Inspection on 06/12/06 for Mullion

This inspection was carried out on 6th December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Mullion 05/12/08

Mullion 20/12/05

Mullion 06/07/05

Mullion 25/01/05

Mullion 20/09/04

Mullion 15/03/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Pinta

Kestrel House, St Anne`s Opportunity Centre,

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

CARE HOME ADULTS 18-65 Mullion 230 Portsmouth Road Horndean Hampshire PO8 9SY Lead Inspector Mr Roy Bega Unannounced Inspection 6th December 2006 09:30 Mullion DS0000011679.V320318.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 Mullion DS0000011679.V320318.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. Mullion DS0000011679.V320318.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mullion Address 230 Portsmouth Road Horndean Hampshire PO8 9SY 023 9259 6820 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) www.c-i-c.co.uk. Community Integrated Care Mr Stephen Richard Brockway Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Mullion DS0000011679.V320318.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20 December 2005 Brief Description of the Service: Mullion is a registered care home, providing personal support and accommodation for three young adults with learning disabilities. Mullion is a bungalow set back from the main road just outside Horndean. Mullion bungalow is owned by Knightstone housing association. Stephen Brockway is Mullion’s registered manager, Community Integrated Care are the service providers. Mullion comprises of three single bedrooms, a communal lounge, dining room and kitchen, a laundry and an enclosed garden. Information in respect of current fees was not available at the time of this visit. Mullion DS0000011679.V320318.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is an assessment of how the National Minimum Key Standards for Care Homes for Young Adults were being met. Evidence has been collated from the service’s history file and this site visit. This visit took place on 6 December 2006 between the hours of 9-30 a.m. and 3.30 p.m., a total of six hours. Residents cognitive and communication skills are severely impaired; therefore it was not possible for the inspector to ascertain directly their viewpoint with regards to this visit. There were not any relatives/representative present at the time of the visit. Opportunity however was taken to spend time with residents and staff, observe the working environment, view records, look around the home and speak with management. There were not any requirements raised resulting from this visit. What the service does well: What has improved since the last inspection? What they could do better: Advice will need to be sought from Hampshire Fire and Rescue Service with regards to the type of hold open devices to be fitted on fire doors. Mullion DS0000011679.V320318.R01.S.doc Version 5.2 Page 6 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. Mullion DS0000011679.V320318.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 Mullion DS0000011679.V320318.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): Key Standard 2 was assessed on this occasion. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents benefit from good pre admissions assessment/ procedures and being fully involved in the process. Relatives/representatives are provided relevant information and documentation to assist with the decision process. EVIDENCE: The home provides a Statement of Purpose that is specific to the individual home, and the resident group they care for. It clearly sets out the objectives and philosophy of the service supported by a Service user Guide. The guide details what the prospective individual can expect and gives a clear account of the specialist services provided, quality of the accommodation, qualifications and experience of staff, how to make a complaint, recent CSCI inspection findings and contains comments and experiences of residents living at the home. Records were seen for the resident most recently admitted to the service. The assessment focused on achieving positive outcomes for the person including ensuring the facilities, staffing and specialist services provided by the home could meet the diversity needs of the individual. The individual was given the Mullion DS0000011679.V320318.R01.S.doc Version 5.2 Page 9 opportunity to spend time in the home prior to all those concerned making a final decision. It was noted the individual, family and professionals were involved in the assessment process. A copy of the statement and terms of conditions of residence was seen. Due to the resident’s severely impaired cognitive and communication skills it was not possible for the inspector to ascertain their viewpoint on the process. However, observations, records seen and discussions with staff indicated good relationships have been made with other residents and staff alike. Staff spoken with informed the inspector they were involved in the assessment/admission process, where their views, opinions, and comments were listened to and fully debated, before agreement was given for the admission. An individual member of staff has been allocated to support them with the settling in/orientation process, ascertain possible further information for a post admission assessment of need/wishes. Observations and discussions indicated this partnership is being effective. Mullion DS0000011679.V320318.R01.S.doc Version 5.2 Page 10 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): Key Standards 6, 7 and 9 were assessed on this occasion. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans provide staff with good information on the needs of the residents, who are encouraged to make decisions about their lives and are encouraged to participate in all aspects of life in the home. EVIDENCE: Residents cognitive and communication skills are severely impaired; therefore it was not possible for the inspector to ascertain directly their viewpoint with regards to this section. Discussions with management and staff indicated they understand the importance of residents being supported to take control of their own lives, and to encourage and enable them to exercise their rights and make their own decisions and choices. Mullion DS0000011679.V320318.R01.S.doc Version 5.2 Page 11 All three care plans were seen, they are up to date and case tracked as part of the visit. They are written in plain language, easy to understand and consider all areas of the individual’s life including health; specialist treatments, personal and social care needs. Training records seen and discussions with staff indicated they have skills and ability to support and encourage residents to be involved in the ongoing development of their plan. A key worker system enables staff to establish special relationships and work on a one to one basis. It was