Inspection on 25/05/07 for Mulberry Court

This inspection was carried out on 25th May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Mulberry Court 27/09/06

Mulberry Court 21/11/05

Mulberry Court 17/08/05

Mulberry Court 21/02/05

Mulberry Court 21/06/04

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

CARE HOME ADULTS 18-65 Mulberry Court Common Mead Lane Gillingham Dorset SP8 4RE Lead Inspector Marion Hurley Key Unannounced Inspection 25th May 2007 10:00 DS0000026847.V339825.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 DS0000026847.V339825.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. DS0000026847.V339825.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mulberry Court Address Common Mead Lane Gillingham Dorset SP8 4RE 01747 822241 01747 822241 mulberry.court@scope.org.uk www.scope.org.uk SCOPE 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) Russell Grant Masters Care Home 10 Category(ies) of Physical disability (10) registration, with number of places DS0000026847.V339825.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named person (as known to the CSCI) to be accommodated in the category (LD) Learning Disability. Maximum number registered not to exceed ten. 27th September 2006 Date of last inspection Brief Description of the Service: Mulberry Court provides care and accommodation for 10 people who have physical disabilities. It was registered as a new service in December 1999 to replace the accommodation at nearby Thorngrove House, where 9 of the current service users had lived for some considerable time. The service provider is SCOPE, a national not for profit organisation for people who have a physical disability. The premises are leased from East Dorset Housing Association. Accommodation comprises one bungalow and one two-storey building, with all accommodation for service users provided at ground level. The home is within walking distance of Gillingham town centre; bus routes and the railway station are nearby. Service users at Mulberry Court live as independently as possible. Staffing is arranged to provide daily 24-hour support. The aims and philosophy of the service seek to promote the independence of service users by providing the degree of support necessary to achieve their chosen daily lifestyles, and also by providing opportunities for service users to develop skills that will support independence. A number of service users are described as having some degree of learning disability, and the Commission for Social Care Inspection has agreed a variation to the homes conditions of registration to accommodate one person in the Learning Disability category, not exceeding 10 service users in total. All service users work at the nearby Thorngrove Garden Centre, which is also operated by SCOPE. Such attendance is not a condition of residence. The service users are very able and are supported in living as ordinary a life as possible. The service users, who are able to communicate the help they require from support workers set the tone of the home. The service users living at the home consider it a home for life and do not anticipate moving elsewhere. Residents can access reports by the Commission for Social Care Inspection via their notice board. Fees for the service, as of May 2007 range between £25,237 and £37,911 per annum. Variable additional charges are payable for holidays, hairdressing, toiletries, activities, trips, magazines/papers and public transport. Response to the Office of Fair Trading Report can be accessed via the following link: www.oft.gov.uk. DS0000026847.V339825.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection of the care home taking place over a six hour period. The inspector spoke with service users, the registered manager, and the service manager. The inspector did a tour of the home viewing all the communal areas and several people showed the inspector their bedrooms. Relevant records related to the standards assessed were read. The Registered Manager who has been undertaking this role in a temporary capacity will shortly stand down when the Service Manager has completed their application to be approved as the Registered manager for the Scope Services in Gillingham. The inspector received a number of comment cards relating to all the Scope Services in the Gillingham area. These included specific comments from people living and using the services (8), General Practitioners (3), relatives of service users (5), and from Health & Social Service Professionals (4). Comments included: “the care is very good, no fault with the support”, “very well trained staff”, ” they (staff) give the quality of life s/he enjoys” “attention to indivual needs which help develop independent action & thought” “we have nothing but praise” “they(staff) provide a safe and supportive environment in which our relative flourishes” “my client ha many health problems which are professionally monitored and attended to” “staff respect client’s wishes, promote independence” “I have two service users they are both entirely happy” “communication is very good and reviews are positive and practical meetings” and finally “ very capable and caring staff.” The inspector would like to take this opportunity to thank everyone for their hospitality and assistance during this inspection visit. What the service does well: The management and administration of the home is based on openness and respect. There are effective quality assurance systems developed by qualified, competent manager(s). Staff in the home are trained, skilled and there are enough of them to support the people who use the service. The physical design and layout of the home enables people to live in a safe, and comfortable environment, which encourages independence. DS0000026847.V339825.R01.S.doc Version 5.2 Page 6 People who use the service are able to express their concerns, and have access to a robust and effective complaints procedure, and are protected from abuse, and have their rights protected. The health and personal care that people receive is based on their individual needs. People who use services are able to make choices about their life style, and supported to develop their life skills. Individuals are involved in decisions about their lives, and play an active role in planning the care and support they receive. People who live at Mulberry Court are given information about the services available to them. What has improved since the last inspection? What they could do better: The manager supported by the Service Manager should continue to maintain the positive standards achieved, ensuring that service users needs are met and that the outcomes for people living at the home remain positive. Staff training is currently recorded on personal training sheets however the Service Manager hopes to develop with each member of staff a personal development file which will supplement the basic training information. DS0000026847.V339825.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. DS0000026847.V339825.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000026847.V339825.