Inspection on 27/09/06 for Myland House.

This inspection was carried out on 27th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 2 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. 12/10/07

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 Final Unannounced Inspection 27th September 2006 09:03 Myland House DS0000017893.V290129.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.V290129.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.V290129.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.V290129.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th February 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, this information was provided by the registered manager during a telephone conversation on the 23rd October 2006. Myland House DS0000017893.V290129.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 for the inspection year 2006/2207, which took place on the 27th September 2006, 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 one member of the care team Tour of the premises included observation of one service users bedroom and bathing facility, communal areas and gardens. During the course of the inspection a range of documentary records were sampled, most of which were found to be in order. Twenty-two of the forty-three standards were inspected, twenty of which were met, and the two not met were considered to be minor shortfalls. What the service does well: What has improved since the last inspection? Myland House DS0000017893.V290129.R01.S.doc Version 5.2 Page 6 Since the previous inspection the homes recruitment processes have been tightened up, and now meet with regulatory requirements. 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 DS0000017893.V290129.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.V290129.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 at least once during a 12 month period. 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 the service. Service users can expect their needs to be assessed prior to admission to the home. EVIDENCE: Three service users files were sampled, two were of longstanding service users, neither of which contained any pre-admission information, the third file sampled was for the service user most recently admitted to the home, the assessment covered the following areas: • Social history • Interests • Medical history • Medication • Reading/writing skills • Method of communication • Family/social contact. This assessment information is then used to generate the service users plan of care. Myland House DS0000017893.V290129.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. Service users can expect their needs and personal goals to be reflected in their plans of care. Service users are supported to make decisions about their everyday lives and Service users are supported to take risks, as part of developing an independent lifestyle. EVIDENCE: Care plans sampled were basic, identifying the nature of the need, the identified goal, and the interventions required by staff to enable the goal to be met, all three of the plans sampled had been reviewed, and service users had been involved in the care planning process. Only one service user residing at the home has a formal advocate, who is currently involved in supporting the service user to sort out access to their finances. All of the service users have their own bank accounts, and money held by the home on behalf of service users is paid out to them twice weekly, as directed by the service users themselves. Myland House DS0000017893.V290129.R01.S.doc Version 5.2 Page 10 Upon admission to the home a risk identification checklist is completed in respect of each service user, from this the risk assessment is developed, which identified the: the nature of the activity, the likely hazards and associated risks, any existing precautions, and the actions to be followed or taken to reduce or minimise the risk. Myland House DS0000017893.V290129.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the 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 enabling and promote independence. Service users can expect to be provided with a diet that is healthy and wholesome. EVIDENCE: Discussion with the service users evidenced that one service user has voluntary employment one day a week at the local environmental centre; another spoke of their hope to soon start attending a local resource drop in centre. One service user spoke of their past interest in arts and crafts, and went on to inform the inspector of being supported to continue this interest through the Local Education College. Myland House DS0000017893.V290129.R01.S.doc Version 5.2 Page 12 The home has access to its own people carrier; service users spoke of taking part in the local community through the usage of local shops, public houses, cinemas, and garden centres. Discussion with all of the service users evidenced that the home has an open door policy on the receiving of visitors, service users spoke of being free to choose where to receive their visitors (the home has a small conservatory area that is available to service users for this purpose, should they wish to use it). The day prior to the visit the home had had an open day, and service users spoke of how well the day had gone, many spoke of family members having attended. All service users rooms are lockable, although none of the service users currently have keys, the registered manager pointed out that keys are available to service users upon request. Staff were seen and heard to interact with service users and not exclusively with each other, the interactions seen and heard were positive. Service users have unrestricted access to all areas of the home. Meals are provided three times daily, at least one of which was cooked, and snacks and drinks are available throughout the day, service users spoke of being consulted with on planning of the menus, meals are provided flexibly to accommodate service users activities, the lunchtime meal was discreetly observed, and was seen to be taken in a relaxed atmosphere. Myland House DS0000017893.V290129.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. Service users can expect their personal care needs to be met in a way that they require and prefer. Service users health care needs are well met, and the medication procedures are safe and well maintained. EVIDENCE: All of the service users residing at the home are independent in respect of their personal care needs; service users spoke of being free to choose their own clothes, and hairstyles. A range of aids and adaptations were available to enable service users to maximise their independence e.g. hand rails, raised toilet seats. Discussion with service users showed that times for getting up and going to bed were flexible, dependant upon individuals plans for the day. All service users are registered with a General practitioner, in addition service users have access to Clinical Psychiatrists and Psychologists provided by the Brain Injuries Trust, all other healthcare professionals are accessed via generic health care services. Service users are supported by the home to attend out patient appointments. Myland House DS0000017893.V290129.R01.S.doc Version 5.2 Page 14 One service user’s care file showed they had recently undergone extensive surgery, their file showed that they had received extensive follow up support to aid their recovery/rehabilitation. All medication is dispensed via a Measured Dosage System, for which all staff have received training, the home does not maintain any controlled medicines. Medication records sampled were all in order, medicines are returned to pharmacy via a medicines return book. Myland House DS0000017893.V290129.