CARE HOME ADULTS 18-65
Northfield House Tower Hill Williton Somerset TA4 4JR Lead Inspector
Ms Sue Hale Unannounced Inspection 23rd November 2005 09:40 Northfield House DS0000059622.V268576.R01.S.doc Version 5.0 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 Northfield House DS0000059622.V268576.R01.S.doc Version 5.0 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. Northfield House DS0000059622.V268576.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Northfield House Address Tower Hill Williton Somerset TA4 4JR 01984 633810 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) Voyage Ltd Marianne Seager Care Home 10 Category(ies) of Learning disability (0), Physical disability (0) registration, with number of places Northfield House DS0000059622.V268576.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Registered for 10 persons in Categories LD and PD Date of last inspection 14th July 2005 Brief Description of the Service: Northfield House is a large detached property located on the outskirts of Williton. Accommodation is provided on two levels. The home has ten bedrooms all have en-suite facilities. There are ground floor bedrooms and facilities for people who have the use of a wheelchair, including a bathroom with an overhead hoist and a walk-in shower. There are further bedrooms and a shower room and bathroom on the second floor. The extensive garden and patio areas of the home are beautifully presented. Northfield House is registered with the Commission for Social Care Inspection to provide personal care for up to 10 residents who have a learning disability and physical disability. Northfield House is not registered to provide nursing care. Voyage Ltd owns the home and the responsible individual is Mr Steve Ball .The registered manager is Marianne Seager. Northfield House DS0000059622.V268576.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over the course of one day in November 2005. The inspector met several of the residents and sat and had lunch with a number of residents and staff. The inspector viewed all parts of the home, checked all records relating to three individual residents including care and support plans and the accident book. Selected files of newly appointed staff were examined. This report can be read in conjunction with the previous report of 14th July 2005. As a result of this inspection one requirement was identified and three recommendations were made. What the service does well:
Care plans and risk assessments were very well maintained, up to date and contain detailed information to enable staff to meet residents, health, social and care needs. Information was stored securely in the office to ensure confidentially was maintained. The home provides a high standard of accommodation and facilities, while ensuring a comfortable, homely environment, focusing on the involvement and independence of residents. The home has excellent links with social and healthcare professionals to ensure that all aspects of residents’ social and healthcare needs are met. Staff were familiar with the likes, dislikes and individual needs of the residents. Interactions between staff and residents were kind and respectful and it was apparent to the inspector that residents were very relaxed and comfortable in the presence of staff. A resident spoken to said that ‘I love living here’. The routines of the home were as flexible as possible to suit the needs and preferences of the residents. Residents’ benefit from a wide range of activities and opportunities. Regular holidays and trips out take place in the home’s vehicles. Some residents were going out to computing and art and craft classes on the day of the inspection. Residents have all had the opportunity to go on holiday or to spend leisure time as they choose. The majority of residents were planning their trips home Northfield House DS0000059622.V268576.R01.S.doc Version 5.0 Page 6 to see family for Christmas. Residents spoken with were very positive regarding the opportunities that were open to them at the home. Residents have been involved in the decision to have a summer house built in the garden in the near future and were looking forward to using it during the warmer weather. 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. Northfield House DS0000059622.V268576.R01.S.doc Version 5.0 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 Northfield House DS0000059622.V268576.R01.S.doc Version 5.0 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, 5. A thorough pre admission process was in place to ensure the home could meet residents’ needs. Contracts between the residents detailing the terms and conditions of residency were in place. EVIDENCE: There have been no new admissions since the last inspection. However, the inspector discussed with the manager what the pre admission process would involve. The home would obtain information from the Local Authorities that were funding a placement and families and any medical or healthcare professionals involved would be part of the process. The manager told the inspector that the pre admission process would be well planned, and would involve visiting the prospective residents in their own environment and arranging for trial periods to be spent at the home. The needs of existing residents would be taken into account when any new admission was being considered. Contracts with residents were on individual files checked and contracts with funding authorities were in place. Placement reviews had taken place yearly Northfield House DS0000059622.V268576.R01.S.doc Version 5.0 Page 9 and reports of the meetings on file that indicated that the placements continued to meet the needs of the individual residents. Northfield House DS0000059622.V268576.R01.S.doc Version 5.0 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 the following standard(s): 7, 9. Service users are supported to maintain an independent lifestyle and are fully involved in life at the home. The company’s procedures for the management of service users’ finances requires improvement to promote independence for service users. Risk assessments were in place to safeguard residents and enable them to have an independent lifestyle. EVIDENCE: Residents are encouraged and supported to make informed decisions about their life and the care they receive. Residents are involved in the care planning process and are fully informed of any restrictions identified. Residents and staff confirmed that they (the residents) are encouraged and supported to be involved and to make decisions about all aspects of life at the home from decisions about the decoration of the home to the recruitment of new staff and the plans to build a summerhouse in the garden.
Northfield House DS0000059622.V268576.R01.S.doc Version 5.0 Page 11 Detailed risk assessments are completed for residents according to individual need and any identified risks are discussed and agreed with the residents and other professionals as appropriate. Residents are supported to take informed risks as part of their plan of care. Detailed up to date risk assessments were seen in the two care plans examined However, whilst residents now have their own bank account, they are neither signatories to the account or able to access their money independently or with staff support. Bank statements for the accounts were not available on the day of the inspection. These should be obtained and shared with residents in a way suited to their capability. The manager and deputy manager are signatories on all the residents’ bank accounts. The manager was unaware if the residents’ bank accounts were interest bearing. In some cases the accounts contained large sums and these should be transferred to savings account to attract interest. Northfield House DS0000059622.V268576.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13, 14. The home encourages and supports residents to access the local community and partake in a wide variety of leisure, recreational and social activities. EVIDENCE: Residents told the inspector that they had lots of opportunities for leisure activities in the local community, including trips to the pub, attending the local education centre where community events take place and classes are available in a variety of subjects including computing and art and crafts. Some residents spoken to were going to the cinema over the coming weekend to see Harry Potter. Staff spoken to confirmed that resident have opportunities for leisure trips and activities in the evenings and weekends with appropriate staff support. A resident spoken to said that they had recently been out with staff and supported to do their Christmas shopping. The home has its own vehicles and residents were involved in choosing the colour before it was ordered. All residents have the opportunity of going on holiday, some residents went to Majorca recently and others have been to Bournemouth and Newcastle.
