CARE HOME ADULTS 18-65
Mr David Chadwick 54 Strawberry Fields Meriden Coventry West Midlands CV7 7SA Lead Inspector
Kevin Ward Unannounced Inspection 14th September 2005 12:00p Mr David Chadwick DS0000004558.V249946.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 Mr David Chadwick DS0000004558.V249946.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. Mr David Chadwick DS0000004558.V249946.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Mr David Chadwick Address 54 Strawberry Fields Meriden Coventry West Midlands CV7 7SA 01676 523 887 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 David Chadwick Mr David Chadwick Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Mr David Chadwick DS0000004558.V249946.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 21st March 2005 Brief Description of the Service: Strawberry Fields is a small care home registered with the Commission for Social Care Inspection to provide care for up to 3 service users who have learning difficulties. The registered person lives on the premises. The home runs very much as an Adult Placement Home although it cannot be registered as this as there is no Adult Placement scheme in the area. The situation remains the same as the last inspection as there is currently one service user residing in the home. The home has two vacancies, which could be available for respite care should the manager make moves to arrange this. The current service user would have to be involved in the planning and decision about the possible provision of respite care. The home has three single bedrooms, one bathroom and two WCs the use of service users. There is a lounge and a separate dining room. The garage has been converted into a second lounge, which has become the designated smoking room. The current service user has almost exclusive use of this room with equipment to make himself a hot drink. The home is located close to the amenities in the village of Meriden. That includes shops, public house and place of worship. The service user travels independently using the local bus service. Coventry, Birmingham and Solihull can be reached using the bus services. The current service user is independent in a majority of aspects of daily living but has encouragement, support and guidance from the registered manager regarding matters as travel, food preparation and time keeping. Mr David Chadwick DS0000004558.V249946.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection involved meeting with the manager to review the progress that has taken place to meet the three requirements made at the last inspection and to inspect a number of records and policies. The inspection also involved spending time in discussion with the person placed at the home to seek his views about the service and the support he receives. What the service does well: What has improved since the last inspection? What they could do better:
Good work has taken place to review the service user’s needs recently, however there is a need to update the action plans and risk assessments in the personal planning folder to take account of action points that were identified at the review meeting. Mr David Chadwick DS0000004558.V249946.R01.S.doc Version 5.0 Page 6 The manager also agreed to re-start the daily diary to record the support provided by the home and any significant events that occur. It is also recommended that the service user’s advocate is encouraged to take part in care reviews to help provide independent representation at these meetings. There is a need to arrange a Criminal Record Bureau Check for a friend who provides very occasional support at the home if the manager goes on holiday. The person living at the home is involved in his care reviews and in the day to day running of the home, e.g. grocery shopping, making drinks, cleaning, however there is not currently an opportunity to formally comment on life at the home. The manager agreed to devise a questionnaire about the home for the service user to fill in with help from his advocate. The service user indicated that he does not enjoy attending health appointments. The manager agreed to encourage the service user to attend a well person check up with the person’s agreement. The service user indicated that he might be prepared to accept a check up when he visits the surgery for a flu vaccination in the coming months. The service user explained that he likes going to his day service and enjoys visiting the local charity shop and meeting with friends but would really like a proper holiday. This matter has been raised with the social worker and the manager undertook follow up on this matter and to investigate other possible options to meet this need. Contact details of relevant professionals are in place in the home’s adult protection procedure, to enable the manager to report any suspicions of abuse that may come to his attention. The manager is recommended to attend “vulnerable adult abuse” to underpin his knowledge of this important area of practice. 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. Mr David Chadwick DS0000004558.V249946.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Mr David Chadwick DS0000004558.V249946.R01.S.doc Version 5.0 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 the following standard(s): These Standards were not assessed on this occasion. EVIDENCE: Mr David Chadwick DS0000004558.V249946.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): 6,7 and 9 The care plan needs to updated after reviews to include agreed actions identified so that there are clear plans can be demonstrated for meeting the service users needs and aspirations. The service user is consulted and involved in making decisions that affect his life. This would be further enhanced by the increased involvement of the person’s advocate at review meetings. Overall appropriate support and guidance is provided for the service user to maintain his independence safely. A risk assessment is necessary, explaining the action taken to discourage the service user from leaving home too early in the morning. EVIDENCE: A personal planning book is in place that acts as a care plan. This book contains basic information about the needs of the person placed at the home and includes brief action plans to address his needs. Notes of a recent review were seen that involved staff of the day service, the home manager, social worker and service user. This document included a number of actions to be taken to support the care of the service user. Mr David Chadwick DS0000004558.V249946.R01.S.doc Version 5.0 Page 10 The manager was advised to update the action plans in the personal planning booklet to take account of these issues. The manager also agreed to restart the daily diary to record significant events and activities undertaken by the service user and support provided by the manager