Inspection on 20/02/07 for Mrs Floretta McLune

This inspection was carried out on 20th February 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Mrs Floretta McLune 29/09/07

Mrs Floretta McLune 23/02/06

Mrs Floretta McLune 25/08/05

Mrs Floretta McLune 23/02/05

Mrs Floretta McLune 16/09/04

Mrs Floretta McLune 23/03/04

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

CARE HOME ADULTS 18-65 Mrs Floretta McLune 10 Maple Leaf Drive Marston Green Solihull West Midlands B37 7JB Lead Inspector Kath Strong Key Unannounced Inspection 20th February 2007 10:00 Mrs Floretta McLune DS0000004550.V328478.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 Mrs Floretta McLune DS0000004550.V328478.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. Mrs Floretta McLune DS0000004550.V328478.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mrs Floretta McLune Address 10 Maple Leaf Drive Marston Green Solihull West Midlands B37 7JB 0121 770 8931 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) Mrs Floretta McLune Mrs Floretta McLune Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Mrs Floretta McLune DS0000004550.V328478.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 4 places for adults, under 65 with a learning disability. Use of the room measuring 7.9sq metres to be reviewed when vacated by the current permanent service user, and prior to the possible admission of any future service users to this room. 23rd February 2006 Date of last inspection Brief Description of the Service: 10 Maple Leaf Drive is an attractive five-bedroom family home in the Marston Green area of Solihull. It is situated in a pleasant newly built private estate. There is a bus route and local amenities within walking distance of the home. The main Chelmsley Wood shopping centre is a short car or bus ride away. The home caters for younger adults who have a learning disability. It is registered to provide care for four people on a long-term basis and intends to apply to Commission for Social Care Inspection (CSCI) to increase the occupancy to five persons. A condition placed upon this service by CSCI is that the residents who reside at the home must know persons who may be admitted for respite care and confirm their satisfaction with the arrangement. Each resident has their own bedroom one of which has an en suite shower and WC. There is a separate bathroom containing a bath with shower over, a wash hand basin and toilet. Bedrooms and the communal bathroom are located on the first floor. The ground floor includes a front lounge, which is used as a music room, a large rear lounge, a spacious kitchen dining room and an extensive conservatory. There is a further toilet on the ground floor. The home does not have any specialist equipment; all service users are fully mobile. Care and support, is provided in the main by Mrs McLune and her family. Mrs McLune lives in the property with her husband. The philosophy of the home is that the residents are considered to be members of the family. The current fee rates range from £367.00 to £633.00 per week. Mrs Floretta McLune DS0000004550.V328478.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced fieldwork visit was carried out over a period of a short day. There were four residents living at the home on a permanent basis at the time of the visit. Information was gathered from speaking with residents and staff. Care and personal needs, health and safety and medications were assessed. Staff personnel files were checked and staff were observed whilst performing their duties. A full tour of the premises was carried out. At the conclusion verbal feedback was given to the registered manager. No immediate requirements were made. The registered manager lives on the premises and is planning to move into her own home. Residents are aware of this arrangement and appear to accept the changes this will incur such as having a fifth resident and recruitment of more staff to ensure that all health and personal care needs will be met. What the service does well: There is a strong family atmosphere and a resident advised that she likes living at the home. Residents are encouraged and supported in leading an independent lifestyle and they also maintain and clean their own bedrooms to promote a responsible way of living and to extend their skills. Residents have a tailored weekly programme of activities, which includes training and a varied range of in-house and external activities and hobbies. It is a family run business and residents consider themselves to be part of the family. There is strong emphasis on health and safety to prevent residents from being put at risk of injury. The home has a history of providing a good service. There was good evidence that the home takes appropriate action in adverse circumstances and CSCI are advised of any accidents or concerns. When equipment is in need of repair the home has a policy of replacing it. Mrs Floretta McLune DS0000004550.V328478.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. Mrs Floretta McLune DS0000004550.V328478.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 Mrs Floretta McLune DS0000004550.V328478.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home gathers pre-admission information from other sources and carries out its own assessment to demonstrate that it is able to meet the person’s needs. EVIDENCE: Plans are in place to increase the number of occupants from four to five places and for a new registered manager to be appointed. Once these arrangements are confirmed the statement of purpose and service user guide will require amendment. The resident whom previously received respite care was confirmed as being permanent since early 2006. The home had carried out assessments during the short stays and had a good amount of information about the persons long term needs. Other residents were consulted about the permanent placement. It appeared that assessments are built on and further information is gathered from other external professionals before a placement is offered. The home has a written procedure about enquiries and the processes it should follow when considering an admission, this includes aspects of health and safety and the contents of the bedroom. Mrs Floretta McLune DS0000004550.V328478.