Inspection on 10/06/05 for Smithy Forge

This inspection was carried out on 10th June 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Smithy Forge 14/05/07

Smithy Forge 15/12/05

Smithy Forge 24/02/05

Smithy Forge 19/08/04

Smithy Forge 22/02/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Smithy Forge 3a Norton Village Runcorn Cheshire WA7 6PZ Lead Inspector Sue Dolley Unannounced 10 June 2005 10.30 th 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. Smithy Forge F51 F01 S5199 Smithy Forge V225744 100605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Smithy Forge Address 3a Norton Village Runcorn Cheshire WA7 6PZ 01928 790986 01928 790986 None Mr Denis Price 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) Mrs Lynn Price Care Home 6 Category(ies) of LD Learning Disability (6) registration, with number of places Smithy Forge F51 F01 S5199 Smithy Forge V225744 100605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: No additional conditions Date of last inspection 24th February 2005 Brief Description of the Service: Smithy Forge is a large modern detached house in a quiet residential area near Norton Priory and within easy reach of the routes to local towns. The home is registered to provide care for six adults who have learning disabilites. There are six single bedrooms in the home. three on the ground floor and three on the first floor. There is a large comfortable lounge with colour television and video. The dining room/conservatory opens onto a patio, which gives access to a large and private rear garden. Smithy Forge is well presented, well maintained and furnished to a high standard. Smithy Forge F51 F01 S5199 Smithy Forge V225744 100605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. What the service does well: What has improved since the last inspection? What they could do better: One of the providers undertakes monitoring visits to the home at least monthly, to speak with staff and residents and to ensure the smooth running of the home. Occasionally the details of these visits are not recorded. Smithy Forge F51 F01 S5199 Smithy Forge V225744 100605 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. Smithy Forge F51 F01 S5199 Smithy Forge V225744 100605 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 Smithy Forge F51 F01 S5199 Smithy Forge V225744 100605 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) 2 The process of new residents moving into the home is very well managed, to ensure that the residents and their relatives know what to expect, and that their needs will be met at the home. EVIDENCE: The care files of three residents were checked. The assessments of need had been thoroughly completed and clearly explained each individual need. Each care file contains a positively written assessment of abilities to ensure each resident has opportunities to maintain their skills and refine emerging skills related to daily living.These assessments are regularly reviewed. The care files contain explanatory information and guidance notes to staff regarding individual care planning and review. Information gathered from other involved professionals enable staff to make accurate assessments. Before residents move into the home, all their important contacts are identified and residents views of the circumstances are explored. Each resident plan is developed with the individual, taking into account family carers’ interests and needs, with the resident’s agreement Smithy Forge F51 F01 S5199 Smithy Forge V225744 100605 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 Residents contribute to their assessments and care planning, so are both well informed and involved regarding all aspects of their care. Residents` needs are accurately identified, fully addressed and met. Continuous review and planning ensureS any changing needs are identified and addressed. EVIDENCE: The three care plans checked showed that residents` needs were fully addressed and met ,with continuous review and planning to ensure any changing needs were identified and addressed. Self care and developmental needs and skills were fully described. Personal preferences were recorded, health requirements were identified in detailed health action plans and communication needs were noted. Residents are involved in developing their own essential lifestyle plans. These show their circle of friends and family, the support they need for their life at the home and in other settings, and are written in the first person. The residents, the home manager and the resident`s key- worker sign the plans when they are completed. Smithy Forge F51 F01 S5199 Smithy Forge V225744 100605 Stage 4.doc Version 1.30 Page 10 The care files showed that residents were being supported by staff, using community learning disability services including day care, and referred for community nursing and psychiatry when needed. Care records showed good communication between staff at the home and workers from other specialist services. Care records included details of significant life events and residents` own comments and care plan reviews were very detailed and up to date. Staff members have put great effort into making an information book, with pictures, for each resident to refer to. These include photographs of the people who provide care for the resident with information about their roles and where they work. The books also contain information about healthy eating and living. As each placement progressed, staff members had explored the residents` hopes, dreams and fears and had appropriately identified and arranged any necessary support. Minutes of residents` house meetings show that residents make choices and decisions. Also discussions with residents confirmed that they are encouraged and supported to make choices and decisions for themselves. The care files kept in the home, included risk assessments about bathing, medication and administration and any challenging behaviour. The care plans identified any