Inspection on 15/05/06 for The Conifers

This inspection was carried out on 15th May 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Conifers 04/09/07

The Conifers 05/10/05

The Conifers 20/06/05

The Conifers 20/07/04

Similar services:

Hillside

Applegarth

122 Scorer Street

St Marys Nursing Home

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

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

CARE HOME ADULTS 18-65 The Conifers 1a Lodge Road Rushden Northants NN10 9HA Lead Inspector Ms Sarah Jenkins Unannounced Inspection 15th May 2006 08:00 The Conifers DS0000012751.V292335.R01.S.doc Version 5.1 Page 1 The Conifers DS0000012751.V292335.R01.S.doc Version 5.1 Page 2 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 Conifers DS0000012751.V292335.R01.S.doc Version 5.1 Page 3 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 Conifers DS0000012751.V292335.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Name of service The Conifers Address 1a Lodge Road Rushden Northants NN10 9HA 01933 395522 01933 395511 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) Mrs Marie Jeanette Judith Mather-Franks Mrs Claudia Atkins Care Home 12 Category(ies) of Learning disability (12), Physical disability (4) registration, with number of places The Conifers DS0000012751.V292335.R01.S.doc Version 5.1 Page 5 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The total number of service users must not exceed 12 All service users have a Learning Disability No service users with a physical disability may be admitted to the home when there are already 4 such service users within the home 5th October 2005 Date of last inspection Brief Description of the Service: The Conifers is a care home providing personal care for 12 Service Users within the categories of Learning Disability and Physical Disability. It is one of three homes in Rushden owned by Mrs Mather Franks, all providing personal care to adults with a learning disability. The home is situated in a quiet residential area of Rushden with access to local facilities and amenities. The home was first registered in 1990 and is a two-storey detached house, with wheelchair accessible bedrooms and communal areas on the ground floor. The home has 6 single bedrooms and 3 shared bedrooms. It also has a range of communal areas and garden area. The level of fees charged is from £526 to £900 per week. Additional costs paid by Service Users include hairdressing, chiropody and some travel (individual taxis for example) The Conifers DS0000012751.V292335.R01.S.doc Version 5.1 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for Service Users and their views of the service provided. The primary method of inspection used was ‘case tracking’ which involved selecting two service users and tracking the care they receive through review of a selection of records, discussion with them, the care staff and observation of care practices. Service users all have Learning disabilities and some have additional physical disabilities. Several Service Users have communication difficulties. Establishing Service Users choices and informed decisions is dependant to a large extent upon the consistency of staff, service users relationships with staff, and the quality of records and communication. Feedback obtained from Service Users in this report was in part through observations of their responses to staff, and interpretations of their general levels of happiness with their routines. The Inspector spent five hours on the site visit in the home. There was only one feedback form received at this inspection and this relayed positive comments. What the service does well: What has improved since the last inspection? The content of records is much improved since the last inspection and care plans are properly detailed and mainly fully updated. Records are better organized and available for staff and for inspection. The Conifers DS0000012751.V292335.R01.S.doc Version 5.1 Page 7 There has been ongoing development in staff training. A proper programme of training and development is maintained and the necessary updated training is accessed appropriately. The development of Service Users access to information and choice is also being worked on with the introduction of various illustrated documents. The management team appear to have developed a more robust system of management, with some duties delegated to seniors and overviewed through staff supervision. 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 Conifers DS0000012751.V292335.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 Conifers DS0000012751.V292335.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, 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission process enables informed choice by prospective Service Users and their advocates. EVIDENCE: There have been no new admissions at the home for some time. Senior members described an admission process that met the standards and enabled service users and their advocates to have a full understanding of the lifestyle offered by the home prior to admission. The admission process was flexible allowing for individual need, and a userfriendly Service Users Guide is being developed. The Conifers DS0000012751.V292335.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): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users Care plans enable staff to offer Service Users consistent care conducive to their happiness and development. EVIDENCE: Service users individual Care plans are detailed and mainly fully updated. There was evidence of service users being involved in the drawing up of their care plans in that their individual choices were recorded. Service Users expressed general satisfaction with the care provided by staff. Staff are alert and responsive to Service users choices through verbal and nonverbal communication. Staff were seen to offer service users choice in all areas of their lives. Service users are enabled to make decisions about their different daily activities. There was evidence of risk recognition and management by staff although not all risk assessments had been fully updated. Through offering opportunities for personal development, service users were enabled to progress towards The Conifers DS0000012751.V292335.R01.S.doc Version 5.1 Page 11 meeting their full potential. Service users have diverse needs and this diversity is recognized and responded to by staff. The Conifers DS0000012751.V292335.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): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are given opportunities to lead a fulfilling lifestyle with plenty of activity and stimulation. EVIDENCE: Service Users who were able to communicate with the inspector verbally, expressed satisfaction with their work placements and leisure activities. Service Users who went out to Day Placements on the day of the inspection were seen to be eager to attend these placments. Staff informed the inspector of the leisure activities that service users engage in, many of which are within the local community (Cinema, Theatre, pubs, libraries etc). there are also visiting entertainers/enablers whose activities are popular among Service Users. Service users are offered a choice of annual holiday away from the home and at the time of the inspection three service users were away in Tunisia with the owner and staff. The Conifers DS0000012751.V292335.R01.S.doc Version 5.1 Page 13 Service users are encouraged and enabled to maintain contact with friends and family and visitors are welcomed to the home and offered hospitality by staff. Service users rights and responsibilities are recognized and encouraged with a proper