Inspection on 12/10/07 for Myland House.

This inspection was carried out on 12th October 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Myland House. 11/08/08

Myland House. 27/09/06

Myland House. 08/02/06

Myland House. 17/08/05

Myland House. 29/03/05

Myland House. 11/01/05

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Myland House 81 Mile End Road Colchester Essex CO4 5BU Lead Inspector Neal Cranmer Key Unannounced Inspection 12th October 2007 09:00 Myland House DS0000017893.V352978.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 Myland House DS0000017893.V352978.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. Myland House DS0000017893.V352978.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Myland House Address 81 Mile End Road Colchester Essex CO4 5BU 01206 853604 01206 853604 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) The Brain Injury Rehabilitation Trust Mrs Suzette Anne Doherty Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Myland House DS0000017893.V352978.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th September 2006 Brief Description of the Service: Myland House is one of a number of homes owned and run by the Brain Injury Rehabilitation Trust. The registered manager is Mrs Suzette Doherty. The home is a detached former family dwelling located in an established residential area of Colchester. It is situated within easy walking distance of all of Colchesters main shopping facilities. The accommodation is arranged on both the ground floor and first floor of the premises. Furnishings throughout the home are in keeping with the needs of the service users. The home provides a service to five service users aged between 18-65, who all have an acquired brain injury. The fee range for staying at the home is between £906.60 to £1.237.20, an additional charge is made for 1.1 care hours required, and service users pay for hairdressing, newspapers etc out of their own monies. Myland House DS0000017893.V352978.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced Key inspection, which took place on the 12th October 2007, lasting 6:00 hours. The inspection process included: some discussion with all five of the service users residing at the home, the registered manager and three members of the care team A tour of the premises included observation of service user’s bedrooms, communal areas, and gardens. During the course of the inspection process a range of documentary records were sampled, including the home’s Annual Quality Self Assessment Audit (AQAA). The information included in the annual quality assurance form (AQAA) which had been submitted to the Commission for Social Care Inspection, was also used in compiling the inspection report. This form gives homes the opportunity of recording what they do well, what they could do better, and what has improved in the previous twelve months as well as future plans for improving the service. What the service does well: The service continues to work with service users to enable them to maximise their independence within the home, and where able externally as well. Service users are supported in an environment that is homely and supportive. Service users are supported by a small team of staff, many of who have known them for a considerable period of time. Service users are supported by the team to maintain links with their families and friends. Staff are supported by a management team who provide them with a clear sense of leadership and direction. Service users spoke of the meals provided by the home as being good. Myland House DS0000017893.V352978.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Myland House DS0000017893.V352978.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 Myland House DS0000017893.V352978.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can expect their needs to be assessed prior to admission to the home. EVIDENCE: The home has not had any new admissions for a number of years, the last being in 2001, however sampling of the assessments used showed that the assessments used covered the following areas: Social history, interests, Medical history, medication in use, reading and writing skills, method of communication and family and social contact. The information gathered during this assessment process was then used as the basis for formulating the service user’s initial plan of care. Discussion with the registered manager indicated that this would be the baseline assessment used for any future service user referred. Myland House DS0000017893.V352978.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users needs and personal goals are not always adequately reflected in their plans of care. Service users are supported to make decisions about their everyday lives and to take risks, as part of developing an independent lifestyle. EVIDENCE: Three service users care plans were sampled, one of these contained evidence of a programme of care that was seen to be of a questionable nature, bordering on, a reward and punishment programme. The organisations Clinical psychologist, and other senior members of the team had agreed the programme, and in consultation with the service user, who the inspector was informed had agreed to the programme. Myland House DS0000017893.V352978.R01.S.doc Version 5.2 Page 10 The inspector was concerned about the service user’s capacity to understand the reason for the programme. The care plan relating to the programme of care was basic, and did not provide a clear rationale for why it was in place, or what the benefits to the service user would be, there was documented evidence that the programme was being regularly reviewed, although it was recommended to the registered manager, the visiting clinical psychologist, and the home’s deputy manager that the programme be reviewed to ensure that it provided a clear rationale for its use, and that it be subjected to even more regular review. Discussion with staff in the home also indicated concerns about the use of this programme of care, and the complaint referred to under Standard 22 also related to this same programme. The other two care plans sampled were generally in order, although some of the rationales for their use were also basic. Discussion with the manager indicated that all of the service users residing in the home have their own bank accounts, and money held by the home on behalf of service users is paid out to them twice weekly at the request of the service users. All of the three service users files sampled have in place in their care plans risk assessments which identify the nature of any risk, the likely hazards and any associated risks, as well as precautions to be followed to minimise the identified risk. Risk assessments were seen to be in place to support service users when accessing the community and undertaking voluntary occupation. Myland House DS0000017893.V352978.