Inspection on 20/06/05 for The Conifers

This inspection was carried out on 20th June 2005.

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 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 04/09/07

The Conifers 15/05/06

The Conifers 05/10/05

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 Sarah Jenkins Unannounced 20 June 2005 08:00 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 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 Stationary 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 D C51 C08 S12751 The Conifers V226374 Stage 4 200605.doc Version 1.30 Page 3 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 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 Mather-Franks Mrs Claudia Atkins Care Home Only (PC) 12 Category(ies) of Learning Disability (LD) 12 registration, with number Physical Disability (PD) 4 of places The Conifers D C51 C08 S12751 The Conifers V226374 Stage 4 200605.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Up to 4 service users will also have an associated Physical Disability. 2. It is a condition of this registration that the home is authorised to care for the two current named service users who have mental health needs in addition to their learning difficulties. Date of last inspection 14th December 2004 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 Conifers D C51 C08 S12751 The Conifers V226374 Stage 4 200605.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspection was undertaken during the early morning period from 7.45am. 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 three 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. What the service does well: What has improved since the last inspection? The Conifers D C51 C08 S12751 The Conifers V226374 Stage 4 200605.doc Version 1.30 Page 6 The necessary decoration is ongoing and since the last inspection the lounge areas and a Service Users bedroom have been decorated. Liaison and good communication with Service Users local Day placements has been developed. 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 D C51 C08 S12751 The Conifers V226374 Stage 4 200605.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection The Conifers D C51 C08 S12751 The Conifers V226374 Stage 4 200605.doc Version 1.30 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 standard(s) None This area was not reviewed at this inspection. EVIDENCE: The Conifers D C51 C08 S12751 The Conifers V226374 Stage 4 200605.doc Version 1.30 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 standard(s) 7 Service Users are enabled to make choices and decisions about their lifestyles. Records do not always reflect this. EVIDENCE: The timing of the early morning routine for one non-verbal Service User is crucial in that he has difficulty waiting for things to happen and wants one activity to run directly after the last. Staff handled this smoothly. Care plans showed some of the Service Users personal preferences, and staff informed the Inspector that Service Users always sat with staff to draw up their care plans. There was a lack of evidence of how this was done with less able and non verbal Service Users. Although it was apparent to the Inspector from her observations of staff and Service User interaction, that Service Users were given choices by staff and enabled to make everyday decisions, this was not always properly reflected in records. The Conifers D C51 C08 S12751 The Conifers V226374 Stage 4 200605.doc Version 1.30 Page 10 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 standard(s) 11, 13, 14, 17 Service Users enjoy satisfying and active lifestyles conducive to their happiness and wellbeing. EVIDENCE: Service Users spoke of their satisfaction with their daily work placements and the interesting activities they were involved in. Those who were not able to communicate with the Inspector were seen to leave the home for “work” with enthusiasm. Service Users are enabled to enjoy activities in the local community and often join up with Service Users from the other homes owned by Mrs Mather-Franks to do this. They are enabled to enjoy an annual holiday in a choice of destinations if they wish to do so. Service Users spoke with enthusiasm about their leisure time. Service Users were seen to be enjoying a breakfast of their choice when the inspector arrived and arrangements for this were flexible according to Service Users early morning routines The menu was seen and Service Users reported The Conifers D C51 C08 S12751 The Conifers V226374 Stage 4 200605.doc Version 1.30 Page 11 satisfaction with the food provision and told the Inspector that their own choices were included. Fresh fruit was available and some Service Users were eating this as part of their breakfast. The Conifers D C51 C08 S12751 The Conifers V226374 Stage 4 200605.doc Version 1.30 Page 12 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 standard(s) 18, 19, 20 Service Users personal and healthcare appear reasonably well met although it was not always possible to verify this through records. Moving and Handling needs did not appear to be properly met. EVIDENCE: Records showed care plans were detailed and regularly updated. There was evidence of regular input from healthcare professionals as required. Service Users expressed satisfaction with the ways in which staff met their needs. There were shortfalls relating to Moving and Handling. No records were available to support the professionalism of this area. Records were said to have been removed by the Registered Owner for review. This left no detail for staff on how Moving and Handling techniques were to be undertaken. The member of staff previously responsible for Assessments on Service Users Moving and Handling needs left the employment of the home approximately 4 months prior to the inspection. There had been no new assessment of Service Users needs since that time. There was evidence in records to show that most staff had not had recent Moving and Handling training. The Registered Manager told the Inspector that the Registered Owner was addressing this. The Conifers D C51 C08 S12751 The Conifers V226374 Stage 4 200605.doc Version 1.30 Page 13 These are serious shortfalls in view of the homes registration category for Physical Disability. Service Users medication was not always being consistently recorded. For example it was difficult to track the prescription and administration of a Service Users hay fever medication since this was not always detailed on the Medication Administration sheet. The policy for the