risks and outlined how these were to be managed. Risk assessments were regularly reviewed. Smithy Forge F51 F01 S5199 Smithy Forge V225744 100605 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) 12,13,15,16 and 17 Residents have opportunities to learn and use practical life skills and to develop learning and employment skills, which, enables them to play an active role in community life and to make a valued contribution through their involvement. EVIDENCE: Copies of student learning agreements in residents files showed past attendance at local college courses and current attendance at day care, industrial therapy and supported employment placements. Residents have occupational profiles on file to record their agreed involvement and to identify means of transport to their placement and any necessary contacts at their placement. Weekly activity charts are also completed to ensure residents and staff are fully aware of planned activity and can help residents prepare for these activities. Advice was given during feedback from the inspection as some conflicting information was on the occupational profile and activity chart for one resident and staff undertook to update and correct this information. Smithy Forge F51 F01 S5199 Smithy Forge V225744 100605 Stage 4.doc Version 1.30 Page 12 In addition to activity away from the home, many home based activities and social activities and interests were recorded along with regular family contact and home leave. In discussion with residents they confirmed that they are encouraged to follow their own hobbies and interests and are supported to maintain family links and friendships. Families continue to be involved in residents’ care and there is a high level of communication between residents, family members and staff. It was evident from conversations with residents and staff that staff members make great efforts to maintain positive working relationships with the relatives of residents to promote trust and to enable shared care and continuity of care. Staff members were seen talking and interacting with residents and also observed respecting residents privacy when they wished to be alone. Residents move around the home as they choose and invite friends and family members to visit and call. Residents share responsibilities for some housekeeping tasks by arrangement and agreement; these tasks are identified in residents’ individual plans. A sample of the menus were checked and showed that balanced and varied meals were provided. Meal times are sociable; staff and residents work together to plan menus, shop, prepare, cook, serve meals and clear away afterwards. Residents` nutritional needs are assessed and regularly reviewed, with any special care needs for food and nutrition recorded and acted upon. Resident`s food preferences are taken into account and healthy eating and regular exercise is encouraged. Occasionally, residents and staff will go out for a meal to celebrate a birthday or special event and take away meals are sometimes ordered. Smithy Forge F51 F01 S5199 Smithy Forge V225744 100605 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) 18,19, and 20 Residents are looked after very well in respect of their health, personal and social care. Their welfare is closely monitored and their health needs are promptly met EVIDENCE: Personal support is given in private, with guidance and support over personal hygiene given when needed. Residents are encouraged to choose their own clothes, hairstyle and make-up and their appearance reflects their personality. Residents can have some choice of staff members who work with them and a key worker system in place. The small staff team ensures consistency and continuity and support. Discussion with staff members confirmed that staff knew the residents well. Care files provided information about any additional support and advice given from medical professionals, therapists and social work representatives. Healthcare is given high priority and residents have annual well person checks in addition to ongoing medical care. Well - written health action plans identified all health related issues and regular appointments for eye tests, dental appointments or health screening were evident. The information within these action plans is to be expanded in the near future following suggestions made at a health care forum by representatives from a Primary Care Trust. Smithy Forge F51 F01 S5199 Smithy Forge V225744 100605 Stage 4.doc Version 1.30 Page 14 Smithy Forge maintains a collection of health care leaflets for reference purposes. The residents use community health care services and details of all health care visits are fully recorded. Health care needs were seen to be identified early, with prompt referral to the appropriate healthcare professional. Specialist support is provided by the local community learning disability service. Care files showed community nurse and psychiatry input. During the inspection, the need for a continence assessment for one resident was discussed, and immediate action was agreed to meet this newly identified need. Medication within the home is mainly managed and administered by use of a monitored dosage system provided by a local pharmacy. A risk assessment is recorded on each residents ability to keep and administer their own medication. Residents are supported to self medicate as far as possible. The medication administration records include a copy of the medication policy and procedure, with individual photographs of residents to aid identification. Records are kept of all medicines received, administered, leaving the home or disposed of, to ensure there is no mishandling. The standard of recording was good and medication records were carefully and accurately maintained. Smithy Forge F51 F01 S5199 Smithy Forge V225744 100605 Stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 Arrangements for protecting service users and for responding to their concerns are in place, to ensure