Inspection on 16/05/05 for Self Unlimited Blackerton House

This inspection was carried out on 16th May 2005.

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

Other inspections for this house

Self Unlimited Blackerton House 21/02/07

Self Unlimited Blackerton House 13/10/05

Self Unlimited Blackerton House 18/10/04

Self Unlimited Blackerton House 10/06/04

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 08/07/2008.

CARE HOME ADULTS 18-65 CARE Blackerton House East Anstey Tiverton Devon EX16 9JT Lead Inspector Sue Dewis Unannounced 16 May 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. CARE Blackerton House D54 D06 S21899 CareBlackerton V227123 160505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Care Blackerton House Address East Anstey, Tiverton, Devon, EX16 9JT 01398 341252 01398 341591 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) CARE (Cottage and Rural Enterprises Ltd) Thelma Sadako Hartas Care Home 36 Category(ies) of LD Learning Disability [36] registration, with number of places CARE Blackerton House D54 D06 S21899 CareBlackerton V227123 160505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: To allow one named service user, over the age of 65 years to remain in the home home. Upon termination of this placement, the registered person will notify the CSCI. Date of last inspection 18 October 2004 Brief Description of the Service: CARE Blackerton provides accommodation and personal care for up to 36 younger adults who have a learning disability, and are between the ages of 18 – 65 years. The Registered Provider, CARE Ltd, have worked with people with learning disabilities since 1966, and developed a number of communities throughout the country.CARE Blackerton aims to create an environment that encourages personal development, confidence and self-esteem. Service users are encouraged and supported to live as independently as possible. The home is situated in the rural location of East Anstey, near to the market town of Tiverton. Accommodation is provided in four cottages, Forbes, Groves, Crowberry and Courtyard. Each offers single bedrooms and communal living space, for up to 10 service users. There are facilities in each of the cottages for laundry and for making meals and snacks. There are opportunities on site for service users to participate in a range of day activities and workshops, which include, woodwork, pottery, textiles, horticulture and catering. CARE Blackerton House D54 D06 S21899 CareBlackerton V227123 160505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place during an early evening in mid May 2005. The inspection focused on looking at how the needs of the residents were met when they were in the cottages, rather than at day-services across the unit. Two inspectors spent time in two of the cottages each. While most residents were seen within the group setting, twelve were spoken with individually as well as seven staff. Seven care plans were looked at, but no staff records. Some requirements and recommendations made at the last inspection could not be checked as they related to staff personnel records and residents’ financial records, which were not available. What the service does well: What has improved since the last inspection? What they could do better: The home could improve the care planning system to ensure that changes in the residents’ needs and any relevant risk assessments are updated. More care needs to be taken when completing medication records to ensure there is clear evidence that the medication has been given or the resident has refused it. Several areas of the home are shabby and need urgent refurbishment. In particular, the shower rooms in Courtyard and Forbes have wall coverings peeling off. The carpets in the hallways, stairs and some resident bedrooms are grubby and worn. Generally residents felt there was little that could be improved, but comments like ‘I would like to go shopping more’ and ‘I would like it to be more quiet’ were made. CARE Blackerton House D54 D06 S21899 CareBlackerton V227123 160505 Stage 4.doc Version 1.30 Page 6 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. CARE Blackerton House D54 D06 S21899 CareBlackerton V227123 160505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection CARE Blackerton House D54 D06 S21899 CareBlackerton V227123 160505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of the above standards were looked at during this inspection. EVIDENCE: CARE Blackerton House D54 D06 S21899 CareBlackerton V227123 160505 Stage 4.doc Version 1.30 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 standard(s) 6, 7 and 9 There is a clear care planning system in place, but this does not always provide the information that staff need in order to satisfactorily meet the needs of the residents and minimise environmental and situational risks. EVIDENCE: The home is starting to use a more person centred planning approach to care plans. Some residents have ‘My Life, My Plan’ documents, with symbols being used to encourage more resident involvement. The plans highlighted the areas of support needed and the action that staff should take in order to meet these needs. One plan contained an ‘About Me’ statement, containing preferred name, clothing preferences and special friends. Several residents were aware of their care plans and said that they attended reviews ‘when they told everyone what they wanted to do’. Staff showed a clear understanding of residents’ needs and their methods of communication. Though there were environmental and