Inspection on 05/06/07 for William Blake House

This inspection was carried out on 5th June 2007.

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 01/06/06

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 Sarah Jenkins Key Unannounced Inspection 5th June 2007 07:30 William Blake House DS0000067122.V337906.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.V337906.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.V337906.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 adminwblakehouse@phonecoop.coop William Blake House Manager post vacant Care Home 2 Category(ies) of Learning disability (2) registration, with number of places William Blake House DS0000067122.V337906.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 1st September 2006 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 accommodation for co-workers. One of the two service users bedrooms has en-suite facilities. The cottage is adjacent to Farm Cottage, the registered office and home for another three service users. There is also a third home run by the organization, (William Blake House, a charity limited by guarantee),in Blakesley. Lois Weedon is close to the village of Wappenham and 6 miles from the nearest town of Towcester. Access to Local facilities requires the use of a vehicle, which is available to the service users and co-workers. The cottage has its own garden and access to leisure facilities close by. The inspector was informed at the time of the inspection that fee levels remain the same, are all-inclusive and start from £2346.15 per week. Further information about the home in the form of the Statement of Purpose or the Service Users Guide can be obtained from the Responsible Individual at the home. The home will also advise and assist people as to how to access the inspection reports on the internet. William Blake House DS0000067122.V337906.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 provision that need further development. The primary method of inspection used was ‘case tracking’ which involved the 2 service users. The Inspector tracked the care they receive through meeting with them, a review of their records, discussions with the staff and volunteers and observation of care practices. The Inspector visited during the morning, and was at the home for approximately four and a half hours. Service users have Learning Disabilities and/or acquired brain injuries and thereby communication is difficult. Establishing Service Users choices and informed decisions is dependant to some extent upon the consistency of staff and co-workers, service users relationships with them, and the quality of communication. Feedback obtained from service users in this report was through observations of their relationships with co-workers, and also through interpretations of their general levels of happiness with their routines. The Responsible Individual filled in the pre-inspection questionnaire prior to the inspection, and two feedback comment cards were received from relative together with recent advocacy reports relating to service users move to Stone Cottage. What the service does well: The home is notable for its commitment to ensuring service users achieve their potential and have the best quality of life that they are able to, considering and taking into account their individual abilities, disabilities and complex needs. Service users are supported to be included within the community and are encouraged to build positive relationships with others. The home is maintained to a high standard. 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 support service users. William Blake House DS0000067122.V337906.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. William Blake House DS0000067122.V337906.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.V337906.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. 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 prospective service users needs are assessed, and that they are well involved in the process. The process is conducive to ensuring service users happiness at the home. EVIDENCE: A reorganization of the three homes including an updated assessment of the best interests of service users has led to some service users changing their home in February. Thereby two new service users moved into Stone Cottage in February after due consultation, input from Independent advocates and a suitable introductory process. The two service users appeared to have settled in well and be quite content within the home. The admission process was discussed and reviewed through records. Service users needs assessments are comprehensive at the time of admission, and made with proper consultation and information gathering from all relevant people with personal or professional experience of the prospective service user. William Blake House DS0000067122.V337906.R01.S.doc Version 5.2 Page 9 Advice was given how service users involvement may be enhanced, by for example establishing their colour preferences in relation to the décor of the room they are to move into. The routine for admission including involvement of service users relatives throughout is flexible and conducive to enabling service users to gradually familiarize themselves with their new environment. William Blake House DS0000067122.V337906.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users, who have communication problems, can be confident that their care needs and preferences are properly recognized and reflected in the information available to co-workers on their files. Service users can expect that practices within the home advocate for their involvement and wellbeing. EVIDENCE: Observation of service users relationships with co-workers showed that good communication had been established despite the very limited verbal ability of service users. Co-workers were sensitive and responsive to service users nonverbal communications and had a good understanding of their routines, preferences and expressions of choice. The atmosphere was calm and conducive to relaxed activities, and possible areas of conflict were anticipated and avoided through good care practices. William Blake House DS0000067122.V337906.R01.S.doc Version 5.2 Page 11 It was evident from records and the inspector’s observations that service