Inspection on 23/02/06 for The Bungalow

This inspection was carried out on 23rd February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Bungalow 28/06/07

The Bungalow 06/12/05

The Bungalow 12/11/04

The Bungalow 14/04/04

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 The Bungalow 121 Worden Lane Leyland Preston Lancashire PR25 2BD Lead Inspector Val Turley Unannounced Inspection 23rd February and 2 March 2006 09:40 nd The Bungalow DS0000040741.V267285.R01.S.doc Version 5.1 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 DS0000040741.V267285.R01.S.doc Version 5.1 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 DS0000040741.V267285.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Bungalow Address 121 Worden Lane Leyland Preston Lancashire PR25 2BD 01772 457585 01772 434973 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) Social Services Directorate Mrs Julie Ray Care Home 4 Category(ies) of Learning disability (4) registration, with number of places The Bungalow DS0000040741.V267285.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The home is registered for a maximum of four service users to include: Up to 4 service users in the category LD - Learning Disability. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Staffing must be provided to meet the needs of the service users at all times and will comply with any guidelines which may be issued through the Commission for Social Care Inspection regarding staffing levels in care homes. 6th December 2005 Date of last inspection Brief Description of the Service: The Bungalow is situated in a residential area of Leyland close to the town centre and associated facilities. It offers respite care for up to 4 younger adults with a learning disability and some additional physical disabilities. The home offers a friendly, domestic environment. Accommodation is in single bedrooms, with lounge areas, dining area, and adequate bathroom and toilet facilities. The grounds are open and spacious with ramped access. Service users are encouraged and supported to become involved in community-based activities. The Bungalow DS0000040741.V267285.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second of two statutory inspections to be carried out this year. The inspection was an unannounced one and took place on the 23/02/06 and 3/3/06. The inspection was undertaken by one regulatory inspector over a period of 5 hours. Files were examined and a service user and support staff spoken to. A tour of the home also took place. As part of the inspection, the inspector used “case tracking” as a means of assessing some of the National Minimum Standards. This process allowed the inspector to focus on two of the service users who stayed at the home. All records relating to these individuals were inspected and where possible discussion took place with them. What the service does well: Before a service user is admitted to the home a full assessment is undertaken to ensure as far as possible that their support needs can be met. Introductory visits were made to the home by the service user, with a view to making the admission process as comfortable as possible. The home had good care plans in place that included good details of the support needs of the service users as well as their preferred routines and likes and dislikes. As the home provided only respite care the home worked towards ensuring that the period that the service user spent at the home was as enjoyable as possible. There was evidence that service users went out for lunch, had trips to the cinema and visited local pubs etc. Staff had a good understanding of the support needs of the service users who stayed at the home for respite care. Activities undertaken both inside the home and in the community were risk assessed and any specific risks were identified during the pre-admission process, enabling the home to make a decision as to whether the risk could be managed or not. The home made contact with carers prior to each admission to enquiries as to whether the support needs of the service user had changed in any way. The routines within the home were flexible and the independence of service user was encouraged as far as possible with a range of equipment being available enabling service users with complex needs use the home for respite care. The home had contact with health professionals and their advice was sought as necessary The home had a knowledge of the health needs of each of the service user and this enabled the staff to attend to any health needs that the service user may have during the course of their stay. The Bungalow DS0000040741.V267285.R01.S.doc Version 5.1 Page 6 The home had achieved two quality assurance awards in recognition of the service that they provide. The manager also undertook a number of regular checks within the home to ensure that all documentation was in place and up to date. What has improved since the last inspection? What they could do better: Although the home made enquiries as to whether the support needs of the service user had changed at all prior to each admission, it is recommended that this review be undertaken in more detail at least once every six months or as necessary, depending on the frequency of the respite care enjoyed by the service user. Although the home made every effort to ensue that service users were able to access the community and its facilities, the home did not have any transport and this often limited the activitities the service user could participate in either on an individual basis or as part of a group. It was recommended that some competency checks be introduced to staff in respect of the administration and management of medication. This was with a view to improving practice and reducing the likelihood of any medication errors being made and consequently afford the service user additional protection. Training records must be improved to indicate the full range of training the team had undertaken including training in the protection of vulnerable adults and the administration of medication. The home should ensure it holds documentation in relation to the selection and recruitment of each member of staff to demonstrate that the staff team are ‘fit’ to work with vulnerable adults. The quality assurance processes in the home were not as extensive as they should have been and a formal survey of service users views should be undertaken. Staff should be made aware of the procedure to follow when reporting an accident or incident. Additional training in first aid should be provided to ensure as far as