Inspection on 08/05/06 for Purbeck Care

This inspection was carried out on 8th May 2006.

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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Purbeck Care 26/01/10

Purbeck Care 13/10/09

Purbeck Care 11/05/09

Purbeck Care 22/10/07

Purbeck Care 20/02/07

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Binnegar Hall East Stoke Wareham Dorset BH20 6AT Lead Inspector Marion Hurley Key Announced Inspection 8th May 2006 09:30 Binnegar Hall DS0000066059.V289197.R01.S.doc Version 5.1 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 Binnegar Hall DS0000066059.V289197.R01.S.doc Version 5.1 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. Binnegar Hall DS0000066059.V289197.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Binnegar Hall Address East Stoke Wareham Dorset BH20 6AT 01929 552201 01929 556441 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) Purbeck Care Limited Terence Leslie Hartley Care Home 52 Category(ies) of Learning disability (52) registration, with number of places Binnegar Hall DS0000066059.V289197.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 5 people in the category of LD(E) Date of last inspection Brief Description of the Service: Binnegar Hall is registered to provide a residential service for up to 52 people with Learning Disabilities. It is situated in extensive grounds just off the road between Wool and Wareham in Dorset. The home consists of three buildings – Binnegar Hall , Stable Cottage and Garden Cottage. Binnegar Hall is approached through electronically conrtolled gates. There is ample parking for both staff and visitors. At the time of the inspection 29 people were accommodated. The main house, Binnegar Hall has 24 bedrooms and is currently accommodating 20 residents. There are two communal lounge areas, two dining rooms, a quiet room and a games room. Areas of the home have been designated for the use by one of the two groups: the older group of service users use one lounge and the younger service users who present with more challenging behaviours use the other lounge. The area known as Purbeck Court comprises Garden Cottage, Stable Cottage and a third area currently used as offices. Garden Cottage houses service users who retain a higher level of independence and self-determination and has 5 en-suite bedrooms, a lounge and kitchen. There are currently four residents living in Garden Cottage. Stable Cottage specialises in the care of service users specifically with autistic spectrum disorders and has 8 en-suite bedrooms, a lounge, a narrow dining area and kitchen. Stable Cottage is currenlty accommodating five service users. Both at Purbeck Court and the main house, bedroom accommodation is on ground and first floor levels and is provided in either single or double rooms. Some rooms have en suite facilities. Toilet and bathroom facilities are sited appropriately around the home in sufficient numbers. Binnegar Hall DS0000066059.V289197.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulations Act 2001, uses the term “service user” to describe those living in care home settings. For the purpose of this report, those people living at Binnegar Hall will be referred to as “residents”. This announced inspection commenced week beginning 8th May 2006. The inspector visited the home at different times during this week. The inspection begun by having discussions with the Registered Manager and the Service Development Manager in respect of progress made since the last visit and the purchase of the home in December 2005 by Purbeck Care Limited. During the inspection, records and documentation relating to the key standards assessed were read and checked; these included a sample of staff files, residents’ care plans and records, financial management of resident’s monies, records of accidents and incidents and any causes for concern. A tour of the home and grounds was completed and some residents’ bedrooms were viewed with their permission. Discussions with residents and staff were conducted both individually and in small groups, and these all contributed to the evidence and understanding on the running of the home on a daily basis. 29 residents were accommodated at the time of this inspection. Some residents have complex needs and communication abilities are variable and where possible these residents were observed going about their normal routines in and around Binnegar. 13 comment cards were returned from relatives/ visitors some acknowledging the changes already implemented by the new owners Purbeck Care Ltd whilst others indicated frustrations that works and staffing levels had not significantly changed. Some comments referred to the lack of activities and outings’ however, the appointment of two full time Activity Co-ordinators have already started to address this issue. One comment card read “ I have always been able to talk to any staff” “very good care thanks to staff from many different parts of the world” “we are grateful.” 