Inspection on 29/09/07 for Mrs Floretta McLune

This inspection was carried out on 29th September 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 20/02/07

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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Polesworth Group Pooley Heights

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Polesworth Group 70 Long Street

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10 Whitfield Avenue

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 Kulwant Ghuman Unannounced Inspection 29th September 2007 10:30 Mrs Floretta McLune DS0000004550.V351758.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.V351758.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.V351758.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 5 Category(ies) of Learning disability (5) registration, with number of places Mrs Floretta McLune DS0000004550.V351758.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide personal care (without nursing) and accommodation for service users of both sexes whose primary care needs on admission to the home are within the following categories: Learning Disability not falling within any other category (LD) 5 The maximum number of service users accommodated is 5. 2. Date of last inspection 20th February 2007 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 five people on a long-term basis. 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 and another has a bath with a shower over it. 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. The philosophy of the home is that the residents are considered to be members of the family. Mrs Floretta McLune DS0000004550.V351758.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. No complaints or adult protection issues had been raised in respect of the service since the last inspection. What the service does well: What has improved since the last inspection? One of the individuals living in the home had bought some new furniture for themselves. Mrs Floretta McLune DS0000004550.V351758.R01.S.doc Version 5.2 Page 6 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.V351758.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.V351758.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 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living in the home were given the opportunity to make choices throughout the day and their needs were regularly reviewed with the involvement of other professionals involved in their care. EVIDENCE: There had been no new admissions to the home however, there was someone who was being considered. The individual had been to the home and met the other people living there however the placement had not progressed due to the placing authority. The manager was well aware of the need to carry out an assessment before an individual was admitted to the home. Mrs Floretta McLune DS0000004550.V351758.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): 6,7,8 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living in the home were given the opportunity to make choices throughout the day and their needs were regularly reviewed with the involvement of other professionals involved in their care. EVIDENCE: The file of one of the people who had been living at the home was sampled. The file was well organised and comprehensive. The long term and short-term goals for the individual were recorded. The person receiving assistance in the home was able to make choices about what to do, what to eat, who to see and when to go to bed and get up. The individual had seen the care plan and had signed to show this. The plan and the individual’s needs were regularly reviewed with the involvement of the other professionals’ involved and family members when this was appropriate. A copy of the care management assessment was in place and formed the basis of the home’s own care plan. There was evidence in the file that the individual Mrs Floretta McLune DS0000004550.V351758.R01.S.doc Version 5.2 Page 10 received regular support for his psychological needs from a CPN, psychologist and psychiatrist. Additional counselling was available if needed. Risk assessments were in place for the identified risks including going out independently, going missing, self-harm, suicidal thoughts and so on. The people working in the home were well aware of how to manage the risks however, it was advised that the risk assessment for going out independently was added to as it was clear that the staff enabled the individual to go out however, he needed to be observed whilst out due to the other risks identified. It was important that the risk assessment had all the relevant details included as new staff were to start work at the home. The current staff in the home were well aware of the behaviours of the people living in the home and the small size of the home made it possible for this information to be easily passed between the staff so that there was consistency in how the individuals were managed. During the day the inspector observed the manager giving the people advice about issues that were worrying them, listening to them and assisting where appropriate and encouraging them to do things for themselves where possible. This inspection was carried out on a Saturday and it was evident that although some activities were to take place the pace was much slower than would be needed on a day that the individuals were going to college or day services. One of the people living in the home had recently had an advocate involved and attended regular meetings with the advocate. The majority of the people in the home could not manage their own finances however the home assisted with the management of the finances with involvement from other relevant individuals including family and social workers. One person living in the home kept their money but the home ensured that when they went out they took out only the money that they needed that day. The people living in the home were helped to save money and purchase things that they wanted. There were adequate records for the management of monies in the home but the home needed to organise the receipts in a way that made the records were easier to audit. The people living in the home were involved in the day to day running of the home by helping to keep the house tidy and washing up their cups after having drinks. During the inspection the manager was very careful not to speak about the people living in the home within earshot of the others in the home. The records were kept locked away until needed. Mrs Floretta McLune DS0000004550.V351758.