Inspection on 15/12/05 for Smithy Forge

This inspection was carried out on 15th December 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 10/06/05

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 Inspection 15th December 2005 10.15 Smithy Forge DS0000005199.V271510.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Smithy Forge DS0000005199.V271510.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Smithy Forge DS0000005199.V271510.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Smithy Forge Address 3a Norton Village Runcorn Cheshire WA7 6PZ 01928 790986 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) Mr Denis Price Mrs Lynn Price Mrs Lynn Price Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Smithy Forge DS0000005199.V271510.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th June 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 disabilities. 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 DS0000005199.V271510.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 15th December 2005 over a period of four hours to assess if residents’ needs were being met. A tour of the premises included the lounge, kitchen, conservatory, bathroom and toilet areas. The manager, a senior member of staff and a resident were spoken to during the inspection. What the service does well: 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. Smithy Forge DS0000005199.V271510.R01.S.doc Version 5.0 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Smithy Forge DS0000005199.V271510.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 and 5 The statement of purpose and the service users’ guide give information about the home, the care and facilities offered, and details on how to make a complaint. Both documents are clearly written, providing useful information to prospective and existing residents. EVIDENCE: The statement of purpose and the service user guide were updated in September 2005. The focus is on explaining to residents that Smithy Forge is driven by the needs, abilities and aspirations of the residents. The service user guide describes the provision well and the admissions process is fully explained as is the range of needs met. How to report concerns and complaints is explained and both documents are user friendly. Advice was given as the documents need revising to state the date of the last inspection and to reflect a recent staffing change. Smithy Forge DS0000005199.V271510.R01.S.doc Version 5.0 Page 8 Two care folders were checked. The assessments and care plans showed that service users’ needs were fully identified. The care plans used at Smithy Forge are based on a thorough needs assessment then continuous planning for each service user. Within each care file there are advisory notes to staff regarding individual care planning and review to ensure all care needs are fully addressed. One assessment of dependency was in need of updating due to very recent changes and advice was given regarding this. There was a completed essential lifestyle plan for each resident and these were informative and thoroughly written to reflect all care needs and aspirations. Examples of diary sheets were read and accurately described the events in each residents day and indicated ongoing monitoring and support to residents. All persons involved in providing health care were clearly identified and with contact numbers and care guidance notes had been provided to staff following health care reviews and appointments. For example an action plan had been agreed with the involvement of a clinical psychologist and linked to this was a flow chart of actions to be taken by staff to help reduce some aspects of challenging behaviour. One health action plan was in need of updating to accurately reflect known and recent changes in a residents physical and mental health. See Recommendation 1. Residents receive annual health screening and are promptly referred to specialist health services when the need arises. Staff members are aware. They are quick to notice changes in health and obtain necessary help and support. The service user group has remained unchanged for a considerable period of time. Unplanned admissions are avoided and previous introductory and trial visits have been thoroughly planned. Prospective residents have been gradually introduced to the home, the staff and existing service users. There are well -written contracts/statement of terms and conditions between the home and the residents. These show the room to be occupied by the residents and the fees charged. When the contract is being drawn up, family members, friends and advocates support residents to aid understanding. The first six weeks is considered as a trial period. Contracts are provided in a format suitable for residents and are fully explained to them. Residents have a copy of their contract, which has been signed by the service user and the registered manager. Smithy Forge DS0000005199.V271510.R01.S.doc Version 5.0 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 the following standard(s): 8 and 10 Residents contribute to their assessments and essential lifestyle plan to ensure they are consulted regarding all aspects of their care. Residents are aware of information held about them by the home and are actively involved in contributing to their care records and supported to participate in the general running of the home to maximise their independence. EVIDENCE: Smithy Forge provides residents with comprehensive, accessible information, which is easy to understand and is up to date. 