Inspection on 17/08/05 for Myland House.

This inspection was carried out on 17th August 2005.

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 but made no statutory requirements on the home.

Other inspections for this house

Myland House. 11/08/08

Myland House. 12/10/07

Myland House. 27/09/06

Myland House. 08/02/06

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 Unannounced 17 August 2005 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 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 Stationary 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 I56 - I05 S17893 Myland House V221665 UI 170805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Myland House Address 81 Mile End Road Colchester Essex CO4 5BU 01206 853604 01206 853604 Not known The Brain Injury Rehabilitation Trust Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Suzette Doherty Care Home 5 Category(ies) of LD Learning Disability (5) registration, with number of places Myland House I56 - I05 S17893 Myland House V221665 UI 170805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th March 2005 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 aquired brain injury. Myland House I56 - I05 S17893 Myland House V221665 UI 170805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on the 17th August 2005, lasting 6.0 hrs. In which, the inspector was joined by a new colleague to the Commission. The inspection process included: discussion with four service users, the registered manager and staff. A tour of the premises included observation of service users’ bedrooms, bathing and toilet facilities, as well as communal and garden areas. During the course of the inspection a range of documentary evidence was sampled. Twenty-three of the forty-three standards were inspected, nineteen of which were met, the remainder were partially meet. What the service does well: The service provides support in a small homely environment, in which service users are encouraged to maximise their potential. Service users are supported by a small number of staff, many of who have known them for a considerable time. The service works hard at encouraging service users to maintain and further develop skills, and maintain interests in hobbies and activities which they may have been involved or had particular interests in before their injuries. Staff benefit from a management team who provide them with sound leadership and direction. Staff further benefit from training provided by the organisation, which is specific to supporting people who have an acquired brain injury. The service works proactively in encouraging service users to maintain contacts with family and friends. The home’s policies and procedures are for the most part corporately developed documents, which are generally clear and concise, and are readily available to staff. Myland House I56 - I05 S17893 Myland House V221665 UI 170805 Stage 4.doc Version 1.40 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. Myland House I56 - I05 S17893 Myland House V221665 UI 170805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Myland House I56 - I05 S17893 Myland House V221665 UI 170805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 4, and 5. The home has a pre-admission assessment which clearly identifies individual’s needs and aspirations. Evidence reflects that service users and their families have opportunities for trial visits to the home. Service users who reside within the service have a clearly defined contract of residency. EVIDENCE: A new admission to the home was made in April 2005. The pre-admission screening tool used by the home included: Social history Medical history Cognitive/communication skills Family social contact. The pre-admission assessment was carried out by a representative of the home and was completed in consultation with the service user’s next of kin. Discussion with the service user and their next of kin indicated that they visited the home twice before finally deciding that the home would be able to meet their needs. A placement review was held after six weeks. Myland House I56 - I05 S17893 Myland House V221665 UI 170805 Stage 4.doc Version 1.40 Page 9 Individual contracts sampled on file evidenced the full terms and conditons of residency at Myland House. Myland House I56 - I05 S17893 Myland House V221665 UI 170805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 and 9. The care plan was written in such a way as to ensure that needs and personal goals were identified. There was evidence to support that the service user is supported to take risks as a part of developing an independent lifestyle. EVIDENCE: The care plan of the service user recently admitted to the home was sampled and there was evidence of goals being set, with guidance as to how the service user should be supported. Review dates were seen to be set, and there was evidence to suggest that the service user had been consulted with in relation to their care plan. On the day of the inspection the service user’s next of kin was visiting and spoke of the home’s willingness to consult on all aspects of their relative’s care. The care plan sampled contained good evidence of risk assessments having been undertaken, which identified the potential hazards and the precautions to be taken to minimise the identified risk. Myland House I56 - I05 S17893 Myland House V221665 UI 170805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 15, and 17. Service users are actively supported to partake in age appropriate activities and to become part of the local community. Service users are actively supported to maintain contact with families and friends. Service users had their food preferences and dietary needs met. EVIDENCE: The service user recently admitted to the home spoke of being supported to engage in a similar activity to that which they had engaged in prior to moving to the home. This was further reiterated in discussion with the service user’s next of kin. The service user further spoke of being supported by the home to maintain their interest in outdoor pursuits, by supporting the service user to acquire a part time voluntary post, working one day a week with the local forestry park rangers. Myland House I56 - I05 S17893 Myland House V221665 UI 170805 Stage 4.doc Version 1.40 Page 12 Discussion with the newly appointed deputy manager indicated that service users’ involvement in the local community is limited to visits to the local public house and the local shops, where service users are reported to be well known. Later, during the course of the inspection, one service user alluded to their visiting the local public house. Service users are supported to vote and visited the polling booths at the recent General Election. On the day of the inspection two service users were witnessed visiting the local shops to purchase a newspaper. Discussion with service users indicated that they access the following community based facilities: Local public house Cinema Library Gateway club Supermarket. On the day of the inspection the next of kin of a service user spoken with spoke of the home being welcoming whenever they visited, and of being consulted with on all aspects of their relative’s care. Discussion