Inspection on 30/06/05 for Weir End House

This inspection was carried out on 30th June 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

Weir End House 30/04/07

Weir End House 28/11/05

Weir End House 19/10/04

Weir End House 28/05/04

Weir End House 04/02/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Weir End House Glewstone, Ross-on-Wye, Herefordshire, HR9 6AL Lead Inspector Christina Lavelle Announced Inspection 30 June 2005 13:00 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. Weir End House S24745 Weir End House V228449 300605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Weir End House Address Glewstone, Ross-on-Wye, Herefordshire HR9 6AL 01989 567711 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) Parkcare Homes Ltd Mrs Ann Fletcher Care Home only 13 13 13 Category(ies) of Learning Disability registration, with number Mental Disorder of places Weir End House S24745 Weir End House V228449 300605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: There are no additional conditions of registration other than the categories of registration detailed on the previous page of this report. Date of last inspection 19 October 2004 Brief Description of the Service: Weir End House is a lovely big old house about a mile or so away from the market town of Ross-on-Wye. There is also a small extension next to the house in which three residents have bedrooms. The property is set in large grounds with a walled vegetable garden and a woodland area, which are also home to a donkey, goat and chickens. The home was first set up in 1997 and was taken over by Parkcare homes last year. It provides care for thirteen adults with learning disabilities who are aged form their early thirties and must be less than sixty-five. They may also have a stable mental health problem and show challenging behaviour. Many of the current residents have lived at the home for years. There are two shared and nine single bedrooms. Residents also share two large sitting rooms, a consevatory and a seperate dining room. Weir End House S24745 Weir End House V228449 300605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine announced inspection that took place in just over five hours on a Thursday afternoon in the summer. It was evident the home continues to provide a high quality service for the residents and is managed very well. Comment cards had been sent to the home before the inspection for residents and their families/visitors asking for their views of the home. Fourteen were filled in and sent back and what they said was all very positive about the home and the staff. Some of their comments have been put in this report. Time was spent talking to residents about what living at Weir End House is like and how they spend their time and get on with staff etc. Some staff were also spoken with and the manager discussed the care given to residents and how the aims of the home were being met. Various records kept about the residents, staff and safety matters in the home were checked and the house and gardens were looked at. What the service does well: Weir End House is a real home to the thirteen people that live in it. Most have been there for a long time and they are a settled group of people who get on well together. The home also has a stable staff group, many of whom have worked at the home for years. This helps them all to know each other very well and residents have trust and confidence in the staff. The staff team are well trained and have very good support from the manager and provider. The home feels a very happy and relaxed place. This was confirmed by some relatives who said Weir End House is “An excellent home in which residents seem bonded into a supportive community” and “There is a warm welcome and homely feeling on entering the home”. Residents who were spoken to (or filled in a comment card) said they all liked living at the home. They felt safe and well cared for by staff and their privacy is respected. Good care planning makes sure that staff know residents’ needs and what help and support they need and how to keep them safe. Each resident has a keyworker from the staff team. This makes their care more personal as they have one special person to help them with things, such as choosing clothes and drawing up their plans, and to discuss what they need and wish. The house is kept in a very good state and is well decorated and furnished inside. The gardens are beautiful and are a place the residents can enjoy. Some of them also like to help with the gardening, growing vegetables and looking after the animals. Weir End House S24745 Weir End House V228449 300605 Stage 4.doc Version 1.30 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. Weir End House S24745 Weir End House V228449 300605 Stage 4.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 Weir End House S24745 Weir End House V228449 300605 Stage 4.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) 1 & 5 Appropriate information documents are provided to help prospective residents and their families decide if Weir End House is where they may like to live and if the home could meet their care needs. Also so that residents know what the service will provide and how much they will be charged and what for. EVIDENCE: The information provided for the home is of a good standard and includes a statement of purpose, service users’ guide and a contract of residency. These documents are available in a format which are more likely to be understood by people with learning disabilities. Other Standards relating to the assessment of care needs and admission of new residents were not reviewed as no one had been admitted to the home recently. Weir End House S24745 Weir End House V228449 300605 Stage 4.