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. Residents are fully engaged in community activities and have been supported to follow their own interests and hobbies. Regular house meetings take place to enable residents to make decisions and air their views about all aspects of life within Smithy Forge. Minutes of these meetings were read and provided evidence of a wide range of subjects discussed. Smithy Forge DS0000005199.V271510.R01.S.doc Version 5.0 Page 10 Residents’ views were recorded in minutes of each meeting and action had been taken in response to opinions expressed and suggestions made. Recently several residents participated in the interview and selection process, for new staff and formulated a series of questions to ask interviewees. Residents know that information held about them, is handled both appropriately and respectfully. Individual and home records are securely kept. There is a policy entitled ‘Confidentiality, Sharing Information and Access to Records’. The content of the policy is brought to the notice of every employee and staff members sign to indicate they have read and understood the policy. Staff members know when information given them in confidence must be shared with their manager or others for the protection of residents. Smithy Forge DS0000005199.V271510.R01.S.doc Version 5.0 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 the following standard(s): 11 and 14 Residents have opportunities to learn and use practical life skills inside and outside the home and maximise their independence. Residents engage in appropriate leisure activities and are encouraged and supported to pursue their own interests and hobbies. EVIDENCE: Service users have opportunities to learn and use practical life skills inside and outside the home. One service user has a work placement at a local nursery and several of the service users attend community based leisure activities and meet with friends socially. The daily care programmes are organised as a response to residents’ individual and combined needs. A wide range of individual and group activities had been organised. Residents are encouraged to pursue existing hobbies, pursuits and relationships and to explore new interests and experiences. There are regular parties, outings and events. Just prior to the inspection the residents had been involved in organising a special Christmas meal within the home and were looking forward to this event. Staff members have a wide knowledge of the community and events within it. Smithy Forge DS0000005199.V271510.R01.S.doc Version 5.0 Page 12 Regularly residents have trips to local shopping centres, to the cinema and to concerts. Some residents travel independently to familiar places and group trips and meals out are planned and chosen by residents who share the same interests. Residents are encouraged to participate in all aspects of life within the home and are consulted individually and as a group about how the home is run and gain confidence and ability as a result. Residents are actively involved in staff selection, menu planning, satisfaction surveys, and in reviewing policies. Smithy Forge DS0000005199.V271510.R01.S.doc Version 5.0 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 the following standard(s): 21 Smithy Forge has gathered information about residents’ wishes regarding death and dying. This information has been recorded to ensure the ageing, illness and death of residents can be handled with respect and as each resident would wish. EVIDENCE: Letters had been sent from the home in August 2004 to the families of service users explaining that residents’ wishes about death and dying were to be recorded. A questionnaire to gather this information was drawn up and the information needed has been collected. The information recorded was very detailed and provided all the necessary information about arrangements and wishes after death. Person centred plans have been compiled regarding death and dying and have been signed by the residents, the manager and a health facilitator from Halton Primary Care Trust, and a family member. A booklet especially for adults who have a learning disability entitled ‘Lets talk about Death’ had been made available for all residents. Smithy Forge DS0000005199.V271510.R01.S.doc Version 5.0 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 the following standard(s): None EVIDENCE: Standards 22 and 23 were assessed at the last inspection on 10th June 2005 Smithy Forge DS0000005199.V271510.R01.S.doc Version 5.0 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 the following standard(s): 25,26,27,28 and 29 Smithy Forge is well furnished, decorated, equipped and maintained. EVIDENCE: Each bedroom is of ample size and personalised to a high degree to be practical and to meet the needs and preferences of individual residents. All bedrooms are for single occupancy and adjacent bathroom and toilet areas are well maintained, pleasantly decorated and clean. The premises were clean throughout. Recently a new ceiling has been fitted to a downstairs toilet and new flooring has been fitted to the conservatory. Care and attention is given to maintenance and renewal to ensure the environment is welcoming, comfortable, clean and