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. The home has a robust process for enabling service users to make complaints, and service users can expect the home to respond. The home’s procedures for protecting service users from harm and or abuse are robust. EVIDENCE: The home’s Complaints Procedure meets with regulatory requirements, service users spoke of being aware of how and who to complain to should they be unhappy with any aspect of their care provision. The home maintains a log for recording complaints received, since the previous inspection no complaints have been received by either the home or the Commission for Social Care Inspection. The home has in place robust procedures for dealing with adult protection matters, and all staff have received training in adult protection. Myland House DS0000017893.V290129.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 at least once during a 12 month period. 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 the service. Service users are supported in an environment that is homely, comfortable and safe. The home is kept clean, and was free of any unpleasant smells or odours. EVIDENCE: Tour of the premises found them to be fit for there stated purpose, being safe, accessible and well maintained, the premises were bright and cheerful and were free from any offensive or unpleasant odours. Furnishings and fittings were of a good quality, and were domestic in nature. Discussion with the service users evidenced that all of their rooms had recently been re-carpeted, and all said that they had chosen their carpets; in additions all communal areas of the home had been re-carpeted as well. One service users en-suite facility was in the process of being converted from a bathroom to a wet room, to better met their individual needs. The home’s laundry facility is situated just of the kitchen, a policy has been developed to cover the transporting of laundry through the kitchen area, and the laundry is equipped with hand-washing facilities. Myland House DS0000017893.V290129.R01.S.doc Version 5.2 Page 17 Myland House DS0000017893.V290129.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 &35. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. Service users are supported by a team of staff who are knowledgeable about their needs. Service users are protected by the home’s recruitment processes. Service users needs are met by a team of staff who have been appropriately trained. EVIDENCE: Service users are supported by a team of staff who have the competencies and qualities to meet their needs, service users spoke of staff being accessible and approachable, and being good listeners and communicators. The home does not employ any carers under the age of eighteen. Carers were knowledgeable of the conditions and disabilities affecting the service users. The home’s recruitment process was sufficiently robust to ensure that service users are protected from the risk of harm and or abuse, all of the records sampled contained all of the required documentary evidence required under regulation 19, schedule 3 of the Care Homes Regulations. Staff training records sampled, showed that since the last inspection the following training has been undertaken at the home: • Adult protection Myland House DS0000017893.V290129.R01.S.doc Version 5.2 Page 19 • Medication administration • Infection control • Fire training. All three of the files sampled evidenced that induction had been undertaken with each member of staff. The home accesses training for its staff via the Brain Injuries Trust, who have a training needs co-ordinator based at one of there home’s locally, care staff spoken with at the time of the inspection spoke of access to training being good. Myland House DS0000017893.V290129.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 &42. Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to the service. The home is well managed and run, in an open and transparent way, and service users are supported by a team of staff who are well supported. The home’s process for reviewing the quality of its service provision requires further development to ensure that the outcome of the process is informed to all interested parties. Service users cannot be assured that safety certificates relating to the safe running and operation of the home are up to date. EVIDENCE: The registered manager has significant previous experience of working in the care sector, and has been in post at the home for a number of years, the manager is qualified at N.V.Q level 4 in management and care, and undertakes periodic training to ensure that their knowledge remains up to date. Staff spoke of the management ethos of the home being open and transparent, Myland House DS0000017893.V290129.R01.S.doc Version 5.2 Page 21 stating that they felt they were provided with a clear sense of leadership and direction. The home’s quality assurance process is corporately developed and includes the use of questionnaires to seek the views of service users and other interested parties, discussion took place with the manager about how the outcome of the survey is reported back to those who took part. Records relating to the home’s safe working practices were sampled as follows: • Fire evacuation record • Emergency lighting records • Electrical installation certificate. The home’ gas installation certificate was out of date, and the manager was reminded of the need to redress this matter urgently. Myland House DS0000017893.V290129.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 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 3 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 2 X X 2 x Myland House DS0000017893.V290129.R01.S.doc Version 5.2 Page 23 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. 1. Standard YA39 Regulation 24 Requirement The process for reviewing the quality of the home’s service provision needs to be further developed to include a mechanism for communicating the outcome back to interested parties. The registered person must ensure that all safety certificates relating to the safe running of the home are available and current. Timescale for action 31/12/06 2. YA42 13 30/12/06 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.V290129.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Colchester Local Office 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. Extracts may not be used or reproduced without the express permission of CSCI Myland House DS0000017893.V290129.R01.S.doc Version 5.2 Page 25 - 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. 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