Inspection on 01/06/06 for William Blake House

This inspection was carried out on 1st June 2006.

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

William Blake House 05/06/07

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 William Blake House Stone Cottage Milthorpe Lois Weedon Towcester Northants NN12 8PP Lead Inspector Judith Roan Unannounced Inspection 1st June 2006 10:00 William Blake House DS0000067122.V298153.R01.S.doc Version 5.2 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 William Blake House DS0000067122.V298153.R01.S.doc Version 5.2 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. William Blake House DS0000067122.V298153.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service William Blake House Address 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) Stone Cottage Milthorpe Lois Weedon Towcester Northants NN12 8PP 01327 860412 William Blake House Mr Clive William John Denby Care Home 2 Category(ies) of Learning disability (2) registration, with number of places William Blake House DS0000067122.V298153.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Learning Disability - up to 2 Service Users Both Male & Female 18 - 65 Years of age First Inspection since registration Date of last inspection Brief Description of the Service: Stone cottage provides accommodation for two people with a Learning Disability. The cottage is on two floors and also provides living accomodation for co-workers. The cottage is adjacent to Farm Cottages the registered office and home for three service users, the registered manager and his family. Weedin Lois is close to the village of Wappenham and 6 miles from the nearest town of Towcester. Access to Local facilities do require a vehicle, which is available to the service users and co-workers. The cottage has its own garden and access to leisure facilties close by. Fee levels start from £2346.15 per week. William Blake House DS0000067122.V298153.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for Service Users and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provisions that need further development. The primary method of inspection used was ‘case tracking’ which involved selecting the one resident service user and tracking the care they receive through review of their records. As the service user was unable to verbally communicate the inspector observed care practices and discussed arising issues with co-workers. The inspector also spent time with the Registered manager discussing developments, reviewing co-worker files and training. The inspection involved the completion of an inspection record that is produced from reviewing information received by the Commission since the last inspection, and case tracking during the inspection that took place over a period of 5 hours. What the service does well: What has improved since the last inspection? This is the first inspection since registration. One service user has been admitted since registration and negotiation is ongoing for a second person to move in shortly. William Blake House DS0000067122.V298153.R01.S.doc Version 5.2 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. William Blake House DS0000067122.V298153.R01.S.doc Version 5.2 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 William Blake House DS0000067122.V298153.R01.S.doc Version 5.2 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): 1,2,3,4,5, Quality in this outcome area is excellent. The admission process ensures that needs are assessed and that service users are involved as fully as they can be within the process. This judgement has been made using available evidence including a visit to the service. EVIDENCE: It is evident from case records that the homes manager and the house manager prior to the admission undertook a through assessment of need. A visit to the school to observe how the service was supported informed the assessment as to whether the service users needs could be met. In discussion with the registered manager family and purchasers are informed whether the home can meet the assessed needs. On moving into the home the service user has trail visits to test drive the placement. A review after a few weeks confirms the placement. Files contain good information that has been gathered as part of the assessment process. This information is updated with ongoing work especially in relation to health care needs. Service users needs are continually assessed and changes to needs and how these are to be met are shared at dedicated forums undertaken within the home. William Blake House DS0000067122.V298153.R01.S.doc Version 5.2 Page 9 Service users files hold contracts made with the funding authorities and the home. Due to service users having complex needs and difficulties with communication contracts are put in place between home and their families as part of good practice. William Blake House DS0000067122.V298153.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9,10 Quality in this outcome area is good. Service users can expect that practices within the home promote their involvement and independence. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Care plans were in place for the service user. Reviews are undertaken on a regular basis and as needs change. Regular forums in which care needs of individual service users are reviewed ensure that there is continuous development. If there is a sudden change in need further meetings of co-workers are called to consider strategies to meet the need. Recording practices at Stone Cottage like other homes in the William Blake Group do not have daily recording procedures. This was raised with the Registered manager for discussion within the organisation of how the home can meet this standard. Co-workers do use a digital camera to record events throughout the year, but do not as a matter of course record other information. Regular meetings within the organisation do address some of this issue. The outcomes for service users is not diminished by the practices. In discussion with co-workers it was evident they are very William Blake House DS0000067122.V298153.R01.S.doc Version 5.2 Page 11 knowledgeable about the needs of service users. A co-worker informed the inspector that they had worked alongside another experienced worker until they has demonstrated that they were competent and confident in meeting the service users needs. Support for service users enables them to develop their skills and participate in everyday activities that they previously were not able to achieve. Learning is achieved by the consistent approaches