Inspection on 21/02/07 for Self Unlimited Blackerton House

This inspection was carried out on 21st February 2007.

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

Other inspections for this house

Self Unlimited Blackerton House 13/10/05

Self Unlimited Blackerton House 16/05/05

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 MIXED CATEGORY MAJORITY ADULTS 18-65 CARE Blackerton House CARE Blackerton House East Anstey Tiverton Devon EX16 9JT Lead Inspector Victoria Stewart Key Unannounced Inspection 21st February 2007 11:00 CARE Blackerton House DS0000021899.V316273.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address CARE Blackerton House DS0000021899.V316273.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People and 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. CARE Blackerton House DS0000021899.V316273.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service CARE Blackerton House Address CARE Blackerton House East Anstey Tiverton Devon EX16 9JT 01398 341252 01398 341591 careblackerton@freeuk.com www.care-ltd.co.uk CARE (Cottage and Rural Enterprises Ltd) 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) Thelma Sadako Hartas Care Home 36 Category(ies) of Learning disability (36) registration, with number of places CARE Blackerton House DS0000021899.V316273.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. To allow one named service user, over the age of 65 years of age, to remain in the home Upon termination of this placement, the registered person will notify the CSCI and the conditions of registration will revert to those which apply on 30 June 2004 13th October 2005 Date of last inspection Brief Description of the Service: CARE Blackerton provides accommodation and personal care for up to 36 younger adults who have a learning disability; most of whom are between the ages of 18 - 65 years but the home does now care for one or two residents who are above the 65 year age range. 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 also self-contained flats within each cottage for those people who live more independently. 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. The current cost of care ranges from £416 - £671 per week depending on individual needs. Additional costs, not covered in the fees, include chiropody, hairdressing, toiletries, newspapers/magazines, bus/taxi fares and some activities. Current information about the service, including CSCI reports, is available to prospective residents, relatives and others who may have an interest such as care managers. CARE Blackerton House DS0000021899.V316273.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out on 21 February, 2007 and took two inspectors 7 hours to complete. The home had been notified that an inspection would take place within three months and had returned a pre-inspection questionnaire. A selection of CSCI postal questionnaires were also sent out to interested parties; 11 out of 17 sent out to residents were returned and 10 out of 18 sent to care staff were returned. The information contained within all of these questionnaires has been used to help write this report. Other evidence has been gained from a tour of the premises, by looking at a sample of records including service user care plans, medication records/procedures, staff recruitment files, risk assessments and health and safety records. Positive discussions took place with the management, care staff and inspectors. During the visit the inspectors’ case tracked three residents, which helps us to understand the experiences of people using the service. Eight staff and ten residents were spoken with at length and several other residents were spoken with in passing. The findings of the inspection were discussed with the management of the home before completing the inspection visit. What the service does well: The home has a warm and homely feel throughout the individual cottages. Residents confirmed that they liked living there and comments included “I like living here”, “I live with nice people” and “I am happy living here and I do not want to move”. Residents are encouraged to live as independently as possible, with more support and encouragement given to those who need it. Staff enable residents to make choices and have control over their lifestyle and displayed a good understanding of how to meet residents’ needs. Residents are supported to participate in a varied programme of community, recreational and social activities. Residents’ work in various areas throughout the home and some have employment outside of the home. Residents are involved in the running of the home and feel like their views are listened to and acted upon. The home regularly reviews its own performance to monitor the service it is providing. Staff employed undergo a thorough recruitment process and are well trained. CARE Blackerton House DS0000021899.V316273.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. CARE Blackerton House DS0000021899.V316273.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Outcomes Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) CARE Blackerton House DS0000021899.V316273.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 (Younger Adults AP) – 3 & 6 (Older People OP) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care needs of prospective residents are assessed before they move into the home to ensure that they can be fully met. EVIDENCE: The care files of three residents were selected and looked at, including the file of the most recently admitted resident to the home. Two of these residents had lived at the home for many years and therefore initial assessments could not be found. However, these files did have evidence of re-assessment in the home. The file of the most recently admitted resident contained an assessment prior to his moving into the home from another establishment which had been completed by a social care professional as part CARE Blackerton House DS0000021899.V316273.R01.S.doc Version 5.2 Page 9 of the “My Life, My Plan” document. The needs of this particular resident had been carefully looked at and whether these could be fully met as he does not fall within the age range of most of the residents at the home. One other resident is in the process of changing cottages - staff are carefully looking at this to discuss his needs and make sure that this particular resident will fit in to the new cottage with the other residents who already live there. All staff confirmed in their questionnaires that they were not asked to care for residents outside of their expertise. The home does not offer intermediate care services. CARE Blackerton House DS0000021899.V316273.