5 cards were returned by professionals and again reflected mixed responses from those who considered some improvements had been achieved “significant improvements” “things have greatly changed in the past six months” to others who remained concerned that there was little evidence demonstrating change in the working practices. “Have your say” questionnaires were completed by residents, some independently and others with the support of staff. Comments ranged from “ I would like to do more” “I know how to complain”” I never see the report”” I can always ask to go out” and finally “I get along alright, I am quite happy”. Binnegar Hall DS0000066059.V289197.R01.S.doc Version 5.1 Page 6 Since the last inspection Regulation 37 reports have been received and Regulation 26 reports completed and submitted to the Commission. At the time of this inspection fees ranged from £451.28 - £1339.80. Once the improvement works have been completed and the new staffing structure in place it is the intention of Purbeck Care Ltd; to produce new brochures, Statement of Purpose and Service User Guide which will clearly describe the facilities, services and staffing arrangements at Binnegar Hall. What the service does well: What has improved since the last inspection? Detailed Care Plans have now been completed with and for each resident. A duty manager system has recently been implemented and this senior member of staff is designated to deal with all matters brought to their attention, ensure medical appointments are kept and that any external professionals are greeted and appropriately assisted during their visit. This is part of the full staffing restructure currently under review. Once implemented it is hoped this will create more time for residents to spend time doing one to one activities of their choice. Binnegar Hall DS0000066059.V289197.R01.S.doc Version 5.1 Page 7 The recruitment procedure has been improved and staff files now have evidence that all references and statutory checks are completed. The appointment of two full time Activity Co-ordinators who are just introducing a weekly programme of events, outings and activities is already being enjoyed by some residents for example one group of four residents followed a sequence of activities shopping, preparing, cooking and enjoying their chosen meal. Three residents have recently commenced full time College courses and are studying life and vocational skills. A group of residents from Garden Cottage have secured a regular contract to deliver a local Community magazine. The introduction of a staff communication book has improved the exchange of information between staff and the management team and has begun to make staff more aware of their duties and responsibilities. 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. Binnegar Hall DS0000066059.V289197.R01.S.doc Version 5.1 Page 8 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 Binnegar Hall DS0000066059.V289197.R01.S.doc Version 5.1 Page 9 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 adequate. This judgement has been made using available evidence including a visit to this service. No new residents have been admitted since the last inspection, EVIDENCE: Purbeck Care Limited purchased Binnegar Hall in December 2005. The registered providers and manager recognised that a major refurbishment and new staffing structures were required and until both are fully completed have elected not to consider any prospective residents. The procedures for considering prospective residents is currently under review, therefore, this key standard will be fully assessed at the next inspection. Binnegar Hall DS0000066059.V289197.R01.S.doc Version 5.1 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): 6, 7, & 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Revised care plans, which are detailed and informative, were completed for each person living at Binnegar between January and March 2006. These plans provide staff with the information they need to satisfactorily meet the assessed needs of the residents. Residents, according to their individual abilities and needs are supported to make decisions about their lives. Residents are encouraged to take responsible risks within the context of the home’s risk assessments and risk management strategies that encourage residents to be as independent as possible. Binnegar Hall DS0000066059.V289197.R01.S.doc Version 5.1 Page 11 EVIDENCE: Since the last inspection members of the management team have worked hard to ensure that all residents now have a comprehensive care plan. The personal files of four residents were examined and each was found to be informative and detailed. Each file contained essential information about the resident and their preferred daily routines, likes and dislikes and any specific health needs. The plans set out in detail the action required by staff to ensure all aspects of the residents’ health and social care needs are met. The care plans demonstrated that the health needs of the residents should be adequately met by staff and by accessing other specialist health care professionals. Records and outcomes of appointments i.e. medical check ups, dental, opticians were recorded in the daily records. Incidents and accidents were cross-referenced from the daily records with regulation 37 reports, the accident book and the staff communication book. This is good practice and in theory should alert all staff to any matters