Inspection on 02/02/06 for The Bungalow [Taunton]

This inspection was carried out on 2nd 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 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 [Taunton] 10/10/06

The Bungalow [Taunton] 30/09/05

The Bungalow [Taunton] 18/03/05

The Bungalow [Taunton] 28/09/04

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

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

CARE HOME ADULTS 18-65 The Bungalow 2 Ilminster Road Taunton Somerset TA1 2DR Lead Inspector Sally Murphy Unannounced Inspection 2 February 2006 12:50 nd The Bungalow DS0000039965.V281304.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 DS0000039965.V281304.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 DS0000039965.V281304.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Bungalow Address 2 Ilminster Road Taunton Somerset TA1 2DR 01823 327050 01823 352994 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) Home First & Foremost Ltd Mrs Susan Elizabeth Perry Care Home 6 Category(ies) of Learning disability (0), Physical disability (0) registration, with number of places The Bungalow DS0000039965.V281304.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for 6 persons in categories LD and PD Date of last inspection 30th September 2005 Brief Description of the Service: The Bungalow is situated on the outskirts of Taunton. Accommodation comprises of two lounges, a dining room, kitchen and six service user rooms with en suite facilities. The home has been decorated and furnished to a high standard. Appropriate adaptations have been provided to meet service users needs. The Bungalow is registered with the Commission for Social Care Inspection to provide care for up to six service users who have a learning and physical disability. The Registered Managers are Mrs Susan Perry and Mrs Emma Lewes who job share the role. The Registered Provider is Voyage Ltd. The Bungalow DS0000039965.V281304.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out as part of the planned annual programme of inspection. The inspection was unannounced and carried out by one inspector over one day. The previous inspection was also unannounced and took place on 30th September 2005. On the day of inspection there were six service users residing at the home. During the course of the inspection service users and staff were spoken with. Care practice was also observed, records examined and a tour of the premises was made. What the service does well: What has improved since the last inspection? What they could do better: Staff must ensure that when a pressure area is noticed, that the wound is described in full, so that any improvement or deterioration may be observed. Care plans must include details of the actions to be undertaken by staff to The Bungalow DS0000039965.V281304.R01.S.doc Version 5.1 Page 6 meet the identified skin care need. Entries in care plans must be signed by the staff member. An opening date had been recorded for prescribed creams. The home must review the system for auditing those creams kept within service user rooms, as two were found in use when the discard date had expired. 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 DS0000039965.V281304.R01.S.doc Version 5.1 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 DS0000039965.V281304.R01.S.doc Version 5.1 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, 3 & 4. Service users and their families are provided with appropriate information to make a decision regarding admission to the home. An assessment is completed to ensure that the home will be able to meet the service users identified needs. EVIDENCE: The home has a Statement of Purpose and Service User Guide that provide details of the services and facilities offered at The Bungalow. An assessment of need is completed for any prospective service user. Service users and their families are invited to spend time at the home to assess the facilities provided. The Registered Managers ensure that appropriate adaptations are installed, and relevant staff training received, prior to a service user moving into the home The Bungalow DS0000039965.V281304.R01.S.doc Version 5.1 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, 8, 9 & 10. The home ensures that an individual plan is developed for each service user. Service users are supported in making decisions over their lives. Care plans are comprehensive and updated regularly. Records relating to service users are stored securely. EVIDENCE: Care plans are maintained for each service user. Two care plans were examined. Care plans were detailed and provided information regarding service users needs, daily routines and preferences. A moving and handling assessment had been completed for each service user. Care plans had been regularly reviewed and updated as required. Service users are encouraged to exercise choice regarding their daily life. There is a notice board in the hall displaying which members of staff will be on duty. Service users are able to spend time in their rooms or communal areas as they choose. Daily routines are flexible to meet service user’s needs. The Bungalow DS0000039965.V281304.R01.S.doc Version 5.1 Page 10 Risk assessments had been completed for each service user. These were comprehensive and addressed a wide range of issues including the use of bed rails. The Bungalow DS0000039965.V281304.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 & 17. Service users are provided with a range of activities that are appropriate to their individual needs, and are supported in accessing the local community. Service users are provided with a well-balanced diet. EVIDENCE: Service users are able to participate in a wide range of activities. These include: bread making, cookery, walks, massage, music and horse and cart. A Creative play therapist, and aromatherapist also visit the home, and a further member of staff supports service users with Intensive Interaction for six hours each week. Service users are also provided with regular opportunities to access the local community. This includes the use of the snoozelum, training kitchen and swimming pool at other Voyage homes. Two service users attend activities organised by the Blind Association each week. There are notice boards in some service user room providing details of the planned activities. Service The Bungalow DS0000039965.V281304.R01.S.doc Version 5.1 Page 12 users are encouraged to participate within the home, as is appropriate to their needs. Service users are provided with a holiday, or a series of days out each year. The home has purchased a collapsible hoist to assist service users when staying away from the home. Service users have enjoyed recent trips out to the Sea Life centre at Weymouth and Paignton Zoo. Staff support service users in maintaining contact with family and friends. Visitors are welcomed at the home. Meals are prepared on the premises by staff as part of their role. Menus are written on a weekly basis, and are flexible. Service users nutritional intake is monitored appropriately. The home is aware of service users dietary preferences and needs. The Bungalow DS0000039965.V281304.