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who live at Mulberry Court are given information about the services available to them. EVIDENCE: The manager explained that if a new person were to move to Mulberry Court, then she and the staff would ensure that an assessment is carried out before offering them a place. The records confirmed this. The records showed that when people have previously moved into the home the assessment process continues after admission. The last person moved to Mulberry Court in 2003. The Service User Guide clearly states “all prospective service users are invited to visit where they can stay overnight giving them a chance to meet with other service users and staff, view their bedroom, common areas and garden and have a meal”. During this visit (with family, friends, advocate and interpreters as appropriate) they will have a chance to discuss how the service can meet their needs and see the type of records that are kept about service users. DS0000026847.V339825.R01.S.doc Version 5.2 Page 10 One comment card received from a service user stated “ I visited here to see if it was okay and another “ I lived locally and was happy to move here”. DS0000026847.V339825.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, & 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Individuals are involved in decisions about their lives and play an active role in planning the care and support they receive. EVIDENCE: The manager explained that the main principle behind the work she and the staff do is based on enabling people to take control of their own lives. Service users who were spoken with said that they make their own decisions about the care and support they receive. One person explained how the staff write up the care plan, which is based on the information given. The records show that the manager and staff have consulted individual service users about their needs; about the things they like and dislike doing and how any risks to them can be reduced or even eliminated. DS0000026847.V339825.R01.S.doc Version 5.2 Page 12 One person discussed how when they take part in a new activity the staff talk to them about any hazards or dangers involved in that activity, and the staff help them to avoid the hazards and dangers. Two people went through their records with the inspector and both confirmed that their records reflected their own interests and level of personal support. Each set of records had been signed. The daily records are written with the individual person and staff stated this helps the individual person understand the practical use of keeping the notes. Each service user is linked to one specific member of staff known as their key worker and they will then have regular key worker meetings to review their care and support plans. Everyone is given the choice of where they would like their records stored and the majority have selected the office however one person has chosen to keep the file in their bedroom. The care plans are well presented and cover all aspects of the person’s lifestyle and personal care and health needs. The Plans are clearly set out with an index, sections include, health care, emotional care, care needs, my home, social and daily activities, risk assessments, annual review, action plans and monthly round up/monitoring meetings. The plans are written using plain language for example under emotional care the section starts, “In this section you can find out what I can do and where I would like staff to support me in the following areas”. DS0000026847.V339825.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 & 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who use services are able to make choices about their lifestyle, and are supported to develop their life skills. A range of social, educational, cultural and recreational activities are provided by the manager and staff. EVIDENCE: The manager explained that the service has a strong commitment to enabling people who live at Mulberry Court to develop their skills including social, emotional, communication and independent living skills. Part of the responsibility of the key worker is to encourage each service user to develop their own preferred lifestyle and activities within the local community. The town centre of Gillingham is approximately half a mile away where there are many facilities including shops, pubs, restaurants, library, sports centre and DS0000026847.V339825.R01.S.doc Version 5.2 Page 14 swimming pool. Discussions with service users demonstrated the range of different occupations and activities each enjoys. People work different hours at the Garden Centre and in the remainder of their time do a range of other things, one person works in a local charity shop, another goes to Adult Education class, several people are keen on riding and swimming and benefit from regular sessions. All the service user records linked with the accounts from the individuals of the various things they enjoyed doing. The records show that individuals are supported to identify their goals and work to achieve them. Feedback from people living at the home indicated that they are given the opportunity to develop and maintain important and personal and family relationships. Visits from family and friends are always welcome but are at the discretion of the service user, there are no formal times. Discussion with the manager showed that individual rights and choices are promoted, and both the verbal and written reports confirmed that people are supported to make informed choices about things such as lifestyle choices, relationships, activities and holidays. All the service users are offered a healthy and well balanced diet. Ample choices are available and people are appropriately supported to prepare and cook their own meals or to cook for the “household”. The menus and records of food consumed were available and up to date, and all food hygiene checks are based on the Food Standards requirements. Temperatures of kitchen appliances and routine cleaning tasks were recorded. Staff have completed the Basic Food Hygiene Certificate and there is an annual “in house refresher course”. Service users regularly meet to discuss the main menu options and if they wish may become involved in the weekly shop. A comment card stated, “ I like this home because I can work at the Garden centre”. “ I always make my own decisions but I am happy with the staff to help me if I need it” DS0000026847.V339825.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The health and personal care people receive is based on their individual needs. EVIDENCE: The records show that the manager and staff ensure that people receive effective and individualised personal healthcare support using a person centred approach. The Statement of Purpose sets out the competencies and specialisms the home offers and delivers effectively through a skilled, trained and knowledgeable staff group that work in a person centred way. The manager explained that care plans are developed and written with the involvement of the person and discussions with individual people verified this and further evidence was obtained from randomly checking a selection of records which demonstrated that the care plans were individualised, person centred, and provided clear guidance on how the care is delivered. Observations of the day also showed that the care is person led and that staff were seen to respect service users preferences. DS0000026847.V339825.R01.S.doc Version 5.2 Page 16 The rota showed that the staff group is balanced to reflect the diverse needs of the people living at the home. A comment card stated “I feel I am treated very nicely”. “ I like it here and feel that I am being looked after OK”. The Service User Guide provides information about other professionals who support Mulberry Court, General Practitioners and Community Nurses in addition to the choice within the local town of health professionals such as optician, dentists and chiropodists. A significant part of the keyworker role is to liaise with other practitioners and monitor the health needs of service users and where possible enable and or accompany them where the need is identified to their respective appointments. DS0000026847.V339825.