arising from one shift to the next. Risk assessments, which were read, reflected the different needs of the residents and covered all aspects of their daily lives both in the home and in the community. One resident helpfully discussed their care plan with the inspector and verified the information stating it was “pretty good, about right.” Some residents living at Binnegar would not understand the concept of personal care plans, however, they are certainly able to indicate their preferences and it is important any observations made by staff should be carefully reported in the daily records and included when the care plans are next reviewed. Residents living in the main house have been divided into two groups currently located in areas known as the East & West Wing. Each group has one file for all their daily records and these are kept in the communal lounges. Managers are aware this is poor practice and breaches residents’ confidentiality. However this is balanced with the need to encourage all staff to read the daily records. A requirement issued in January 2006 remains within the timescale. Most entries in the daily records were informative however some were minimal and subjective and not supported by evidence. A recommendation has been made for the home to include personal goals and achievements for each resident. These should be included with their care plans and reviewed with other aspects of their individual care plans. Resident’s financial affairs and personal money is safely handled and all the records were clear and carefully balanced. Purbeck care Limited with the management team hope to introduce a system, which supports all the residents to manage their own finances. However, it is understood not all the Binnegar Hall DS0000066059.V289197.R01.S.doc Version 5.1 Page 12 resident’s personal allowances are held at Binnegar Hall and some personal benefits remain with relatives. This issue may have to be addressed to ensure all the residents with support can take greater control over their own money. Binnegar Hall DS0000066059.V289197.R01.S.doc Version 5.1 Page 13 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 adequate. This judgement has been made using available evidence including a visit to this service. Opportunities for residents to participate in meaningful activities both within the home and out and about in the community are being developed. The recent recruitment of two full time Activity Co-ordinators is already benefiting some of the residents who are involved in a weekly programme of events, outings and activities. Residents are offered meals, which take into account their nutritional and health needs. EVIDENCE: Care plans examined documented the residents’ leisure and vocational interests. However from observations made through this inspection there were many times when staff seemed to be “minding” the residents and there was little evidence of attempts to engage residents in activities. Binnegar Hall DS0000066059.V289197.R01.S.doc Version 5.1 Page 14 It is clear that some residents have become very used to the routine of being able to walk round the grounds unsupervised and therefore avoid contact with staff. It is equally apparent that some staff accept this as a routine pattern of behaviour and seem to make few attempts to engage with those residents or seek activities which may stimulate and interest those residents who have got into the habit of walking without much purpose. This lack of structure and purpose was reinforced at the staff handover where there was no discussion about the morning’s activities or any planning for the afternoon. The inspector does acknowledge that aspects of the freedom and the expanse of the grounds may be a positive experience for some residents but this must be balanced against what might just be interpreted as an “uneventful day.” A lack of structure may be beneficial to some residents particularly when they can occupy their time but for others it appears to leave them with no structure or sense of purpose to their day. Some older residents are more independent and access local transport to go out and about. One person spoke of their bus trip to Seatown and another described going to the local market. Another spoke of their “garden.” The activity co-ordinators are at the very early stages of developing a weekly programme of events both on and off site. During the time of this inspection one group had been shopping for their cookery ingredients and another group went swimming and one resident accessed their regular placement at the Community College. Therefore, despite the observations of some care staff not motivating residents there was equally evidence of the beginnings of some positive activities being initiated based on the residents’ individual interests. Three residents were specifically asked about their lifestyles and all three described them as “ quite happy, okay, I come and go, I can take myself off if I want to”. Other residents were observed to be quite relaxed and generally there was a calm atmosphere throughout the home though not necessarily very stimulating. Most residents have relatives which they go and stay with whilst others choose to visit their son or daughter at