noted plans are reviewed regularly involving the resident and, where agreed, their families. They are updated and action taken to respond to any changes. They focus on how residents will develop their skills and considers their future aspirations. All members of staff regard the plan as a working tool they understand it, and support residents to achieve their desired outcomes. They also reflect what is possible and not what is available. Up to date risks assessments and reviews have been completed that coincide with residents’ chosen and agreed activities and lifestyle. Staff spoken with informed the inspector they find this way of planning residents care very positive in that the resident is put first. It is regarded as a working tool to assist them in supporting residents to achieve their desired outcomes. Where limitations are in place, the decisions have been made with the resident and their representative. For example personal interests participated include music, dance, horse riding football, theatre, swimming and walking. One resident who is a wheelchair user enjoys outward-bound holidays of which a photographic diary was shown to the inspector. It was seen activities enjoyed by the resident includes, rock climbing, abs ailing and an aerial runway. Mullion DS0000011679.V320318.R01.S.doc Version 5.2 Page 12 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): Key Standards 12, 13, 15, 16 and 17 were assessed on this occasion. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to take part in age, peer group appropriate activities, and the local community. Residents are supported to maintain and make new relationships. Residents’ rights are respected in their daily living. A varied and healthy diet is provided. EVIDENCE: See also previous section “Individual Needs and Choices”. Residents cognitive and communication skills are severely impaired; therefore it was not possible for the inspector to ascertain directly their viewpoint with regards to this section. Records seen observations and discussions showed central to the home’s aims and objectives is the promotion of the individual’s right to live an ordinary and Mullion DS0000011679.V320318.R01.S.doc Version 5.2 Page 13 meaningful life, both in the home and in the community appropriate to their peer group. The home understands the importance of enabling younger adults to achieve their goals, follow their interests and be integrated into community life and leisure activities. Residents are involved in meaningful daytime activities of their own choice and according to their individual interests and capability; they have been involved in the planning of their lifestyle and quality of life. For example personal interests participated include music, dance, horse riding football, theatre, swimming and walking. One resident who is a wheelchair user enjoys outwardbound holidays of which a photographic diary was shown to the inspector. It was seen activities enjoyed by the resident includes, rock climbing, abs ailing and an aerial runway. It was seen residents are encouraged to maintain family and personal relationships and the opportunity of forming new ones. The service is committed to the principles of inclusion and promotes, and fosters good relationships with neighbours and other members of the community. For example with support from staff, residents’ access their local public transport, library services, the local pub, and leisure facilities. The menu is varied with a number of choices including a healthy option. It includes a variety of dishes that encourage individuals to try new and sometimes unfamiliar food. The meals are balanced and nutritional and cater for the varying cultural and dietary needs of the residents. Staff were seen to be sensitive to the eating needs of a resident. Mullion DS0000011679.V320318.R01.S.doc Version 5.2 Page 14 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): Key Standards 18, 19 and 20 were assessed on this occasion. Quality in this outcome area is (excellent, good, adequate or poor) This judgement has been made using available evidence including a visit to this service. Residents receive support to ensure their physical and emotional needs are met and are protected by the home’s good procedures in the management of medicines. EVIDENCE: Residents cognitive and communication skills are severely impaired; therefore it was not possible for the inspector to ascertain directly their viewpoint with regards to this section. Observation and discussions indicated staff provide sensitive and flexible personal support to maximise residents privacy, dignity, independence and control over their lives. Staff were observed to manage instances of unacceptable behaviour with sensitivity and a calm manner therefore, decreasing the level of stress for all those present. Care plans seen and discussions showed residents’ health care needs have been assessed, and appropriate procedures put in place to ensure they are Mullion DS0000011679.V320318.R01.S.doc Version 5.2 Page 15 carried out. Records and discussions indicated that residents visit their doctor and other health related services as required. Staff spoken with understand the key principles of giving personal support and are responsive to the varied and individual requirements of the residents. It is recognised that the delivery of personal care is highly individual and must be flexible, consistent and reliable. Attention is given to ensuring privacy and dignity when delivering personal care. Where possible residents are supported and helped to be independent and responsible for their own personal hygiene and personal care. It was seen the home works to an efficient medication policy supported by procedures and practice guidance. Staff follow robust systems to make sure medication records are fully completed, contain required entries, and are signed by appropriate staff. Regular management checks are recorded to monitor compliance. Records of medication retuned to the pharmacist were seen and well documented. Evidence was seen that staff who administer medication have received appropriate training by a recognised organisation. Mullion DS0000011679.V320318.R01.S.doc Version 5.2 Page 16 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): Key Standards 22 and 23 were assessed on this occasion. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A clear complaints procedure is in place and residents are safeguarded by the home’s policy, procedures, dissemination of knowledge and training with regards to adult protection. EVIDENCE: Residents cognitive and communication skills are severely impaired; therefore it was not possible for the inspector to ascertain their viewpoint directly with regards to this section. The service has a complaints procedure that is up to date, very clearly written, and is easy to understand. It is widely distributed, and has a high profile within the service. The Commission has not received any concerns regarding the service in the preceding year. Records and discussions indicated that episodes of physical or verbal aggression by residents are documented and evaluated. Guidelines have been drawn up to manage behaviours and these are reviewed in consultation with the community learning disability team. The home has an adult protection policy and procedure in place of which staff spoken with had a good understanding. Confirmation was seen to show staff have received adult protection training by an accredited trainer within the Mullion DS0000011679.V320318.R01.S.doc Version 5.2 Page 17 organisation. The service is clear when incidents need external input and who to refer the incident to. Records seen and discussions showed the service has very efficient systems to ensure effective safeguarding and management of resident’s money. Invoices/receipts were seen where the service had purchased goods on behalf of residents and requested the money from relatives/representatives. Mullion DS0000011679.V320318.R01.S.doc Version 5.2 Page 18 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): Key Standards 24 and 30 were assessed on this occasion. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ benefit from a well maintained, clean homely environment. EVIDENCE: The inspector toured the building with the manager. It was noted subsequent to the previous inspection, all three bedrooms have been re-decorated; new French doors and seven fire doors have been fitted. All residents are accommodated in single rooms that are meeting their needs. Bedrooms seen are bright, cheerful and contain many personal items including posters, photographs, soft toys and ornaments. Furniture and fittings are of good quality, domestic in design, unobtrusive and compatible with fulfilling their purpose. Management complete a weekly health and safety and maintenance record that was seen. Any defects are then passed onto the organisation’s Mullion DS0000011679.V320318.R01.S.doc Version 5.2 Page 19 maintenance department. Discussion and records seen indicated faults are dealt with promptly. The home was clean, hygienic and free from offensive odours. Laundry facilities are of a domestic type and meet requirements. Evidence was seen to show staff have received training with regards to infection control and care of substances hazardous to health. Mullion DS0000011679.V320318.R01.S.doc Version 5.2 Page 20 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): Key Standards 32, 34 and 35 were assessed on this occasion. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ are protected by the agency’s recruitment policy and procedures. Residents’ benefit from appropriately trained and supervised staff. EVIDENCE: Two support worker files were sampled. All information required has been recorded including a completed application form, two written references and a Criminal Records Bureau check. Discussions and records seen showed, after interview and on appointment, all new staff are required to complete a full induction that covers the service’s policies and requirements of the Skills for Care programme. A support worker talked through the induction programme with the inspector and confirmed that it was rigorous and appropriate in giving them the right background knowledge to work with the client group. For the first week they spent their time on a one to one with the manager then for four weeks were supported by a senior member of staff. Mullion DS0000011679.V320318.R01.S.doc Version 5.2 Page 21 The service has a positive attitude towards training. Evidence was seen that two support staff have completed the National Vocation Qualification Course level three and two have been enrolled to complete level two. A comprehensive training programme is organised annually. For example, as well as covering specialist areas relevant to learning disabilities, courses include, managing challenging behaviour; risk assessments; infection control and adult protection. Care staff spoken with told the inspector they are well-supported regards to training. Mullion DS0000011679.V320318.R01.S.doc Version 5.2 Page 22 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): Key Standards 37, 39 and 42 were assessed on this occasion. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is experienced and competent to run the home. Management and administration of the home is based on openness and respect. An effective quality assurance system is in place. Safeguards are in place to protect the interests of the residents. As is reasonably practicable the health, safety and welfare of residents and staff is promoted. EVIDENCE: The Manager has the required qualifications and experience and is competent to run the home. Discussions and records show he works continuously to improve services and provide an increased quality of life for residents. Staff informed the inspector management has a strong ethos of being open in all areas of running the home and is resident focused. Mullion DS0000011679.V320318.R01.S.doc Version 5.2 Page 23 Records and observations showed management leads and supports a strong staff team who have been recruited and trained to a good standard. Discussions indicated management is aware of current developments both nationally and by the Commission and plans the service accordingly. A quality assurance and monitoring system based on seeking the views of, relatives, staff and professionals is in place. Monthly staff meetings are held and considered as another source in obtaining views in monitoring the service. The service works to a clear health and safety policy, all staff are given a copy, and regular random checks take place to ensure they are working to it. Records seen and discussions showed staff are provided with appropriate training in the area of health and safety. The service has a good record of meeting relevant health and safety requirements and legislation. Records are of a good standard and are routinely completed. Service records for systems and equipment were seen and are up to date. The type of hold open devices to be fitted on fire doors was discussed with the manager. Advice will need to be sought from Hampshire Fire and Rescue Service. Mullion DS0000011679.V320318.R01.S.doc Version 5.2 Page 24 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 4 3 X 4 X 5 3 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 X 26 X 27 X 28 X 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 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Mullion DS0000011679.V320318.R01.S.doc Version 5.2 Page 25 No. Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Mullion DS0000011679.V320318.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Mullion DS0000011679.V320318.R01.S.doc Version 5.2 Page 27 - 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!