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents assessed needs are clearly described in their individual care plan to ensure that staff are fully informed about the support needed. Staff encourage and support residents in making decisions about the way in which they wish to live and relevant risk assessments are developed concerning residents decisions. EVIDENCE: Care plans contained good details about the activities of daily living, likes and dislikes and individuals’ aspirations and goals. Residents can choose how they wish to spend their day, leisure time and what they spend money on. Discussions were overheard during lunch; residents were being consulted about what they would like to do for the rest of the day. Each care plan included risk assessments for the range of activities the person pursues. Mrs Floretta McLune DS0000004550.V328478.R01.S.doc Version 5.2 Page 10 One resident retains and handles her own personal finances. She is escorted to the bank for safety reasons, when making withdrawals. The arrangements for the safekeeping and financial transactions of personal monies held on behalf of the other three residents are satisfactory. Residents are protected from financial abuse. Mrs Floretta McLune DS0000004550.V328478.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures that residents have a varied and meaningful lifestyle. Personal and family relationships are encouraged and supported. A wholesome and varied diet is offered and specialist dietary needs are catered for. EVIDENCE: Each person has their own weekly programme of opportunities, lifestyles and experiences. One resident goes to college three times per week and has computer lessons. He also goes to a ‘drop in centre’ and occasionally goes to a cinema during the evening. He goes out shopping with staff and may use the opportunity to have a pub lunch. He also goes home every week to visit his family. Another resident goes to a club and meets up with her boyfriend when attending college. One individual enjoys going to a pub for a drink and another recently attended a Valentines dance, goes swimming regularly and has a ’Ring and Ride registration card to access the community. Mrs Floretta McLune DS0000004550.V328478.R01.S.doc Version 5.2 Page 12 Regular residents meetings are held and the discussions are documented. Agenda items include holidays and preparation for them such as the resident who is planning to go to Australia with his father. Other topics include the registered managers arrangements for retirement and specific issues about improvements made in individual peoples well being. Advice was given that meals are planned one day in advance to assist residents in retaining the information. All residents make requests or suggestions until they all agree. The main meal of the day is served in the evening. Lunch was served during the visit, it consisted of soup, bread or toast and yoghurt and/or fresh fruit. One resident is unable to have dairy products and the home has adapted the diet to accommodate this. There were conversations held throughout the meal and there was a light hearted and friendly atmosphere noted. Mrs Floretta McLune DS0000004550.V328478.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, 20 and 21. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ healthcare needs are well met and these are reflected in the care plans. Staff practices regarding medications are good and protect residents from risks of harm. EVIDENCE: Each resident has a written care plan. This identifies the assessments carried out and the care needs that staff should deliver to promote the resident’s health and well being. Individual health care plans were noted to have been developed for each resident and they were currently being updated. The files were indexed and presented in a logical format for ease of access by staff. Information was found to be comprehensive and included physical and mental health conditions and unpredictable behaviour patterns were well documented and what staff should do in response. Long and short term goals have been listed and a description of action taken by staff towards making them happen. Information included details of what residents could do for themselves and what supervision and care staff need to deliver. This ensures that residents maintain their independence and daily living skills. Relevant risk assessments Mrs Floretta McLune DS0000004550.V328478.R01.S.doc Version 5.2 Page 14 had been carried out for a variety of activities and these were being regularly reviewed and updated. A range of health professionals continue to be involved in healthcare needs and well person checks. With the assistance of Speech and Language service the home has recently introduced individual healthcare plans that are written in simple English and are accompanied by pictorial signs to explain the text. These have been signed by the GP to confirm the contents as being correct and residents have a better understanding of their healthcare needs. Medication is stored in a locked cupboard. The arrangements for ordering, receipt, administration, storage and disposal of medications were reviewed. These were found to be satisfactory and ensure that residents receive their prescribed medications. Medications received from the pharmacist are routinely audited. The Primary Care Trust (PCT) had recently carried out a check of the arrangements for medications and a discussion was held about a problem that staff were unable to rectify. Prescriptions issued by the GP do not give clear guidance regarding PRN (as required) medications. Information was given that PCT will be assisting the home in resolving this problem. The home has written policies regarding medications and homely remedies to provide staff with a clear understanding of the task. Staff have completed training in safe administration of medications to ensure their competency. Staff have undergone training in death and bereavement and there are written procedures to give them guidance in this aspect of care. Mrs Floretta McLune DS0000004550.V328478.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives are confident that their views will be listened to and any complaints made would be dealt with effectively. The arrangements regarding adult protection are good and prevent residents from risks of harm. EVIDENCE: There is written guidance in place for staff to follow in the event of a complaint being made. There have been no complaints made to the home or CSCI since the inspection of August 2005. Residents expressed their satisfaction with the home. The written policy in respect of adult protection was found to be satisfactory and the home had not had any concerns in this matter since the last inspection of February 2006. All staff have had training in how to deal with abuse or suspected abuse. Mrs Floretta McLune DS0000004550.V328478.