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14 and 33 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 (YA) - 7, 14 & 33 (OP) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ changing needs and personal goals are reflected in some individual care plans, but improved recording would ensure that this is done in a consistent manner by care staff. Residents are enabled to carry out tasks, which will enhance their independence, by the use of thorough risk assessments. The home operates a system which ensures that residents are consulted regarding the running of the home and are able to make choices about their lives. CARE Blackerton House DS0000021899.V316273.R01.S.doc Version 5.2 Page 11 EVIDENCE: Three care files were looked at. Two residents showed their care files to the inspectors (Personal Care Plans) which included their Essential Life Plan (ELP) and Health Action Plans (HAP). They explained how they were involved in making them. The care records are held in the residents’ individual locked bedrooms. The first care file looked at held comprehensive records, which showed that their personal and health care needs were being met. This resident also explained how he/she takes the Health Action Plan to any hospital, GP or other similar appointments – this provides to any professional involved in his/her care with up to date information about the care received. These records were easy to follow and written in a way that residents can fully understand using simple language and/or symbols. The second care file was looked at with the resident and key worker. Whilst this file contained some useful information, the inspector felt that it could be improved upon. The third care file contained lots of information but was not organised, co-ordinated and did not show any evidence of being recently used or reviewed. The documents relating to the previous care home he/she had lived at were held in the file but no care planning or risk assessments had been completed since he had begun to live at Care Blackerton. This resident had been in the home for several weeks on a short-term (respite) basis but was now permanently living in the home. The home holds regular cottage meetings which enable the residents to be involved in the running of the home. Records demonstrated that residents’ views are listened to and acted upon. Residents at Care Blackerton are encouraged to be as independent as they are able. Although the home is situated in a rural, fairly isolated location, residents are involved in many activities in the community, some which involve work placements. All resident surveys said that they are able to make decisions about what to do each day. In order that residents can live as independently as possible, but have their safety assured, the home uses risk assessments. Inspection of these records showed that they are comprehensive and are compiled for virtually every activity in the home. In this home risk assessments are used to encourage and support residents in activities which have an element of risk. For example residents were seen working outside with outdoor mechanical and building equipment in a safe and well-managed way using the proper equipment as detailed on the risk assessment. Another example was a risk assessment to support a resident to assist with the safe removal of a glass greenhouse. CARE Blackerton House DS0000021899.V316273.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. Service Users find the lifestyle experienced in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. Service users find the lifestyle experienced in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): CARE Blackerton House DS0000021899.V316273.R01.S.doc Version 5.2 Page 13 12, 13, 15,16 & 17 (YA) – 10, 12, 13 & 15 (OP) Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents enjoy varied activities, which enhance their lives and promote their independence and personal development. Residents enjoy a varied diet which reflects their individual choice, tastes and dietary requirements. Links with the community are good and support and enrich residents’ social and educational opportunities. The daily routine in the home reflects the choice that individual residents make in their lives. EVIDENCE: Residents’ surveys confirmed that they ‘always’ or ‘sometimes’ are able to make decisions about what to do each day and at weekends. One resident commented that he/she can do what he/she wants “provided there are enough staff members to take me where I want to go”. Two staff surveys said they would like more staff on duty to be able to go out more with residents to support them with social activities. The home has a general friendly and open atmosphere. During the inspection visit some residents were going to work, some were already working and some were going on a trip to see an ice-skating show. The home has use of several vehicles to transport residents to and from outside activities. One resident spoke of his/her enjoyment at going on holidays each year, supported by a member of care staff. Each cottage has either one or two self-contained flats – these are used for those residents who are able to lead as independent a life as possible, with minimal support from care support staff. The home also encourages and supports residents who are able to move into the wider community - one resident spoke of how she had moved out into the community but returned to Care Blakerton for paid employment in the administration office. Despite being situated in a rural location, Care Blackerton is proactive in ensuring that those people who live there are part of the local community. To help residents obtain meaningful employment and lead fulfilled lives, Care Blackerton is involved with a support employment service and works in partnership with them. Through this link, the home is hoping to set up a firm linked to the food industry which it is anticipated will be able to offer employment to some residents. CARE Blackerton House DS0000021899.V316273.R01.S.doc