administration of medicines did not fully protect Service Users, for example details on what to do in the event of a wrong medication being given were not documented although the Registered Manager said that staff were aware. The Conifers D C51 C08 S12751 The Conifers V226374 Stage 4 200605.doc Version 1.30 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 standard(s) 22, 23 Service Users views are listened to and acted upon. Staff training in this area should be improved. EVIDENCE: Staff were seen to respond to Service Users expressed wishes and there was evidence from a Quality Audit questionnaire that Service Users who were able to speak for themselves were generally happy with the service. The complaints log showed a complaint made by a staff member that the Registered Manager had responded to. It was not clear from the record whether the complainant was satisfied with the response and she has since left the service. Protection of Vulnerable Adults procedures were available for staff in the policies and procedures for the home but there was a lack of evidence of sufficient staff training in this area. The Conifers D C51 C08 S12751 The Conifers V226374 Stage 4 200605.doc Version 1.30 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 standard(s) 24 30 The home is comfortable and homely but in need of further decoration and refurbishment. EVIDENCE: Some areas of the home have been redecorated but there were areas including some Service Users bedrooms, which remain in need of improvement. The Registered Manager informed the inspector that these are planned and that the staff at the home have already established the preferences of Service Users advocates in order to decorate and refurbish rooms appropriately. All areas of the home sampled were seen to be clean and hygienic. Service Users expressed general contentment with the facilities and decoration of their bedrooms. The Conifers D C51 C08 S12751 The Conifers V226374 Stage 4 200605.doc Version 1.30 Page 16 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35, 36 Staff training had not been kept properly updated. Staff supervision was said to be regularly undertaken but records did not support this. EVIDENCE: Staff refresher training was overdue in several critical areas including Moving and Handling and First Aid. There was no evidence that staff have been properly trained in Protection of Vulnerable Adults issues. The individual training plan for staff was not available as it was being reviewed by the Registered Owner. Staff supervision was said to have taken place, but records for the past 12 months were not available and apparently awaiting filing. The Conifers D C51 C08 S12751 The Conifers V226374 Stage 4 200605.doc Version 1.30 Page 17 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38, 41 The management style promotes a homely atmosphere but records were not sufficiently organized, maintained, or overviewed, to support Service Users best interests. EVIDENCE: The management style of the home was seen to promote a homely environment where Service Users were enabled to develop their individuality and potential. There was a good atmosphere and teamwork was evident. Records were not properly organized or available to fully protect Service Users or promote good practices by staff. Two out of three Service Users financial records were not found in the file where they should have been at the time of the inspection and could not be inspected. Training records had not been sufficiently overviewed by the Registered Manager to promote further staff training before the expiry of some certificates. The Conifers D C51 C08 S12751 The Conifers V226374 Stage 4 200605.doc Version 1.30 Page 18 Policies and procedures sampled were well indexed and organized and generally supported professional practice, but they were not always sufficiently detailed or robust to promote best practice in the home. The Conifers D C51 C08 S12751 The Conifers V226374 Stage 4 200605.doc Version 1.30 Page 19 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 x x x x x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x 2 x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 3 x 3 3 x x 3 Standard No 31 32 33 34 35 36 Score x x x x 1 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Conifers Score 1 3 2 x Standard No 37 38 39 40 41 42 43 Score x 3 x x 1 x x D C51 C08 S12751 The Conifers V226374 Stage 4 200605.doc Version 1.30 Page 20 No 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 18 Regulation 13 Timescale for action Service users must be protected By July 31st from unecessary risk through the 2005 regular review of their Moving and Handling needs by a qualified assessor, and through the availability of up to date information and training for staff. By July Staff training and refresher 14th 2005 training must be prompted before certificates expire to ensure the availability of properly trained staff at all times. e.g First Aid training. To this end an individual programme of staff training needs and how these are to be met must be forwarded to the Commission for Social Care inspection. Records as required by By July 31st legislation must be available at 2005 the home for inspection. Requirement 2. 35 13 3. 41 17and Schedules 3 and 4 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. The Conifers D C51 C08 S12751 The Conifers V226374 Stage 4 200605.doc Version 1.30 Page 21 No. 1. 2. Refer to Standard 7 20 Good Practice Recommendations There should be better detail on care plans to demonstrate how the service user or their advocate has been involved in the drawing up of these plans. The inspector recommends that the Registered Manager obtains a copy of The Royal Pharmaceutical Guidance on the Administration of Medications in care homes to add to the procedures documents. Medications administered to Service users should always be recorded on the medication administration sheets. The Inspector strongly recommends that the Registered Manager introduce more detailed training for staff on Protection of Vulnerable Adults issues. The ongoing programme of redecoration and refurbishments should be continued. There should be evidence of staff supervision filed on the relevant files. 3. 4. 5. 23 24 36 The Conifers D C51 C08 S12751 The Conifers V226374 Stage 4 200605.doc Version 1.30 Page 22 Commission for Social Care Inspection Northamptonshire Area Office Newland House, First Floor Campbell Square Northants, 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. 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