situational risk assessments available, not all were up to date and some had not been reviewed since 2002. One care plan was looked at specifically because of comments made by staff at their handover, concerning the behaviour of the resident. Though the resident’s CARE Blackerton House D54 D06 S21899 CareBlackerton V227123 160505 Stage 4.doc Version 1.30 Page 10 behaviour was becoming erratic and posing a greater risk than usual, neither their care plan nor their risk assessment had been updated to reflect this. One resident spoke of helping with Health and Safety matters around the home, including checking fire exits. He was also very knowledgeable about the protective clothing needed when helping with gardening. Residents said they were involved in preparing menus, shopping for food and preparing the meals and a group was discussing recipes and cooking for that evening. Residents also said that they were helped by staff to keep their rooms tidy and do their own laundry. CARE Blackerton House D54 D06 S21899 CareBlackerton V227123 160505 Stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15, 16 and 17 Activities offered are excellent, they are very well organised and provide stimulation, variety and interest for the majority of residents. Meals are nutritious and balanced and offer a healthy and varied diet for residents. EVIDENCE: Most day care activities take place on the CARE site. Workshops include pottery, woodwork and gardening. Residents also go swimming each week. Several residents were out on the evening of inspection at the local gateway Club, where they enjoy a variety of activities. Residents spoke of their involvement with CARE’s team that will be competing at the Special Olympics in Glasgow this summer and how much they enjoyed all the sporting activities. There are holiday meetings held to find out where residents would like to go, staff then get brochures and find out further information and costs. CARE contribute £250 towards each resident’s holiday. Some residents choose to go on several small breaks rather than one large holiday. One resident said that CARE Blackerton House D54 D06 S21899 CareBlackerton V227123 160505 Stage 4.doc Version 1.30 Page 12 they were hoping to go to London to see the Billy Elliot musical. Four residents and two staff had just returned from a trip to New York and residents were very eager to show the inspectors items that they had bought there. The home tries to keep to a ‘working day’ and residents are expected to get up and go to day services on the site or attend college. Not all residents were entirely happy with the range of activities though, as one resident would like to be able to go shopping more. Another resident has recently moved into a quieter cottage, but still felt that there was too much noise for him. Residents are encouraged to maintain contact with family and friends and there were lists within care plans of important dates for residents to send cards on. Some residents were away visiting family and others spoke of the regular visits they receive. A consenting relationship between two particular residents is encouraged, and notes were seen for staff to remind them to ensure contact is maintained. Both residents spoke warmly of their friendship. Residents were helping prepare tea and told the inspectors how they help plan and shop for food, then cook it on a rota basis. Residents spoke of how they try to eat healthily and some were pleased at having lost some weight. Tea is taken in the communal dining room in each cottage, and there was much friendly chat between residents and staff. CARE Blackerton House D54 D06 S21899 CareBlackerton V227123 160505 Stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 and 20 Staff have a good understanding of the residents’ personal support needs, and residents benefit from the positive relationships they have with staff. The health needs of residents are well met with evidence of good multidisciplinary working taking place on a regular basis. Though the systems for the administration of medications are generally good, some recording practices are poor and potentially place residents at risk. EVIDENCE: Staff spoke in depth of the individual care needs of residents, and were well aware of residents’ needs, preferences and communication needs. One resident had been taken to the dentist by their key-worker and they had stopped to feed the ducks on their way home. Residents have varying degrees of ability and levels of communication, and staff were seen encouraging and supporting residents on all levels. Though medication administration was generally good, two areas gave cause for concern: one handwritten MAR (Medication Administration Record) sheet had not been signed and dated as required; codes were not being used to indicate the reason, when medication had not been taken. CARE Blackerton House D54 D06 S21899 CareBlackerton V227123 160505 Stage 4.doc Version 1.30 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 The home has a satisfactory complaints system with some evidence that residents feel their views are listened to and acted upon. EVIDENCE: One complaint was seen recorded in a resident’s file, which had been investigated and the outcome recorded. Residents told inspectors that they felt they could speak to any member of staff if they were unhappy about anything. Two staff gave a good account of the procedure they would follow if any abuse was suspected. CARE Blackerton House D54 D06 S21899 CareBlackerton V227123 160505 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 