understanding by staff of the diversity in their individual abilities to make informed decisions. Service Users are appropriately involved in household tasks, according to their abilities and choices. There was evidence of a healthy diet available at the home, and service users choices for breakfast were available. Service users said that they enjoyed the food provision and/or were seen to do so. The Conifers DS0000012751.V292335.R01.S.doc Version 5.1 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): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users are properly supported in their health and personal care needs. EVIDENCE: Staff are fully aware of privacy and dignity matters and service users were seen to be happy with the way in which care was offered. Records and policies and procedures show the ways in which Service Users rights to privacy and dignity are respected. Service Users healthcare is properly overviewed and service users are supported to obtain a full service from the Community Healthcare team. A service user ill in bed at the time of the inspection was comfortable, and staff gave regular input and liased with the service users Doctor and District nurse appropriately. A fluid chart had been implemented to ensure adequate intake. Service Users with speech difficulties are encouraged to deveop their communication skills through liason and advice from a speech therapist. Medication is generally well managed although at the time of the inspection the full procedure for administration was not properly followed by a staff member. The Conifers DS0000012751.V292335.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users are properly protected through the knowledge and commitment of staff. EVIDENCE: Service Users were seen to communicate with staff verbally and non-verbally about their needs, and showed confidence in staff. A complaints book has been implemented but showed no recent entries. Staff expressed confidence in each other and were fully aware of the issues around the Protection of Vulnerable Adults. They receive regular input and training in this area and have discussions about different scenarios. There is a whistle blowing policy available to staff who informed the inspector that they would be confident in approaching both the Registered Manager and the Owner if they had any concerns. The Conifers DS0000012751.V292335.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): 24,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was comfortable, clean and homely, providing a pleasant environment for Service Users. EVIDENCE: The home was seen to be comfortable and generally safe (But see also under management). One shared room was ready for redecoration but staff explained this was not going to be done until the second resident returned from holiday to be involved in the choice of decor. There is a maintenance book which is used by staff, and evidence of follow up to reported issues. The home was clean throughout. Service users are encouraged to contribute to the cleaning and tidying of their own rooms. The Conifers DS0000012751.V292335.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): 32,34,35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staffing of the home has improved but there are still issues to address. EVIDENCE: On the day of the inspection the night staff member on duty had gone off duty early due to a personal emergency and this had left the two staff remaining pressured to fully meet the needs of the service users. Another staff member was available, supporting service users who had been brought from the sister home to await transport to the day Placement. The pressure on staff was given as the reason for the medication procedure not having been properly followed on this occasion only. Service Users were seen to have trust in staff and warm responsive relationships were observed. The records relating to a recently appointed staff member were reviewed, and the recruitment process discussed with the Registered Manager. A professional recruitment procedure was demonstrated. Staff informed the inspector that they were offered regular and appropriate training, and there was a training programme demonstrating this. Training shortfalls detailed on previous inspections had been resolved with the The Conifers DS0000012751.V292335.R01.S.doc Version 5.1 Page 18 exception of specific training in the disabilities for which the home is registered. Staff are committed to the programme of National Vocational Award Training and several have completed their courses. The Conifers DS0000012751.V292335.R01.S.doc Version 5.1 Page 19 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 judgement has been made using available evidence including a visit to this service. The management style promotes the homely atmosphere and the management of the home has generally improved. EVIDENCE: The Registered Manager is experienced and capable and has improved the content and accessibility of the records at the home with the assistance of her deputy since the last inspection. The Manager and Deputy state that they both feel they work very well as a team and this was evident in a number of areas. Quality Assurance has been implemented and there is a culture of observing and nuturing service users rights and needs. Whilst aspects of Health and Safety have been improved over recent months the Inspector was concerned to find that yet again Fire doors were wedged open and one was chained open. The Registered Manager informed the inspector that when the Fire Officer inspected in January he gave the home The Conifers DS0000012751.V292335.R01.S.doc Version 5.1 Page 20 some flexibility in the use of Fire doors to enable care givers freedom to come and go when in the process of actual care giving. However it was observed that fire doors were wedged of chained open throughout the morning, and there were no written details of what had been advised by the Fire Officer, it was unclear therefore whether staff were abiding by these instructions. An incident which had occurred at the home in November 2005 had not been notified to the Commission for Social Care Inspection. The issue which related to Health and Safety had been followed up by the Registered Manager. The Conifers DS0000012751.V292335.R01.S.doc Version 5.1 Page 21 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 3 4 x 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 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 2 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 2 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 x 3 x x 1 x The Conifers DS0000012751.V292335.R01.S.doc Version 5.1 Page 22 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 YA42 Regulation 23.4 Requirement Designated Fire doors must function to protect Service Users in the event of a fire. (Outstanding) To this end the Registered Manager must contact the Fire Officer for advice and to discuss how this is to be implemented. Timescale for action 01/06/06 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 2 3 4 Refer to Standard YA9 YA20 YA35 YA42 Good Practice Recommendations All risk assessments should be regularly reviewed and updated. Staff should follow medication procedures at all times. Staff should have specific training in relation to the disabilities for which the home is registered. Notifications of incidents should be made to the Commission for Social Care Inspection without delay. The Conifers DS0000012751.V292335.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 Conifers DS0000012751.V292335.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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