Inspection on 05/12/05 for The Bungalow

This inspection was carried out on 5th 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Bungalow 18/07/07

The Bungalow 10/07/06

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 The Bungalow 115 Cross Keys Lane Hadley Telford Shropshire TF1 5LR Lead Inspector Rebecca Harrison Announced Inspection 5th December 2005 09:30 The Bungalow DS0000064999.V257526.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 The Bungalow DS0000064999.V257526.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. The Bungalow DS0000064999.V257526.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Bungalow Address 115 Cross Keys Lane Hadley Telford Shropshire TF1 5LR 01952 260712 01952 610996 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) Care Tech Community Services Limited Care Home 3 Category(ies) of Learning disability (3) registration, with number of places The Bungalow DS0000064999.V257526.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st July 2005 – (under the previous registered provider). Brief Description of the Service: The Bungalow is a care home registered with the Commission for Social Care Inspection to provide accommodation and personal care for a maximum of three adults who have a learning disability. The home is situated in Hadley, Telford and is accessible to local amenities, local transport and relevant support services. The home is in keeping with the local community. The new registered provider is CareTech Community Services Ltd who were registered with CSCI on 11.08.05. The responsible individual is Mr Stewart Wallace. The manager, Ms Clare Goodwin is not yet registered with the CSCI. Caretech’s philosophy is included in the Statement of Purpose for the home and states ‘CareTech and their staff workon the philosophy of enabling people to live as full a life as possible, supporting them in their daily activities and any identified long term plans. We recognise that all people with disabilties should be given due respect to their individuality enabling all to be fully involved in any decisions having an affect on their lifestyle commensurate to the level of their abilities and enabling people to maintain all their entitlement assocoiated with citizenship’ The Bungalow DS0000064999.V257526.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Bungalow is registered for three people who have a learning disability. At the time of this inspection the home had one vacancy. The inspection was announced and commenced at 09.30 a.m. and lasted just under four hours. The manager and deputy manager were on duty supporting the two people accommodated at the home. The Director of Operations met with the inspector at the beginning of the inspection and the area manager was also present throughout. This inspection was carried out by talking with both service users, the manager and area manager, deputy manager, observing activity, a tour of the home and inspecting a number of records. The service users and managers were welcoming and cooperated fully throughout the inspection. One service user, in particular, played an active role in the inspection process and was keen to assist with the process wherever possible. This is the third inspection undertaken by CSCI since 1st April 2005. The purpose of this announced inspection was to consider the requirements and recommendations made under the previous registered provider at the unannounced inspection undertaken on the 21st July 2005 and to review the progress made by the home under the new registered provider, CareTech Community Services Ltd. No complaints have been received by the home or referred to the Commission for Social Care Inspection since the home was last inspected. There have been no referrals made under adult protection procedures. What the service does well: It was evident through talking with service users that they very much enjoy living at their home and appear to be compatible with one another. Two comment cards were received by CSCI in preparation for the inspection from a health and social care professional and a general practitioner. The comments were positive with both professionals stating that they are satisfied with the overall care provided. One professional stated that they are very happy with the home, clients are happy and are supported by excellent staff and the home is well managed. Throughout the inspection managers were seen to interact positively with the two people living at the home. They were accessible, approachable, presented good listening and communication skills and appeared interested and committed to their work. A new member of the team stated ‘Service users The Bungalow DS0000064999.V257526.R01.S.doc Version 5.0 Page 6 have ownership over decisions about their lifestyle and are empowered and made to feel important and valued and are respected’. 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 DS0000064999.V257526.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 The Bungalow DS0000064999.V257526.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): 1,2 ,4 and 5 Prospective service users are provided with the necessary information on the services the home provides, enabling an informed decision about admission to the home and their needs are fully assessed. Service users are provided with a Statement of Services. EVIDENCE: A Statement of Purpose and Service user Guide were submitted to CSCI in preparation for the registration of the new providers. Both documents meet Schedule 1, Regulations 4 and 5 of The Care Homes Regulations 2001. Since the last inspection one person has been successfully admitted to the home on 29.11.05. A Community Care Assessment was seen on file in addition to a plan of care from the previous provider. There was clear evidence available to demonstrate that a comprehensive pre-admission needs assessment had been undertaken by CareTech in addition to a series of introductory visits to the home with the outcome of all visits well documented in the service user file and the minutes of the staff team meeting. Discussions held with the new service user indicate that he appears comfortable and is settling into his new home well. It is positive to report the existing service user was fully involved in the transitional process and helped prepare the new service users room, made refreshments and cooked meals with him and invited him to attend her birthday party at the local pub during The Bungalow DS0000064999.V257526.R01.S.doc Version 5.0 Page 9 his introductory visits to the home. This also provided staff the opportunity to assess compatibility. A signed ‘Statement of Services’ was seen on the new service users file. The Bungalow DS0000064999.V257526.R01.S.doc Version 5.0 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 Care planning systems are in