Version 5.2 Page 14 The home is involved with a local college through which residents will be achieving nationally recognised qualifications in catering and hospitality. This will be achieved using a high tutor to resident ratio and intensive support regarding literacy. The home is also involved with other groups across Devon which seek to give people with learning disabilities fulfilling lives, for example the Joint Investment Planning Group which the inspectors were informed had, as its focus, ensuring people with learning disabilities in North and Mid Devon had ‘fulfilling lives’. Other groups were concerned with housing and moving towards employment. Residents are encouraged to find employment in the community and five do part-time cleaning jobs. The group of residents who work on the estate contracts team maintaining the grounds, hope to develop into a social enterprise and work more within the community. Four residents attend the East Devon College where they participate on a course promoting independence which will enable them to live more independently or develop skills which will enhance their independence. Many residents work in areas within the home, for example one resident explained how he/she liked working in the kitchen and three other residents enjoyed working in the grounds. Within the grounds is a newly constructed walkway around an area which is kept as a nature reserve and pond. This was constructed by residents and supported by the Devon Wildlife Trust. Residents were seen enjoying themselves taking part in pottery and tapestry sessions and were keen to proudly show off what they had made. The home also has a forum which it is hoped will guide the development of the service further and involve parents, relatives and friends. Care Blackerton is modernising its day services and is putting particular emphasis on issues such as citizenship training and self advocacy with residents moving from work within the campus, to wherever possible outside in the wider community. Residents enjoy social activities in the community. The Meerkats Social Club, which the home runs, goes to different venues in the area, including those at Tiverton and Barnstaple. Information regarding forthcoming events showed trips to Exmoor Zoo, a disco at a local football club and a games night already planned. As well has having involvement in activities within the community, residents have access to specialist social groups such as the twice weekly Gateway Club held in Tiverton. One resident very much enjoys her involvement with the local St. John’s Ambulance Service and displayed her knowledge of first-aid. One other resident enjoys her weekly attendance at a local diet group. CARE Blackerton House DS0000021899.V316273.R01.S.doc Version 5.2 Page 15 Residents eat their meals in their individual cottages rather than the large communal dining room of the home. Residents are involved in the choice of menus and take it in turns to help cook the main evening meal of the day with the care support staff. Individual choices and dietary requirements are taken into account, for example one resident has a supply of ready meals if she does not like what is on the menu. Each cottage shops for the week individually residents are supported by staff to do this and buy what food is needed for the week. Menus are discussed in the regular cottage meetings and are well balanced and varied. Light food and drinks are available throughout the day for residents to snack on. The mealtimes were relaxed and unhurried - staff were helping the residents to prepare food in a patient and helpful way. There was a real ‘buzz’ at teatime with all the residents in the kitchen, giving it a homely and communal atmosphere. Each room is kept locked and residents who are able look after their own keys which encourages their independence as well as ensures privacy and dignity of their private rooms and possessions. CARE Blackerton House DS0000021899.V316273.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) 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. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 (YA) – 8, 9 & 10 (OP) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The healthcare needs of residents are well met with evidence of good multidisciplinary working taking place where necessary. The systems in place for the administration of medication are adequate but some improvement is needed to ensure that residents are not put an unnecessary risk of harm. EVIDENCE: Records and residents confirmed that health and personal care needs of residents are met with regular advice/support from various health care professionals. All residents are registered with a GP and have regular dental, CARE Blackerton House DS0000021899.V316273.R01.S.doc Version 5.2 Page 17 optical and hearing tests as needed. The home has a permanent chiropodist who visits the home on a regular basis and takes care of residents’ feet – whether this is for treatment or a foot massage - which residents said they really enjoyed. Medication is generally well managed at the home. One cottage is currently keeping all residents’ medication in their own rooms in a lockable space. This is to help prevent medication being given to the wrong person and encourages the resident to have more person-centred care. Staff are responsible for holding the keys to these cupboards for security, except when a resident is able to self medicate. Where possible, residents are signing to say their medication has been given. This system is good practice. The Medication Administration Records (MAR) for three residents were looked at. Two of these were incorrectly completed. When one record was checked against the monitored dosage system (MDS), it showed that a resident had been given the evening dose of medication in the morning. Immediate steps were taken by staff to put this right by contacting the GP. Prescribed medication is correctly signed into stock when it arrives on a regular weekly basis. However, amendments and hand-written entries to the pre-printed dose were not signed into stock, nor independently checked and countersigned. This also applies to those medications which are no longer being used and no record showing why these have been discontinued and when. Some staff have had appropriate training in the dispensing of medication carried out by Boots pharmacy but some have not. Training is carried out as part of the induction but no formal training undertaken. A regular audit of the medication by a manager takes place internally in the home to ensure that errors are not being made. Throughout the inspection, staff were observed to be responding sensitively and appropriately to residents changing needs. CARE Blackerton House DS0000021899.V316273.