Inspection on 23/11/06 for William Blake House

This inspection was carried out on 23rd November 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

William Blake House 25/11/05

William Blake House 05/04/05

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

CARE HOME ADULTS 18-65 William Blake House Farm Cottage 8 Milthorpe Lois Weedon Towcester Northants NN12 8PP Lead Inspector Judith Roan Key Unannounced Inspection 23rd November 2006 10:00 William Blake House DS0000063104.V314060.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 DS0000063104.V314060.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 DS0000063104.V314060.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) Farm Cottage 8 Milthorpe Lois Weedon Towcester Northants NN12 8PP 01327 860412 clivewblakehouse@phonecoop.coop William Blake House Mr Clive William John Denby Care Home 3 Category(ies) of Learning disability (3) registration, with number of places William Blake House DS0000063104.V314060.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Learning Disability - up to 3 Service Users. Both male & female 18 - 65 years of age. 25th November 2005 Date of last inspection Brief Description of the Service: The home is situated in the quiet village of Weedon Lois approximately six miles from the market town of Towcester in Northamptonshire. The home itself is a large detached cottage with accommodation provided across two floors. All bedrooms are single occupancy; the home also has two sitting areas, kitchen and dining areas. The home has its own transport, which enables service users to access local facilities. Three young adults with a learning disability are cared for living alongside coworkers as a family unit. The home uses overseas volunteers to support service users. Fee levels vary according to assessed needs of service users. William Blake House DS0000063104.V314060.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 of Social Care Inspection is upon the outcomes for Service Users and their views of the service provided. The primary method of inspection used was ‘case tracking’ which involved selecting 2 service users and tracking the care they receive through review of their records, discussion with them, the care staff and observation of care practices. Since the last inspection the Registered Manager has commenced sabbatical period and the Responsible Individual has taken over as acting manager with support from the house manager from another home within the William Blake Group. The inspection took place during the late morning and afternoon, over a period of 6 hours and was carried out on an unannounced basis. What the service does well: Continuous assessment of needs and good communication systems ensure that co-workers are very knowledgeable about service users needs. Health care needs are monitored and appropriate action is taken. Service users have a range of daily activities of their choice. Service users are supported to be included within the community and continue to build positive relationship with others in the surrounding area. Photographic evidence is used to develop life history work and demonstrate how service users are supported with activities within the home and in the community. The home is maintained to a high standard and service users have access to individual rooms that reflect their personal preferences. Communal areas are homely and enable a range of activities to be undertaken within a family setting. The co-workers show a high level of commitment to the work and bring a range of skills to support service users. Management arrangements are in place to ensure that service users needs are met and co-workers supported. William Blake House DS0000063104.V314060.R01.S.doc Version 5.2 Page 6 The William Blake Community has strong leadership that encourages service user, co-worker and family reflection on the service provided. 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. William Blake House DS0000063104.V314060.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 DS0000063104.V314060.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The admission process ensures that needs are assessed and that service users are fully involved within the process. EVIDENCE: There is a current statement of intent and philosophy that clearly sets out the service to be provided. Within the document you can find the aims and objectives of the service, information about the management arrangements, the co-workers and important policies that service users, relatives and commissioners of the service need to know. The three service users resident at Farm Cottages have been in the home since it opened and their files contain all the relevant assessment documentation that was thoroughly checked at previous inspections. Service users and they representatives are given a service users guide that informs readers about the service provided at the home. William Blake House DS0000063104.V314060.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Informative care plans ensure that service users needs and choices are met. EVIDENCE: After the initial assessment of care needs a care plan is developed jointly with the service users and their representatives. All co-workers are fully aware of the needs of service users. All new co-workers shadow experienced members of the team before supporting service users on their own. The regular meetings held within the community ensure that any new needs are identified and shared. Service user can and do attend their reviews. Their views and those of their representatives are gained and recorded. A diary is kept within the house to ensure that appointments and daily plans are kept. A service user spoken with said that they were happy within the home and that they were involved within the day-to-day decision making about their care. In discussion with the Responsible and co-workers it was established that service users were being monitored to check for any adverse effects since the Registered Manager and their family had moved out. A new team of coworkers had become resident at the home. William Blake House DS0000063104.V314060.R01.S.doc Version 5.2 Page 10 Two of the service users could not verbally communicate but in observation it was noted that they were being consulted by staff and enabled to make decisions. In discussion with co-workers they explained that they used various communication methods to assist service users to make choices. Service users care plans were supported by risk assessments both general and specific to the activities service users undertook whilst in the home and in the community. It is recommended that a person-centred approach within the home is developed whereby service users and co-workers use a diary to note the activities undertaken each day. William Blake House DS0000063104.V314060.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. Planned intervention enables and supports service users to develop personal skills and take opportunities for social and community activities. Practices respect service users rights and encourage individual and joint responsibility in the management of the home. EVIDENCE: A weekly plan of activities for each service user is drawn up. Co-workers inform service users daily of their routines and activities planned for that day. The information could be made available to service users in an accessible visual format to encourage independence and choice. Activities for service users remain good and varied. Service users are fully involved with day-to-day living tasks within the home dependent on their ability. All of the service users were at home with one service user undertaking an english session with a teacher to improve language and communication skills. A co-worker who was including another service user within the process was preparing lunch. Planned activity for the afternoon for two service users was swimming at a local health spa. As member, all service users and co-workers can access this resource whenever they need to. The William Blake House DS0000063104.V314060.R01.S.doc Version 5.2 Page 12 third service users had a planned afternoon at home including a video and personal support. Service users remain involved with the recycling project and have other various work and leisure options within the week. New opportunities are being planned to ensure that service users are fully included within the community. Throughout the inspection the inspector observed positive work with service users using strategies noted within the care plans in supporting people with behaviours that challenge. The lunchtime meal that is freshly cooked was healthy, tasty and attractively prepared. A record is kept of what meals had been prepared throughout the week to ensure variety and balance. Co-workers have a good understanding of health care needs for service users and give full attention throughout the meal. The standard of food prepared at the home remains high being produced from fresh, seasonal and local produce. The files demonstrated that there is good communication between families, managers and the team of co-workers. William Blake House DS0000063104.V314060.