possible that there is always a member of staff on duty with an appropriate qualification. Please contact the provider for advice of actions taken in response to this The Bungalow DS0000040741.V267285.R01.S.doc Version 5.1 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Bungalow DS0000040741.V267285.R01.S.doc Version 5.1 Page 8 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 DS0000040741.V267285.R01.S.doc Version 5.1 Page 9 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 The pre-admission process was in sufficient detail to ensure that prospective service users supports needs are fully assessed before admission. EVIDENCE: The file of a service user who had recently started to use the home for respite care was examined. The file indicated that a full assessment of the service users needs had been made prior to the first admission. As well as the formal assessment processes additional information had been obtained from the family and an introductory visit had been made to the home prior to admission, with a view to making the admission process as positive as possible. The Bungalow DS0000040741.V267285.R01.S.doc Version 5.1 Page 10 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 home had good care planning processes in place to ensure that the support needs of the service users were met appropriately and that the service users were safeguarded from any unnecessary risks. A formal system of reviewing the care plans should be introduced to strengthen the process. EVIDENCE: The files of two service users were examined. These contained good details of the support needs of the service users. The care plans were based on a care management assessment, information obtained from families and the homes knowledge of the individuals. As the home provided respite care only the care plans had been developed with this in mind and with the aim of ensuring that the period the service user spent at the home was as positive as possible. The service users communication strategies were included within the plans as were the service users preferred routines, likes and dislikes and information regarding their ability to make informed choices. One of the files belonged to a service user who was present at the home during the period of the inspection. The care plan reflected his actual support needs and included good guidance for staff especially with regard to his communication needs. Discussion with the two members of staff on duty indicated they had a good understanding of the support needs of the two service users. There were general risk The Bungalow DS0000040741.V267285.R01.S.doc Version 5.1 Page 11 assessments in place for each of the service users and the home had risk assessments in place for any activities the service users participated in whilst resident there with a view to safeguarding the service users as far as possible. Any specific risks were identified as part of the admission process enabling the home to make an informed decision as to whether the risks could be managed or not. Prior to each admission the staff at the home made enquiries as to whether the support needs of the service user had changed at all. Although this alerted the staff to any changes that may have to be made to the care plan, it is recommended that this review be undertaken in more detail at least once every six months or as necessary, depending on the frequency of the respite care enjoyed by the service user. The Bungalow DS0000040741.V267285.R01.S.doc Version 5.1 Page 12 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): 13 Every effort was made to support service users to access the facilities in the local community although these opportunities were often restricted by the lack of available transport. EVIDENCE: Standard 13 was partly assessed following a recommendation regarding the availability of transport being made at the previous inspection. The staff stated that the situation remained unchanged and that transport was still not freely available. This situation did restrict the possibilities of involving service users either as a group or on an individual level in the local community and allowing them to make use of the facilities in the local area. There was evidence however that the service users were supported to access the local community and one gentleman resident on the day of the inspection told the inspector of his trip out for lunch on the previous day and a visit to the cinema. The Bungalow DS0000040741.V267285.R01.S.doc Version 5.1 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 20 The service users were provided with personal and individual support to ensure that their stay at the home was as positive as possible. Some improvements could be made to ensure that medication at the home is managed safely. EVIDENCE: The service users files examined contained detailed information about the service users preferred routines and their specific support needs which the staff were aware of and aimed to follow. Routines within the home were flexible although were service users continued to attend day centre during their period of respite care the routine was influenced accordingly. As the home offered only respite care there were some limitations on allowing service users to choose what clothes they would like to wear although staff encouraged them as far as possible. The home had a range equipment to give service users, with a range of needs, maximum independence during their stay. Contact with health professionals was limited because of the nature of respite care but The Bungalow did have links with a range of professionals and had recently sought advice and guidance from a behaviour specialist in respect of the challenges presented by one of the service users using the home. The home was aware of any medical conditions or health difficulties the service user may have had, with this information being checked prior to each admission. This enabled the home to attend to the health needs of the service user and ensure that medical advice or assistance was sought as necessary. The Bungalow DS0000040741.V267285.R01.S.doc Version 5.1 Page 14 The home had a key worker system in place to ensure continuity of care as far as possible. Standard 20 was partly assessed at this inspection. The manager stated that the staff team had received training in the administration of medication. Unfortunately there was no documentation in place to support this and it was required that the manager provide evidence that this training had taken place. It was also recommended that competency checks be