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16-18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are safeguarded. (OP NMS 35) The Commission considers Standards 22-23 (Adults 18-65) and Standards 16-18 and 35 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 (YA) 16, 17 & 18 (OP) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by an appropriate complaints procedure with evidence that complainants’ views are listened to and acted upon. Staff have a good understanding of Adult Protection issues which protects residents from potential abuse. EVIDENCE: Residents confirmed in their questionnaires that they knew how to make a complaint and who to speak to if they were not happy. The majority said that they “always” feel listened to. Each cottage within the home has a complaints procedure displayed and records are held centrally in the main house. These were looked at and showed that complaints are thoroughly investigated. Questionnaires showed that staff have a good awareness of issues relating to abuse and the home ensures staff receive formal training in this area - this was confirmed by speaking to staff on the day of inspection and ensures that residents are fully protected. CARE Blackerton House DS0000021899.V316273.R01.S.doc Version 5.2 Page 19 CARE Blackerton House DS0000021899.V316273.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 (YA) – 19 & 26 (OP) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a well-maintained, clean environment which meets their needs. EVIDENCE: Residents live in purpose built small cottages which surround the main house where day services are run from. All residents confirmed in their surveys that CARE Blackerton House DS0000021899.V316273.R01.S.doc Version 5.2 Page 21 the home was “always” fresh and clean. This was confirmed during a tour of the premises. These cottages provide residents with single occupancy private rooms – all have lockable doors ensuring residents can have privacy. The rooms seen, with the consent of the residents, were well furnished and had been personalised by the individual residents. One resident showed how his/her room had been decorated in the colour of his/her choice, with bed linen and curtains to match his/her taste and likes. Each house has its own dining area, kitchen, lounge and laundry area. These were all domestic in layout and furnishings were suitable to meet the needs of the residents. Two residents were seen choosing the colour of paint for their rooms suitable to their own tastes – this information was then passed on to the decorator by the care staff. Externally the grounds are well maintained and are easily accessed by residents. They also contain rural walks, a pond and areas where sculptures made by residents have been put on display which creates a pleasant and stimulating environment for residents to live in. CARE Blackerton House DS0000021899.V316273.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 32, 34 and 35 (Adults 18-65) and Standards 27, 28, 29 and 30 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ benefit from the home’s excellent commitment to staff training and development which is excellent. The manager is supported by senior staff in the home who are aware of their roles and responsibilities. Residents are protected by the homes robust recruitment procedure. The home has an enthusiastic and caring workforce but systems could be further developed to ensure that they feel fully supported in the workplace. CARE Blackerton House DS0000021899.V316273.R01.S.doc Version 5.2 Page 23 EVIDENCE: The organisation has a strong commitment to staff training. The training available is well documented with all staff members having individual files listing the training that they have received. These records were looked at and showed that the home operates a rolling programme which includes training in mandatory subjects such as the Protection of Vulnerable Adults, moving and handling, first aid and health and safety. In addition, there is training, which will offer staff the knowledge to improve their care, and also to work more professionally - this includes an introduction to dementia, report writing skills and interviewing skills. Some staff were receiving formal training from an outside agency during the inspection to help them do their jobs better. Staff commented in their questionnaires that funding and time is provided to receive training – with comments such as “staff training available is excellent” and “plenty of training and courses relevant to my job role”. Residents’ surveys confirmed that they felt supported by staff. Newly appointed staff complete an approved induction. This is the Learning Disability Framework Award (LDAF) which has been specially formulated to ensure staff receive the right initial information to offer appropriate care to people with a learning disability. The home also funds other courses, such as those relevant to staff caring for people with a learning disability run by the Open University. Three staff files were looked at, including the last two people employed by the home. All these files contained the appropriate information and documents required. Staff also take a numeracy and literacy test as part of their recruitment process; this ensures that they are able to understand care plans and carry out written or verbal instruction with appropriate communication to enable them to carry out the duties of a carer. The home has a good organisational structure with a registered manager taking overall responsibility of the home. A residential services manager and a development manager support her. The registered manager was not present on the day of inspection but the development manager assisted the inspectors and was familiar with the systems and procedures of the home. Each individual cottage then has a home manager, a deputy manager and care support staff employed. Other staff are employed to offer 