to address the service user’s assessed needs. The person living at the home confirmed that he is able to enjoy a good level of independence at the home and receives support with daily living activities, such as cooking and cleaning. The service user confirmed that he has a friend who also acts as an advocate in some circumstances. The manager agreed to support the service user to ask the advocate to help represent his interests at future reviews. The service user confirmed that he enjoys venturing out places independently to meet friends and likes to travel on public transport to his day service. The manager explained that the service user has been leaving the house very early during the summer, probably due to the lighter mornings. This was seen to have been addressed in the notes of a recent review, involving the social worker. The manager agreed to monitor this matter closely and to keep a record of the times the service user leaves the home each day. The manager also agreed to write a risk assessment / action plan explaining the work taking place to address this issue, so that the service user is supported to remain safe. Good work has taken place to provide the service user with a card containing the contact details of the provider and to inform them of actions to take in the event that they were to get lost. Mr David Chadwick DS0000004558.V249946.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): 12,13, 15 and16 The service user is supported to attend day services and venture out in the community so that he has access to a reasonable social life and takes part in community life. Further support is necessary to help the person to have access to a holiday. The manager respects the service user’s privacy and independence so that his rights are respected. The service user is supported to have regular contact with friends and receive visitors at the home so that his personal relationships are maintained. EVIDENCE: The service user stated that he enjoys attending a social services day service during the week, where he likes to help out. He also confirmed that he continues to see his friends frequently at the local charity shop and at church. The manager explained that the service user’s friends are welcome to visit the home. The service user confirmed that his friends occasionally visit him at the home. Mr David Chadwick DS0000004558.V249946.R01.S.doc Version 5.0 Page 12 The service user stated that he enjoyed a recent day trip to Weston SuperMare with the day service and said that he would really like a holiday. The manager explained that he had raised this with the social worker. Evidence of this was seen the notes of the service user’s recent care review. The manager explained that he will continue to follow up this matter with the social worker and investigate possible holiday opportunities, e.g. with Gateway club. The person living at the home confirmed that his privacy is respected and that he has is encouraged to be independent. He explained that he has been issued with a front door key so that he can come and go as he wishes and has a place to lock away his personal belongings. The manager explained that he always passes he service user’s mail to him to open. The service user confirmed this. The service user explained that he receives support with cleaning and tidying his bedroom, bathroom and other areas of the home. The service user has use of a separate room for smoking that is equipped with a kettle so that he can make himself a drink. Mr David Chadwick DS0000004558.V249946.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): 18,19 and 21 The manager is aware of the needs of the service user so he able to deliver personal care support in the way that the person prefers. Further work is necessary to encourage the service user to have his health needs assessed at the well person clinic to ensure that his health needs are being appropriately met. Support has been provided for the service user to make their wishes known, in the event of death, so that his wishes may be respected. EVIDENCE: The service user is independent in most aspects of personal care and does not require the provision of any lifting equipment. The manager explained that the service user requires a little assistance but that he has fairly set routines and will only accept help at certain times. The service user explained that bedtimes are flexible and that he can stay up if he wishes to do so. The manager said that he is trying to encourage the service user to stay up later into the evening so that he may sleep in longer and not leave home so early in the mornings. The service user has his own bathroom for his personal use. Mr David Chadwick DS0000004558.V249946.R01.S.doc Version 5.0 Page 14 The service user confirmed that he has recently attended the opticians for an eye test and new glasses. The manager explained that the service user does not normally like attending health appointments but will usually accept a winter flu vaccination. This was confirmed by the service user. However during the course of the inspection the service user agreed to consider a well person check if the nurse can carry this out when he visits for his next flu vaccination. A lockable cabinet is available in the bathroom for service users medication, should this be required in future. The cabinet was not inspected as the manager explained that the service user currently living at the home is not on any prescribed medication. The manager has recently received training in the administration of medication. Since the last inspection the manager has talked to the service user to discuss arrangements in the event of his death. A record summarising these arrangements is on file and was signed by the service user during the inspection. The manager explained said that he has discussed these arrangements withy the local clergyman to ensure that the service user’s wishes can be carried out. Mr David Chadwick DS0000004558.V249946.R01.S.doc Version 5.0 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 the following standard(s): 22 and 23 The service user has opportunities to raise concerns with a number of people who can support them so that concerns and complaints can be acted upon. A procedure is in place for reporting any suspicions of abuse so that they can be appropriately investigated. Additional training would be beneficial for further increasing the manager’s knowledge of this area practice. EVIDENCE: The service user confirmed that he has several people to whom he may complain or raise concerns. In addition to the manager the service user said that he would be comfortable raising concerns with day service staff and his friend / advocate. At the last inspection the service user expressed concerns regarding treatment by local children. He explained that he has received support from the manager