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, 25, 28 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a homely, comfortable, safe, age appropriate and clean environment that meets their individual their needs. EVIDENCE: The home is a modern detached house situated in a residential area. There is a lounge at the front of the premises that is used as a music room and contains a vast range of CD’s for use on the hi fi system. The main lounge is located at the rear of the building and there is also a spacious and bright kitchen/dining room. The large conservatory spans the full width of the house and includes a comfortable seating area and dining table and chairs. There is also a downstairs toilet. The enclosed rear garden is well maintained and residents help with its maintenance. The bedrooms located on the first floor were noted to be very personalised. One room has en-suite shower facilities and there is a communal bathroom with a shower over the bath, wash hand basin and toilet. The bedroom Mrs Floretta McLune DS0000004550.V328478.R01.S.doc Version 5.2 Page 17 currently occupied by the owner/responsible individual also has en-suite facilities and will be available to another resident when the proposed changes have been completed. The laundry room is separate from the kitchen and is located on the ground floor. Throughout the premises, they were well maintained, furnished to a high standard and very hygienic. Mrs Floretta McLune DS0000004550.V328478.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels are maintained in sufficient numbers to ensure that resident’s needs are met. Staff have received training to supply them with the knowledge and skills to carry out their roles effectively and to meet the specialist needs of residents. EVIDENCE: The registered manager and family members provide 24 hour care to the residents. The arrangements appeared to be sufficient to meet residents needs. The home was in the process of recruiting some staff to compensate for the planned retirement of the registered manager. Following the changes the registered manager will continue to work on a part time basis and staff recruited will fill the resultant vacant shifts. A job description and application forms have been developed to be issued to applicants. Advice was given that prospective staff will be interviewed, all necessary checks will be carried out and two written satisfactory references will be obtained before a post is confirmed. A current applicant spent three hours Mrs Floretta McLune DS0000004550.V328478.R01.S.doc Version 5.2 Page 19 with residents, following which, staff asked for their opinions about the suitability of the candidate. All staff had received training in Moving and Handling, Health and Safety, First Aid, Safe Medications, Death and Bereavement, Adult Protection and Disability Awareness. The training provides staff with the knowledge and skills to carry out their roles effectively. Staff employed will be expected to undertake the Skills for Care Induction programme to ensure they have the basic knowledge of how to care for the residents. Mrs Floretta McLune DS0000004550.V328478.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. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The registered manager is experienced and possesses the skills to oversee the day to day running of the home and has a vision to implement developments. The arrangements in place regarding health and safety ensure that residents are protected from risks of accidents. EVIDENCE: The registered manager is experienced and is keen to make continuing improvements for the benefit of residents. She is supported by a senior member of staff who has been taking on management tasks as preparation for taking over the role of manager. The home discusses the standard of the services with residents during meetings and the senior member of staff has developed a quality assurance programme that takes into account the opinions of residents, and all others Mrs Floretta McLune DS0000004550.V328478.R01.S.doc Version 5.2 Page 21 who come into contact with the home. Audits of the premises are also carried out and advice given that the home intends to develop a report, which will include any shortfalls and how they will be dealt with. Accidents are infrequent and records are good and copies of Regulation 37 forms are retained by the home. Any concerns about a residents’ safety are reported to CSCI without delay. All relevant checks and servicing of equipment are carried out to ensure that they are fit for purpose. The fire alarm system is regularly checked and the findings recorded to protect residents from harm in the event of an emergency situation. Regular fire drills are carried out and the names of staff that have participated are recorded to ensure that all staff are captured. Random testing of hot water outlets are carried out and the results recorded to prevent residents from receiving scalds. The arrangements are robust and appear to protect residents and others from the risk of injury. During discussions and planning of activities for the remainder of the day staff were overheard talking about safety aspects to be considered. Mrs Floretta McLune DS0000004550.V328478.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 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 CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 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 3 3 X 3 X X 3 x Mrs Floretta McLune DS0000004550.V328478.R01.S.doc Version 5.2 Page 23 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 7919Sch 2 Requirement For all staff employed at the home the following must be available: a recent photograph, two written references, proof of identity, a completed application form, evidence of qualifications and evidence that they are physically/mentally fit to do the job they are employed to do. Timescale for action 31/03/07 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 YA6 Good Practice Recommendations All residents care plans should include the short and longterm goals and aspirations of the individual. Mrs Floretta McLune DS0000004550.V328478.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Mrs Floretta McLune DS0000004550.V328478.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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