Inspection on 01/02/07 for The Bungalow

This inspection was carried out on 1st February 2007.

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

The Bungalow 26/01/09

Similar services:

Credence House

Radfords

Honeybourne House

32 Beaumont Way

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

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

CARE HOME ADULTS 18-65 The Bungalow 193 Crownhill Road Crownhill Plymouth Devon PL5 3SN Lead Inspector Kim Fowler Unannounced Inspection 1 February 2007 09:30 st The Bungalow DS0000067375.V300374.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 The Bungalow DS0000067375.V300374.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 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. The Bungalow DS0000067375.V300374.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Bungalow Address 193 Crownhill Road Crownhill Plymouth Devon PL5 3SN 01752 701057 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) Selborne Care Limited Mr Valentine Lawrence Taylor Care Home 2 Category(ies) of Learning disability (2) registration, with number of places The Bungalow DS0000067375.V300374.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Service Users who may also have a sensory impairment. Aged 18-65 years Date of last inspection Brief Description of the Service: The Bungalow is a care home providing personal care and accommodation for two people with learning disabilities and sensory impairment. Selborne Care Ltd now owns this home. This is a private sector organisation that also provides day and supported living services for adults with learning disabilities. This home is located in the residential area of Crownhill, close to shops, pubs, the post office and other amenities. The home was opened in 1999 and is a detached bungalow. All the homes bedrooms are single and none of them have en suite facilities. There are separate lounge and dining rooms and a large, attractive garden accessible to the service users. The Bungalow DS0000067375.V300374.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over 2 days. The Registered Manager was not available throughout the inspection. However the manager and the inspector spoke by telephone after the inspection. A full tour of the building was undertaken and the inspector spoke to both of the service users. The staff that were on duty at the time were spoken with. Documentation relating to the care planning process and the management of the home were examined. One relative feedback card was returned to the Commission. Any comments are discussed in the relevant section of the report. 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. The Bungalow DS0000067375.V300374.R01.S.doc Version 5.2 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 The Bungalow DS0000067375.V300374.R01.S.doc Version 5.2 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): 2 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Prospective new service users can be assured that the home will complete a detailed pre-admission assessment which will assist staff to meet their individual needs. EVIDENCE: The home has had no new admissions since the last inspection. However the home has an admission policy should the need arise. Both service users files were examined as part of the inspection process. These files contained detailed individual care plans. These documents provided all the relevant information required to meet the assessed needs of both service users. A comprehensive list of care needs held on each file allows the staff to access information to meet the complex needs of both the service users. These details included information on how to meet service users personal care needs and to deal with any aggressive behaviour. Completed assessments are important to assure that not only can their health care needs be met but also their emotional, social, cultural or religious needs. The Bungalow DS0000067375.V300374.R01.S.doc Version 5.2 Page 8 All staff spoken with agreed that the information provided on each file assist them to meet the complex needs of each service user and in such a way that it promotes the structured care needed to ensure the well being of each of the service users. The Bungalow DS0000067375.V300374.R01.S.doc Version 5.2 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): 6/7/9 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Service users can be confident that the care plans will provide information that enable staff to meet their care needs in a way that they require. EVIDENCE: The service users files were examined. Each contained a completed Care Plan and included a “My Life Plan”. These plans describe how the home will meet the assessed needs of individuals. Each care plan has information clearly recorded relating to each aspect of the service users daily life. Each section is laid out to assist staff to meet the complex needs of each service user and both hold comprehensive details. This assists the care staff to meet the care needs of individuals and includes medication, personal care and communication. The records show these care plans are reviewed regularly and record any changes in needs of the service users. Both service users have regular The Bungalow DS0000067375.V300374.R01.S.doc Version 5.2 Page 10 involvement in their reviews with input from family members and the service users key worker. The review dates recorded showed these had taken place recently. One feedback card commented, “ They are sensitive to his individual needs. For example building a sensory garden for him”. Both service users are only able to access the community with one to one staff support and this is recorded to include guidelines to assist the staff when they take service users out. Both have guidelines in place for dealing with any challenging behaviour or physical aggression. Due to the complex needs of the service users in the home they are unable to make decisions independently. The staff interviewed stated that they encourage service users in daily decision-making. This included one service user accessing their bedroom to be on their own when they wished, a choice of dessert for lunch and, using of sign language, to decide about going out in the homes transport. One comment card received by the Commission states under the, do you and/or your friend or relative get enough information about the care home to help you make decisions wrote, “Staff make decisions based on day to day needs and I am invited to quarterly reviews. I am phoned to ask my opinion appropriately and have confidence in my relatives key workers to react in his best interest”. As both service users require one to one staffing risk assessments have clear guidelines in place for staff to follow. These risk assessments are based on risk and choice. Many risk assessments relate to everyday issues including personal care. These support staff in their everyday care of service users. All staff agreed that the risk assessments were accurate and are reviewed and updated when needed to meet the complex needs