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): 11,12,13,14,15,16,and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living in the home have activities appropriate to their needs and lead happy lives. EVIDENCE: Residents meetings were held on a regular basis however, it was evident from observations throughout the inspection that the people living in the home were given choices about what to eat and were involved in the home as part of a large family. One of the people living in the home went out during the day to visit a friend. She was going to have lunch with the friend and return home for the evening meal. The friend was also invited to her home for tea during one day in the week. It was pleasing to note that the manager rang up the other home before the individual left to make sure it was still appropriate for her to go and checked that she had arrived there. Mrs Floretta McLune DS0000004550.V351758.R01.S.doc Version 5.2 Page 12 One of the people living in the home told the inspector that she would be going to church with the manager the following day and spent a lot of time playing snooker during the day of the inspection. All the people living in the home had their own style of dress that was appropriate to their ages and the weather. People living in the home went to college for computer classes, day centres, drop in centres, cinemas and out for meals. It was obvious from the interactions between the people living in the home and the people working there that the atmosphere was calm and accommodating to each other’s needs. The cultural and racial needs of the individuals were met by being included in the local community, contact with their families where possible and contact with the wider family of the manager. One of the individuals in the home had an issue about their own personal identity and this was seen to be appropriately and sensitively managed by the manager. The people living in the home had access to their bedrooms whenever they wanted. The bedrooms had appropriate locks on the doors however none of the individuals had keys to their bedrooms. The inspector was told that they had been tried with keys but they kept losing them. This needed to be recorded on their individual files. On the day of the inspection the people living in the home were asked about what they wanted at lunchtime and the easy going nature and comfortable environment in the home was shown by one of the people living in the home asking ‘ what are you offering’. They eventually decided on beans on toast with a cheese topping and rice pudding. The individuals’ likes and dislikes with respect to food were recorded. The home did not actually record what the individuals were eating during the day and although there were no concerns about what they were eating it was good practice to record what they were eating on an individual daily basis to show that choices were available and that a varied and nutritious diet was being served. One of the people living in the home said that the best thing about living in the home was the food and that the manager was a good cook. The people living in the home had had a variety of holidays during the summer. One had been to Australia with a relative and the others had been to Cornwall. All said they had enjoyed their holidays. Mrs Floretta McLune DS0000004550.V351758.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living in the home were being provided with support to enable their personal and health care needs to be appropriately met. EVIDENCE: The staff were fully aware of the needs of the people living in the home and were able to support them with these whilst enabling them to remain independent as far as possible. The home was able to manage all the personal care needs of the individuals in a private and sensitive manner. Each person had a written care plan that identified long and short-term goals for them. Care plans covered daily routines for personal hygiene. Individuals were able to get up and go to bed at times that suited them and weekends were observed to be at a much slower pace than was required during the rest of the week. There was a health action plan available on the file sampled. There was involvement with speech and language services for one individual and this had led to some marked improvement in the communication abilities of one of the Mrs Floretta McLune DS0000004550.V351758.R01.S.doc Version 5.2 Page 14 people living in the home. There was evidence that another persons mental health needs were being met and appropriate referrals were made to help the individual. Medical services were available as needed with involvement from CPN’s, GP’s and psychologists. The management of medicines in the home was good. There were appropriate records kept. The majority of medicines were available in blister packs but the audit of some boxed medicines also showed that they were being appropriately administered. Mrs Floretta McLune DS0000004550.V351758.