hygienic. The entrance hall has recently been repainted and the communal areas including the lounge, kitchen and conservatory were well equipped and furnished. There are plans to redecorate the lounge and one bedroom in the early part of 2006.Individual accommodation contains all necessary furniture and furnishings and all personal space reflects the character of each individual resident. Many or the residents have their own televisions, video, CD and DVD equipment. Smithy Forge DS0000005199.V271510.R01.S.doc Version 5.0 Page 16 Some residents have chosen their own items of furniture and have chosen not to have particular items of furniture in their rooms. This choice is indicated within the plans of care. The residents living in home at the time of the inspection could use standard domestic fixtures and fittings without the need for specialist adaptations. One service user uses dial-a-ride services to take them to a work placement. The domestic nature of the home and the levels of independence of the service users make a call bell system unnecessary at the moment but this would be reviewed as the needs of the service users change. There are satisfactory arrangements to ensure that repairs and maintenance of equipment are carried out. Outdoor space is well maintained. The large rear garden is fenced and private and is well used by residents in the summer months. Smithy Forge DS0000005199.V271510.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35 and 36 The registered manager ensures that staff members have clearly defined job descriptions and understand their own and others’ roles and responsibilities. Staff members know and support the main aims and values of the home, understand and implement the home’s policies and procedures, and know how their work, and that of other staff, promotes the main aims of the home. Residents are well supported by an effective staff team. EVIDENCE: The registered manager is a co-owner of Smithy Forge and has more than fourteen years experience of working with adults with learning disabilities. In September 2005 the registered manager completed work towards NVQ level 4 and awaits confirmation of qualification. Staff members were observed to respect residents and have the skills and experience necessary for the tasks they are expected to do. The staff team are encouraged to undertake training to support them in their roles and responsibilities and to enable them to confident and competent. Recent recruitment has resulted in one new member of staff appointed. The recruitment process was seen to be thorough. Advice was given at feedback to the inspection regarding obtaining Protection Of Vulnerable Adult First checks prior to commencement of employment. Smithy Forge DS0000005199.V271510.R01.S.doc Version 5.0 Page 18 Evidence of planned staff supervision was seen. Staff members have regular recorded and formal supervision plus annual appraisals. Smithy Forge DS0000005199.V271510.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,40,41 and 43 Smithy Forge is well run and residents’ rights and best interests are safeguarded by the home’s practices, policies and procedures. EVIDENCE: Residents benefit from the management and leadership within the home and residents know that they will be listened to and consulted. The management approach to the home creates an open, positive and inclusive atmosphere in which residents can develop to their full potential. Residents and staff are involved in decision making processes are consulted and well informed, Staff are knowledgeable about residents and their circumstances and therefore are able to support them well. Residents have access to their records and individual and home records are up to date, in good order and securely kept. The results of residents’ surveys are published and made available to residents. There is a system of continuous self- monitoring in place and the owner completes monthly monitoring checks plus makes frequent visits to the home to check on the smooth running of the home and maintenance of the premises. Smithy Forge DS0000005199.V271510.R01.S.doc Version 5.0 Page 20 Smithy Forge is committed to maintaining and improving the quality of the service provided. There is a comprehensive quality, policies and procedures manual in place, which is constantly under review and revision. Feedback is actively sought from residents, their family members and other stakeholders to ensure the service meets the needs and best interests of service users. The registered manager ensures that staff members maintain safe working practices by providing appropriate training, supervision and monitoring. Smithy Forge DS0000005199.V271510.R01.S.doc Version 5.0 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 4 3 2 3 3 Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X 3 X 3 Standard No 24 25 26 27 28 29 30 STAFFING Score X 3 3 3 3 3 X LIFESTYLES Standard No Score 11 4 12 X 13 X 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Smithy Forge Score X X X 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 X 3 DS0000005199.V271510.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation 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 YA3 Good Practice Recommendations Ensure that health action plans are always updated to accurately reflect changes in residents’ physical and mental health. 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