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service user can expect to be supported to take part in age appropriate activities that are community based. Service users are supported to maintain links with their families and friends. The daily routines of the home are flexible and enabling and help to promote independence. Service users can expect to be provided with a diet that is healthy and wholesome. Myland House DS0000017893.V352978.R01.S.doc Version 5.2 Page 12 EVIDENCE: One of the five service users residing in the home has some voluntary employment at a local environmental centre. Discussion with the service user confirmed that they continue to enjoy taking part in this voluntary occupation. Other service users spoken with spoke of attending a local college, as well as going out for coffees to the local supermarket, visiting the local public house or going out to visit garden Centres and occasional visits to the cinema. In addition to these activities all of the service users spoke of attending the Gateway club, something they all spoke of enjoying. One of the service users also spoke of walking to the local shop each day to purchase the local newspaper. All of the service users spoke of the home having an open door policy on the receiving of visitors, and they spoke of being free to choose where to receive their visitors e.g. either in the privacy of their own rooms, the lounge or if they wish the home has a small conservatory which looks out over the rear garden which is available to be used for this purpose. Service user’s personal rooms are all lockable; although keys were available should they wish to lock their rooms none of the service users at the time of the inspection choose to hold keys. Staff were witnessed interacting with the service users and not exclusively with each other and the interaction seen and heard was positive and mutual. Meals at the home are provided three times daily, at least one of which was hot. Discussion with service users indicated that meals are provided flexibly to facilitate their daytime activities, and snacks and drinks are available throughout the day. Sampling of the menu for the week of the inspection indicated that the menus were varied and nutritious. Meals are taken in a small dining room adjacent to the conservatory. Discussion with service users indicated that the meals provided by the home are good, they also spoke of the quantity of food provided as being good, service users were seen accessing the kitchen to make drinks as they wished, although staff were on hand to provide support if it was required. Myland House DS0000017893.V352978.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. Service users can expect their personal care needs to be met in a way that they require and prefer. Service users can expect their health care needs to be well met, and the medication procedures of the home were safe and well maintained. EVIDENCE: All of the service users residing in the home are generally quite selfdependent. However from discussion with all of the service users it was apparent that whenever assistance of a personal nature might be required from staff, this would be provided in a way that respected the service users privacy and dignity. The home operates a key worker system and each of the service users was aware of who their key worker was. Myland House DS0000017893.V352978.R01.S.doc Version 5.2 Page 14 Further discussion with service users indicated that routines within the home are flexible and dependent on each person’s plans for the day. Service users are all registered with a local general practitioner, and access other relevant healthcare professionals via generic healthcare services. In addition to these services service users have access to clinical psychiatrists and psychologists who are provided by the Brain Injuries Trust. Service users continue to be supported by staff to attend out patient appointments. Service users medication is dispensed via a Measured Dosage System (MDS) and all staff administering medicines have received training. The home does not hold any controlled medicines. Records sampled were all in order, with no evidence of any errors or omissions. Medicines out of date or no longer in use are returned to pharmacy via a medicines return book. Myland House DS0000017893.V352978.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a robust process for enabling service users to make complaints, and service users can expect the home to respond to their concerns. The home’s procedures for dealing with and responding to allegations of abuse are robust. EVIDENCE: The home has in place a robust complaints procedure, and service users spoke of being aware of how and who they should direct any complaint too. Since the previous inspection visit to the home, one complaint has been received by the Commission for Social Care inspection; This complaint was discussed with the registered manager at the time of the inspection. The home’s procedure for dealing with and responding to adult protection issues is robust, and all staff have received training in adult protection. Staff spoken with during the course of the inspection, were clear about their responsibilities in responding to suspicions or allegation of abuse. No adult protection referrals have been made since the previous inspection of the service. Myland House DS0000017893.V352978.