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): 20 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living in the home are listened to and they have the chance to speak to people who work in the home and people outside of the home about any thing that could be worrying them. EVIDENCE: There had been no complaints about the service to the Commission and no complaints had been received at the home. The people living in the home all attended day centres and colleges and had contact with their family, friends or advocates giving them opportunities to discuss any issues they may have. There were good relationships seen between the people who worked in the home and the people who lived there. One of the residents told the inspector that they could speak to the manager at any time. Staff at the home had had training in adult protection. The adult protection and complaints procedures were not seen at this inspection but were found to be satisfactory at the inspection of February 2007. Mrs Floretta McLune DS0000004550.V351758.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 excellent. This judgement has been made using available evidence including a visit to this service. The home provides very good, comfortable accommodation to the people living there. EVIDENCE: The home remains homely, clean, comfortable and well maintained. Everyone living in the home has their own bedroom that is decorated to their liking and they have things in the bedroom that belong to them. The laundry is also on the ground floor. All the bedrooms and the main bathroom are on the first floor. One of the bedrooms had it s own shower and toilet and another bedroom has a bath and toilet available. One of these bedrooms had recently become available for a fifth person to be able to live in the home as the owner had moved out. This bedroom was not occupied at the time of this inspection. Mrs Floretta McLune DS0000004550.V351758.R01.S.doc Version 5.2 Page 17 On the ground floor was the front lounge that would become the office and sleeping in room when a new person moved into the home. There was also another lounge, lounge/dining room and kitchen and a large conservatory that had comfortable seating, a television and pool table. The people who live in the home could use the garden and they also helped to keep it looking tidy. Mrs Floretta McLune DS0000004550.V351758.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. The people living in the home are cared for by people who know their needs and have the skills to help them. EVIDENCE: The registered manager and family continue to provide 24-hour care to the people living there. The registered manager was no longer living in the home however there was always someone sleeping in. One of the members of staff was starting to take over the running of the home with support from the manager. Two members of staff had been recruited. One had recently started work but had not yet completed induction training and the other person had not yet started working there as references had not been received. The recruitment process ensured that all the appropriate checks had taken place prior to people starting work. Mrs Floretta McLune DS0000004550.V351758.R01.S.doc Version 5.2 Page 19 The staff present in the home at the time of the inspection knew the people and how to care for them. Mrs Floretta McLune DS0000004550.V351758.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 has the skills and knowledge to manage the home ensuring that the needs of the people living there are appropriately met. Health and safety is managed well. EVIDENCE: The registered manager was at the home at the time of the inspection but the senior care who was due to take up the management of the home was also available and showed the inspector that she had a good knowledge of the people in her care and the systems in place in the home. There was no formal quality assurance report available in the home however, it was evident that all decisions about what was happening in the home was discussed with the people living there. For example, one of the individuals had chosen the colour of their bedroom and the views of the people living in the Mrs Floretta McLune DS0000004550.V351758.R01.S.doc Version 5.2 Page 21 home were taken into consideration when someone new was being introduced to the home. The safety of the people living in the home was very important as evidenced by the manager who checked if it was still alright for one of the people to go and visit a friend at another home before she went and asked that when she arrived the other home let them know. The home was well-managed and all relevant checks and servicing of equipment was undertaken to ensure that they were safe. The fire alarm was regularly tested and fire drills were undertaken. Mrs Floretta McLune DS0000004550.V351758.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 3 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 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Mrs Floretta McLune DS0000004550.V351758.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 YA7 Regulation Requirement Timescale for action 01/11/07 17(2) Receipts for expenses Sch4(9)(a) undertaken on behalf of the people living in the home must organised. This will ensure that the records can be easily audited to ensure that the people living in the home are safeguarded. 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 YA9 Good Practice Recommendations The risk assessment should make clear the actions that must be taken by staff when one of the people living in the home goes out alone. This will ensure that the individual remains safe whilst being able to take some risks. A record should be kept of the food eaten by the people living in the home. This will ensure that the people living in the home are Mrs Floretta McLune DS0000004550.V351758.R01.S.doc Version 5.2 Page 24 2. YA17 offered choices and a variety of meals. Mrs Floretta McLune DS0000004550.V351758.R01.S.doc Version 5.2 Page 25 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.V351758.R01.S.doc Version 5.2 Page 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!