Inspection on 25/05/05 for The Stables

This inspection was carried out on 25th May 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 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 Stables 01/05/07

The Stables 14/07/06

The Stables 25/10/05

The Stables 27/09/04

The Stables 05/05/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 The Stables Stables Family Home Trust Bisterne Ringwood BH24 3BL Lead Inspector Craig Willis Unannounced 25.05.05 14:30 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 Stables H54 S11981 The Stables V223495 25.05.05.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Stables Address Stables Family Home Trust Bisterne Ringwood Hampshire BH24 3BL 01425 478043 01425 461076 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) The Stables Family Home Trust Kevin Michael Forward CRH 8 Category(ies) of LD Learning Disability registration, with number of places The Stables H54 S11981 The Stables V223495 25.05.05.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27.09.04 Brief Description of the Service: The Stables is one of five care homes owned by The Stables Family Home Trust and is registered to provide care and accommodation for eight adults with learning disabilities. The home is located in Bisterne, three miles out of Ringwood and is set in four acres of agricultural land and gardens. The home forms part of the Old Stables, which provides a day, employment, training and leisure service for up to seventy service users each day. This inspection did not cover any of the day service provision. The Stables H54 S11981 The Stables V223495 25.05.05.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over two days, 25th of May and 31st May 2005. A second visit was required as all of the service users were out on the first day and staff were also about to leave. On the first day the inspector toured all of the communal areas of the home and viewed some of the personal records held. The second day of the inspection was used to look at further documents and to speak with four service users, a member of staff and the manager. What the service does well: What has improved since the last inspection? Work has started on developing “person centred plans” for all the people living at the home. Staff have received additional fire safety instruction and some of the policies and procedures in the home have been re-written. The Stables H54 S11981 The Stables V223495 25.05.05.doc Version 1.30 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 Stables H54 S11981 The Stables V223495 25.05.05.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 Stables H54 S11981 The Stables V223495 25.05.05.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) 2 The systems for assessing the needs and aspirations of service users are good, leading to a clear understanding of the needs. EVIDENCE: The inspector viewed the files of three service users. Each of these files contained a needs assessment that was completed prior to the service user moving into the home. Copies of the assessments completed by care managers were also available. No service users have been admitted to the home since the last inspection and there are currently no vacancies at the home. The Stables H54 S11981 The Stables V223495 25.05.05.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) 6, 7 and 9 There are clear care planning systems in place which enable service users to make decisions about their lives and set personal goals. The system for completing risk assessments is good, enabling action to be taken to minimise identified risks, however, the monitoring and reviewing of the assessments is not satisfactory. EVIDENCE: The files of three service users were seen during the inspection. All of the files contained a care plan, which included personal goals. These plans had been amended where applicable after their six monthly reviews. One service user reported that they had been involved in the setting of their plan and its review. Each service user had started work on creating a person centred plan and time had been allocated on the staff rota to provide support to service users to complete this work. Service users had been involved in the planning process and had signed their plans to indicate that they agreed with their contents. Risk assessments were in place for all service users and covered the use of domestic appliances, personal safety and activities such as horse riding and cycling. The assessments included actions that should be taken to minimise the risks identified. It was noted that some of the risk assessments had dates for reviews that had not been met and some did not contain a date for review. The Stables H54 S11981 The Stables V223495 25.05.05.doc Version 1.30 Page 10 The Stables H54 S11981 The Stables V223495 25.05.05.doc Version 1.30 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 standard(s) 12, 15, 16 and 17 The home offers service users a good range of educational and employment opportunities and encourages service users to maintain relationships with family and friends. Dietary needs of service users are well catered for with a balanced and varied selection of food available. EVIDENCE: Service users were supported to take part in a range of activities in the day service including pottery, domestic studies, music and personal safety. One service user reported that they worked in the kitchen of a local pub and the manager said that one service user was a volunteer at a local charity shop. Service users were supported to maintain contact with family and friends and visitors were welcome at the home at “any reasonable time”. Service users spoken with said that they took part in household tasks and that staff treated them well in their home. Details of the tasks service users took part in and the support they required were recorded in their individual plans. One service user said they prepare some of the meals and that they food in the home was good. The home had a planned menu, which provided a The Stables H54 S11981 The Stables V223495 25.05.05.doc Version 1.30 Page 12 balanced and nutritious diet and details of what service users had eaten were recorded. The Stables H54 S11981 The Stables V223495 25.05.05.doc Version 1.30 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 standard(s) 18, 19 and 20 The personal and health needs of service users are met with evidence of access to a range of NHS services. The home has a suitable medication system, although this was not being followed, leaving service users at risk. EVIDENCE: One service user reported that staff treated them well and provided support in the way that they wanted. Details of the way personal support should be provided were included in individual plans. Service users’ files contained details of access to a range of NHS services, including GP, psychiatry, dentist and audiologist. Each service user had an “ok health check” which was completed annually by staff at the home. Medication was stored in a locked cupboard in the office and records were kept of all medication in the home. One gap was noted in the medication administration record for the week preceding the inspection where staff had not signed to say that the medication had been administered, although the tablet was taken from the box. It was also noted that diazepam tablets were being held for one service user who was no longer prescribed this medication. Action must be taken to return this medication to the pharmacist and ensure that medication administration records are accurately completed. The majority of staff had received medicine management training, although two new staff had only received the in-house medication induction. The Stables H54 S11981 The Stables V223495 25.05.05.doc Version 1.30 Page 14 The Stables H54 S11981 The Stables V223495 25.05.05.