28, 29 and 30 There are areas of the home where the standard of décor is poor, with little evidence of regular maintenance. The home does not, therefore, present an entirely homely and comfortable environment for residents. EVIDENCE: Residents’ individual rooms are very personalised and reflect their choices and tastes and are fitted with suitable locks. One resident was happy to be able to have a key to their own room and said that staff have to ‘ring the bell (to the cottage) and we let them in’. Specialist equipment is provided as required and includes grab rails and ramps. There are several communal areas in each cottage enabling residents to have a TV room and a quiet room as well as the kitchen/dining room. The home was generally clean and hygienic, and there are laundry facilities and disposable gloves and aprons in all cottages However, some areas of the cottages are looking very shabby, particularly the shower rooms in Courtyard and Forbes and some carpets in all cottages. Staff said that refurbishment for the cottages was planned in the coming months and includes some decorating, a new kitchen in one cottage and replacement of some carpets. Residents said that they know they will be asked to help choose new colours. CARE Blackerton House D54 D06 S21899 CareBlackerton V227123 160505 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 35 and 36 Progress has been made in addressing staffing shortages and residents are now receiving more consistent care. The procedures for recruiting and inducting new staff are robust and offer protection to residents. The deployment and numbers of staff are generally sufficient to meet the needs of residents. EVIDENCE: Staff spoke clearly and confidently about their roles and responsibilities within the home, explaining how they were aware of the importance of boundaries and confidentiality within their work. Staff said that they received regular supervision and newly appointed staff said that they had received a thorough induction. Staff said that they regularly received training that helped them improve their skills. Staff said that there have been times recently when they have been very short of staff, due to vacancies and resident holidays. New staff have now been appointed and staff said that things had greatly improved, though there are still occasion when staffing levels are low. There were two seniors and four support workers on duty on the evening of inspection and staff felt that this was sufficient to allow them to meet residents’ needs. CARE Blackerton House D54 D06 S21899 CareBlackerton V227123 160505 Stage 4.doc Version 1.30 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 and 42 The systems for service user consultation are good, with a variety of evidence that indicates that residents’ views are both sought and acted upon. Risk assessments are not being regularly reviewed and this could place residents at risk from situational and environmental hazards. EVIDENCE: One resident said that they ‘ know who to tell if I’m not happy and they will do something for me’. Residents also spoke of meetings they attend to discuss menus and holidays. Though there were comprehensive environmental risk assessments available, some had not been reviewed since 2002. CARE Blackerton House D54 D06 S21899 CareBlackerton V227123 160505 Stage 4.doc Version 1.30 Page 18 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 x x x x Standard No 22 23 ENVIRONMENT Score 3 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 1 3 x 1 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 3 3 x 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 2 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 CARE Blackerton House Score 3 x 2 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 1 x D54 D06 S21899 CareBlackerton V227123 160505 Stage 4.doc Version 1.30 Page 19 Yes 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 YA23 Regulation 20(1)(a) (b) Requirement You are required to ensure no money belonging to a service user is paid into a bank account, unless the account is in the name of the service user to which the money belongs and the account is not used by the registered person in connection with the management of the care home (this was not looked at at this inspection-remains from previous inspection) You are required to ensure the environment is suitably maintained - please supply an action plan) Timescale for action 04/07/05 2. YA24 & YA26 16 29/08/05 3. YA6 15(2)(6) You are required to update and 04/07/05 continually review residents care plans You are required to update and review environmental and situational risk assessments for residents 04/07/05 4. YA9 & 42 13(4) CARE Blackerton House D54 D06 S21899 CareBlackerton V227123 160505 Stage 4.doc Version 1.30 Page 20 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. Refer to Standard YA 33 YA 20 Good Practice Recommendations You are recommended to continue to monitor the staff roster to ensure the needs of service users are met at all times You are recommended to ensure that medication administraion records are correctly maintained CARE Blackerton House D54 D06 S21899 CareBlackerton V227123 160505 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Suite 1, Renslade House Bonhay Road Exeter EX4 3AY 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 CARE Blackerton House D54 D06 S21899 CareBlackerton V227123 160505 Stage 4.doc Version 1.30 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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