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, & 9 The care planning system used is very thorough and person centred which enables residents to make their own choices and decisions. The plans ensure individuals’ care needs and wishes are identified and that staff are fully aware of what they need to do to support or assist them. Relevant risk assessments are carried out to allow residents to take responsible risks to promote their independence whilst making sure that any risks to their safety are minimised. EVIDENCE: The sample of residents’ care records checked showed that all relevant areas of need were covered in care plans and appropriate risk assessments had been carried out. Plans reflected the support and assistance each person needed with instructions to staff about how to manage their needs and any difficulties or behaviours that could put that person and others at risk. Behaviour observation and incident charts were used to monitor and record any issues as they arose so that a plan to deal with them could be made. A Person Centred Planning format had recently been introduced which involves residents and their allocated keyworker from the staff team drawing up a care plan that includes their preferences and goals in life. Progress to meet their goals, plans and risk assessments had been reviewed and updated at appropriate intervals. Home staff had also attended day service reviews. Weir End House S24745 Weir End House V228449 300605 Stage 4.doc Version 1.30 Page 10 The manager monitors all the plans monthly to ensure they are accurate, sufficiently detailed and up to date. A health care professional commented “The staff are consistent and thorough when implementing care plans and behavioural programmes”. Care records included photographs of each resident, their food likes and dislikes and other helpful information about their background and medical history. Daily reports are made by staff, which show how residents had been occupied, how they are and any events in their lives. There is a emphasis in the home on residents developing independent living skills. One relative said “I am very happy with the care provided and the tremendous input in providing opportunities to practice individual skills”. Residents are encouraged to be involved in household tasks and to clean their own rooms and laundry. They choose their own clothes, with their keyworker’s help if they need it. Some residents help with gardening and the vegetables grown and good state of the gardens is a credit to them and the home. Residents are supported and encouraged to make decisions about their lives. Whilst a few indicated they would sometimes like to be more involved in decision-making in the home residents’ meetings are held regularly (with records kept) to provide a forum to express their opinions. It was evident that residents were very comfortable with the manager and staff and could air their views freely. Weir End House S24745 Weir End House V228449 300605 Stage 4.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) 11, 12, 14, 15, 16 & 17 The home enables residents to take part in a wide range of leisure, educational and work related activities to help them lead interesting lives and develop their skills. Whilst they live in a fairly large group their individuality is kept and their rights and responsibilities to the home and others living in it are respected. Residents are supported to maintain links with their families and friends. Good attention is given to providing food that residents like and which is healthy and also suits anybody with special dietary needs. EVIDENCE: Residents feel the home provides suitable activities and each person has a weekly programme of activities, college courses, day services and work placements. Staff are always looking for new opportunities to offer residents and were trying to arrange leisure activities and outings on a more individual basis. One person for example had recently been to the Imperial War Museum with their keyworker. As well as going out into the community residents pursue their own interests whilst at home e.g. music, television, the garden Weir End House S24745 Weir End House V228449 300605 Stage 4.doc Version 1.30 Page 12 and a music therapist visits to take a session weekly. The home’s vehicles provide transport to the town and further afield. Ten relatives/visitors returned their comment cards and all indicated they were happy with the overall care provided and were kept well informed. The following comments reflect the general view of the service: • “We are totally satisfied with the care and attention given. The staff keep us fully informed and we know we can visit at anytime and be made welcome”. • “Weir End House is a very welcoming place to visit and I am always made to feel comfortable and as if it were my own home”. Other residents discussed how contact with their family was supported by staff. Weekly menus are drawn up which residents help to choose. A daily menu board shows the meals each day and residents’ can request alternatives if they wish. Residents’ diet has had a nutritional assessment and staff encourage and provide healthy food e.g. five portions of fruit and vegetables a day. A special diet is provided to meet one resident’s needs. Residents said they liked the food and the evening meal of lasagne and salad, followed by fresh strawberries and cream looked very appetising. Homemade cakes were also seen and are cooked regularly. Weir End House S24745 Weir End House V228449 300605 Stage 4.