introduced on a periodic basis to ensure that staff are following the correct procedures when managing or administering medication. This would reduce the likelihood of any medication errors being made and therefore afford the service users additional protection. The Bungalow DS0000040741.V267285.R01.S.doc Version 5.1 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): 23 The home did not have any evidence in place to demonstrate that the safety and well-being of the service users had been protected by providing the staff team with training in the Protection of Vulnerable Adults EVIDENCE: Standard 23 was partly assessed. At the previous inspection it had been noted that there was no evidence that the staff team had received training in the protection of vulnerable adults. The manager and a member of staff stated that this training had been delivered but unfortunately there was no documentation to support this. It was required that evidence of the training undertaken be provided demonstrating that the service users had been protected as far as possible in this respect. The Bungalow DS0000040741.V267285.R01.S.doc Version 5.1 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): None of these standards were assessed at this inspection. EVIDENCE: The Bungalow DS0000040741.V267285.R01.S.doc Version 5.1 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 The home did not hold the required documentation to confirm the ‘fitness’ of the staff working at the home to work with vulnerable adults. EVIDENCE: The staff team at The Bungalow were very well established and trusted as reliable members of staff. The staff files did not however hold all of the documentation required to indicate that the necessary checks had been undertaken to confirm their fitness to work at the home. The manager stated that these documents were held within the Social Services Directorate Human Resources Department. Arrangements should be made to transfer the required documentation to the home. The Bungalow DS0000040741.V267285.R01.S.doc Version 5.1 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 and 42 The home was well managed providing a generally safe and relevant service for the service users although additional measures must be put into place to ensure a quality service continues to be provided. EVIDENCE: There were a number of quality assurance processes in place. The manager audited service users files to ensure that all documentation was in order. A number of checks were made on the environment to ensure that all equipment and systems were in good order. The home had achieved the Investors in People Award which is a quality assurance award accredited by an outside body. The home had also achieved the Chartermark Standard for Customer Service Excellence. Policies and procedures were reviewed centrally and there were opportunities for staff to contribute to these reviews making them relevant for the service provided at The Bungalow. Staff were in regular contact with families and received feedback from them regarding the service they provided which they were able to act upon. No formal surveys of service users views of the service had been undertaken since 2004 and neither had the views of involved health and social care professionals. A requirement made The Bungalow DS0000040741.V267285.R01.S.doc Version 5.1 Page 19 at the previous inspection had been acted upon and monthly monitoring visits to the home were now being undertaken and reports of these were being forwarded to the Commission for Social Care Inspection. The home was well maintained with equipment and systems being serviced and tested on an appropriate basis. Staff had received training in safe working practices and policies and procedures in respect of this were available in the home to ensure as far as possible the safety of the service users. The procedure around the recording and reporting of accidents and incidents was not clear and the staff team should be made aware of the steps they should follow should an accident or incident occur. Not all staff had received training in first aid. The manager should ensure that either all staff receive this training or that there is always a member of staff qualified in first aid on duty, to ensure that any accidents may be dealt with and managed appropriately. The Bungalow DS0000040741.V267285.R01.S.doc Version 5.1 Page 20 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 Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 2 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 X 34 2 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 2 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X X X 2 X X 2 X The Bungalow DS0000040741.V267285.R01.S.doc Version 5.1 Page 21 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 YA13 Regulation 16(2)(m) Requirement Transport should be readily available so that there are no constraints on users of the service who may choose to use community facilities. The registered manager must provide evidence that the staff team have received training in the management and administration of medication. The registered manager must provide evidence that the staff team have received training in the Protection of Vulnerable Adults. The registered manager must ensure that all of the required documents in respect of each member of staff employed are held at the home. (Timescale of 31/01/06 not met) Consultation must take place with the service users and their representatives with a view to improving the service provided. The registered persons must make arrangements for the training of staff in first aid. Timescale for action 30/06/06 2. YA20 18(1) 30/04/06 3. YA23 13(6) 30/04/06 4. YA34 19(1)(b) Schedule 2 30/04/06 5 YA39 24(3) 30/06/06 6. YA42 13(4) 30/04/06 The Bungalow DS0000040741.V267285.R01.S.doc Version 5.1 Page 22 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. 4. Refer to Standard YA6 YA20 YA39 YA42 Good Practice Recommendations Care plans should be formally reviewed on at least a six monthly basis. A competency checklist for staff should be developed in relation to the management of medication in the home. The home should seek the views of stakeholders on how the home is achieving goals for service users. The staff team should be made aware of the procedures to be followed when reporting accidents and procedures. The Bungalow DS0000040741.V267285.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 DS0000040741.V267285.R01.S.doc Version 5.1 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. 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