they remain safe and are satisfied with the care they receive. EVIDENCE: Smithy Forge has a well - written complaints procedure, which has been given to and explained to each resident. No complaints have been made since November 2002. The complaints policy refers to the residents’ right to use the borough council’s complaints procedure through the contracts department. A copy of the ‘No Secrets’ documentation outlines adult protection procedures in Halton and explains inter-agency policy, procedures and guidance. The home`s protection from abuse policy is clearly written, describing indicators of abuse, for staff members to recognise signs of abuse at an early stage. The manager knew of the need to obtain both Protection of Vulnerable Adults (POVA) checks for potential new staff and satisfactory Criminal Record Bureau (CRB) disclosures. Staff members had all the relevant contact telephone numbers to be used in the event of suspicion or allegation of abuse. Adult protection training is currently being planned by Halton Social Services. Staff members will be nominated for this training as soon as it is available. A whistle blowing policy encourages staff to report any malpractice. There are also policies on handling residents’ money and valuables to ensure their interests are safeguarded. Smithy Forge F51 F01 S5199 Smithy Forge V225744 100605 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 30 The home is very well maintained, clean and hygienic. It is decorated and furnished to a high standard and this helps to create a comfortable, bright, welcoming and homely environment for residents. EVIDENCE: All communal areas of the home were inspected; the premises were bright, clean and well maintained. Shared space is well used by residents and provides room to relax and socialise. Adequate levels of light, heating and ventilation are maintained. The statement of facilities for the home, accurately and clearly describe, the premises and the facilities. The staff and residents follow hygienic procedures when dealing with food, cleaning and laundry tasks. Laundry facilities are domestic in style, and are nearby a utility sink at one end of the kitchen area, away from food preparation areas. Clear instructions to staff are provided to explain thorough hand washing techniques, the promotion of effective hand hygiene and to reduce the incidence of cross infection. Smithy Forge F51 F01 S5199 Smithy Forge V225744 100605 Stage 4.doc Version 1.30 Page 17 Smithy Forge F51 F01 S5199 Smithy Forge V225744 100605 Stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 All staff members receive training appropriate to their role which helps them to be better informed and well prepared to provide the necessary care and support to residents. EVIDENCE: All staff members have been given structured induction training, with induction-training checklists maintained. The manager identifies appropriate training and encourages staff to attend. Staff members continue to demonstrate a willingness to undertake training and to increase their knowledge and skills. Smithy Forge F51 F01 S5199 Smithy Forge V225744 100605 Stage 4.doc Version 1.30 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 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 Effective quality assurance systems are in place to seek residents` views, ensure satisfaction and to develop and improve the care and service where possible. EVIDENCE: On reading samples of completed residents questionnaires, all gave positive comments about the standards of care and support within the home. Besides responding to specific questions, residents were invited to include other comments. The last survey in January 2005 showed that residents were clearly very satisfied with the management and staffing within the home. They also appreciated the care and supportive environment and pleasant surroundings. Smithy Forge F51 F01 S5199 Smithy Forge V225744 100605 Stage 4.doc Version 1.30 Page 20 The results of residents surveys are published and made available to residents, their representatives and other interested parties. A record of the owners visit was checked. The last owners visit was recorded as 20th January 2005, which was before the last inspection, although other sources indicated that there had been very frequent visits to the home by the owner resulting in maintenance and refurbishment work. See Recommendation 1. The fire safety precautions record book was well maintained; fire alarms were checked, and fire evacuations and fire safety training had been carried out. A certificate of inspection was available for the fire extinguishers, and health and safety risk assessments were in place as appropriate. Room temperature checks and checks on water temperature are recorded. The Registered Manager ensures that staff members maintain safe working practices by providing appropriate training, supervision and monitoring. Smithy Forge F51 F01 S5199 Smithy Forge V225744 100605 Stage 4.doc Version 1.30 Page 21 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 4 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Smithy Forge Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 2 x x 3 x F51 F01 S5199 Smithy Forge V225744 100605 Stage 4.doc Version 1.30 Page 22 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 Regulation None Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 39 Good Practice Recommendations The registered provider should ensure the`regular monthly vists to the home`are recorded and a written report on the conduct of the home should be provided for inspection. Smithy Forge F51 F01 S5199 Smithy Forge V225744 100605 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Northwich Local Office Unit D, Off Rudheath Way Gadbrook Park Northwich. Cheshire. CW9 7LT 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 Smithy Forge F51 F01 S5199 Smithy Forge V225744 100605 Stage 4.doc Version 1.30 Page 24 - 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!