users had confidence in the people caring for them, and were enabled to express their choices and views to some extent. The inspector discussed with staff possible ways that choice making could be developed. Risks within activities are considered on an individual basis and plans made to minimise these for each service user. Due to the degree of dependency of service users and need for close supervision in most activities, most risk management is fully incorporated into the care plans. Advice was given on the need to ensure proper records are kept of the consultation, and multidisciplinary decision making process and review in relation to practices that properly protect service users, such as handling belts for use outside the home. The Responsible Individual was also advised to familiarize herself with the new Mental Capacity Act with regard to good practice in records, in relation to restrictions made on service users for their own protection. William Blake House DS0000067122.V337906.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are enabled to enjoy active and stimulating lifestyles and a good quality of life, whilst being supported in maintaining and developing their skills. EVIDENCE: New service users are supported to experience daily living within the home and their ability. Co-workers 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 enabled to access the local community on a regular basis. Service users may choose to attend religious services at the local church and one attends regularly. Co-workers were able to demonstrate that a varied menu is available to service users. Service users enjoyed breakfasts of their choice and preference William Blake House DS0000067122.V337906.R01.S.doc Version 5.2 Page 13 as detailed in their records, and an appetizing and nutritious mid day meal was being prepared later in the morning. The co-workers ensure that a food diary is maintained to show the varied and balanced diet available. A healthy eating pattern is encouraged and there was evidence of a good understanding of the importance of good nutrition. 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 co-workers. The Inspector had an opportunity to speak with one of the relatives who confirmed that her experience of communication with the home was very good. William Blake House DS0000067122.V337906.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are properly supported to access community healthcare professionals as needed and supported within the home with their health and personal care. Further attention needs to be given to the medication system to ensure outcomes for service users are not compromised in this area. EVIDENCE: Service users appeared healthy, happy and active, and feedback forms did not raise any specific health or care issues. Personal support is provided in a discreet manner and with service users preferences being a priority. There are generally, but not always, male and female co-workers on duty to provide gender appropriate support. From discussion with staff, and evidence of correspondence on files it is judged that healthcare is good and that co-workers recognize and respond satisfactorily to health issues arising. However, the home does not keep daily records relating to service users activities and appointments. In the absence of these it was not possible for the inspector to fully check the consistency of William Blake House DS0000067122.V337906.R01.S.doc Version 5.2 Page 15 health care provision. It is important that the home can demonstrate that service users are enabled to access all aspects of healthcare available to them through the community and that they have periodic medication and health reviews. Advice was given on several aspects of the medication system, including storage and suitable refrigeration where needed; accuracy of Medication Administration Sheets; the need to update medication profiles, and a specific administration issue. Although improvements were made after the last inspection there are still aspects of this area that need to be addressed to promote professional practice. The Responsible Individual assured the inspector that given the fact that this area had now arisen twice she would be asking the local pharmacist to visit the home to offer inspection services. William Blake House DS0000067122.V337906.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. 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 this service. Service users are well protected by the conscientiousness of a caring staff team and the training that has been delivered. EVIDENCE: The Protection of Vulnerable Adults investigation undertaken last year by the Registered Owners was described by the Responsible Individual and demonstrated a comprehensive process including the gathering and recording of information from staff and co-workers. The Inspector did not see the evidence at the time of the inspection, as it was not on the premises. Comprehensive policies and procedures are available in relation to handling concerns and complaints made. Co-workers are aware of these and have now received training in this area. The Responsible Individual informed the Inspector that she maintains close contact with service users, their representatives, co-workers and involved professionals in order to have a good understanding of how the service is seen to be functioning and to pick up on any concerns early. Relatives have been informed and are fully aware of how to make complaints but neither the home nor the Commission for Social Care Inspection have received any other complaints since the last inspection. William Blake House DS0000067122.V337906.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is maintained to a high standard, providing a warm and relaxed environment for service users with good personal and communal space. EVIDENCE: Stone cottage is a large converted cottage, pleasantly situated in a quiet village, and providing a bright and spacious home for service users. It is well maintained and decorated to a high standard. Service user rooms are personalised, comfortable and well maintained. Service users are supported in maintaining their rooms to a high standard of cleanliness and safety. There is a family size kitchen where co-workers prepare all meals, and communal facilities are homely and welcoming. The communal space provides William Blake House DS0000067122.V337906.R01.S.doc Version 5.2 Page 18 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 pleasant and well maintained and service users were seen to be enjoying this facility at the time of the inspection. William Blake House DS0000067122.V337906.