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 Arrangements were in place to ensure the personal, health and emotional care needs of residents were fully met and their good health and welfare was promoted. EVIDENCE: Plans clearly show the support each resident needs to maintain good hygiene and to develop independence in respect of their personal care. Staff give appropriate guidance and help when it is needed. Residents were seen to be very well presented and appropriately dressed. Care records showed that residents’ health care is closely monitored and any issues were picked up by staff and dealt with quickly and properly. This included obtaining advice and input from health care professionals such as a Psychiatrist and community nurse. One health care professional confirmed that staff always contact their team for advice and support regarding residents health and mental health. Weir End House S24745 Weir End House V228449 300605 Stage 4.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 The home has a good and open approach to the management of complaints and to the protection of residents from abuse or neglect. EVIDENCE: It was evident from observation and talking to residents that they trust the manager and staff and would feel able to air their views and raise concerns. Further they would be confident that having done so appropriate action would be taken to deal with the issues. There is a complaints procedure that is produced in a way people with learning disabilities can understand better. Relatives also knew about the home’s complaints procedure and said they could look at inspection reports to check whether the home was providing a good service in line with regulations. There had not been any complaints made to the home or to the Commission. The home provides adult protection and whistle blowing policies and a copy of the local multi-agency procedures for the Protection of Vulnerable Adults. Staff had received relevant training so they would be able to identify indicators of abuse and know how and whom to report this. Weir End House S24745 Weir End House V228449 300605 Stage 4.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, 25, 26 & 28 Weir End House can suitably meet the needs of residents and provides a very homely and comfortable place for them to live. Residents also benefit from the good quality of the furnishing, fittings, décor and accommodation in general. Appropriate arrangements are in place for the ongoing repair and upgrading of the home to improve the environment for residents. Also to ensure that a good standard of cleanliness and safety is maintained. EVIDENCE: Weir End House is suitable for this physically able group of younger adults. Although the town is not within easy walking distance the home has the advantage of being in the countryside and so having the space for residents to grow vegetables, keep animals and enjoy the wildlife. The home has some lovely period features, with large rooms that are very well furnished and decorated. There is a programme of upgrading and renovation to improve the environment and recently new carpets had been fitted in the hallway and dining room and looked very nice. Other redecoration had also been carried out recently. Weir End House S24745 Weir End House V228449 300605 Stage 4.doc Version 1.30 Page 16 The two sitting rooms and conservatory provide a variety of communal rooms for residents to use. Their bedrooms are also very well personalised so they can provide personal space and the choice for them not to mix with other people. One relative commented on the fact that her son’s individuality is respected and is reflected in his bedroom decoration. All bedroom doors have locks, which some people chose to use and had their own keys for. The home accommodates thirteen people, living as one group. The Standards specify that care homes should be organised in clusters of up to ten people by April 2007. The Standards also specify all bedrooms should be single, and two are shared currently. Consideration should be given by the provider to addressing these matters. Weir End House S24745 Weir End House V228449 300605 Stage 4.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) 31, 32, 33, 34, 35 & 36 Staff understood the aims the home and how their role promoted these. They were committed to providing residents with a good quality of care and life. There were appropriate staffing arrangements in place to ensure residents’ needs were met properly, and by a competent and well-supported staff team. Thorough recruitment procedures are used so that only suitable people are employed at the home, for the protection of residents. EVIDENCE: Staff were clearly happy and committed to working at the home. They were observed to have an open, relaxed and caring attitude and approach to residents. This was confirmed by one relative who commented “We are absolutely satisfied with the care and love shown to X and are impressed with the professionalism and knowledge of all staff”. There was an appropriate number and skill mix of staff to meet residents’ needs and allow for activities and the running of the home to be carried out. Staff turnover was low which helps to give stability and means that residents and staff know each other well and care received is consistent. Weir End House S24745 Weir End House