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Co- workers ensure that service users personal and health care needs are met by using good information and communication systems within the home. EVIDENCE: Service users are supported as appropriate to attend healthcare appointments and planned in advance as to the support they need. Where appropriate family representatives were involved. One service user who had had an accident at home was supported to attend outpatients locally. There was an omission in recording, as the records need to clarify that the incident had not happened at the home. There are good communication systems in place with families. Personal support is provided in a discreet manner, with service users preferences being a top priority. Medical profiles for service users are clear with information on service users needs of how they prefer the medication to be given. Co- support workers are in need of training in medication administration. Medication was found not to be stored safely. This was acted upon immediately and resolved by the coworkers. It was also noted that one medication in tablet form was being physically cut in half as directed by the GP. In discussion with the responsible William Blake House DS0000063104.V314060.R01.S.doc Version 5.2 Page 14 individual it was agreed that they would speak with the Pharmacist and GP to gain the medication in the correct dosage. Requirements are made to ensure safe handling of medication and training for co-workers. All incidents and accidents are recorded on file. Records of incidents and accidents are kept according to data protection guidelines. William Blake House DS0000063104.V314060.R01.S.doc Version 5.2 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 the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users are protected by the robust policies and practices used by staff. EVIDENCE: There are comprehensive policies and procedures in relation to handling any concerns and complaints. As the service user 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 undertake abuse awareness training as part of their induction/ foundation training. The inspector was able to check out their understanding during the inspection. There is an open approach by senior co-workers that enables families to feel comfortable if there is a need to make a complaint or express a concern. There have been no complaints since the last inspection. William Blake House DS0000063104.V314060.R01.S.doc Version 5.2 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 the following standard(s): 24, 25,26,27,28,30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. The home is clean and hygienic with a homely atmosphere. EVIDENCE: There are adequate rooms to enable everyone to have their own personal space in the large converted dwelling. Service user rooms are comfortable and well maintained. Service users are supported in maintaining their rooms to a high standard of cleanliness and safety. Service users have personalised their rooms. The home is maintained to a high standard and all health and safety checks are completed and meet regulations. The present communal space provides for three service users to undertake a range of activities with co- workers. There is a separate laundry area that meets the needs of service users. The garden is well maintained and provides good outside space for service users to relax. A local gardener has been employed who also works alongside service users. William Blake House DS0000063104.V314060.R01.S.doc Version 5.2 Page 17 William Blake House DS0000063104.V314060.R01.S.doc Version 5.2 Page 18 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 good. This judgement has been made using available evidence including a visit to the service. Positive recruitment and training ensures that service users are safe and supported by a competent staff team. EVIDENCE: The recruitment and selection processes within the home ensure that all required employment checks are undertaken prior to co-workers commencing their duties. All co-workers receive induction training and complete most required basic courses. The co-worker files checked contained all the required documentation. Since the commencement of the Registered Manager’s sabbatical period they and their family have moved out of the house. A house manager has been appointed from the co-worker group within the community who is supported by three more co-workers. The team of co-workers are contracted placements through community service volunteers (CSV) from overseas. 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 William Blake House DS0000063104.V314060.R01.S.doc Version 5.2 Page 19 the CSV application when they apply in their country of birth. 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. Co-workers are offered a range of opportunities to train. The house manager has commenced the National Vocational Qualification (NVQ) level three in care 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 undertaken with an external consultant who liaises with senior managers within the organisation about issues, confidentiality is always maintained. 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 DS0000063104.V314060.R01.S.doc Version 5.2 Page 20 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): 37,39,41,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Effective leadership ensures that the home is run in the best interests of service users. EVIDENCE: The Registered Manager is presently on a sabbatical period for one year. CSCI has requested that full management arrangements are mad to ensure that all the component of the manager’s role are covered and that there is clear delegation of duties. In discussion with the Responsible individual and another house manager within the group it was clear that the interests of service users are being maintained. Service users and their families are invited to give their views of the service throughout the year to ensure development of the service. Daily recording needs to be more robust so it demonstrates how co-workers are meeting service users needs. Records are kept within the office at the home and managers are reviewing their security. Procedures are in place to William Blake House DS0000063104.V314060.R01.S.doc Version 5.2 Page 21 ensure that health & safety checks are undertaken and up to date. Records were available for inspection. The home has undertaken all the health and safety checks required. William Blake House DS0000063104.V314060.R01.S.doc Version 5.2 Page 22 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 4 26 4 27 4 28 4 29 X 30 4 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 1 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 1 X 3 X 3 X 2 3 X William Blake House DS0000063104.V314060.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 Timescale for action 31/12/06 2. YA35 18(1) (c) The responsible individual must ensure that medication is stored and administered in accordance with the guidelines set out by the Royal Pharmaceutical Society guidelines. All co-workers that administer 31/12/06 medication must receive appropriate training prior to undertaking this activity. 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 YA41 Good Practice Recommendations It is recommended that service user records could be improved by having details on how co-workers support individuals daily. William Blake House DS0000063104.V314060.R01.S.doc Version 5.2 Page 24 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 DS0000063104.V314060.R01.S.doc Version 5.2 Page 25 - 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!