CARE HOME ADULTS 18-65
The Willows 30 Hunnable Road Braintree Essex CM7 2NU Lead Inspector
Brian Bailey Unannounced Inspection 5th December 2005 1:45pm The Willows DS0000017953.V270398.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 Willows DS0000017953.V270398.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 Willows DS0000017953.V270398.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service The Willows Address 30 Hunnable Road Braintree Essex CM7 2NU 01376 550669 01376 550779 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 Linda Samaranayake Mrs Muriel Howe Mrs Linda Samaranayake Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (1) of places The Willows DS0000017953.V270398.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Persons of either sex, under the aged of 65 years, who require care by reason of a learning disability (not to exceed 6 persons) One female, over the age of 65 years, who requires care by reason of a learning disability (not to exceed 1 person) 28th July 2005 Date of last inspection Brief Description of the Service: The Willows is a care home registered under the Care Standards Act 2000 providing personal care and accommodation for six adults with learning disabilities. The property was originally built in the early 1900’s and is a detached house in a mainly residential area. Mrs Muriel Howe and Linda Samaranayake who is also the registered manager, privately own the home. The home is located close to Braintree town centre and is on a regular bus route to Chelmsford and Colchester. The local amenities include supermarkets, church, library, post office, bank and building societies and newsagents. This is a two-storey building with residents occupying four single and one shared bedroom, which is on the ground floor. There are two bathrooms, a separate WC and a lounge/dining room and an activities room. There is a secure private rear garden laid mainly to lawn with a patio. The majority of residents have lived at the home for many years. The Willows DS0000017953.V270398.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on 5th December 2005 at 1.45pm. This was the second unannounced inspection of The Willows in the inspection year 2005/06. There was a member of staff on duty and two residents were at home. During the course of the afternoon, a second member of staff arrived for duty to take over the running of the home and the manager arrived later. All five residents were seen and spoken to. A tour of the building included a look at the bedrooms, bathrooms, and kitchen and lounges/dining area. Care records were looked at and discussions held with staff about care practices, the range of activities available, and the health of residents, staff training and the abilities of residents to participate and be independent. Residents appeared relaxed in the company of staff and in their surroundings and indicated they were happy living at the home. What the service does well:
The Willows is a small home that blends in well with the neighbouring properties and is homely and comfortable in appearance. Although there is one shared bedroom, all rooms were suited to the needs of residents and the majority had been personalised. The lounge/dining room seems to be the focal point for residents to meet although when they returned from their day centres there was little interaction between residents, which was primarily initiated by staff. Residents were however relaxed and clearly pleased to see the staff. The range of activities available has continued to be provided with all residents being enabled to access the community according to their wishes. Training opportunities provided to staff has resulted in the home having achieved the target of 50 of staff being trained to National Vocational Qualification at level 2. Staff were cheerful and said they liked working at the home; they were confident and considered the standard of care was good. They were knowledgeable about residents’ needs and demonstrated that they were responsive and flexible in their support of residents. Residents care records continued to be well written, up to date and reflected their current needs. The Willows DS0000017953.V270398.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Willows DS0000017953.V270398.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 Willows DS0000017953.V270398.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 and 3. Information is available about the home and ongoing assessments of needs ensure the type and level of care provided is appropriate. Prospective residents would have opportunities to assess whether the home would meet their needs. EVIDENCE: All five residents have lived at the home for several years. From observation and discussion with staff and a sample check of the care records, it was evident that the home was able to meet residents’ needs, although it was apparent that some residents’ needs had changed over the past year, but these were recorded in the reviews of care. The home had one vacancy at the time of the inspection, but the staff and the manager were clear that assessments would be essential for any prospective resident. This would be necessary to ensure the home could meet their needs and that the person was compatible to live with existing residents. The Willows DS0000017953.V270398.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): 9. Residents are able to take risks and act independently as assessed within an agreed care plan. EVIDENCE: It was evident from records and discussions with residents, staff and the manager that residents are encouraged to lead a full and interesting life, dependent only on their abilities and wishes. Residents participate within the home, although this is on a very limited scale. None of the residents were able to prepare meals but can help with some of the daily chores such as tidying their own rooms. None of the residents are assessed as able to go out of the home without being accompanied by staff. Four residents were observed returning from their day centres; they were made welcome by staff and were clearly free to come and go about the house as they wished. Risk assessments were available for each service user. Care records selected were up to date and the manager had carried out reviews of care plans.