place to provide staff with the information they require to meet the individual assessed needs of the service users. Service users are supported and enabled to make decisions about their lives and take responsible risks within a risk-assessed framework. EVIDENCE: Two requirements were made at the last inspection in relation to the review of the existing service users plan and risk assessments. The findings of this inspection evidence that both these requirements have since been met. The service user plan had been reviewed on 05.08.05 with the service user, and significant others and updated to reflect the individuals changing needs. The service user plan for the most recent admission is under development and will be reviewed at the next inspection. The team are currently working to their pre-admission assessment documentation, the Community Care Assessment and the care plan provided by the previous provider. Discussions held with both service users and records seen clearly evidence that both people are very much involved in decision-making processes. The person The Bungalow DS0000064999.V257526.R01.S.doc Version 5.0 Page 11 most recently admitted to the home has an advocate and the manager reported that the advocate would be invited to attend the individual’s review of placement. The existing service user informed the inspector how she makes decisions in relation to her lifestyle, meals, clothes shopping and the home. She continues to maintain a friendship with the former registered responsible individual for the home and it is evident through discussions held with her that she continues to benefit from this friendship. She also attends the latter part of staff meetings and was fully involved with meeting the prospective service user, introductory visits and ensuring that he was made welcome in his new home. A new member of the team stated ‘Service users have ownership over decisions about their lifestyle and are empowered and made to feel important and valued and are respected’. Generic risk assessments developed for the organisation have been individualised and these were seen on the existing service user file reviewed. Assessments were comprehensive The Bungalow DS0000064999.V257526.R01.S.doc Version 5.0 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): 17 Service users are encouraged to eat healthily and exercise choice and control over their diet. EVIDENCE: The intended outcomes for standards 12,13,14,15 and 16 were assessed and met at a previous inspection and were therefore not reviewed on this occasion. The existing service user informed the inspector about her involvement in the planning of meals and compiling a menu and shopping list, purchasing food and COSHH products and her involvement in meal preparation and also having meals out. This was also seen documented with nutritional needs identified and recorded on the ‘individuals support requirement’ plan. The service user commented that she likes the food and also enjoys cooking meals for the staff. The manager later provided a good example of how staff support the individual with choosing healthy options and how they support and empower her as much as possible including providing training on food hygiene. During the inspection the new service user was seen preparing his chosen lunch in the kitchen under staff supervision. The individual appeared The Bungalow DS0000064999.V257526.R01.S.doc Version 5.0 Page 13 comfortable and the staff member was seen to offer an appropriate level of support whilst encouraging him to develop his skills. The Bungalow DS0000064999.V257526.R01.S.doc Version 5.0 Page 14 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): 20 Service users are protected by the improved medication systems that are now in place. EVIDENCE: The intended outcomes for key standards 18 and 19 were assessed and met at the previous inspection. Standard 20 was previously assessed and not met. A requirement was made at the previous inspection for all staff responsible for administering medicines to receive training from an accredited external organisation to include all elements specified in national minimum standard 20.10. Since the last inspection the home has changed pharmacists and Boots Chemists now supply the home with prescribed medicines. It was reported that the Monitored Dosage System (MDS) is now used and that staff have received training in the new system. The area manager reported that she has sought accredited training provided through a local college, has applied and is awaiting dates for staff to commence. The Bungalow DS0000064999.V257526.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): x EVIDENCE: The intended outcomes for standards 22 and 23 were assessed and met at the previous inspection and were therefore not reviewed on this occasion. It was reported that the home has not received any complaints since the last inspection. No formal complaints have been referred to the Commission for Social Care Inspection and there have been no referrals made under adult protection procedures. The Bungalow DS0000064999.V257526.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): 30 Service users are provided with a comfortable and clean place to live. EVIDENCE: The intended outcomes for standards 24,25,26,27 and 28 were assessed and met at the previous inspection. Through a general tour of the home it is evident that the home is in need of investment and the new provider has acknowledged this. Discussions have taken place with CSCI in relation to this. Since the last inspection the existing service user requested to move rooms and this request was fully supported by the team. The service user is responsible for keeping her room clean and tidy and this was evident during the inspection. The person most recently admitted to the home was fully involved in choosing new furniture, furnishings and the carpet for his room prior to admission. His room is very personalised and discussions held with him evidence that he is extremely happy with his room. The home was found very clean and tidy throughout and service users are encouraged to maintain a clean environment and assist with general household tasks. A COSHH assessment and information file is available and data sheets The Bungalow DS0000064999.V257526.R01.S.doc Version 5.0 Page 17 and risk assessments have recently been updated to include service users using COSHH products. One service user spoke about her involvement with regularly purchasing COSHH products for the home. It was reported that training in infection control is planned for the future. The Bungalow DS0000064999.V257526.R01.S.doc Version 5.0 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): 32,33 and 35 Service users are supported by an effective, committed and trained staff team; who have a good understanding of their individual