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 & 20 Service users are provided with appropriate assistance to meet their personal care needs. The home supports service users in accessing healthcare services. Service user plans include epilepsy and nutritional guidelines. Staff must ensure that records relating to a pressure areas are completed in full. All medications are stored securely. Staff receive appropriate medications training. EVIDENCE: All service users rooms are single occupancy. Care plans provide details of the level and type of assistance to be provided to each service user. Staff support service users in accessing health care services and ensure that specialist advice is sought as required. The home has established a protocol regarding hospital admission for one service user. Appropriate actions had been outlined to meet the nutritional needs of a further service user who had recently lost weight. Care plans included epilepsy guidelines. A physiotherapist and chiropodist regularly visit the home. The Bungalow DS0000039965.V281304.R01.S.doc Version 5.1 Page 14 Pressure relieving equipment is provided as required. Staff must ensure that when a pressure area is noticed, that the wound is described in full, so that any improvement or deterioration may be observed. Care plans must include details of the actions to be undertaken by staff to meet the identified skin care need. Entries in care plans must be signed by the staff member. All medications are stored securely. Medication Administration Records were examined. These included a photograph of the service user, and were found to follow best practice. An opening date had been recorded for prescribed creams. The home must review the system for auditing creams kept within service user rooms, as two were found where the discard date had expired. The home will provide care to service users until the end of their life whenever possible, and work closely with staff from other agencies to ensure that they are able to continue meeting their needs. The Bungalow DS0000039965.V281304.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): 22 & 23. The home has appropriate policies and procedures in place to safeguard vulnerable adults. EVIDENCE: The home has a complaints procedure that provides details of external agencies that may also be contacted including CSCI. There have been no complaints received by the home or CSCI. The home has appropriate policies relating to the Protection of Vulnerable Adults and whistleblowing. The Bungalow DS0000039965.V281304.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): 24, 25, 26, 27, 28, 29 & 30. The home has been decorated and furnished to a high standard. Adaptations have been provided as required. There is a range of communal areas available. The home was found to have a high standard of cleanliness. EVIDENCE: The Registered Managers ensure that appropriate adaptations are provided prior to any service user moving into the home. All service user rooms have en suite facilities. Bedrooms have been decorated to reflect individuals’ tastes and preferences. Communal areas comprise of two lounges, a conservatory, activities room, dining room and kitchen. All communal areas are homely and have been pleasantly decorated and furnished. One sofa in the conservatory is starting to show signs of wear and tear. Sleeping-in facilities are provided for staff. There is a garden at the rear of the property that is accessible to service users. For the safety of service users, radiators have been guarded and thermostatic controls fitted to hot water outlets. The Bungalow DS0000039965.V281304.R01.S.doc Version 5.1 Page 17 The laundry is tidy and well organised. The washing machine has the facility to meet disinfectant standards. Red alginate bags are used when required. The home has followed good practice in relation to infection control. The Bungalow DS0000039965.V281304.R01.S.doc Version 5.1 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): 31, 32, 33, 35 & 36. Staff levels are appropriate to meet service user’ needs. Staff are provided with relevant training to undertake their role. Staff are provided with appropriate support and supervision. EVIDENCE: Duty rotas are maintained. At present there are generally four staff on duty during the day and two waking staff at night. Newly employed staff complete a thorough Induction programme. All staff are provided with a job description giving details of their role. Staff are provided with regular opportunities to receive training, and have attended courses on health and safety, food hygiene, First Aid, Total Communication and Intensive Interaction. Staff spoken with advised that there were in the process of completing courses on the safe administration of medications and infection control via distance learning. Staff are also encouraged to study for NVQ qualifications. Staff receive regular supervision, and appraisals are completed on an annual basis. Staff stated that it was a good place to work and that they received appropriate support. The Bungalow DS0000039965.V281304.R01.S.doc Version 5.1 Page 19 The Registered Managers were not on duty at the time of the inspection therefore recruitment files could not be examined during this visit, and will be seen at the next inspection. The Bungalow DS0000039965.V281304.R01.S.doc Version 5.1 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, 38, 39, 40, 41 & 42. The Registered Managers provide effective leadership to the staff team. There is a relaxed and open atmosphere within the home. Records relating to service users are stored securely. Appropriate actions have been taken to promote the health and safety of staff and service users at the home. EVIDENCE: The Registered Managers are Mrs Susan Perry and Mrs Emma Lewes, who job share the role. Both have considerable experience of providing care to service users who have a learning disability. The home has appropriate policies and procedures in place to safeguard vulnerable service users. Regulation 26 visits are completed each month, and a copy forwarded to CSCI. The home displays appropriate Employers Liability Insurance. The Bungalow DS0000039965.V281304.R01.S.doc Version 5.1 Page 21 The home operates a comprehensive system of health and safety audits. Fire equipment have been tested and serviced as required. Staff are provided with regular fire safety training. Kitchen records are appropriately maintained. Hoists and assisted baths have been tested under LOLER Regulations. Risk assessments are regularly reviewed and updated appropriately. Accidents have been recorded and an analysis completed on a monthly basis. The Bungalow DS0000039965.V281304.R01.S.doc Version 5.1 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 Score 1 3 2 3 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 4 26 3 27 3 28 4 29 4 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 X 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 4 12 3 13 4 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 X 3 3 3 3 3 3 X The Bungalow DS0000039965.V281304.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? na 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 YA19 Regulation Schedule 3 (3n) Requirement Staff must ensure that when a pressure area is noticed, that the wound is described in full, so that any improvement or deterioration may be observed. Timescale for action 17/02/06 2. YA20 13(2) Care plans must include details of the actions to be undertaken by staff to meet the identified skin care need. Entries in care plans must be signed by the staff member. The home must review the 24/02/06 system for auditing prescribed creams kept within service users rooms, as two were found where the discard date had expired. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Bungalow DS0000039965.V281304.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 DS0000039965.V281304.R01.S.doc Version 5.1 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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