of both service users. Many of the staff spoken with confirmed they had received training on Manual Handling and Health and Safety for the safety of them and the service users. None of the service users are able to manage their own finances. Each file records how service users family manage their money. One family member is an appointee for the service user. Individual Bank Statements are held and records clearly state the income and expenditure for each service user. The money was checked for one service user during this inspection and was found to be correct. The Bungalow DS0000067375.V300374.R01.S.doc Version 5.2 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): 12/13/15/16/17 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Service users can be confident that the home will provide support for them to access the local community and many leisure activities. This home provides good quality, wholesome food. EVIDENCE: Due to the complex needs of the service users in the home none are able to gain employment or attend education training. In the files of both service users was an activities list showing what service users did and were they went each day. Staff record on the daily programmes record the trip or activity undertaken for each service user. This included carrying out any housekeeping tasks around the home, local walks and shopping trips. The Bungalow DS0000067375.V300374.R01.S.doc Version 5.2 Page 12 The home continues to encourage service users to participate in social activities and develop their social skills. This is assisted by providing transport and additional staff support to enable service users to access the community, to go to day centres and enjoy outings. During the inspection the Inspector observed one service user attending an aromatherapy session with staff support. Records showed details of family involvement as well as information that service users saw family members regularly. During interviews with the staff the inspector was informed that they knock on service users bedroom doors but due to needs of these service users they are unable to acknowledge entry. The staff spoken with all agreed that the daily routines are organised to promote as much independence as possible. Neither of the service users are able to have key to their bedrooms and this information was recorded onto individual files. The homes menus were examined and staff confirmed that there is a good budget to purchase provisions. The staff spoken with agreed that the home provides good quality and wholesome food. The menu is designed to meet the service users likes and dislikes and staff are aware of each service users individual need. Food seen prepared for the service users during the visit to the home was well presented. One staff member informed the inspector that to promote the health of each service user one has a fluid chart and both service users have a record of all food eaten. One relative feedback card commented under the does the care service support people to live the life they choose wrote, “Individually planned. My relative has aromatherapy twice a week and has sessions at a local gym”. The Bungalow DS0000067375.V300374.R01.S.doc Version 5.2 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): 18/19/20 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The home provides good healthcare support for service users in the home and promotes privacy and dignity at all times. Access to health care is maintained which promotes the wellbeing of the service users. EVIDENCE: During the inspection, staff provided service users with personal support which was carried out in private. The service users dignity was maintained. All Care Plans have details on how personal support should be carried out. Manual handling information is also recorded. Also, there are Occupational therapist assessments on individual files. Staff informed the inspector that service users are able to go to bed or get up when they wished. On the service users needs guidance, there is information about an agreed bedtime. This guidance showed family and staff involvement in agreeing this time. The Bungalow DS0000067375.V300374.R01.S.doc Version 5.2 Page 14 The staff interviewed clearly showed that they are aware of the emotional needs of each service user and able to support these needs. Both service users rely on staff observation for any changes in their health needs and both service users health is monitored for any changes in condition and extra provision and support needed was well documented into individual files. One staff member confirmed that the service users have yearly health checks. Specialist input from other professionals are recorded on individual care plans. This includeds Speech and Language therapist and a Consultant Psychiatrist. Only one service user has regular medication and the home uses the blister pack monitoring system made up by the pharmacist. The inspector observed a staff member administering medication for one service user and a discussion with this staff member showed that the home has a clear audit trail for all medication. The Bungalow DS0000067375.V300374.R01.S.doc Version 5.2 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): 22/23 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The service users can be confident that any complaints or concerns raised by family on their behalf would be listened to and acted upon. EVIDENCE: The homes complaints procedures with designated forms to complete were clearly displayed and accessible for all. Due to the needs of the service users at the home neither is able to make complaints themselves. However they both have regular family involvement who could complain on the service users behalf if needed. The Commission has not received any complaints. One staff member said they had been involved in a recent Adult Protection issue. It was evident from this conversation and the involvement of the Commission that the home managed the situation well and the manager and staff are to be commended for this. All staff interviewed confirmed that they had completed a POVA (Protection of Vulnerable Adult) course with Plymouth City council. All staff files held completed CRB’s (Criminal Record Bureau checks). Therefore providing protection of service users. One relative feedback card commented under the do you know how to make a complaint about the care provided by the home wrote, “I have confidence that I could find out without obstruction”. The Bungalow DS0000067375.V300374.R01.S.doc Version 5.2 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): 24/30 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The service users benefit from a homely, comfortable, clean and wellmaintained building that is appropriate to meet their needs. EVIDENCE: The premises were accessible to both the service users with level access throughout. It is comfortable, well furnished and clean. Both bedrooms were single rooms and each bedroom was decorated with individual needs meet and reflected the personality of the occupant. Each room