Inspection on 26/03/07 for Mirabeau

This inspection was carried out on 26th March 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 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

Mirabeau 23/01/09

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Mirabeau Sheepcotes Lane Witham Essex CM8 3PJ Lead Inspector Ray Burwood Unannounced Inspection 26th March 2007 09:00 Mirabeau DS0000068335.V334437.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 Mirabeau DS0000068335.V334437.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. Mirabeau DS0000068335.V334437.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mirabeau Address Sheepcotes Lane Witham Essex CM8 3PJ 01376 585599 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) mirabeau@zerothreecarehomes.co.uk Zero Three Care Homes LLP Mrs Melanie Wilkinson Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Mirabeau DS0000068335.V334437.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection New Service Brief Description of the Service: Mirabeau is a Registered Care Home providing twenty-four hour support to six adults with a learning disability (potentially mixed gender, age range 16 to 25). The Registered Provider is Zero Three Care Homes Limited Liability Partnership. The home has the advantage of being located in a rural setting close to excellent community facilities including a shop; post office; library and pubs. There are bus links to towns in the area and a rail link close by. Other facilities within easy reach are churches; sports and leisure; colleges and parks. The property is situated down a quiet lane over looking fields to the front and rear. The grounds extend over one acre with a patio area at the rear that overlooks gardens and an orchard. The home provides six single rooms furnished to a high standard, four upstairs and two on the ground floor. Communal facilities include a kitchen diner, a separate dining area and a large lounge area. Parking is provided to the front of the property. Fees are primarily based on the care needs and requirements of the individual. The baseline cost of care is £2003:45 per week with any additional costs for individual support time over and above the baseline fee charged at £11:26 per hour. Mirabeau DS0000068335.V334437.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced Key Inspection was carried out on the 26th March 2007 with the assistance of the Registered Manager, people living at Mirabeau and staff, my thanks to them all. The inspection of the home was conducted between the hours of 10:30am and 3.00pm. This was the first inspection for the service since being registered in 2006. The inspection involved a tour of the premises, looking at records, documents, and talking to people who live at the home. Surveys were received from people who live at the home and relatives before the day the inspection took place. A total of 21 standards were inspected and all were found to meet the National Minimum Standards (NMS), some standards were exceeded. At the end of the site visit, the findings were discussed with the Registered Manager and staff What the service does well: The home is managed well by an experienced and qualified manager and provides a high standard of accommodation and care. The premises are clean, fresh and well maintained. Care planning and record keeping is well maintained with the needs of people living in the home continually assessed so any changes in their health, social and recreational needs are addressed. Furniture and fittings are of a good quality and provide individuals with a comfortable home to live in. The staff team is stable, appropriately trained and sympathetic to the needs of people living at Mirabeau. The home is professionally run, with high standards. One relative said staff were understanding and could be trusted to provide a family home atmosphere. Another relative said Personal healthcare needs are well-supported and social activities promoted and encouraged. People living in the home and staff spoken with during the inspection said the home provided the support to enable people to live and work in a pleasant environment. Mirabeau DS0000068335.V334437.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Mirabeau DS0000068335.V334437.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 Mirabeau DS0000068335.V334437.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. The home’s assessment process is well managed and ensures that admissions are not made to the home until a full needs assessment has been undertaken. EVIDENCE: The home’s pre-assessment procedures and records were examined and provided evidence that all areas of need were covered and prospective residents and their families/professionals were involved in the process. The home’s Manager (or nominated other) conducts assessments for admission to the home that includes identified risks to establish if the home can provide the appropriate care required. Prior to admission, people are welcome to visit the home for short periods, meals, or overnight stays following consultation, where possible, with current people who use the service. Mirabeau DS0000068335.V334437.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. Care plans provide detailed information so that that the needs of people living in the home are identified and how their needs are to be addressed. Residents are consulted and supported by staff in making decisions about their lives EVIDENCE: The care plans of three residents were sampled and inspected during this inspection visit and found to contain evidence that they are supported in developing their social and interpersonal skills and assisted in taking control of their lives within a risk management framework. People living in the home were observed in making decisions about going out into the local community by themselves or having a member of staff with them. Mirabeau DS0000068335.V334437.R01.S.doc Version 5.2 Page 10 Care plans provided sufficient information and guidance for staff in addressing individual needs; choices and aspirations. There was evidence to confirm that people living at the home and their relatives had been consulted and had been involved with developing their support plans. The home’s manager and key-workers are responsible for ensuring that agreed plans are implemented effectively through regular staff and residents meetings. Staff spoken with said that consistency of approach and supporting individual needs was improving the personal development and self-esteem of some people who live at the home. Observations made during the site visit confirmed that good relationships had been developed between staff and residents. One resident who found it difficult to go out of the home was observed in going out for walks with their key-worker. Plans are regularly reviewed, evaluated and changes made as individual needs dictate. Formal reviews are held after four to six weeks after admission and every six to twelve there after. Risk assessments seen in each of the residents care plans focussed on them being able to take appropriate risks that promoted their independence, but at the same time identifying the appropriate degree of support to minimise risk. Mirabeau DS0000068335.V334437.