Binnegar Hall. Visitors are always welcome and there are no restrictions on visiting. A menu is available for residents as they enter the dining room and the choice for the day is presented in the heated cabinet from which they can make their selection. There was no evidence to suggest residents are involved with the menu planning except for those living in Garden Cottage who choose the weekly menu together and do their own shopping and cooking. Those residents spoken with thought the meals were “fine” and one person described them as “good they’re okay most of the time ” and another person said the food was “pretty good.” At the time of this inspection Agency staff were employed in the kitchen and appeared not to have followed all the good practice guidelines. Food was found in the fridges, which had not been labelled, an open packet of bacon had Binnegar Hall DS0000066059.V289197.R01.S.doc Version 5.1 Page 15 not been properly sealed and no records of meals eaten by residents could be found for example the prepared menu for the day had not been followed and alternative dishes had been produced. The dishes were similar but not the same and therefore should have been recorded. A record of food consumed would ensure staff could monitor if each resident was maintaining a healthy eating regime. Binnegar Hall DS0000066059.V289197.R01.S.doc Version 5.1 Page 16 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ health care needs are primarily met by care staff and through other health care agencies. Care plans document the residents’ preferences in the level and style they are comfortable with. The CSCI Pharmacist undertook an inspection of the arrangements for the handling and administration of medicines in February 2006(NMS 20.) A report of that inspection may be obtained from the National Enquiry Line 0845 015 0120 or viewed on the web: www.csci.org.uk. EVIDENCE: Senior staff understand the health care needs of each resident and the level of assistance required for each resident to ensure their dignity and respect are upheld at all times. Several of the residents have very specific routines and clear instructions are available for care staff in the care plans. Health care needs are routinely met through a range of primary and secondary health care services. Records and discussions with the manager demonstrated that specialist support and advice are appropriately sought on behalf of the Binnegar Hall DS0000066059.V289197.R01.S.doc Version 5.1 Page 17 residents. Residents frequently see their GP and regularly use the local dental and optical services. Residents receive support from members of the Community Learning Disability Teams and others benefit from specialist psychological and psychiatric services. A record of referrals, meetings and outcomes were included with the residents care plans and one example described the involvement of the Occupational therapist. The resident in question proudly showed the inspector the aids and adaptations, though did confess, “I don’t always bother with them.” The home has good links with local GP’s and District Nurses who have provided valuable support and advise to both residents and staff. Binnegar Hall DS0000066059.V289197.R01.S.doc Version 5.1 Page 18 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 adequate. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints procedure and staff receive training in the protection of vulnerable adults. The home works well with the appropriate agencies in reporting any suspected forms of abuse. EVIDENCE: Four residents when directly asked said they would speak to any member of the management team if they had things to say or wanted to complain about anything. The four residents stated that they felt all members of the management team would listen to them and try hard to “get things sorted” The residents expressed considerably less confidence in the general staff being active in responding to their concerns. Some residents are members of a Speaking Up Group and use this forum for expressing their concerns and emotions whilst others join the Advocacy Group held at Binnegar Hall but independently facilitated by staff from Dorset Advocacy. The inspector was given permission by the residents to join this group, which on this occasion was attended, by three residents. Throughout the main house and in the two Cottages notice boards were displaying information about the Advocacy Groups, on making a Complaint and other related posters were noted including a prominent one on a Bill of Rights. The notices were written and in pictorial formats. The new owners and management team have introduced a system for staff to raise any issues /concerns by instigating a new folder with referral forms entitled A Cause for Concern. This new format for reporting any issues is Binnegar Hall DS0000066059.V289197.R01.S.doc Version 5.1 Page 19 being used. However, the records need to describe the outcomes and should cross reference with details of those outcomes in the relevant files i.e. staff and residents. It was obvious from discussions with staff and residents that verbal feedback and outcomes had been discussed but not recorded. The new management team and Registered providers are keen to work