with service users clearly identified that menus reflected a wide range of food preferences that matched individuals’ choices. Opportunity to be involved with food preparation was confirmed by both staff and service users. Ample food supplies were observed, purchased locally by service users on a regular weekly basis, supported by staff. Myland House I56 - I05 S17893 Myland House V221665 UI 170805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 20. The home’s policies and procedures relating to service users’ medication are robust and safe. EVIDENCE: Although the home’s practices in relation to the administration of medicines were not inspected on this occasion, they were deemed to be safe at the last inspection, apart from the fact that there were no certificates to confirm that staff had received accredited training. Those records were subsequently seen at this inspection. Myland House I56 - I05 S17893 Myland House V221665 UI 170805 Stage 4.doc Version 1.40 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23. The home’s complaints and protection policies are robust in terms of protecting service users. EVIDENCE: The home has a complaints procedure which is corporately developed and which was deemed to meet with regulatory requirements. At the time of the inspection no complaints had been received by either the home or the Commission for Social care Inspection. Whilst a service user spoken with during the course of the inspection spoke of knowing who and how to complain, a relative spoken with spoke of not being aware of the home’s complaints procedure. Once again the home’s adult protection procedure is corporately developed and was deemed to be robust in terms of protecting service users. All staff have received training in this area, which was evidenced by certificates of attendance. Myland House I56 - I05 S17893 Myland House V221665 UI 170805 Stage 4.doc Version 1.40 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 26, 27, 28, 29 and 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms and en suite facilities maximise independence and reflected individual choice in its furnishings and décor. Communal areas, including the lounge, dinning room, sunroom and garden, provide ample shared space. No secure arrangements were available for staff to store their personal effects. The home presents as clean and tidy. EVIDENCE: The premises are in keeping with the local community, and were deemed to be safe for its stated purpose, being accessible to all service users. Furnishings and fittings were of a good quality. Myland House I56 - I05 S17893 Myland House V221665 UI 170805 Stage 4.doc Version 1.40 Page 16 Service users’ bedrooms and en suite facilities were reflective of individual need. Personalisation of each room was apparent. Service users spoken to confirmed involvement of choice of furnishings and décor. Shared space was ample and the garden facilities had been upgraded to incorporate a gravel stepped area, with hand rails to facilitate access for those individuals with mobility problems. The current sleeping in system is under review, to include replacement of the sofa bed used. The need to address the shortfall in providing a secure staff storage area for personal effects needs to be addressed. The home presents as being clean and tidy, and free from any offensive odours. Current practices around soiled laundry need to be reviewed and a procedure, with an associated risk assessment, devised to reflect the same. Myland House I56 - I05 S17893 Myland House V221665 UI 170805 Stage 4.doc Version 1.40 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34 and 36. The home’s recruitment practices continue to require further development to ensure that they adequately protect service users. Formal supervision took place at regular intervals and specialist training of staff was evident. EVIDENCE: Three staff files were sampled and a number of omissions continued to be noted in respect of Schedule 2 of the Care Homes Regulations: Photographs of identity Evidence of the employees physical/mental health status. The manager was referred to Schedule 2 for further guidance. Discussion with staff and sampling of staff files indicated that formal supervison and its regularity had improved since the last inspection. Staff accessed specialist training specific to service user need. Myland House I56 - I05 S17893 Myland House V221665 UI 170805 Stage 4.doc Version 1.40 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38, 39 and 43. There is evidence of a process for ensuring that service users’ views of the home are taken account of. There is evidence to support that the home has competent and accountable management. The management operates an open style of leadership. EVIDENCE: The home has a corporate policy on quality management (developed in July 2005) that identifies the need for an annual quality audit to be carried out by the organisation’s quality assurance division, which includes feedback from service users and stakeholders. The home has a current business plan, which included future projections for the service. Myland House I56 - I05 S17893 Myland House V221665 UI 170805 Stage 4.doc Version 1.40 Page 19 Current public liability insurance was seen. Lines of accountability were clear and concise. Staff spoke of a positive working relationship with management, confirming the home manager’s approachability. Direct observation indicated a positive working relationship with staff. Myland House I56 - I05 S17893 Myland House V221665 UI 170805 Stage 4.doc Version 1.40 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 3 Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 3 2 3 2 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x 3 Standard No 31 32 33 34 35 36 Score x x x 2 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Myland House Score x x 3 x Standard No 37 38 39 40 41 42 43 Score x 3 3 x x x 3 I56 - I05 S17893 Myland House V221665 UI 170805 Stage 4.doc Version 1.40 Page 21 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 28 Regulation 23 (3)(a) (ii) 13(4c)16 (e) Requirement The registered person must provide secure storage space for staffs personal effects, when sleeping in at the service. The registered person must ensure that a review of laundry procedures takes place, and that appropriate risk assessments are put in place to reflect the same. The registered person must ensure that records pertaining to staff recruitment are held by the home, as listed under Schedule2 of the Care Homes Regulations. The previous timescale set of June 2005 was not met. 4. Timescale for action 30th November 2005 30th November 2005 30th November 2005 2. 30 3. 34 19 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 22 Good Practice Recommendations It is recommended that the home ensures that all next of kin of service users are made aware of the homes complaints procedure. I56 - I05 S17893 Myland House V221665 UI 170805 Stage 4.doc Version 1.40 Page 22 Myland House Myland House I56 - I05 S17893 Myland House V221665 UI 170805 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: 0845 015 0120 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. 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