1:1 specialist attention to some residents. The home uses a list of ‘bank’ staff who are available to cover staff shortages – this benefits the residents, as they are familiar with them and aware of their needs. All staff spoken with had a clear understanding of their roles and responsibilities. CARE Blackerton House DS0000021899.V316273.R01.S.doc Version 5.2 Page 24 Whilst staff demonstrated a commitment to working at the home, some staff questionnaires demonstrated that there may be a low morale. Some staff are feeling unsettled about projected changes in the organisation and running of the home. Whilst some staff have received regular supervision, others commented that they have not had formal individual or group supervision and have never been observed in their care practice. One member of staff commented “I am expected to know what I am doing”. CARE Blackerton House DS0000021899.V316273.R01.S.doc Version 5.2 Page 25 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. Service users live in a home which is run and managed by a person who is fit to be in charge of good character and able to discharge his or her responsibilities fully. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) 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 homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 37, 39 and 42 (Adults 18-65) and Standards 31, 33, 35 and 38 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 (YA) - 31, 33, 35, 36 & 38 (OP) Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. CARE Blackerton House DS0000021899.V316273.R01.S.doc Version 5.2 Page 26 The management of the home is good, and residents’ benefit from a service which is good at seeking out their views to underpin the development of the service. Staff are well supported by the management arrangements but a small minority of staff have a low morale which if not addressed has the potential to affect the care received by residents at the home. Residents are protected by good health and safety systems in place at the home. EVIDENCE: The manager of the home is experienced and suitably qualified. There are good arrangements in place to ensure that the quality of care is monitored externally as well as internal arrangements. There is a very good emphasis on enabling residents to be as independent as they can, and to be involved in the local community as much as they want to be. Residents are also encouraged to play an active role in the development of the service. This is accomplished by the home actively seeking the views of residents and also involving them in the Quality Assurance meetings. Records of these meetings showed that this group meets every month. Residents are invited to attend this meeting and give them an opportunity to voice any opinions about the service. Cottage meetings are held in the individual houses where residents live and minutes of these meetings showed that they focus on the quality of care available and seek the views of residents on issues connected with living in the unit, for example choice of food, keys for bedrooms and choice of decoration. The home also has quality assurance questionnaires which are completed by residents. The Quality Assurance Group then follows up comments made on these with the results forwarded to the Head Office. Each cottage has a member of staff who has the role of Quality Assurance Co-Ordinator and who interacts with the residents to ascertain their views about the running of the home. The home produces a regular information pack called the “Blackerton Bugle” which is available for relatives, friends, residents and others. This contains lots of useful information and aids communication between the home and outside parties. Family and friends are kept updated with news and changes in the home and this is helped with a ‘Family and Friends Day’. Whilst the majority of staff questionnaires felt supported by management, some commented that there was a “lack of support” and “not much support from management”. Other comments included that they attend too many CARE Blackerton House DS0000021899.V316273.R01.S.doc Version 5.2 Page 27 meetings, which do not resolve any issues, and one said, “group meetings are poorly focussed and inconclusive”. These issues refer to the wider organisational structure rather than the management within the home. The pre-inspection questionnaire confirmed that equipment is maintained and serviced appropriately. Fire records in one house were selected and found to be satisfactory. CARE Blackerton House DS0000021899.V316273.R01.S.doc Version 5.2 Page 28 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 4 36 2 CONDUCT AND MANAGEMENT Standard No Score 37 3 38 X 39 3 40 X 41 X 42 3 43 X 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 CARE Blackerton House Score 3 3 1 X DS0000021899.V316273.R01.S.doc Version 5.2 Page 29 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 YA20 Regulation 13 (2) Requirement When medication is received into the home, it must be recorded. When medication is administered to people who use the service, the correct does must be given at the stated time to ensure that people receive the correct levels of medication. Timescale for action 21/03/07 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 YA6 YA20 Good Practice Recommendations All residents should have a care plan which includes all the information necessary, is in a logical order for staff to follow and shows evidence of regular review. When an entry is hand written on, or removed from, the Medication Administration Record chart, it should be signed and dated by the person making the entry and it is DS0000021899.V316273.R01.S.doc Version 5.2 Page 30 CARE Blackerton House 3. 4. YA20 YA36 then checked and countersigned by a second person. Staff should receive training to administer medication and have their competence reviewed as part of the supervision process at least twice a year. Systems should be developed to ensure that all the staff team receive regular supervision and feel supported by management. CARE Blackerton House DS0000021899.V316273.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Devon Area Unit D1 Linhay Business Park Ashburton Devon TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000021899.V316273.R01.S.doc Version 5.2 Page 32 - 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!