cooperatively with all Local Authorities and Voluntary Agencies to respond and resolve any issues or complaints or allegations, which are reported. Records demonstrated the work with other agencies and during the course of this inspection visit a multi agency meeting was taking place with the clear objectives of ensuring consistent practice when working with and managing one of the residents. A visiting social worker confirmed they “always found the management team co-operative and helpful to work with”. Discussions with senior staff confirmed their knowledge and understanding of the policies and procedures for the protection of vulnerable adults and their responsibilities and duties to take action. Abuse of adults with learning disabilities is identified as core training for all staff and the training matrix showed staff having completed training over the past eighteen months, however, it is important all staff continue to receive regular refresher training. Binnegar Hall DS0000066059.V289197.R01.S.doc Version 5.1 Page 20 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 adequate. This judgement has been made using available evidence including a visit to this service. Binnegar Hall does not currently provide a homely environment for residents to live in, however, many of the residents’ bedrooms have been personalised and reflect the resident’s individual tastes. A planned programme of major refurbishment is about to get underway which will significantly impact on the whole environment. This work with the planned investment in new furnishings and fittings will ensure the environment develops into a comfortable and homely environment for all those who live and work at the home. Residents and staff live and work in a clean environment. EVIDENCE: All areas seen on the day of the inspection were found to be clean, tidy and hygienic with no distinct odours detected anywhere. This standard has been greatly enhanced by the employment of domestic staff dedicated to household duties. Binnegar Hall DS0000066059.V289197.R01.S.doc Version 5.1 Page 21 The laundry is small but meets the requirements and appears totally functional and the member of staff who has overall responsibility reported that all the equipment and facilities are adequate to ensure the laundry is properly managed. Please note a concern has recently been raised with reference to one resident and their personal clothing. It is understood this matter has been resolved directly with staff and the person raising the concerns. Binnegar Hall DS0000066059.V289197.R01.S.doc Version 5.1 Page 22 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 adequate. This judgement has been made using available evidence including a visit to this service. Residents are supported by a strong management team, which lead and supervise the support workers. Recruitment policies and procedures are thorough and fully implemented which help safeguard and protect the residents. The home has recently appointed new staff. This should relieve the staffing pressures, which have existed throughout 2005. Once the new staff have completed their induction and the new staffing structure is implemented residents should benefit by experiencing more consistency in staffing and by having increased opportunities to participate in social and recreational activities with staff support. EVIDENCE: Six staff files were examined and were found to contain information, which provided evidence of thorough recruitment procedures being implemented at the home; however, three of the six had no photograph with the records. Staff have recently been recruited from overseas and two were on duty at the time of the inspection. Both employees explained they had had previous experience Binnegar Hall DS0000066059.V289197.R01.S.doc Version 5.1 Page 23 in the care sector. They both said they had been positively welcomed and felt they were settling in to their new jobs. One is currently completing their induction, orientation and familiarisation with the home, local services and the area. They think this may take up to three months to comprehensively complete. Language can be a problem on occasions and it is very important that new staff are encouraged and supported to take action to improve their English and their understanding of the range of accents they meet in the UK. Purbeck Care Limited who took ownership of Binnegar Hall in December 2005 are currently considering new staffing structures for the home and have started recruiting to newly created posts. Staffing jobs are to be grouped together with senior staff identified as supervisors. For example one group are classified under Household. This group includes staff employed specifically to work in the kitchens, in the laundry and others who undertake domestic /cleaning tasks. The newly appointed Household Supervisor will supervise this group. New contracts and new terms and conditions are being agreed and a Code of Conduct is currently under discussion. Purbeck Care Limited are currently recruiting staff for two new posts of Care Co-ordinators and these posts have superseded the existing role and functions of the Team leaders. A further two Care Co-ordinator posts will be recruited when further residents