Inspection on 05/10/05 for The Conifers

This inspection was carried out on 5th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 6 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 15/05/06

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 5th October 2005 07.35 The Conifers DS0000012751.V252544.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Conifers DS0000012751.V252544.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Conifers DS0000012751.V252544.R01.S.doc Version 5.0 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 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.V252544.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The total number of service users must not exceed 6 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 20 June 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 Conifers DS0000012751.V252544.R01.S.doc Version 5.0 Page 5 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 three quarters of an hour preparing for the inspection and three hours in the home. There were no feedback forms received at this inspection. What the service does well: What has improved since the last inspection? The necessary redecoration is ongoing; the Inspector noted at this Inspection that an upstairs bathroom was in the process of being decorated. Liaison and good communication with Service Users local Day placements has been developed, and leisure activities continue to be developed according to the needs and choices of Service Users. There was evidence of some improvement in the organization of records The Conifers DS0000012751.V252544.R01.S.doc Version 5.0 Page 6 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.V252544.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Conifers DS0000012751.V252544.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None Not reviewed at this Inspection EVIDENCE: The Conifers DS0000012751.V252544.R01.S.doc Version 5.0 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): 6,7,9 Service Users care plans are not fully updated, and care from different staff may therefore be inconsistent. EVIDENCE: Service Users care plans had not all been recently reviewed and updated. Some essential information was not included on the care plan. There was a lack of evidence to show how Service Users had been included in the drawing up of their plans. Staff are alert, and responsive to Service Users choices through verbal and non-verbal communication. There was evidence of the progress and development of a Service User in their happiness, social skills and understanding. There was evidence of some risk recognition and management by staff, on Service Users care plans, but further information should be available to cover all areas of risk. The Conifers DS0000012751.V252544.R01.S.doc Version 5.0 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 the following standard(s): 14,15,16 Service Users enjoy active and sociable lifestyles. EVIDENCE: Service Users chatted to the Inspector about their lifestyles and activities, which they clearly enjoyed. They had enjoyed their annual holidays to various destinations, according to their choices and abilities. Those who were not able to communicate with the Inspector were seen to leave the home for their “work-placements” with enthusiasm. Service Users discussed how they were enabled to maintain contact with their relatives and enjoy weekends away. Staff recognize Service Users rights, and Service Users are encouraged to take on responsibility, with staff assistance, for the cleaning and upkeep of their own bedrooms The Conifers DS0000012751.V252544.R01.S.doc Version 5.0 Page 11 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): 19 Service Users healthcare needs are generally well met. EVIDENCE: Service Users healthcare is properly monitored and recorded although care plans need improvement. There was evidence of the regular input of healthcare professionals, and of Service Users being enabled to access health screening through community resources. Service Users who spoke with the Inspector said that they were happy with this aspect of the service. The lack of up to date Moving and Handling training for all staff is a serious shortfall in view of the homes registration for Physical Disabilities. The Registered Manager is addressing this. The Conifers DS0000012751.V252544.R01.S.doc Version 5.0 Page 12 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): 23 Service Users views are listened to and acted upon. EVIDENCE: Policies and procedures on Protection of Vulnerable Adults issues are easily accessible by staff and give clear guidance. Staff are currently undertaking further training in this area as recommended at the last inspection. The Conifers DS0000012751.V252544.R01.S.doc Version 5.0 Page 13 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 The home is comfortable and homely but in need of further decoration and refurbishment. EVIDENCE: Decoration and refurbishment is ongoing. At the time of the inspection an upstairs bathroom was in the process of being redecorated. There were safety issues in that dangerous tools had been left accessible to Service Users. The senior staff member on duty at the time of the inspector’s arrival had a large bunch of keys and took some time to identify the key to the front door. As this is an emergency exit this time taken, although it would normally be acceptable, is considered unacceptable and a risk to staff and Service Users in the event of the need for emergency evacuation of the premises. The Registered Manager showed the Inspector that she was issuing small key bunches to staff with just two keys thereon. The home was comfortable clean and odour free. The Conifers DS0000012751.V252544.R01.S.doc Version 5.0 Page 14 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): 35,36 Staff training needs to be prioritized to ensure good outcomes for Service Users. EVIDENCE: Staff refresher training remains overdue in several critical areas including Moving and Handling and First Aid. The Inspector was advised by the Registered Manager of the progress made in organizing appropriate training for staff but there were serious shortfalls in the evidence available to the inspector to demonstrate what training had been undertaken by individual staff. Records in this area must be properly maintained. There were shortfalls in the records of staff supervision, some staff having very few opportunities for formal supervision in the last 12 months. The availability of fully trained and competent staff to Service Users between 7.30 and 8.00am was compromised due to the Registered Manager having had to leave the home for a short period. There was one experienced carer and another new staff member who is not yet trained or able to undertake full duties. The Conifers DS0000012751.V252544.R01.S.doc Version 5.0 Page 15 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): 41,42 The management style promotes a homely atmosphere but records are still not sufficiently organized, maintained, or overviewed, to ensure that Service Users best interests are fully supported. EVIDENCE: The Registered Manager was unable to produce a full and up to date plan of staff training, despite this being an area where advice was given at the last inspection. There was evidence that the Registered Manager had made some progress in the areas outlined at the last inspection (staff training and supervision; organization and availability of records), but progress needs to be accelerated. Records relating to the safety of electrical wiring and equipment were not available. There was no evidence to demonstrate when tests of gas-powered equipment, or bacteriological tests of water supplies were last undertaken. Fire protection safety checks should be recorded better, as discussed. The Conifers DS0000012751.V252544.R01.S.doc Version 5.0 Page 16 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 Score x 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 x 2 x Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 LIFESTYLES Standard No Score 11 x 12 x 13 x 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score x x x x 1 2 CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Conifers Score x 3 x x Standard No 37 38 39 40 41 42 43 Score x x x x 1 1 x DS0000012751.V252544.R01.S.doc Version 5.0 Page 17 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 2 Standard Regulation Requirement Service Users care plans must be regulary reviewed and updated. An up to date training programme demonstrating how individual staff training needs are to be met must be forwarded to the Commission for Social Care inspection. There must be evidence of the appropriate regular supervision of staff. Timescale for action 01/01/06 20/10/05 YA41YA9YA6, 15,17 YA23YA35 18 3 YA36 18 01/01/06 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 Refer to Standard YA42 YA42 YA24YA42 Good Practice Recommendations There should be evidence of a robust approach to Health and Safety issues. To this end records of relevant checks should be kept on the premises There should be evidence that a staff member is checking fire safety alarms and signing that they have done so. Staff should be issued with the two keys as soon as possible. DS0000012751.V252544.R01.S.doc Version 5.0 Page 18 The Conifers 4 5 YA42 YA42 Tools, which could be hazardous to Service Users, should not be left unattended. Where there are notices that doors should be kept locked these should be kept locked. 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