Inspection on 20/09/05 for The Mill House

This inspection was carried out on 20th September 2005.

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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Mill House 03/01/07

The Mill House 16/05/05

The Mill House 31/01/05

The Mill House 24/08/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 The Mill House Cliff Top Ingham Lincolnshire LN1 2YQ Lead Inspector Mr Doug Tunmore Unannounced Inspection 20th September 2005 09:00 The Mill House DS0000002455.V250675.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 Mill House DS0000002455.V250675.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 Mill House DS0000002455.V250675.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Mill House Address Cliff Top Ingham Lincolnshire LN1 2YQ 01522 730130 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) Thelma Turner Homes Limited Mrs Lynne Louise Gaskin Care Home 8 Category(ies) of Learning disability (8) registration, with number of places The Mill House DS0000002455.V250675.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20/09/05 Brief Description of the Service: Mill House is an adapted property, situated on the edge of the village of Ingham. Local facilities include a post office, village shop, GP surgery and public house. The home has its own mini-bus to enable residents to access other facilities within the community. The property stands in its own grounds and gardens, which includes aviaries with birds of prey and other small animals that residents care for. The home provides accommodation for up to eight residents who have a learning disability and accompanying challenging needs and behaviours. Communal facilities are on the ground floor, as is one resident’s bedroom. All residents have single room accommodation, with one room having en-suite facilities. A detached bungalow at the front of the main building offers separate accommodation with en-suite facilities for two residents working towards independent living. There are car-parking facilities to the front of the building. The Mill House DS0000002455.V250675.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and started at 9.00 am. The main method of inspection used was called case tracking, which involved selecting one resident and tracking the care he receives through the checking of his records, discussion with him, the care staff and observations of care practice. This was a very positive inspection with only two requirements being made. The manager, staff and residents were very open to the inspection and made it a very positive experience for the inspector. A partial tour of the home took place. What the service does well: What has improved since the last inspection? What they could do better: The Responsible Individual must inform the Commission in writing when the registered manager will be absent from the home for long periods of time. The home must write to relatives of residents informing them when an accident or incident has occurred. The Mill House DS0000002455.V250675.R01.S.doc Version 5.0 Page 6 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 Mill House DS0000002455.V250675.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 Mill House DS0000002455.V250675.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): 2 Service users benefit from a comprehensive care assessment process that involves people who are important in their lives. EVIDENCE: One resident’s file was looked at. The home carries out a care assessment prior to admission of residents. Other assessments are carried out by social workers and psychiatrists and other health care workers if required. Prospective residents are also given the homes welcome pack, which is also available in pictorial form for residents. A letter was available on file confirming that the home can meet a residents needs and giving details of which room the resident will have and who his key worker would be. Two residents stated that they had visited the home prior to admission and were aware of receiving a letter from the home outlining the care to be provided. There was evidence that the assessments are continually updated, which residents are involved and are encouraged to sign all documentation relating to their care. The Mill House DS0000002455.V250675.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 Residents are empowered by being involved in all aspects of the homes assessment process. EVIDENCE: All residents have individual detailed care plans and ongoing care need assessments. One resident’s file showed that monthly and six monthly reviews are undertaken of his care needs. The residents work with their key worker in discussing their reports and signing them to confirm that they agree with its content. Two residents confirmed that they are actively involved in care planning and have an input into what college courses or outings they wish to undertake. Residents were also aware that ABC reports (incident reports) are undertaken on them. The minutes of the last residents meeting was seen and showed that incident reports were discussed with residents and what their purpose was. Files seen did not show that relatives or the funding authority are informed of any incidents or accidents in writing. The manager commented that relatives The Mill House DS0000002455.V250675.R01.S.doc Version 5.0 Page 10 and organisation are informed but letters should be sent to relatives confirming any communication made by telephone. The Mill House DS0000002455.V250675.R01.S.doc Version 5.0 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): 13, 16 & 17 Residents benefit from individual activity programmes that include familiar and new experiences. Residents are involved in menu planning. EVIDENCE: Each resident has a weekly timetable that is been drawn up by him or her with his or her key worker. These weekly programmes are on display in the dining room for the information of residents. Care plans show that both short and long term goals are discussed with the resident and plans made to achieve agreed outcomes. Residents commented that they attend college courses of their choice and also to club 87 on a Thursday. They also go shopping, swimming and visit a pub on a Saturday. One resident confirmed that he likes going to a particular pub because of the live bands. Residents have keys to their rooms and confirmed that neither staff nor other residents can enter without getting their permission. They also stated that they are involved in learning daily living skills by keeping their rooms clean and tidy, cleaning the mini-bus, budgeting and undertaking college courses which promote their independent living skills. The Mill House DS0000002455.V250675.R01.S.doc Version 5.0 Page 12 Food cupboards are kept locked to a number of residents having Prader Willi Syndrome, which is an eating disorder where people are unaware when they have eaten enough. Due to this, residents and care staff work together to monitor food intakes and work out calorie needs of each resident. Residents also visit their GP for weighing on a regular basis as well as obtaining dietary advice when required. The homes menu sheets were seen and showed that a wide range of meals are available. One resident stated that I think (the food) is very good’. ‘I help in the food preparation and cook them’. Seven residents comment cards sent by the Commission were returned with six of the seven stating that they liked the food and one resident said he sometimes likes the food. The Mill House DS0000002455.V250675.R01.S.doc Version 5.0 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): 20 Safe medication practices are undertaken at this home. EVIDENCE: Medication records and storage were satisfactory