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, 26 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported in an environment that is homely, comfortable and safe. Service users can expect to be supported in an environment that is kept free of any unpleasant smells or odours. EVIDENCE: The home is fit for its stated purpose, being safe, comfortable, accessible and well maintained. On the day of the inspection the premises were bright and cheerful and were free of any unpleasant odours. Furnishings and fittings were domestic in nature and were of a good quality. The home was in keeping with the local community and is situated close to local amenities. Myland House DS0000017893.V352978.R01.S.doc Version 5.2 Page 17 Service users spoke of being happy with their rooms, and of having been consulted with about any redecoration undertaken. Service users bedrooms were seen to be equipped to suit their individual lifestyles, and furnishings and fittings provided were adequate. Evidence was seen of service users personal possessions. The home’s laundry facility is situated just off the kitchen, and is equipped with domestic style washing machines and dryers, hand-washing facilities were also available. The home has in place a policy for the transporting of laundry through the kitchen area, which ensured that soiled laundry was kept away from food. Myland House DS0000017893.V352978.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 poor. This judgement has been made using available evidence including a visit to this service. Service users are supported by a team of staff, who are knowledgeable about their needs, and who have received an appropriate level of training. However Service users are not adequately protected by the home’s recruitment processes. EVIDENCE: Service users are supported by a team of staff who, are provided with a good level of training and who have the competencies, skills and qualities to meet their needs. Service users spoke of staff being accessible and approachable, and of having a good understanding of their needs. The home’s recruitment process was reviewed through the sampling of three staffs’ recruitment records. A number of omissions were noted regarding the documentation held, for example: one of the three files sampled did not contain any references, and two files did not contain any evidence of Criminal Record Checks having been undertaken, the third did have a Criminal Record Myland House DS0000017893.V352978.R01.S.doc Version 5.2 Page 19 Check. However this was not current e.g. not in the name of the current employer. These omissions could potentially leave service users at risk. Therefore the home needs to review its recruitment practice as a matter of urgency to minimise risk to service users. Sampling of staff training records indicated that staff have access to a good level of training. The files of senior staff indicated that since the previous inspection the following training had been undertaken: food hygiene, administration training, managing staff absence, adult protection, first aid, dealing with disciplenaries and grievances, and recruitment and selection. Discussion with care staff during the course of the inspection also confirmed that access to training was good. Myland House DS0000017893.V352978.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 good. This judgement has been made using available evidence including a visit to this service. Residents can expect to be cared for and their opinions about the service listened to by a staff team who are well supported by a manager who has good leadership skills. However residents cannot be confident that a clear audit of safety checks undertaken to protect them will be available. EVIDENCE: The home is managed and run by a registered manager who has significant previous experience of working in the care sector, and who holds an N.V.Q level 4 in management award, and they undertake periodic training to ensure that their knowledge remains up to date. Myland House DS0000017893.V352978.R01.S.doc Version 5.2 Page 21 Staff spoken with felt that they were generally well provided with a clear sense of leadership and direction. The home’s quality assurance process is managed corporately and is addressed through the use of questionnaires disseminated to service users and other interested parties. These questionnaires are collated centrally and a report on the outcome is published. Sampling of the home’s safety certificates indicated that the home’s safe working practices are sufficient to protect both service users and staff. However sampling of these records did evidence that the home’s Gas safety certificate was out of date and there was no evidence that this utility had been checked recently. Myland House DS0000017893.V352978.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 1 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 2 x Myland House DS0000017893.V352978.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 YA6 Regulation 15 Requirement Timescale for action 31/12/07 2. YA34 19 (Schedule 2) 2. YA42 13 The home must ensure that all service users plans of care are kept under regular review, and that service users are consulted with regarding all aspects of their care. The home must ensure that 31/12/07 documentary evidence relating to staff employed in the home is maintained, as defined under Schedule 2 of the Care Homes Regulations. This is to ensure that service users are adequately protected. The registered person must 31/12/07 ensure that all safety certificates relating to the safe running of the home are available and current. This is to ensure the health and safety of both residents and staff. The previous timescale set of the 30/12/07 was not met. Myland House DS0000017893.V352978.R01.S.doc Version 5.2 Page 24 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 Myland House DS0000017893.V352978.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Colchester Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Myland House DS0000017893.V352978.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!