V228449 300605 Stage 4.doc Version 1.30 Page 18 A staff training grid provided information about all the training completed by the staff team. This showed they all had done the core health and safety topics and adult protection training and most had attended a session on challenging behaviour and autism awareness. Four people already had an NVQ qualification and five were working towards doing so, which was helped by the manager being an NVQ assessor. This level of training indicates that staff had the knowledge and skills to provide good care to meet residents’ special needs and to safeguard them from harm. One staff member had six working hours allocated just to training and will use these to support new staff with induction and co-ordinate all the other training The provider had recently introduced induction and foundation training for new staff that is in line with relevant specifications. This training is specifically for staff who care for people with learning disabilities and so is of great benefit. A new supervision and appraisal system was being introduced and each staff member will be given a Personal Performance Agreement booklet to review their performance and development. This appropriately involved two monthly individual supervisions. The manager had recently attended a training session to help her to implement this positive development. Each staff member had a CRB/POVA check undertaken. One staff record of a new person to the home was checked and contained all the required information, plus their photograph, two written references and a CRB/POVA check. They also had been given an appropriate job description, completed an application form and undertaken all the relevant induction training. Weir End House S24745 Weir End House V228449 300605 Stage 4.doc Version 1.30 Page 19 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) 37, 38, 39, & 42 The home is well managed by a suitably qualified and experienced manager. It also has strong and positive management systems in place, which has all lead to very good outcomes for residents. The development of the service is appropriately monitored and reviewed with input obtained from residents and their relatives or representatives. Appropriate arrangements are in place to safeguard residents, staff and other people in the home. EVIDENCE: The manager is suitably qualified and has a great deal or relevant experience. Mrs Fletcher’s approach to the role and responsibilities is organised and competent and there is a clear sense of direction and leadership. She also manages another small care home located in the grounds of Weir End House. Certain areas of work are therefore delegated to other staff and this approach works well. The manager has working hours over and above care hours for the Weir End House S24745 Weir End House V228449 300605 Stage 4.doc Version 1.30 Page 20 management task and the home also has a twenty-hour a week administrative assistant to assist her. There is a quality monitoring and assurance system (QA) operated by the home. Regular audits are undertaken of the service e.g. care planning, the premises and health and safety by the provider. Questionnaires are sent to residents and their relatives to monitor how they feel about the home. These questionnaires state they will use the feedback to improve the service, which is required of a QA if it is to be effective . The home and manager receive good support from the provider. Monthly visits to report on the conduct of the home are carried out as required. The manager also receives supervision from an area manager two monthly and said they are responsive to her and the home’s needs. The maintenance person for the home is very thorough and operates a procedures book recording any work identified as needed and action taken. Checklists and schedules ensure regular testing and servicing of services and equipment such as electrical, water temperature & storage and the boilers. There was evidence that risk assessment relating to the premises were undertaken. Cleaning products were also locked up and COSHH assessments in place. The fire log showed that all required tests and checks had been carried out and an external Fire Safety consultant had recently inspected the premises and updated the home’s fire risk assessment. Weir End House S24745 Weir End House V228449 300605 Stage 4.doc Version 1.30 Page 21 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 3 x x x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 2 x 3 x x Standard No 11 12 13 14 15 16 17 3 3 3 3 3 x 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Weir End House Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x x 3 x S24745 Weir End House V228449 300605 Stage 4.doc Version 1.30 Page 22 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 Regulation Requirement Timescale for action 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 YA 24 YA 25 Good Practice Recommendations Consideration should be given to how each resident could have their own bedroom. Considertaion should be given to organising the home into groups of up to ten residents by 1st April 2007. Weir End House S24745 Weir End House V228449 300605 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Hereford Area Office 178 Widemarsh Street Hereford HR4 9HN 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 Weir End House S24745 Weir End House V228449 300605 Stage 4.doc Version 1.30 Page 24 - 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. 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