Inspection on 25/11/05 for William Blake House

This inspection was carried out on 25th November 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

William Blake House 23/11/06

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 Unannounced Inspection 25th November 2005 16:00 William Blake House DS0000063104.V266682.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 William Blake House DS0000063104.V266682.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. William Blake House DS0000063104.V266682.R01.S.doc Version 5.0 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@aol.com 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.V266682.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Learning Disability - up to 3 Service Users. Both male & female 18 - 65 years of age. 05/04/05 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 within a family unit living alongside family members on a day-to-day basis. This home also uses overseas volunteers to support service users one of whom also lives on the premises. William Blake House DS0000063104.V266682.R01.S.doc Version 5.0 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 one service user and tracking the care they receive through review of their records, discussion with them, care staff and observation of care practices. This inspection report additionally addresses specific areas where recommendations were identified at the previous inspection. The report also reflects on feedback gained from meeting with family members at a social event held at Slapton Lodge another home managed by William Blake House group that the inspector was invited to. The inspection took place during the afternoon and evening, over a period of 4.5 hours and was carried out on an unannounced basis. What the service does well: The home provides continuous assessment of service users needs. 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 have built a positive relationship with others in the surrounding area. The home is maintained to a high standard and service users have access to individual rooms that reflect their personal preferences. Communal areas 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 their work. The home has strong leadership that encourages service user, co-worker and family reflection on the service provided. William Blake House DS0000063104.V266682.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. William Blake House DS0000063104.V266682.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 William Blake House DS0000063104.V266682.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): 2,3,5 Outcomes from the homes admission process informed the service user that their needs could be met. Continuous assessment ensures that the service users needs are met by the service provided. EVIDENCE: Prior to admission the registered manager ensures through the assessment process that full information is gained. This together with time spent with the service user and their family enables a decision to be made as to whether identified needs can be met within the homes provision. 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 as part of forums undertaken within the home. These groups cover a range of areas and service user are part of these along with service users and co-workers from two others homes within the William Blake group. Service users files hold contracts made with the funding authorities and the home. Contracts have been put in place between home and their families as part of good practice. William Blake House DS0000063104.V266682.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): 7,8,9,10 Consultation processes enable service users to make informed choices about their lives. EVIDENCE: It was observed that co-workers continually consult service user in their daily support of their needs. Service users are part of their reviews to discuss how their care needs are to be met. Any need that requires a consistent strategy is discussed in co-worker meetings. In discussion with the registered the issue of making daily recordings of care undertaken was discussed and they felt that the home had sufficient systems in place to review and confirm needs were being met. The inspector however is unable to confirm their findings that the home is meeting national minimum standards due to lack of written evidence. It must be stressed that outcomes for service users are positive and that needs are being met within the systems in place at the home. William Blake House DS0000063104.V266682.R01.S.doc Version 5.0 Page 10 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. Risks within activities are considered on an individual basis and plans made to minimise these for each service user. 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 DS0000063104.V266682.R01.S.doc Version 5.0 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 Options available to service users enables them to develop daily living skills in a family environment where respect and rights are central to the support. EVIDENCE: Experiences for service users remain good and varied. Service users are fully involved with day-to-day living tasks within the home. Four service users were being supported to make Christmas cards as part of a craft activity. Service users remain involved with the recycling project and have other various work and leisure options within the week. During the inspection the inspector was invited to share a meal. There was a choice available to service users from a range of home made items. The food was tasty and healthy options were offered. The standard of food prepared at the home remains high being produced from fresh and local produce. In June the inspector was invited to join in a housewarming for a service user at another home within the William Blake Group. All service users from farm Cottage and their families were invited. The direct feedback from family William Blake House DS0000063104.V266682.R01.S.doc Version 5.0 Page 12 members about the service provided was very good. Families commented on how good the communication has been with them and that the registered manager and the team of co-workers always kept them informed. They were especially pleased about the development opportunities for their son or daughter and the progress they hade made. All service users and co-workers had a two week holiday in Iceland this summer that was well planned and enabled the holiday to