The Willows DS0000017953.V270398.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): 13, 15 and 16. Residents benefit from being enabled and supported to exercise their rights to access the facilities in the community and to maintain links with family and friends. EVIDENCE: From discussion with staff and observation of records, it was evident that staff enable and support residents to make use of the facilities in the local and wider community. This is, however, dependent on the ability and wishes of individual residents. Staff are aware of each individual’s interests and of those places they prefer and like to visit. None of the current residents are in any form of voluntary or paid employment or able to access the community independently. Residents benefit from having a mini bus available for outings. Staff spoke of visiting coastal resorts during the summer months and of going on picnics and trips to garden centres, pick your own fruit, hairdressers and swimming. When the mini bus or a driver isn’t available, staff walk into town with residents to go shopping for the home and themselves and to visit cafes. The Willows DS0000017953.V270398.R01.S.doc Version 5.0 Page 11 The home encourages residents to maintain contact with relatives and several visit during the year. Four residents attend local centres and are able to meet friends. The Willows DS0000017953.V270398.R01.S.doc Version 5.0 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 the following standard(s): EVIDENCE: The above key standards were assessed as met at the last inspection of The Willows in July 2005. The Willows DS0000017953.V270398.R01.S.doc Version 5.0 Page 13 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): EVIDENCE: These standards were assessed as met at the previous inspection carried out in July 2005. No complaints had been received by the home or CSCI since the last inspection and although staff had received in-house training on the protection of vulnerable adults from abuse, the manager was seeking training from the Essex Vulnerable Adults Committee. The Willows DS0000017953.V270398.R01.S.doc Version 5.0 Page 14 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 and 30. Residents benefit from being provided with comfortable and homely accommodation. EVIDENCE: The home blends in well with the neighbouring properties. Accommodation consists of a lounge/dining room and a separate music/activities room that overlooks the rear garden, which is private and secure. A new perimeter fence had been erected. There are three single bedrooms on the first floor and a single room and one shared bedroom on the ground floor. All bedrooms in use were bright and cheerful and had been personalised. The ground floor single bedroom is still in the process of being redecorated and the manager is aware that the work will need to be completed before any new admission can take place. The front door has a step that would present a difficulty for wheelchair users. Unrestricted car parking is available in the road at the front of the property. The home has a mini bus that provides residents with good access to local amenities. All rooms were clean and tidy including the kitchen, which was well equipped.
The Willows DS0000017953.V270398.R01.S.doc Version 5.0 Page 15 Residents were observed to have free access to all communal areas within the home. The manager had stated at the previous inspection that the next project would be to upgrade the bathrooms and toilets, which would benefit from being upgraded, but the erection of a new fence had taken priority. The Willows DS0000017953.V270398.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): 32 and 34. Residents benefit from being supported by a team of trained and motivated staff that are recruited appropriately. EVIDENCE: The manager has obtained a National Vocational Qualification (NVQ) at level 4 in management. Of the eight staff employed, five have a NVQ at level 2 and one staff member has a nursing qualification, the home therefore meets the target of 50 of care staff acquiring a NVQ 2 qualification by the end of December 2005. One member of staff is working towards a NVQ level 3. The majority of staff have received training in the basic health and safety requirements that include infection control, first aid, moving and handling and food hygiene. One member of staff had not completed a food hygiene-training course and will need to undertake this as quickly as possible. One new member of staff had been employed at the home since the last inspection in July 2005. The manager and the member of staff confirmed that an up to date CRB disclosure at enhanced level had been obtained, although the record was not checked. The Willows DS0000017953.V270398.R01.S.doc Version 5.0 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 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): 39 and 42. Systems exist for obtaining feedback on the service provided, although an annual review would help to identify those areas that may require improvement and an opportunity to evaluate the effectiveness of the services provided. EVIDENCE: The manager has a Quality Assurance system in place and undertakes a survey of relatives and other interested people such as the GP. The most recent survey was carried out in 2005 and according to the manager the feedback was positive, however, the results of the survey need to be published and made available and a copy sent to the CSCI. There was no evidence that the manager carries out an annual review of the services provided to ascertain the objectives for the following year. As already stated not all staff had received all the basic health and safety training such as food hygiene. The Willows DS0000017953.V270398.R01.S.doc Version 5.0 Page 18 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 3 X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X 3 X Standard No 24 25 26 27 28 29 30
STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
The Willows Score X X X X Standard No 37 38 39 40 41 42 43 Score X X 2 X X 2 X DS0000017953.V270398.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? Yes 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 YA23 Regulation 12 Requirement The manager must ensure that all staff receive up to date and periodic training on the protection of vulnerable adults from abuse. The manager must submit a copy of the home’s latest 2005 Quality Assurance survey summary report to the CSCI local office. An annual review must be undertaken that looks back on the previous year, which helps to establish objectives for the future year. 3 YA42 13 The manager must ensure that all staff are provided with health and safety training including moving and handling, fire safety, food hygiene, first aid, and infection control. 01/02/06 Timescale for action 01/03/06 2 YA39 24 01/02/06 The Willows DS0000017953.V270398.R01.S.doc Version 5.0 Page 20 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 YA27 Good Practice Recommendations The manager should upgrade the bathrooms during 2006. The Willows DS0000017953.V270398.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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