to address this and has not suffered any further problems with young people. The service user said that he is very happy at the home and has no current complaints. A complaints procedure was seen to be in place at the home. There is only one person placed at the home and the manager and service user see each other everyday so any concerns can be easily identified and resolved. A basic adult protection procedure is in place providing the contact details of social work staff in Solihull to whom any suspicions of adult abuse should be reported. The manager stated that he had not been on adult abuse training but indicated that he would be prepared to do so. This would be beneficial so that the manager is equipped to respond appropriately to incidents of abuse that may come to his attention in future. A financial ledger is being retained by the manager to account for the service user’s monies, including records of income and expenditure. Mr David Chadwick DS0000004558.V249946.R01.S.doc Version 5.0 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 the following standard(s): 24. The home is suitably decorated and furnished to provide a comfortable place for people to live in. EVIDENCE: The home continues to offer a comfortable place for the service user to live in to meet his needs. The house was seen to be clean, well decorated and contains comfortable domestic style furniture. The home is currently shared between the provider and the service user. The manager advised that he has no plans to introduce anyone else to the home and explained that if a new person was to move in at some point in the future this would involve consultation with the current service user. A room has been set-aside for the service user to use for smoking. The room is also equipped with a TV and video player, drink making facilities and a smoke alarm. The service user has a single bedroom and sole use of a bathroom. The bathroom was seen to be modern and maintained in a clean condition. Overall the home is modern, clean and attractive and provides a very comfortable place to live in. Mr David Chadwick DS0000004558.V249946.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): 34 and 35 There is a need for a Criminal Record Bureau check to be carried out for one volunteer to ensure that they are suitable to provide support at the home. The manager has attended training in mandatory subjects to equip him to support the service user in a safe manner. EVIDENCE: There are no staff employed by the home, although the manager explained that he continues to make occasional use of a friend to be available to support the service user, when he goes out for the home for a long time. A Criminal Record Bureau (CRB) Check was seen on file for this person. The manager said that he intended to renew the CRB check as it was carried out nearly three years ago. This is in keeping with good practice. The manager said a second friend /volunteer is used very occasionally to provide support at the home when the manager goes on holiday. The manager confirmed that he has not made use of this person since the last inspection. The manager explained that he had tried to apply for a CRB check for this person as required at the last inspection but that had gone through the wrong channels. The manager was advised to try an umbrella organisation (details on the internet) to carry out CRB checks on is behalf. Since the last inspection the manager has completed fire safety training for managers. During the last year the manager has also completed training in the following subjects: administration of medication, first aid, food hygiene. Training certificates were seen on file verifying the dates of courses attended. As previously mentioned the manager has not yet completed vulnerable adult abuse training.
Mr David Chadwick DS0000004558.V249946.R01.S.doc Version 5.0 Page 18 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): 39 Opportunities are available for the service user to comment on his care. A quality assurance questionnaire would be beneficial in enabling the service user to comment specifically about the service provided by the home. EVIDENCE: The small size of the home means that there is not a need for a complex quality assurance system to be in operation. However the manager agreed to make arrangements for the service user to have the opportunity to complete a periodic questionnaire to voice their views about the home. The manager agreed to assist the service user to approach their advocate to provide support to complete the questionnaire. As previously noted the service user has been involved in their care review and sees the manager on a daily basis. This provides opportunities for the service user to comment on their care and raise any concerns. Mr David Chadwick DS0000004558.V249946.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 x 2 x Standard No 24 25 26 27 28 29 30
STAFFING Score 3 x x x x x x LIFESTYLES Standard No Score 11 x 12 3 13 2 14 x 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score x x x 2 3 x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Mr David Chadwick Score 3 2 x 3 Standard No 37 38 39 40 41 42 43 Score x x 2 x x x x DS0000004558.V249946.R01.S.doc Version 5.0 Page 20 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA6 Regulation 15 Requirement Update action plans in personal planning book to take account of issues raised at the last review and plans to assess health needs at well person clinic. Write a risk assessment addressing action taken to monitor and address any risks that may be associated with the service user leaving home early in the morning. Provide encouragement and support for the service user to attend a well person check. Carry out a Criminal Record Bureau Check for the friend of the manager who occasionally covers at the home at holiday times. This person must not work at then home until the check has been carried out. Timescale for action 30/10/05 2 YA9 13 (2) (c) 30/10/05 3 4 YA19 YA34 12 (1) (b) Schedule 2 30/11/05 30/11/05 5 YA39 24 Ongoing from the last inspection. Action date 31/3/05. Support the service user to seek 30/11/05 assistance from their advocate to complete a quality assurance questionnaire about the home. Mr David Chadwick DS0000004558.V249946.R01.S.doc Version 5.0 Page 21 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard YA6 YA7 YA23 Good Practice Recommendations Encourage the involvement of the advocate in the service user’s care reviews. Support the service user to go on holiday. The manager is recommended to attend Vulnerable Adult Abuse training. Mr David Chadwick DS0000004558.V249946.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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 Mr David Chadwick DS0000004558.V249946.R01.S.doc Version 5.0 Page 23 - 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!