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. Links with the community are well managed, support and enrich the social and educational opportunities of people living in the home. The meals are good with evidence that people living at the home are involved in the process and are offered quality meals and choice. EVIDENCE: Residents care plans inspected contained a Weekly Schedule based on their likes, dislikes and preferences in terms of how they wished to spend their time both in the home and in the community. Residents attend a range of educational, social and leisure activities supported by professionals and the home’s staff team. Mirabeau DS0000068335.V334437.R01.S.doc Version 5.2 Page 12 One person living at the home attends a horticultural placement that enables them to participate in a gardening course. Another person is soon to start the same project. One of the people spoken with said they were looking forward to the better weather so that they can plant flowers and work in the home’s gardens. Someone else living at the home said they looked forward to their daily programme that they had chosen particularly their daily morning walks. Residents who wish, access community facilities and activities in line with their level of ability. Those who find it difficult to be part of certain activities are encouraged to participate in walks with a member of staff or group/individual outings using the home’s vehicle. Two residents access public transport and have bus and rail cards. As residents become more confident, activities such as horse riding; swimming; visiting pubs and using the local shops and café’s are encouraged. A group of residents support the local village football team at weekends by attending the teams’ home matches. Two people living at the home attend school during weekdays and were observed on their return to the home in the afternoon. Although communication was difficult one service user indicated that they enjoyed school but found it tiring. Contact arrangements with parents, relatives and friends are well managed with the home encouraging visits. Some residents spend weekends with their families with staff supporting the visits through the transport arrangements. One relative said they receive a telephone call every Tuesday from someone living at the home and they come home for weekend visits every third weekend. All residents are actively involved at some stage in the food-planning programme from menus to shopping. On the morning of the inspection one resident was observed to be involved in planning a food-shopping trip with staff. A four weekly menu is in place with some residents able to assist with the preparation, cooking of food and cleaning and clearing up following meals. Snacks and drinks were observed to be available during the day. Mirabeau DS0000068335.V334437.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20. People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service The health care needs of residents are managed effectively, ensuring that their wellbeing is supported. EVIDENCE: Observations undertaken during the inspection visit to this service provided good evidence that residents’ privacy; dignity; independence and control over their lives was encouraged and supported by the management and care provided by staff. Information relating to how personal support for people living at the home is provided was noted in their individual care plans. Continuity and consistency of support for residents is provided through a keyworker system in which they choose a specific carer whenever possible. As some of the people living at the home have limited verbal communication skills a system of observations and picture cards helps to ensure their wishes are met. Mirabeau DS0000068335.V334437.R01.S.doc Version 5.2 Page 14 Residents’ care plans examined provided evidence that appropriate healthcare services are available, accessed, and fully recorded following referrals/outcomes. Access to health care professionals such as Opticians, Dentists, hospital services and routine health checks were provided and well documented. The home is served by the local G.P. surgery who provide a 24-hour call out service. However, people living at the home are encouraged to visit their G.P. whenever possible. The management of medication was found to be of a good standard with appropriate ordering, administration and the recording of medicines by staff. The registered manager oversees the disposal of medication. The home operates the Monitored Dosage System (MDS) and is supported by the local Pharmacist who undertakes periodic checks on the home’s administration and recording systems. All staff had received medication training and are responsible for the administration and recording of medications. Mirabeau DS0000068335.V334437.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. Arrangements for the protection of residents are good, ensuring that they protected from harm and abuse. EVIDENCE: The home’s complaints policy and procedures were clearly set out and openly available to residents, visitors and staff. The home has not received any complaints since it was registered in 2006. Information regarding the home’s complaints procedures and to whom individuals may wish to consult, including the Commission for Social Care Inspection (CSCI) is contained in the home’s Statement of Purpose and Service User Guide. Adult/Child Protection policies and procedures were in place for staff guidance and available to individuals should they wish to access the information. Staff spoken with confirmed that they had received the appropriate protection training and guidance during their induction period and Learning Disability Award Framework (LDAF) training. Mirabeau DS0000068335.V334437.