be a positive experience for all. The registered manager is presently preparing an edited version of the eight hour video record taken to present to parents at the next meeting. William Blake House DS0000063104.V266682.R01.S.doc Version 5.0 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): 18,20 Personal preferences are met and respected. Medication administration protects service users. EVIDENCE: Service users wishes are central to the support they receive from the coworker team. Sensitive needs are met in a way that respects individuals and protects their privacy. The home has responded positively to the recommendation made at the last inspection in relation to medication. The inspector was pleased to see the development of medical profiles for service users with clear information given by the Homeopathic doctor about its benefits and how it is used. Notes were also available from Dr. Olaf after his visits and review of current homeopathic medication. William Blake House DS0000063104.V266682.R01.S.doc Version 5.0 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 the following standard(s): 22,23 Policies, procedures and work practices ensure that service users are listened to and protected. EVIDENCE: The home has comprehensive policies and procedures 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 users is unhappy with the support they receive. Coworkers undertake abuse awareness training as part of their foundation training. Families spoken with when the inspector met with them on the social event in June gave positive feedback about the support and were fully aware of the complaints policy and procedures if they needed to express a concern. William Blake House DS0000063104.V266682.R01.S.doc Version 5.0 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 the following standard(s): 24,25,26,27,28,30 A homely, safe and clean environment is created with and in the interests of service users. EVIDENCE: The home is shared with co-workers and family members. There are adequate rooms to enable everyone to have their own personal space in the large converted dwelling The home is well maintained and decorated to a high standard. Since the last inspection repairs have been carried out to the ceiling in the lounge due to water damage. The large dining area doubles as an activity area. On arrival four service users were involved with a craft activity. A service user from another home within the William Blake group had joined the three service users who live at Farm cottage. The communal space provides for service users to undertake a range of activities with co-workers. William Blake House DS0000063104.V266682.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): 32,33,34,35 Service users benefit from the support of a team of co-workers that have a wide range of expertise and training. Recruitment practices protect service users EVIDENCE: The registered manager, his wife remain as core members of the team. Their daughter has also recently joined the team as a co-worker. At all times there is at least 1 member of staff to 1 service user depending on the activity. Co-workers within William Blake House group will on occasions support at Farm Cottages to enable workers days off. Foundation training for all new co-workers is planned for the new year. Co-workers undertake a criminal records bureau check on arrival. The inspector checked these records and found them satisfactory. They are stored securely with the registered manager. References are completed by VSO organisation if a co-worker is engaged through this system. In all other cases the home uses their own recruitment policy and procedures. Co-workers are offered a range of opportunities to train. The registered manager already holds the NVQ Level four and the RMA. William Blake House DS0000063104.V266682.R01.S.doc Version 5.0 Page 17 In discussion with the registered manager about contracts for co-workers the inspector was shown a new document ‘Memorandum of Understanding’ that he and the responsible individual have jointly developed. This sets out the role and responsibilities of individuals within the William Blake House organisation. William Blake House DS0000063104.V266682.R01.S.doc Version 5.0 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 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): 38,39,42 The home has strong leadership that benefits service users. EVIDENCE: Since the last inspection Jane brazier has been appointed as the new Responsible Individual. Their reports are being received by CSCI on a regular basis. In discussion with the registered manager the inspector was made aware of developments within the organisation. A number of groups have been established to ensure the effective running of the service across the three 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 Environmental – how to help the environment William Blake House DS0000063104.V266682.R01.S.doc Version 5.0 Page 19 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 home has undertaken all health and safety checks required apart from PAT testing of electrical equipment. In discussion with the registered manager they are to seek guidance as to the electrical system installed and the trip system in operation. It is recommended that the advice is also sort from Health & Safety Executive. William Blake House DS0000063104.V266682.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 3 X 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 3 3 2 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X 3 X 3 LIFESTYLES Standard No Score 11 3 12 3 13 4 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 3 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 William Blake House Score 3 X 3 X Standard No 37 38 39 40 41 42 43 Score X 3 3 X X 2 X DS0000063104.V266682.R01.S.doc Version 5.0 Page 21 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. 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 YA10 YA42 Good Practice Recommendations The home needs to review their policies on what records are required to meet national minimum standards. It is recommended that the registered manager take guidance in relation to the PAT testing of electrical equipment. William Blake House DS0000063104.V266682.R01.S.doc Version 5.0 Page 22 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.V266682.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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