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People using the service are able to express their concerns, and have access to a robust, effective complaints procedure, and are protected from abuse, and have their rights protected. EVIDENCE: The records show that the manager has developed a clear complaints procedure provided in a format that the people living in the home could understand. The document starts with “ Complaining isn’t wrong – it’s a right” It highlights the importance of complaining and/or making suggestions for improvement that benefit people living and working at Mulberry Court. The document continues to add “Complaints are really positive – they give us an opportunity to improve things, both for ourselves and for other people” The document received a Crystal Mark for its clarity by the Plain English Campaign. From discussions with people living in the home it was clear that people do understand how to make complaints and are not inhibited in doing so if the need should arise. Comment cards received stated “ I could speak to any member of staff” “ I would speak to my key worker, if I wasn’t happy the manager would write a report” The records show that quality monitoring systems are in place to make sure staff are fully aware of the policies and procedures provided in relation to protecting and safeguarding the rights of the people living at the home. DS0000026847.V339825.R01.S.doc Version 5.2 Page 18 Observations made on the day indicated that the views and experiences of people living at the home are valued. Scope has a full Adult Protection Policy and Procedure on which staff receive training. Service users are also encouraged to attend training and be aware of the procedures. All service users have either a bank or building society account, which they can access, cash from. Most people have two accounts one for service fees and benefits and the other for their personal allowances and income. Staff provide discreet support or where required will support the person to ensure safe handling of their individual money. DS0000026847.V339825.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enable people to live in a safe well maintained and comfortable environment, which encourages independence. EVIDENCE: The provider and manager have ensured that the physical environment of the home provides for the individual requirements of the people who use the service. Discussions with the people living at the home showed that they are happy with “their house” and the living environment is appropriate for their particular lifestyle and needs. Further conversations with service users confirmed that they are encouraged to see the home as their own. It is well maintained, attractive and has very good access to community facilities and services. The inspector was shown several bedrooms each of which had been personally decorated and reflected the individual’s interests. All the communal areas are spacious and provide sufficient room for everyone. A comment card in response to the question what do you feel the care home does well stated, DS0000026847.V339825.R01.S.doc Version 5.2 Page 20 “makes it a home”. Another card, which referred to the cleanliness of the home, and a further one read “ stated “we all help to clean our own spaces” and another said “I help to clean” and another read “ I am happy with the way it is kept cclean” DS0000026847.V339825.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 & 35 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained, skilled and there are enough of them to support the people who use the service EVIDENCE: The records how that the service has a highly developed recruitment procedure that has the needs of the people who use the service at its core. The manager explained that the recruitment of good quality carers is seen as integral to the delivery of an excellent service, and continued to say that the recruitment of the right person for the job is always seen as more important than the filling of the vacancy. The rotas show that the service has enough staff available at all times to support the needs, activities and aspirations of the people using the service in an individualised and person centred way. The records show that the service is proactive rather than reactive in its staffing, recruitment and training, with planning for the needs of the service users taking place day-to-day. Discussions with several staff demonstrated a thorough understanding of the particular needs of the people who use the DS0000026847.V339825.R01.S.doc Version 5.2 Page 22 services. There is a staff team that has a balance of varying skills , knowledge and experience to meet the needs of people who use the services. Staff supervision is professionally completed with each member of staff with regular reviews of overall performance, and monitoring of personal responsibilities. Objectives are set for a twelve-month period but these are updated and new objectives set where appropriate. All achievements are reviewed and recorded. DS0000026847.V339825.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified competent manager. EVIDENCE: The registered manager, who has been temporarily covering the duties and responsibilities of this role for the past 11 months will shortly be standing down once the Service Manager has completed their application to be approved as the Registered Manger for the Scope services in Gillingham. The Registered Manager is currently completing the Registered Manager’s Award and will continue to complete this qualification. The Service manager has already attained this qualification. Both are experienced and highly competent to run the home and meet the stated aims DS0000026847.V339825.R01.S.doc Version 5.2 Page 24 and objectives. Discussions with them illustrated that they have a sound knowledge of both strategic and financial planning and review. The records show that checks and quality monitoring systems are in place which provide the management with evidence that systems are working and that the health and safety needs of people are promoted. Discussions with people living at the home indicated that the home is open and transparent. The views of both residents and staff are listened to, and valued. DS0000026847.V339825.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 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 4 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 4 33 X 34 4 35 4 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 X 3 3 X X X 3 x DS0000026847.V339825.R01.S.doc Version 5.2 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. 1. Refer to Standard YA15 Good Practice Recommendations Policies, which have been in draft for some 18 months, on sexuality and personal relationships should be verified and made available to staff in order for them to guide and support residents appropriately. It is recommended that a new style statutory training matrix is designed to ensure all training records can be easily updated and maintained. 2. 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