used by co-workers and service users having access to and observing a broad spectrum of daily living activities. The house manager explained that developing personal care and social skills had to secondary to supporting the priority health care issues. Risks within activities are considered on an individual basis and plans made to minimise these for each service user. In observation it was noted that some co-workers communication skills were preventing positive responses from the service user. In discussion with the registered manager it was agreed to review the induction training to include the development of new co-workers knowledge and skills in positive communication with service users that have complex needs In the long-term service users are encouraged to be as independent as possible with appropriate support. In this way service users are included within activities and not excluded because of any behaviour that may arise. William Blake House DS0000067122.V298153.R01.S.doc Version 5.2 Page 12 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): 11,12,13,15,16,17 Quality in this outcome area is good. Work continues to promote the inclusion of service users within community activities. Practices respect service users rights and support individuals to take responsibility for actions. This judgement has been made using available evidence including a visit to the service. EVIDENCE: New service users are supported to experience daily living within the home and their ability. During the early months after admission service users are given time to adapt to their new surroundings and feel comfortable in working with co-workers. Co-workers will continue to promote a varied lifestyle with service users as skills are developed. Service users are encouraged and supported to be involved with every day activities within the house and aided to make choices. Service users are supported to take part in community activities and Christian events. William Blake House DS0000067122.V298153.R01.S.doc Version 5.2 Page 13 Co-workers were able to demonstrate that a varied menu is available to service users. The inspector was able to observe how co-workers support service users during a shared meal. The support team ensure that a food diary is maintained to show the varied and balanced diet available. The use of health, organic and seasonal foods is part of the ethos within the William Blake Group. Service users are supported to maintain contact with families by regular communication from the Registered Manager and co-workers. The files reflected that important information was communicated to families. William Blake House DS0000067122.V298153.R01.S.doc Version 5.2 Page 14 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): 18,19,20 Quality in this outcome area is good. Service users’ physical and emotional health needs are met. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Service users are supported to have regular health checks and there is evidence on files. The home had been proactive in meeting the health care needs for a service user by arranging private consultation to review their medication that had been overlooked prior to their admission into the home. It was possible to see an overview of how this was managed. The effect of new medication is being carefully monitored, as the old is being withdrawn by the use of seizure charts to note significant changes. The house manager was clearly knowledgeable and competent in ensuring that information was shared to other workers. Personal support is provided in a discreet manner and with service users preferences being a top priority. There are always sufficient male and female co-workers on duty to provide gender appropriate support. Medication profiles were found on the service users file. Background information is available about the service users medical conditions which aided the co-workers understanding of their needs. The home does not have a good William Blake House DS0000067122.V298153.R01.S.doc Version 5.2 Page 15 medication recording system that meets standards to demonstrate the path of medication coming into the home, safe administration and disposal. In discussion with the Registered manager it was agreed that the systems that operates in the other homes within the group would be implemented immediately. All incidents are recorded on file to show how co-workers have reviewed practice to minimise future risks. William Blake House DS0000067122.V298153.R01.S.doc Version 5.2 Page 16 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): 22,23 Quality in this outcome area is adequate. Service users can be assured that their views will be listened to and acted upon. Service users are not fully protected by abuse awareness practices within the home. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Comprehensive policies and procedures are available in relation to handling concerns and complaints made. As the service users group has limited communication staff are trained to observe changes in behaviour that may indicate that a service user is unhappy with the support they receive. Co-workers usually undertake abuse awareness training as part of their induction/ foundation training. However new co-workers have not received the training and in discussion with the Registered manager it was agreed that this would be undertaken as a matter of urgency to aid their understanding. The open approach of the registered manager does enable families to feel comfortable if there was a need to make a complaint or express a concern. There have been no complaints since the home opened. William Blake House DS0000067122.V298153.R01.S.doc Version 5.2 Page 17 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): 24,25,26,27,28,29,30 Quality in this outcome area is excellent. The home is maintained to a high standard, providing a warm and relaxed environment with good personal and communal space. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The home is shared with co-workers and service users. There are adequate rooms to enable everyone to have their own personal space in the large converted dwelling. Service user rooms are personalised prior to admission, are comfortable and well maintained. Service users are supported in maintaining their rooms to a high standard of cleanliness and safety. One service users room has been adapted to support a service user with physical disabilities with en-suite shower/bathroom. There is a family bathroom on the first floor that is shared and on the ground floor there is a cloakroom facility. The home is overall well maintained and decorated to a high standard. There is a family size kitchen where co-workers prepare all meals. Off the kitchen there is a laundry room/ William Blake House DS0000067122.V298153.R01.S.doc Version 5.2 Page 18 The communal space provides for service users to undertake a range of activities with co-workers in the main house. There is a separate dining room that can be used for activities. The small garden is well maintained; service users are involved whenever possible. William Blake House DS0000067122.V298153.R01.S.doc Version 5.2 Page 19 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): 32,33,34,35,36 Quality in this outcome area is adequate. Induction and training needs to improve so that co-workers can meet service users’ needs effectively. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The core of co-workers consists of a house manager and a team of co-workers working on contracted placements through community service volunteers (CSV) that also co-ordinate volunteers from overseas. The house manager has developed skills and knowledge in supporting service users need through their induction and core training. New co-workers undertake an induction and work alongside an experienced member of the team to gain full knowledge about the needs of the service users. Co-workers confirmed that they shadowed an experienced worker until they were competent and confident in providing the level of support required. Prior to co-workers arrival CSV undertake extensive checks on volunteers. CSV have confirmed that references are taken up by their organisation as part of the screening process. All overseas volunteers have a police check as part of the CSV application when they apply in their country. Criminal Records Bureau checks (CRB) are undertaken on arrival. The records confirm this to be the procedure followed in the entire William Blake House group. William Blake House DS0000067122.V298153.R01.S.doc Version 5.2 Page 20 Co-workers are offered a range of opportunities to train. The house manager is preparing to commence the National Vocational Qualification (NVQ) at level three in care as part of their development. The registered manager already holds the NVQ Level four and the Registered Managers Award. There was a shortfall in basic training for co-workers that reflected in the quality of service to service users. This shortfall was in adult protection awareness, communication skills, and food hygiene. In discussion with the registered manager it was agreed that the induction programme would be reviewed. Co-workers have a ‘Memorandum of Understanding’ that they sign jointly with the manager that sets out their responsibilities and role within the William Blake House organisation. Supervision is done at two levels one directly with the house manager that discusses a co-workers role with service users and the service provided and one with an external consultant. Supervision levels at the home exceed the national minimum standards All co-workers and the house managers meet with the consultant to look at issues of living and working within the community. In addition to supervision all co-workers are part of forums that discuss a range of work areas to enable the service to run more effectively. William Blake House DS0000067122.V298153.R01.S.doc Version 5.2 Page 21 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): 37,38,39,41,42 Quality in this outcome area is good. The home is effectively managed and ensures that the service is run in the service users best interests. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The Registered Manager and the house maanger effectively manage the home in the best interests of service users and co-workers. A number of groups ensure the effective running of the service across the four homes. Co-workers and service users are part of the groups that have various roles as follows: Organisations – diary, visitors, cover of shifts and holidays Specialist – Medical, primary health care, spiritual guidance, supervision Welcome – reception group for new co-workers Work projects -activities and work placements Resources – maintenance of houses Prep – for Management meeting and directors William Blake House DS0000067122.V298153.R01.S.doc Version 5.2 Page 22 Environmental – how to help the environment Policy – development and review of organisational policies Finance – budgets and training Therapy – use of therapies and their effectiveness In addition to the focus groups the home continues with internal meetings like house and co-worker meetings that provide for a regular review of service users needs. The registered manager and responsible individual are developing a quality assurance system that is service users centred and is used to inform management on how to develop the service in their best interests. The lack of daily recording does not fully protect service users and the inspector discussed with the Registered manager how this area could be improved. All health and safety checks e.g. fire alarm testing, fridge and freezer temperature monitoring that are necessary are carried out as required. William Blake House DS0000067122.V298153.R01.S.doc Version 5.2 Page 23 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 Standard No Score 1 4 2 4 3 4 4 4 5 4 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 2 ENVIRONMENT Standard No Score 24 4 25 4 26 4 27 4 28 4 29 4 30 4 STAFFING Standard No Score 31 X 32 2 33 3 34 4 35 2 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 1 X 3 4 3 X 2 4 X William Blake House DS0000067122.V298153.R01.S.doc Version 5.2 Page 24 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 YA20 Regulation 13(2) Requirement The registered Manager must ensure that all medication is administered and recorded safely Timescale for action 30/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard YA23 YA35 YA32 YA41 Good Practice Recommendations The registered manager needs to ensure that protection of vulnerable adults training is undertaken by co-workers within their induction programme. The registered Manager needs to review the induction training programme to ensure that co-workers are equipped with core knowledge and skills. The registered manager needs to review how they maintain records to provide evidence on how this standard is met. William Blake House DS0000067122.V298153.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 William Blake House DS0000067122.V298153.R01.S.doc Version 5.2 Page 26 - 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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