Inspection on 19/09/06 for The Conifers

This inspection was carried out on 19th September 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Conifers 12/12/05

The Conifers 01/06/05

The Conifers 24/02/05

The Conifers 24/09/04

The Conifers 12/03/04

The Conifers 29/01/04

The Conifers 17/09/02

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

CARE HOME ADULTS 18-65 Conifers The 1 Turmer Avenue Bridlington East Riding Of Yorks YO15 2HJ Lead Inspector Ms Wilma Crawford Unannounced Inspection 19th September 2006 09:30 Conifers The DS0000019738.V311459.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Conifers The DS0000019738.V311459.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Conifers The DS0000019738.V311459.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Conifers The Address 1 Turmer Avenue Bridlington East Riding Of Yorks YO15 2HJ 01262 606303 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) The Conifers Residential Home Limited Mrs Anne Sarah Sage Care Home 23 Category(ies) of Learning disability (23) registration, with number of places Conifers The DS0000019738.V311459.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th December 2005 Brief Description of the Service: The Conifers is a family-run home providing care and accommodation for up to 19 adults with a learning disability. Accommodation includes lounge/dining area, smoking lounge, single and double bedrooms and a rear garden with patio area. Four additional self-contained flats have been built in the last year, providing more independent living for Residents wishing to access this type of accommodation, The home is close to the centre of Bridlington with good access to local transport and amenities. Conifers The DS0000019738.V311459.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 6 hours. A tour of the premises was conducted with a member of staff. The main method of inspection used was called case tracking which involved selecting three residents and tracking the care they receive through the checking of their records, discussion with the residents, the care staff and observation of care practices. The manager assisted the inspector during the inspection. Ten Residents, three staff members and a visiting occupational therapist were spoken with during the inspection. A Pre Inspection Questionnaire asking for information about home was sent out before this visit and information from this was included as part of the inspection process of this service. Comments from replies to questionnaires that were sent out to Residents, relatives and professionals are also included in the report. The range of fees charged is from £296.50 to £700. What the service does well: The needs of residents are met through individual care plans that enable them to play an active part in and meet others within their local community. This includes some Residents having paid part time jobs. Residents are able to access a range of activities in both the home and local community including yachting and diving clubs, riding for the disabled, England disabled pool team, visits to nightclubs, pubs, golf, church, luncheon clubs, adult education and work placements. The home provides good quality care to the residents living there in a friendly, homely environment. Four self-contained flats have been built in the last year to provide people wishing to live more independently, the opportunity to do so, with the help they need available. Staff are well supported through regular appropriate training and supervision. Staff were observed carrying out care and they spoke to the residents in a kind and patient way. Visitors and professionals visiting the home made positive comments including: • “The staff at the Conifers have always been, very helpful and understanding. They are warm and friendly.” • “ I have always found their commitment and professionalism to be of a very high standard.” The manager has completed the NVQ Level 4 and Registered Managers Award. Conifers The DS0000019738.V311459.R01.S.doc Version 5.2 Page 6 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. Conifers The DS0000019738.V311459.R01.S.doc Version 5.2 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 Conifers The DS0000019738.V311459.R01.S.doc Version 5.2 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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home.Prospective residents can be assured that their needs will be met. EVIDENCE: Each resident has an individual care plan, which contain a full assessment and gives a detailed description of likes, dislikes and particular care needs. Risk assessments for all areas of daily living are included where necessary. All professional visits are recorded separately, which makes tracking health care issues easier. The manager explained that all Residents are visited and assessed prior to moving into the home. They also are given the opportunity to visit, have a meal and an overnight stay before moving into the home. Residents, staff and a visiting professional were also able to confirm that this happened. Conifers The DS0000019738.V311459.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9,10 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the home. Residents are able to exercise choice and risk in their lives through their involvement and participation in the care planning process. EVIDENCE: All care plans were completed in detail with involvement from the resident and/or their families. . Everybody involved with the residents’ care are detailed in the care plan and their contact details recorded so the resident is aware how to contact them if they wish. Reviews are carried out six-monthly and residents and their representatives are invited to these to ensure their continued participation in the care planning. Residents’ wishes regarding what activities they want to participate in are documented and appropriate risk assessments are carried out in relation to these if required, ensuring individual choice is exercised. All the residents have a timetable of activities and hobbies that they have chosen to take part in. Conifers The DS0000019738.V311459.R01.S.doc Version 5.2 Page 10 The home operates a key worker system and residents are aware of who their key worker is. All the residents have a timetable of activities and hobbies that they have chosen to take part in. Residents’ health care needs are met by accessing health professionals when required. A visiting health professional said that the staff in the home follow instructions given and support. Residents’ health care needs well. Conifers The DS0000019738.V311459.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the home. Residents live fulfilling lives both in the home and in the community. EVIDENCE: The care plans showed that the residents are involved in a wide variety of their chosen activities. On the day of inspection many residents had gone to the local day centre, work placements, college, adult education classes and a local community group. The Residents in the home were helping with domestic tasks, knitting, listening to music, watching T.V. and shopping. One resident told the inspector about the scuba diving and yachting clubs that they were a member of. Another said that they particularly enjoyed a local handwriting class and drama group. Residents were also keen to show the inspector certificates that they had been awarded for different social and academic achievements. Residents attend two different local churches and church groups. Conifers The DS0000019738.V311459.R01.S.doc Version 5.2 Page 12 Another resident said ‘There is plenty to do, I can come and go as I please, I really enjoy going out and joining in with things.’ The residents and staff spoken with were looking forward to planning a trip to Blackpool to see the lights and described holidays and various outings that they had recently enjoyed. A resident had recently been supported to trace a relative in Australia and as a result of this, is now writing to them regularly. Residents meetings are held every two months and minutes are recorded. Residents spoke about being consulted about aspects of the day-to-day running of the home including menus. Comments made about the food included • “I like the food, it is nice. I don’t like some of the puddings, but I can always have something else, whatever I want.” • “We have good meals, we are asked what we want and it is written down. We can have whatever we want” The home has a comprehensive complaints policy and procedure. Residents were confident that any concerns they had would be dealt with and would have no hesitation in raising anything with staff. • “If I was worried, I could talk to my key worker or Linda or Anne.” Conifers The DS0000019738.V311459.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. Residents receive appropriate health care and personal support. EVIDENCE: Residents said they received the support they needed in the way they wanted it to be given. For example, female residents who prefer to receive personal care from a female carer have this written in their care plan. Residents’ emotional well being is monitored through file notes by staff or any professional healthcare workers. They are assisted to attend outpatient and other appointments. A Nomad system of medication is used in the home and only staff that have received appropriate training are able to administer this. Medication is suitably stored and administered. Newly appointed staff now complete the Learning Disability Award Framework as well as an induction. Conifers The DS0000019738.V311459.R01.S.doc Version 5.2 Page 14 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 the home. Residents are protected from abuse and their views are listened to. EVIDENCE: There are policies and procedures that are in place to inform residents and staff of how complaints and allegations of abuse will be dealt with. Both the manager and the deputy have an open door policy and residents and staff are free to see them when they please. This was observed at the inspection when residents present freely approached them. Staff receive induction training when they are first employed and during this time have training on policies relating to recognising and reporting incidents. Recruitment policies ensure that the staff employed are suitable to care for the people who use this service. Conifers The DS0000019738.V311459.R01.S.doc Version 5.2 Page 15 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): 24,25,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. The residents live in a comfortable, pleasant and safe environment, with both private and communal space being suitable for their needs. EVIDENCE: The home is generally well maintained and the décor is satisfactory. The home is currently going through a refurbishment programme to provide an additional ground floor office/meeting room and an adapted bathroom. Once this has been completed further, redecoration and refurbishment will take place of bathrooms and hallways. Residents’ bedrooms were personalised with photographs, pictures and personal belongings. They also have the opportunity to bring their own furnishings into the home if they wish. The four double bedrooms in the home have privacy screens or a dividing wall to ensure residents privacy. Service users sharing rooms have chosen to do so. There are three bathrooms and seven further toilets in the home. Washbasins are provided in each bedroom. Conifers The DS0000019738.V311459.R01.S.doc Version 5.2 Page 16 One resident is now in need of specialist equipment that is being provided by the Occupational therapy services. A bathroom is also being adapted with a specialist bath to meet this individual’s needs. There is a spacious lounge, a separate smoking lounge and dining room available to residents. Office accommodation, a newly fitted kitchen and utility are also provided. Conifers The DS0000019738.V311459.R01.S.doc Version 5.2 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 good. This judgement has been made using available evidence including a visit to the home. Staff are well trained and supported. EVIDENCE: All staff are subject to an induction and statutory training, which includes fire safety, food handling, infection control, manual handling and first aid. Other training provided includes medication, managing challenging behaviour, dementia, and protection of vulnerable adults. Staff meetings are held on a regular basis and records are kept of the outcomes and the actions agreed. All staff receive regular supervision from a senior member of staff. The home currently has 57 of staff with an NVQ qualification. Three of the remaining staff are working towards this qualification. The home has sufficient staff on duty at all times to meet the needs of the service users. There are always three members of staff on duty during the day and two staff at night. The manager’s hours are supernumerary to this. Conifers The DS0000019738.V311459.R01.S.doc Version 5.2 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): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. The home is managed in an open and inclusive manner. EVIDENCE: The registered manager has an N.V.Q. level 4 and the Registered Managers award. Staff spoken with felt confident to approach the acting manager. They also felt that she was very approachable and listened to them. Discussion with staff and inspection of the home’s training records indicated that the health, safety and welfare of service users and staff were being promoted and protected. The home’s maintenance records for the home were seen and found to be satisfactory. Certificates were seen for the maintenance of fire equipment, gas safety and electrical safety. To ensure that the home is run to the best interests of the people who use the service, quality assurance systems are in place. The manager seeks the views of all people involved in the home through regular user questionnaires. The manager collates the results from these and people who use the service are Conifers The DS0000019738.V311459.R01.S.doc Version 5.2 Page 19 informed of the results. The results form the basis of the annual development plan. These procedures ensure that the home continues to meet the needs of the people who use the service and that their opinions matter and are taken into account. Conifers The DS0000019738.V311459.R01.S.doc Version 5.2 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 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 X 25 3 26 X 27 3 28 3 29 3 30 X STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 4 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Conifers The DS0000019738.V311459.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Conifers The DS0000019738.V311459.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Conifers The DS0000019738.V311459.R01.S.doc Version 5.2 Page 23 - 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!