Northfield House DS0000059622.V268576.R01.S.doc Version 5.0 Page 13 Residents spoken to said that the routines of the home were flexible to suit their choices and preferences. Northfield House DS0000059622.V268576.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19. The home ensures that residents have access to all appropriate health care professionals. Residents receive personal support and care in a flexible way to suit their choices and preferences. EVIDENCE: The care and support plans view contained records of visits made to health care professionals. These included visits to the GP, dentist, chiropodist, optician and psychologists. The inspector observed that residents were supported by staff to choose their own daily routines as far as practicable. Residents spoken to said that they were able to choose when they got up and went to bed, and when they did activities it was of their own choosing. Northfield House DS0000059622.V268576.R01.S.doc Version 5.0 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. The home’s complaints procedure is good and residents are clear that any concerns will be taken seriously. EVIDENCE: The home has a clear complaints procedure that has also been produced in symbol format for service users. Copies of the complaints procedure are available to residents in a format suited to their needs. The policy needs minor revision to make clear that complainants can contact the Commission for Social Care Inspection at any stage of a complaint. Residents spoken to told the inspector that they were clear on how to make a complaint, if necessary, and that they were confident that their concerns would be taken seriously. A resident spoken to said that they would ‘tell Marianne (the manager) or staff if I had a problem’. The inspector was informed that there have been no complaints since the last inspection and no complaints/concerns have been raised directly with the CSCI. Northfield House DS0000059622.V268576.R01.S.doc Version 5.0 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, 25, 26 & 28. Residents benefit from a safe, clean, homely environment that meets their needs and provides private accommodation and a good range of communal areas. EVIDENCE: Northfield House is situated in a quiet residential area not far from the centre of the small town of Williton. The home was clean and tidy on the day of the inspection. The accommodation is arranged over two floors. The home has 10 single bedrooms all of which have en-suite toilet facilities. 5 bedrooms are on the ground floor with 5 on the first floor. 4 of the bedrooms are accessible to wheelchair users. Residents spoken to told the inspector that they liked their bedrooms and had been involved in choosing colour schemes for their rooms and were able to personalise their rooms, according to their choices and preferences. Communal areas are situated on the ground floor and consist of 2 lounges, a dining room, kitchen, computer and sensory room. Some areas of the home
Northfield House DS0000059622.V268576.R01.S.doc Version 5.0 Page 17 have been suitably adapted to meet the needs of residents with a physical disability. Adequate facilities were provided for staff. Northfield House DS0000059622.V268576.R01.S.doc Version 5.0 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. Voyage has a commitment to provide staff with the knowledge and skills to provide a high standard of care for residents. Voyage has a robust recruitment process that protects residents from the risk of abuse and harm. EVIDENCE: The inspector viewed the recruitment files of three recently appointed staff members. The files contained the required documentation. Voyage has a dedicated training department and the manager is notified of forthcoming courses and able to nominate staff as required for their professional development. All staff had completed basic training such as first aid, moving and handling, food hygiene and fire safety. Newly appointed staff undertake the Learning Disability Award Framework training. The manager told the inspector that 47 of staff were qualified to NVQ level 2 or above, with a further three staff registered on NVQ level 2 courses. The manager and staff spoken to said that Voyage has a commitment to providing staff training and that relevant training courses are available with encouragement and support to attend readily available.
Northfield House DS0000059622.V268576.R01.S.doc Version 5.0 Page 19 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): 41. The home has detailed policies and procedures that were up-to-date and relevant. Not all information was kept in accordance with the Data Protection Act 1998. EVIDENCE: The home has a good selection of policies and procedures for staff and residents and some have been produced in symbol format. These had been kept under review to ensure that they meet with current legislation. Information was stored securely in the office to ensure confidentially. Regular meetings are held for staff and minutes are taken. The staff meeting minutes and some other records within the home contained personal information about the residents and were not kept in accordance with the Data Protection Act 1998. Northfield House DS0000059622.V268576.R01.S.doc Version 5.0 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 X 3 Standard No 22 23 Score 2 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 2 X 3 X Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 3 X 3 X X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Northfield House Score 3 3 X X Standard No 37 38 39 40 41 42 43 Score X X X X 2 X X DS0000059622.V268576.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? No. 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 YA41 Regulation 17(3)(b) Requirement Information relating to individual residents must be kept in their care file in line with the Data Protection Act 1998. Timescale for action 31/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA7 Good Practice Recommendations The manager should ensure that residents’ finances are managed in a manner that they benefit from interest bearing accounts or savings accounts. The manager should look into the possibility of residents who are able to, having their own cash card for their bank account. The manager should ensure that information about their finances is shared with residents in a manner to suit their abilities including bank statements. The complaints policy should be revised to make clear that complainants are able to contact the Commission for Social Care Inspection at any stage of complaint. 2 3 YA7 YA22 Northfield House DS0000059622.V268576.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Northfield House DS0000059622.V268576.R01.S.doc Version 5.0 Page 23 - 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!