had many personal possessions. All furnishings are of good quality and both bedrooms have been decorated recently and had new carpets fitted. The premises were found to be clean, hygienic and free from odour during the visit to the home. One staff member confirmed they had completed Infection control training. The Bungalow DS0000067375.V300374.R01.S.doc Version 5.2 Page 17 The homes laundry facilities based in the converted garage are sufficient to meet the needs of the service users in the home. Selborne Care employs a maintenance person to carry out everyday repairs and an outside contactor was working in the home during the inspection. The main bathroom is in need of upgrading. The manager spoke to the inspector after the inspection to state that this bathroom is now being decorated. The Bungalow DS0000067375.V300374.R01.S.doc Version 5.2 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 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): 32/34/35/36 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Service users are supported by well-motivated and caring staff in sufficient numbers to meet the needs of those currently living at the home. Staff training, supervision and appraisals are carried out regularly with all staff to ensure that all assessed needs of service users are met. EVIDENCE: The homes pre-inspection questionnaire stated that the home currently employs 8 care staff and presently 4 have gained and NVQ at level 2 or above. Staff files were examined during the inspection process. These files confirmed that not all relevant checks were undertaken prior to employment which does not safeguard of service users. One staff member’s files did not hold a second reference as required. Some staff records are held at the home and other information, often duplicated is held at Selborne Care’s main office situated in another part of The Bungalow DS0000067375.V300374.R01.S.doc Version 5.2 Page 19 Devon. The streamlining of the staff files would ensure continuity of the records that are kept. All the staff files and discussion with the staff confirmed that regular and updated training is carried out. Displayed on the homes notice board were the staffs training record showing courses completed and courses booked for the near future. The inspector examined six staff members files and each file showed that all newly appointed staff members had received Induction training. One newly appointed member of staff spoken with confirmed a probation period, CRB clearance and shadowing of experienced staff when first employed. All staff spoken with confirmed that Selborne Care supports their training needs and training is regularly offered. All staff interviewed felt that the home has a sufficient number of staff on duty to meet the current needs of the service users living at the home. One staff member confirmed that the home holds regular staff meetings and supervision sessions. All staff stated that they were able to express their view at these meetings. Regular consultation with staff ensures staff can contribute to the running of the home and that they are aware of the home’s aims and objectives and philosophies of care. This promotes consistency and improvement. One relative feedback card stated under the, does the care home help your relative to keep in touch with you wrote, “ They are happy and welcoming to me and my family”. They went onto say under the do the care staff have the right skills and experience to look after people properly wrote, “Extra training seems available for example Makaton (sign Language) updates”. The relative went onto say when asked about what do you feel the care home does well wrote “cares consistently” and went onto say under how do you think the care can improve commented “ Carry on in the same direction”. The Bungalow DS0000067375.V300374.R01.S.doc Version 5.2 Page 20 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): 37/39/42 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The management of this home is very good. And the staff team are well trained to meet service users needs. EVIDENCE: The registered manager was unavailable on the visit to the home but the inspector had telephone contact with the manager. The pre inspection questionnaire states that the manager is in the process of completing an NVQ4 qualification in care and plans to commence the Registered Managers award. The manager has recently dealt with an Adult Protection issue involving one of the service users. The observation by the inspector during this process showed The Bungalow DS0000067375.V300374.R01.S.doc Version 5.2 Page 21 the manager understood the adult protection procedure and was competent throughout the process. One staff member who reported this incident stated, “ I felt well supported throughout the investigation”. One relative feedback card received commente, “ There was an alleged abuse by a member of staff, who has been dismissed. The care home offered support and worked in a professional manner when involved with the subsequent investigation”. All staff agreed that the homes manager is approachable. None of the service users are able to completed quality assurance questionnaires. However the home provides quality assurance forms for family members. These were sent to the inspector and all were positive. Sampling of servicing records indicated that equipment is serviced regularly and maintained in good working order, including the fire alarm system. Certificates were available on all Health and Safety equipment i.e. hoist ensuring all have been checked. Gas and electrical appliances were being routinely serviced and checked. The fire protection system was well maintained. Maintenance checks are being carried out. Staff are receiving appropriate fire protection training to ensure they have the skills to deal with emergencies. All staff have completed manadatory training in Fire safety, First Aid and food hygenie. The staff spoken with confirmed the completion of these courses and certificates were held on individual files. Good health and safety practices reduce any unreasonable risk, affecting residents or staff, to an acceptable level. The Bungalow DS0000067375.V300374.R01.S.doc Version 5.2 Page 22 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 Standard No 1 2 3 4 5 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 4 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 3 X X X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 4 X 3 X X 3 X The Bungalow DS0000067375.V300374.R01.S.doc Version 5.2 Page 23 No 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. 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 2 Refer to Standard YA20 YA34 Good Practice Recommendations Staff should have updated medication training. All staff files should be held in one place. The Bungalow DS0000067375.V300374.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 The Bungalow DS0000067375.V300374.R01.S.doc Version 5.2 Page 25 - 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. 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