day”. Service users were supported to develop and maintain positive personal relationships. Appropriate links with relatives were encouraged, and several service users visited their families, and relatives visited the home. Service users were given advice and support in intimate personal relationships. Service users had some choice regarding activities and routines, for example one service user was concentrating on music rather than taking part in all the physical activities. Service users accepted that doing some household tasks, such as cleaning and food preparation, are part of normal everyday life and are useful routines to maintain for future independent living. Service users benefited from a healthy eating programme, which they helped to plan. Service users stated that they enjoyed the food served and one service user confirmed that she was responsible for her own food with staff help and support. Millerbank DS0000009507.V261424.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 & 19 Service users felt that their right to privacy was upheld and that staff treated them with respect. They were supported to maintain their physical and psychological health, and at the time of the inspection these health needs were being met EVIDENCE: The present group of service users did not require support with personal care. The inspection methods, including talking with service users and those who completed comment cards, indicated that staff respected their rights to privacy, treated them with respect and assisted them to make choices. Discussion with the manager and service users, and looking at records, showed that the service users’ physical and psychological health was monitored and matters addressed. All service users were part of the Care Programme Approach (CPA) and had regular contact with members of the community mental health team. Health screening was made available to those who agreed. Staff offered emotional support when needed, and this was confirmed in discussion with the service users who said that staff were supportive and available. The “assertive outreach team” was used at times for additional support. Millerbank DS0000009507.V261424.R01.S.doc Version 5.0 Page 16 The systems and procedures for the service users’ medication were not fully assessed at this inspection but it was established that the 2 requirements made at the last inspection had been met. Millerbank DS0000009507.V261424.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Service users had various ways to voice their concerns, including a complaints procedure, and there were appropriate policies and procedures to help protect service users from abuse. EVIDENCE: The home had a complaints procedure which was in accordance with Regulation 22 and this standard. Service users also raised issues of concern in one to one discussions with staff. At the time of the inspection the manager was dealing with some complaints made about the behaviour of another service user. The service users informed the inspector that they had no complaints to make, that they “felt safe” living in the home, and that they knew who to speak to if they were unhappy about any matters. Since the previous inspection an anonymous complaint had been made to the CSCI about some staffing matters and a broken fridge door. The CSCI passed this to the management team at Millerbank to investigate. The CSCI considered the matters to be fully and satisfactorily investigated and no further action was required Millerbank had policies and procedures for responding to suspicion and allegations of abuse. These included a policy on the preclusion of staff involvement in service users’ wills and gratuities. The inspector was informed that staff were given guidance on how to deal with difficult and aggressive behaviour by service users. Millerbank DS0000009507.V261424.R01.S.doc Version 5.0 Page 18 The registered person’s insurance covered the service users’ personal possessions, and valuables could be kept locked and secure. Millerbank DS0000009507.V261424.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 The premises were clean, well maintained and decorated. The home provided the service users with a comfortable and homely environment in keeping with the service users’ age group and tastes. EVIDENCE: The home’s premises were suitable for their purpose. The property is a large older, end of row terrace, close to the town centre. The home was well maintained and tastefully decorated and furnished. One bedroom had been decorated and refurnished since the previous inspection. As a home in existence before the National Minimum Standards were implemented in April 2002, Millerbank is exempt from meeting the standards on communal living and private space. The communal and private living space was the same as prior to April 2002. An extension was planned for office/ staff accommodation and a WC with disabled access. The registered person must submit the architect’s plans to the CSCI and consult with the fire service. The home was clean and fresh at the time of the inspection. Laundry facilities were sited in the basement. At previous inspections it was established that the home had infection control policies, and one for the COSHH. Millerbank DS0000009507.V261424.R01.S.doc Version 5.0 Page 20 The member of staff designated as the “house assistant” was trained to NVQ level 2 in infection control. Millerbank DS0000009507.V261424.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 The home’s staff training programme was being developed according to Government guidelines, and the needs of the service users and staff. This will ensure that staff have the necessary skills and competencies. The home’s recruitment procedures helped to protect service users from the employment of unsuitable staff. EVIDENCE: The staff training programme was constantly under review and development, to ensure that support workers have the skills and competencies to meet the service users’ needs. The target of 50 of staff being qualified to at least NVQ level 2 by the end of 2005 had been achieved. Other members of staff, including the deputy manager, were enrolled for NVQ courses. The staffing levels were sufficient staff to meet the needs of the service users and have consistently been at a satisfactory level. Support workers were rostered according to the needs and activities of the service users. Regular staff meetings were held. Staff recruitment procedures were in accordance with legal requirements but the registered manager was advised that employment, or college based, references should always be obtained if at all possible. Since the previous inspection the home’s Induction training had been developed according to Government guidelines. A new member of staff Millerbank DS0000009507.V261424.R01.S.doc Version 5.0 Page 22 confirmed that he had undertaken an Induction course based on “Skills for Care” specifications. Staff attended courses on first aid, protection of vulnerable adults, medication and “dealing with drug related incidents”. Although the standard on staff supervision was not assessed, the member of staff spoken with stated that he was well supported by the registered manager and other members of staff. Millerbank DS0000009507.V261424.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 & 42 The service users benefited from strong leadership and a well run home. The manager was well qualified and competent. The service users were involved in the running of the home and could express their views through quality monitoring surveys and meetings. The health and safety practices and procedures ensured a safe environment for service users and staff. EVIDENCE: Since her appointment about 4 years ago, the registered manager has consistently demonstrated strong leadership and commitment to raising standards, and commitment to meeting the Care Homes regulations and the National Minimum Standards for Younger Adults. She has the relevant qualifications required for the registered manager and has demonstrated commitment to ongoing learning. Mr Ian Smith, the owner and responsible individual, supports the manager. Staff and service users view both the registered manager and the owner as being supportive and approachable. One relative who completed a comment card also agreed with this view. Millerbank DS0000009507.V261424.R01.S.doc Version 5.0 Page 24 A quality monitoring survey had been completed in 2005. This survey had included the views of service users and relatives and also included the views expressed in meetings. There were regular service user meetings. The health and safety of staff and service users was promoted. One member of staff had been appointed as the “health and safety representative” and was responsible for this aspect of the home. The fire safety precautions were satisfactory, and the fire equipment appropriately tested and maintained. The gas and electrical installations had current certificates of testing, and the portable appliances had been recently tested. There was a person competent in first aid on every shift. The staff training programme included health and safety training according to Skills for Care specifications. Millerbank DS0000009507.V261424.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 3 3 x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 4 13 3 14 x 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 3 x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Millerbank Score 3 3 X x Standard No 37 38 39 40 41 42 43 Score 3 3 3 X X 3 x DS0000009507.V261424.R01.S.doc Version 5.0 Page 26 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. Standard Regulation Requirement Timescale for action 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 Standard Good Practice Recommendations Millerbank DS0000009507.V261424.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB 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. 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