are admitted. Binnegar Hall DS0000066059.V289197.R01.S.doc Version 5.1 Page 24 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 this service. Within the home there is clear leadership from the management team and residents benefit from this open and consistent style of management. The home is managed to ensure the health, safety and welfare of the residents is maintained. EVIDENCE: The Registered manager has many years experience of working with people with learning disabilities. He is well supported by the Directors of Purbeck Care Ltd and other members of the management team. The Service Development Manager discussed the Purbeck Care Development /Improvement Plan for Binnegar Hall. This is a detailed document clearly Binnegar Hall DS0000066059.V289197.R01.S.doc Version 5.1 Page 25 identifying the desired outcomes and the action plan and realistic timescales to achieve these. The home is currently addressing many issues affecting the living and working environment for both residents and staff. Plans are progressing and it is hoped work will be complete within a six-month period. Purbeck Care Ltd since taking ownership has appointed staff to work full time at undertaking essential remedial work. Records relating to the health safety and welfare of residents were examined and found to be maintained and currently in date. Binnegar Hall DS0000066059.V289197.R01.S.doc Version 5.1 Page 26 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 2 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 2 33 x 34 3 35 2 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 x 3 2 LIFESTYLES Standard No Score 11 x 12 2 13 2 14 x 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 X x 3 x 2 x x 3 x Binnegar Hall DS0000066059.V289197.R01.S.doc Version 5.1 Page 27 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 YA7 Regulation 12(1)(2) Requirement Timescale for action 31/10/06 2 YA10 Staff must ensure all residents so far as practicable make decisions with respect to the care they receive. Some progress has been made but this is not yet consistently achieved for all residents, therefore, this requirement remains. The timescale for this requirement has been agreed and extended. 12(1)(4)a17(1)a(2) A reorganisation of record 31/10/06 keeping and staff administration areas has been achieved however, all records relating to residents must be securely maintained to ensure their privacy and dignity is safeguarded in respect of this personal information. It is recognised that confidentiality has greatly improved and at the current time there is a fine balance in protecting service user’s privacy DS0000066059.V289197.R01.S.doc Version 5.1 Page 28 Binnegar Hall 3 YA17 16(2)(j) 4 YA39 24 whilst encouraging all staff to read the care plans and daily information therefore the timescale to achieve all aspects of this standard has been extended by agreement. The Registered providers 31/07/06 must ensure suitable arrangements for maintaining satisfactory standards of hygiene in the care home /kitchen area. Effective quality assurance 31/10/06 and quality monitoring systems based on seeking the views of service users must be in place to measure the success in the aims, objectives and statement of purpose. This standard is partly being addressed through regular staff and service user meetings. Comprehensive Regulation 26 Reports are submitted to CSCI and a staff survey is currently being undertaken. The timescale for this requirement has been agreed and extended. Binnegar Hall DS0000066059.V289197.R01.S.doc Version 5.1 Page 29 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 2 3 Refer to Standard YA6 YA7 YA12 Good Practice Recommendations It is recommended that individual aspirations and achievements should be record for each resident. It recommended each resident is encouraged with support and understanding to manage their own personal allowances. It is recommended that staff provide residents with the level of support and understanding required to ensure that residents are encouraged to access both educational and employment opportunities. It is recommended staff support residents to become part of, and participate in, the local community in accordance with assessed needs and the individual Plans. Please note the new Activity Centred has just opened and a daily programme of planned events about to commence. It is recommended staff are encouraged to provide sensitive and flexible personal support to maximise residents privacy, dignity, independence and control over their lives. It is recommended that the works to improve the living and working environment ensuring it is comfortable and homely are completed as soon as possible. Please note this work is in hand. It is recommended that the new staffing structure takes account of the need to meet the individual and collective needs of residents by the effective deployment of appropriately trained staff. 4 YA13 5 YA18 6 YA24 7 YA35 Binnegar Hall DS0000066059.V289197.R01.S.doc Version 5.1 Page 30 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Binnegar Hall DS0000066059.V289197.R01.S.doc Version 5.1 Page 31 - 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. 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