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are well supported by a skilled and experienced team of workers, who are caring, committed and appropriately trained. Service users benefit from the warm caring relationships that are established. EVIDENCE: There are three co-workers living in the house and providing regular support to service users. There is no Registered Manager at the present time and coworkers are currently supported by the Responsible Individual who is the Acting Manager. An application for the registration of a new Manager is expected shortly. Co-workers are generally working on contracted placements through community service volunteers (CSV) that also co-ordinate volunteers from overseas. Recruitment procedures are full and thorough and meet the Standards, as demonstrated in discussion and through staff records. New coworkers undertake an induction and work alongside an experienced member of the team to gain full knowledge about the needs of the service users. CoWilliam Blake House DS0000067122.V337906.R01.S.doc Version 5.2 Page 20 workers confirmed that they shadowed an experienced worker until they were competent and confident in providing the level of support required. At the time of the inspection there were two co-workers and a work placement helper on duty. The senior co-worker demonstrated suitable experience and was seen from the records to have undertaken appropriate training for her position, including up to date First Aid. National Vocational Qualification training is offered and there was evidence that co-workers take up these opportunities. The senior co-worker on duty was able to contact the on-call Responsible Individual at the time of the inspection, and the Inspection was supported through her arrival at the home. A relative confirmed in discussion that she felt the way in which the home was staffed was good, that staffing levels were appropriate and that co-workers were always caring and helpful. The Responsible Individual, Acting Manager has assessed service users night time needs, and at present these are supported through monitors in service users rooms and receivers held by sleep in co-workers. Advice was given that the review and risk assessment of this practice should be updated regularly to check the adequacy of the arrangement. William Blake House DS0000067122.V337906.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. JUDGEMENT – we looked at outcomes for the following standard(s): 39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is effectively managed and ensures that the service is run in the service users best interests. EVIDENCE: Standard 37 has not been assessed as such as this relates specifically to a registered manager and there is no registered manager in post. However management arrangements have been considered and are reported on as they have a direct effect on standards of care provided to residents. Although there is no Registered Manager at present, an application is expected shortly. The Acting Manager, who is the Responsible Individual is closely involved with the home and was able to discuss all aspects of its management with the Inspector. The Responsible Individual had identified a need to better William Blake House DS0000067122.V337906.R01.S.doc Version 5.2 Page 22 organize and update records and this was in process at the time of the inspection, with one of the service users records nearly completed. The ethos of the home as a small “family” type environment was discussed, and in this context the inspector accepted the lack of formality in relation to some processes. For example Quality Assurance is mainly undertaken through verbal communication with relatives, care managers and healthcare professionals. The inspector accepted that the use of an Advocacy service and the quality of the close relationships that had been established were likely to pre-empt concerns or complaints arising, but also advised on the continuing need to check and monitor the quality of all aspects of provision within the home. Co-workers found the Registered Owner and Managers supportive and approachable and expressed pleasure with their working and lifestyle conditions, and the opportunities for training that were afforded to them. Health and Safety is generally well monitored and documented but at the time of the inspection the annual fire safety equipment checks were slightly overdue. Advice has been given to the Responsible Individual on various areas where further evidence of the multidisciplinary decision-making process, and/or risk review should be available in records William Blake House DS0000067122.V337906.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 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 x 26 x 27 x 28 x 29 x 30 4 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x N/A x 3 x x 3 x William Blake House DS0000067122.V337906.R01.S.doc Version 5.2 Page 24 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 YA20 Regulation 13(2) Requirement The registered Manager must ensure that all medication is stored, administered and recorded safely. Timescale for action 15/07/07 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 YA20 YA20 Good Practice Recommendations Medication profiles should be updated. Medication Administration Sheets should accurately reflect the full directions as given by the pharmacist on the medicine itself. The Royal Pharmaceutical Society guidance on the administration of medicines in Care Homes should be accessed and the full medication procedure reviewed against the guidance. Evidence of risk assessment and multidisciplinary review, as discussed, and detailed in the body of the report, should be available for inspection. YA20 4 YA42 William Blake House DS0000067122.V337906.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V337906.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. 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!