needs. EVIDENCE: The intended outcomes for standards 31 and 34 were assessed and met at the previous inspections. The intended outcomes for standards 33 and 35 were not met at the previous inspections. Throughout the inspection managers were seen to interact positively with the two people living at the home. They were accessible, approachable, presented good listening and communication skills and appeared interested and committed to their work. Staff have the specialist skills to meet service users’ individual needs and agency staff are also trained in the same procedures adopted in dealing with any anticipated behaviours and interventions. Discussions held identified that the behaviours previously displayed by one individual have significantly reduced with minimal incidents occurring since the last inspection. It is evident that staff are being consistent in their approach, which has proved very positive. The manager reported that the team would continue to closely monitor following the admission of a second person to the home. Comments received from a health and social care professional in preparation for this inspection were very positive stating ‘Clients are happy and are supported by excellent staff and the home is well managed’. The Bungalow DS0000064999.V257526.R01.S.doc Version 5.0 Page 19 It was reported that three care staff hold an NVQ qualification and that the home has no vacancies with two core agency staff covering the posts of two support workers who are currently on maternity leave. The minutes of the last team meeting held were comprehensive. A requirement was made at the two previous inspections in relation to staffing levels and complementary skills to support the service users assessed needs at all times. Staffing was increased by the previous provider with two staff being provided to support one service user. This staffing level was continued by the new provider. Following the admission of a further person the staffing ratio provided is two staff to two service users throughout waking hours, although an additional 15 hours have been negotiated with the placing authority and available as required. Staffing levels will remain under review. A requirement was made at the previous two inspections for a training needs assessment to be carried out for the staff team as a whole and with individual staff members to inform future planning. The manager is currently working towards this and a completed course nomination form was seen for 2006 requested specific training courses for the staff. Managers were very complimentary regarding the training opportunities provided through CareTech and staff have attended mandatory and service specific training in learning disability. There was clear evidence of a new staff member currently undertaking LDAF induction training. One service user said that she has had training in food hygiene, fire safety, equal opportunities and dress code. It was reported that training has been scheduled on adult protection as recommended at the previous inspection. The Bungalow DS0000064999.V257526.R01.S.doc Version 5.0 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): 39,41 and 42 Record keeping systems are much improved however Quality Assurance systems require further development in measuring success for the service users. The home has safe working systems in place, which fully promote the health, safety and welfare of service users and staff. EVIDENCE: The intended outcomes for standards 37 and 38 were assessed and met at a previous inspection. The intended outcomes for standards 41,42 and 43 were not met at the previous inspections. Four requirements were previous made regarding the ‘Conduct and Management of the Home’ in relation to the maintenance of records, mandatory training in safe working practices, all staff must receive mandatory training in safe working practices, the health and safety of service users and staff and risk assessment. The findings of this inspection evidence that these requirements have since been met and are much improved. The Bungalow DS0000064999.V257526.R01.S.doc Version 5.0 Page 21 Since the last inspection the manager has attended a one-day training course in relation to Quality Assurance. It was reported that an Independent Quality Assurance Consultant is due to visit the home on 14th December 2005. A copy of the organisations quality assurance baseline standards was made available to the inspector. The assessment is based on twelve objectives that are linked to the National Minimum Standards. Under the previous provider the views of service users and professionals etc were sought however due to the recent take over the manager has not yet had the opportunity to seek the views of others on how the home is achieving goals for service users or to develop an annual development plan for the home. The organisation has a quality assurance policy in place and the CSCI receive monthly reports as required by Regulation 26, which are completed by the area manager. As previous stated two comment cards were received in preparation for the inspection and both were positive. Managers and a service user completed an in-site CSCI survey and again the feedback was positive. A service user commented ‘I like my bedroom, I like the staff that work here and I am happy here’. It was reported that under the new provider, managers will have more control in relation to the homes budgets and will be closely supported by the area manager as recommended at the previous inspection. The Bungalow DS0000064999.V257526.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x 3 3 Standard No 22 23 Score x x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 4 x 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x 3 LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score x 3 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Bungalow Score x x 3 x Standard No 37 38 39 40 41 42 43 Score x x 2 x 3 3 x DS0000064999.V257526.R01.S.doc Version 5.0 Page 23 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 YA39 Regulation Requirement Timescale for action 31/03/06 2 YA39 24(1)(a&b)(2)(3) An annual development plan for the home must be developed reflecting aims and outcomes for service users. 24(1)(a&b)(2)(3) The views of service users, family, stakeholders etc must be sought on how the home is achieving goals for service users. 31/03/06 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 YA41 Good Practice Recommendations It is recommended that a more person centred approach be adopted for all records relating to individual service users. The Bungalow DS0000064999.V257526.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 DS0000064999.V257526.R01.S.doc Version 5.0 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. 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!