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 The home has a satisfactory complaints procedure which service users know how to use. EVIDENCE: The home has a complaints procedure in place that includes details of who would investigate a complaint and the time within which a complainant could expect a response. Contact details of the Commission for Social Care Inspection were also available. The complaints book was viewed and details were available of complaints made and the action that the home took as a result. One service user said that they knew what to do if they had a complaint and what action they would take if they were not happy with the response they received. The Stables H54 S11981 The Stables V223495 25.05.05.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25 and 30 The systems for maintaining and cleaning the home are good, which provides a homely and safe environment for service users. Bedrooms are well furnished, although the use of a shared bedroom does not meet the needs of all service users. EVIDENCE: All of the communal areas of the home were seen during the inspection and were bright, airy and well maintained. Furnishings were domestic and of good quality throughout the home. Three service users showed the inspector their bedroom, which were well furnished and had been personalised by the service users. Two service users currently share a bedroom and both said that while they were okay with this, they would prefer to have their own room. The manager reported that plans have been drawn up to create a single bedroom for all service users. The home was clean throughout and had separate laundry facilities. Personal protective clothing was available for staff. The Stables H54 S11981 The Stables V223495 25.05.05.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 The systems for inducting and training new staff are not satisfactory and leave staff without the support they need to meet service users needs. EVIDENCE: The inspector looked at the training records of two staff who started work in the last six months. Records indicated that whilst both of these staff had started the home’s induction programme, this had not been completed and one staff member’s induction had not been signed until three months after their start date. The manager reported that this induction had taken place, although the records had not been signed at the time. The manager had identified that these staff required training in first aid, health and safety, food hygiene, protection of vulnerable adults, Makaton, risk assessment and infection control and was waiting for courses to be available. Action must be taken to ensure that all staff have received appropriate training to meet the needs of service users. The manager reported that he had started work on the Registered Managers Award. The Stables H54 S11981 The Stables V223495 25.05.05.doc Version 1.30 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 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) 39, 40 and 42 The home has good systems to obtain the views of service users, which they feel are acted upon to ensure their safety and welfare. Some of the home’s policies and procedures are out of date and do not reflect the service provided and may not give clear direction to staff on how to meet service users’ needs. EVIDENCE: Service users confirmed that they have monthly meetings to plan the running of the home and said that they feel their views about the service are taken seriously. The manager reported that the home had conducted a service user survey that was facilitated by one of the service users and was produced in a pictorial format to aid understanding. Monthly visits are made by the director under regulation 26 of the Care Homes Regulations. Since the last inspection the organisation has reviewed all of the policies and procedures in the home. New procedures on sexuality and relationships, promoting rights and community links have been introduced and the manager The Stables H54 S11981 The Stables V223495 25.05.05.doc Version 1.30 Page 19 said plans were in place to rewrite other procedures to make them relevant to the service. Fire safety instruction had been provided to staff and checks had been made of the fire alarm and fire equipment. An engineer had also serviced the fire system and fire equipment. Assessments had been completed on chemicals used in the home and the chemicals were stored in a locked cupboard. Portable electrical appliances had been tested to ensure they were safe for use. The Stables H54 S11981 The Stables V223495 25.05.05.doc Version 1.30 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 3 x x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 2 x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 x x 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Stables Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 3 2 x 3 x H54 S11981 The Stables V223495 25.05.05.doc Version 1.30 Page 21 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 9 Regulation 13 (4) Requirement The registered person must ensure that risk assessments are reviewed within the stated dates and updated where necessary. The registered person must ensure that medication administration records are fully completed and medication no longer required is returned to the pharmacist. The registered person must ensure that all staff receive appropriate training to meet the needs of service users. Timescale for action 31/8/05 2. 20 13 (2) 1/6/05 3. 35 18 (1) (c) 31/8/05 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. Refer to Standard 40 Good Practice Recommendations The registered person should ensure that all policies and procedures are up to date and reflect current practices. The Stables H54 S11981 The Stables V223495 25.05.05.doc Version 1.30 Page 22 Commission for Social Care Inspection 4th FLoor Overline House Blechynden Terrace Southampton SO15 1GW 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 Stables H54 S11981 The Stables V223495 25.05.05.doc Version 1.30 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!