ensuring that medication is administered safely and correctly. The pharmacist visited every three months. At the last visit on 04/07/05 the pharmacist report showed that stock control storage, spot check on records, homely remedies and admin sheet were well kept with no signature issues. The home has updated its PRN (when required) information on individual service user files relating to administration and when action is to be taken given behaviours of residents. Training certificates was seen relating to those care workers charged with the administration of medication. The Mill House DS0000002455.V250675.R01.S.doc Version 5.0 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 The home has a robust complaints procedure in place. EVIDENCE: The homes complaints procedure is available in each residents bedroom. A pictorial format is also available for residents information. All complaints received are dealt with either by the key worker, manager or the providers. The resident is empowered to nominate who they wish to investigate their complaint. Seven residents feedback cards showed that they all felt that staff treated them well and that they felt safe at the home. One resident confirmed that he had made two or three complaints and that it was jointly decided ‘what was best to do and asked me if it was alright’. ‘I signed to say ok’. I The Mill House DS0000002455.V250675.R01.S.doc Version 5.0 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 & 30 The home provide a homely and comfortable environment for residents. The home is clean and tidy with a pleasant smell throughout the home. EVIDENCE: The homes maintenance plan for 2005-2006 was seen and showed that since the last inspection the laundry has been painted and major refurbishment programmes are planned for the coming year. A new roof (tiles) and kitchen and freezer room are to be modernised. The homes estate department are now awaiting results carried out for asbestos in some rooms before work can be undertaken. Two residents showed the inspector around the home and their bedrooms. These rooms had been personalised and contained all the electronic games and televisions that these young men require. One resident said that he is going to decorate his room in Manchester United colours, whilst the second resident said that he keeps his own room clean. A partial tour of the home by the inspector found it to be clean and smelt fresh. The Mill House DS0000002455.V250675.R01.S.doc Version 5.0 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 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): 33 & 34 Residents are protected by robust recruitment practices. They benefit from a staff team who are well trained and receive appropriate levels of support. EVIDENCE: Since the last inspection six care staff have been employed with a further two awaiting for checks to be completed. The rota was seen and showed that adequate numbers of staff are on duty depending on the activities planned for that day. Two care workers commented that they felt there were enough staff on duty at the busiest time of the day and that if required the home can get agency staff. One care worker who had been recently recruited said that she is still undertaking her induction training which includes, reading policies and procedures, whistle blowing, complaints and my role and responsibilities. The inspector contacted one relative who had concerns about staffing levels and the high turnover of staff. She felt that her son’s needs could not be met as there wasn’t enough time given for his personal needs. All care workers have been given and signed for The General Social Care Council Codes of Practice, which sets out their responsibilities as care workers looking after vulnerable adults. Good recruitment practices were in place and staff files for permanent and bank staff contained all of the documentation required by law. The home had The Mill House DS0000002455.V250675.R01.S.doc Version 5.0 Page 17 an written signed agreement with the agencies used that they would carry out all of the recruitment checks required by law on the staff they provided. The home asks for CRB (Criminal record Bureau checks) verification on all agency staff. The home also acquires a blank induction form from the agency, which is used as the homes induction process for any new agency worker. This improves practice around the use of agency staff and ensures that the staff are suitable to work with the service users. Eight staff are working towards the National Vocational Qualification. The manager had established a training programme and expected that staff would achieve the qualification within the timescales she had identified. The Mill House DS0000002455.V250675.R01.S.doc Version 5.0 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 & 42 The current management structure ensures that the home is managed for and with the residents. Appropriate checks are carried out to ensure the safety of residents. EVIDENCE: The manager has worked for this company for five years and has achieved the registered managers award. She has an open door approach to both residents and staff who require support and guidance. The inspector was informed by telephone that the manager has been seconded to another home for an indeterminate period of time (initially one month). The providers now need to write to the Commission outlining the management changes in the home. There are a range of policies and procedures available in the home relating to fire safety and fire risk assessments. There was also evidence that fire alarm, fire drills and emergency lighting checks are carried out. Staff also receive fire training as part of the homes initial training and as a regular training event. The Mill House DS0000002455.V250675.R01.S.doc Version 5.0 Page 19 The homes self-assessment shows that ‘policies and procedures are read and signed by staff and that they inform practice’. Certificates were available showing that; gas safety inspections have been carried out, electrical wiring checks, and portable electrical equipment checks. Risk assessments are also available for all window restrictors on the first floor. The Mill House DS0000002455.V250675.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 4 X X X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X X 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 4 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X X 3 3 X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Mill House Score X X 3 X Standard No 37 38 39 40 41 42 43 Score 2 X X X X 3 X DS0000002455.V250675.R01.S.doc Version 5.0 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. 1 Standard YA37 Regulation 39(a) Requirement The provider shall give notice in writing to the Commission as soon as it is practical to do so if a person other than the registered person carries on or manages a care home. Timescale for action 01/10/05 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 Refer to Standard YA24 YA24 Good Practice Recommendations The registered person should consider refurbishing the kitchen. The home is currently awaiting safety check regarding asbestos. The registered person should consider enclosing all the fridges and freezers behind one lockable door. The home is currently awaiting safety check regarding asbestos. The home should as good practice write to relatives of residents confirming that an incident or accident has taken place and give details of the outcome. 3 YA6 The Mill House DS0000002455.V250675.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Mill House DS0000002455.V250675.R01.S.doc Version 5.0 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. 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