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. The standard of the environment within this home is good, providing people who live at the home with an attractive and homely place to live. EVIDENCE: The home’s environment has been designed to meet the individual needs and lifestyles of the people it accommodates. The house has been renovated and alterations made prior to it being registered in 2007. The home is situated close to local facilities as well as being homely, clean, safe, comfortable and suitable for it’s stated purpose. Mirabeau DS0000068335.V334437.R01.S.doc Version 5.2 Page 17 A tour of the premises, communal areas and grounds found that they are accessible, furnished to a good standard and meet the requirements of the local fire service and environment health department. The home has a planned maintenance and renewal programme for the renewal of fabric and decoration. Laundry facilities are domestic in nature and provide hand-washing facilities. Policies and procedures for the control of infection are in place and appropriate COSHH Records maintained on cleaning materials. Mirabeau DS0000068335.V334437.R01.S.doc Version 5.2 Page 18 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. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. Staff at the home are trained, supported and employed in sufficient numbers to meet the complex needs of residents. The home operates a robust recruitment process that helps to ensure the safety of people living in the home. EVIDENCE: Zero Three provides staff with a comprehensive training programme that includes statutory training in line with the National Minimum Standards (NMS) and detailed training in working with residents who present with challenging behaviour. The home’s induction programme follows the guidance in line with the LDAF requirements, Skills for Care and includes further foundation and NVQ training. Mirabeau DS0000068335.V334437.R01.S.doc Version 5.2 Page 19 Staff spoken with said the training opportunities are good and relevant to the work they carryout. The home employs a total number of fourteen members of staff of which thirteen are Support Workers. Staff rotas examined provided the evidence that sufficient numbers of staff are on duty to meet the needs and lifestyles of people living at the home. Of the total number of Support Workers employed, four are qualified to NVQ Level 2 or above with a further ten staff starting the Level 2 course in April 2007. Staff training undertaken following needs identified during supervision and appraisals since the Registration of the service includes: • • • • • • • • • • • • • • Service Philosophy. LDAF and NVQ. Learning Disability (Meaning). Record Keeping and Confidentiality. Accident and Incident Reporting. Adult Protection and Abuse. Challenging Behaviour. Medication, Fire, Manual Handling. Health and Safety. First Aid. Food Hygiene. Studio Three. Sensory Integration Training. Autism. The files of two members of staff were examined and found to contain information and checks required before staff are able to commence work at the home. Also included in files, was information relating to training qualifications, employment contracts and job descriptions. Mirabeau DS0000068335.V334437.R01.S.doc Version 5.2 Page 20 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. People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. The management of the home is good ensuring that the health and safety of residents and others are promoted. The systems for resident consultation helps to ensure their views are being both sought and acted upon. EVIDENCE: The Registered Manager of the home is experienced and competent to manage the service in an effective and professional manner. The Registered Manager is qualified to NVQ Level 4 in Care and has completed the Registered Managers Mirabeau DS0000068335.V334437.R01.S.doc Version 5.2 Page 21 Award (RMA), the Registered Manager is also an NVQ Assessor for levels 2,3 and 4. Pre-inspection documentation was received from the home in good time and contained comprehensive information in readiness for the Key Inspection of the service. As previously outlined in the training completed (Standard 33) the Registered Manager undertakes periodic training and development in meeting Skills for Care specifications to maintain their skills, knowledge and competence whilst managing the home. One relative who completed a survey before the unannounced inspection said the Registered Manager was always approachable and is clearly a very experienced person, and has the appropriate knowledge base and relevant skills. Feedback from questionnaires and interviews with people who live at the home and staff were positive about the standard of care, support, and the commitment of the management team Quality assurance and quality monitoring of the service based on seeking the views of residents are difficult due to their ability to communicate. However, a range of communication aids is used to help such as close contact, regular keyworker discussions, observations and the use of picture cards to find out their views. For the more able resident a monthly Voices and Choices meeting is held. The Senior Partner of Zero Three carries out monthly Regulation 26 visits and together with staff meetings, aid the development of the monitoring system. Certificates for gas appliances, electrical installations and insurance cover were seen to be in place and up to date. Staff training and development files included health and safety training in safe working practices. A nominated member of staff undertakes health and safety responsibilities for the home. Mirabeau DS0000068335.V334437.R01.S.doc Version 5.2 Page 22 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 CONCERNS AND COMPLAINTS CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score Standard No 22 23 Score 3 3 3 3 X 3 X ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000068335.V334437.R01.S.doc LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Mirabeau Score 4 3 3 X 4 X 3 X X 3 X Version 5.2 Page 23 New Service. 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 Mirabeau DS0000068335.V334437.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Mirabeau DS0000068335.V334437.R01.S.doc Version 5.2 Page 25 - 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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