Care Home: 43 Freeman Street

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What the care home does well 43 Freeman Street continues to provide a genuine home and family environment, with a comfortable and cheerful atmosphere for each of the three people who live there. Each person continues to have a significant say in all aspects of the home and they are all able to have their own hobbies and interests, in addition to a wide selection of external activities.Each person`s bedroom continues to be very individual and personalised and all three people appear to be happy and settled. All three people continue to enjoy their meals and be involved in choosing what to have. Each person continues to be registered with the local doctor and dentist as well as a number of other healthcare professionals. What has improved since the last inspection? A written record is now maintained on a regular basis, which demonstrates the involvement of residents in activities, contact with friends and family, healthcare appointments and general well being. Miss Marshall has commenced a relevant training programme, in order to obtain an appropriate management qualification. What the care home could do better: Regular support staff need to be recruited and maintained, to ensure people`s individual and joint needs are able to be met consistently and to enable Miss Marshall to have recreation time, as well as time for continuing relevant personal training and development. CARE HOME ADULTS 18-65 43 Freeman Street Wells-next-the-Sea Norfolk NR23 1BQ Lead Inspector Debra Allen Unannounced Inspection 19th August 2008 08:30 43 Freeman Street DS0000065466.V370422.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 43 Freeman Street DS0000065466.V370422.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. 43 Freeman Street DS0000065466.V370422.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 43 Freeman Street Address Wells-next-the-Sea Norfolk NR23 1BQ 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) 01328 710140 bj.marshall@virgin.net Miss Bridget Jane Marshall Not applicable Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 43 Freeman Street DS0000065466.V370422.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: 43 Freeman Street is a small domestic type environment offering support to three adults with learning difficulties. The residents share the house with the provider, Miss Bridget Marshall. The house is situated close to the centre of the seaside town of Wells-NextThe-Sea on the Norfolk coast. The fees are variable in accordance with the individual need of each resident. 43 Freeman Street DS0000065466.V370422.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. Care Services are judged against outcome groups, which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out, by using information from previous inspections, information from the providers, the residents and their relatives, as well as others who work in or visit the home. This has included a recent unannounced visit to the home. This report gives a brief overview of the service and the current judgements for each outcome group. Following comments from the provider, the draft report was amended to reflect the fact that, following the recent resignation of the regular part-time staff member, Miss Marshall has taken positive action steps to recruit additional staff. Meanwhile, this inspection was carried out over a period of five hours, during which time a discussion was held with the registered manager/owner, records and files were checked, observations of the premises were carried out and all three people living at the home were met and spoken with. An Annual Quality Assurance Assesment (AQAA) was completed by the manager/owner and submitted it to The Commission prior to this inspection. All three people living at 43 Freeman Street returned completed CSCI surveys, which contained positive responses in all areas, although no additional comments were made. Following a previous discussion with the three service users, an ‘Easy Read Summary’ has not been produced for this report as everyone said they preferred this format. Two requirements have been made as a result of this inspection. What the service does well: 43 Freeman Street continues to provide a genuine home and family environment, with a comfortable and cheerful atmosphere for each of the three people who live there. Each person continues to have a significant say in all aspects of the home and they are all able to have their own hobbies and interests, in addition to a wide selection of external activities. 43 Freeman Street DS0000065466.V370422.R01.S.doc Version 5.2 Page 6 Each person’s bedroom continues to be very individual and personalised and all three people appear to be happy and settled. All three people continue to enjoy their meals and be involved in choosing what to have. Each person continues to be registered with the local doctor and dentist as well as a number of other healthcare professionals. 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. 43 Freeman Street DS0000065466.V370422.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 43 Freeman Street DS0000065466.V370422.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. Service users’ individual needs and aspirations continue to be assessed on an ongoing basis, which helps ensure the service continues to meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: As with previous inspections, there have been no new admissions for some years, all three residents remain settled and there are no foreseeable plans for any future admissions. 43 Freeman Street DS0000065466.V370422.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. All three people living at the home continue to be able to make decisions about their lives and their assessed and changing needs and personal goals are reflected in their personal plans. The ‘daily event’ record keeping has improved since the last inspection, together with risk assessments, which show how people are supported to take risks as part of an independent lifestyle. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Personal records and care plans were looked at for all three residents and each of these were found to contain detailed information about each individual and how they are supported. These were noted to have been updated on a regular basis and continue to focus on the more positive attributes of each person. 43 Freeman Street DS0000065466.V370422.R01.S.doc Version 5.2 Page 10 Regular and ongoing information relating to the day-to-day lifestyles of each service user is now maintained in a diary format and includes areas such as work, leisure, family contacts and general mood and wellbeing. Following a previous recommendation that each person could be actively involved in creating their own ‘This is Me’ style person centred plans, the manager confirmed that this had been tried but none of the three residents had any interest in pursuing it, although the manager also confirmed that each person continued to be actively involved in the regular reviews of their care plans. The care plans were seen to include information in areas such as Social Skills, Medical Conditions, Sleeping, Food, Hygiene, Laundry/Bedroom Hygiene, Key Holding, Interests & Pastimes, Family, Finances, Particular Problems, Healthcare and Goals/Enjoyment. Risk assessments continue to be in place, which cover aspects such as being home alone, cycling, money handling, boating or kayaking, fishing, selfadministering medication, neglect to self, abuse/exploitation and self-harm. It was noted that where hazards are reduced or managed but not totally eliminated, the following statement of explanation was applied: “To provide an active lifestyle involves some risk taking in every field but the risks can only be minimised. To remove all risks would mean taking away the activity, which is also taking away all independence. [Name] is an active outgoing individual and our lifestyle has been based on outgoing activities from the day [name] first came. Most persons involved with myself over the years feel the drive and stimulation which come with the outdoor activities is what has given such positive results within the home.” 43 Freeman Street DS0000065466.V370422.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good. All three people continue to be able to pursue their own hobbies and interests and have work/day placements during the week. Regular contact with friends and family is maintained and each person continues to enjoy their meals, be involved in food shopping and deciding what they want to eat. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All three people were seen and spoken to during the inspection and each person appeared happy living at Freeman Street. Observations, records seen and discussions provided confirmation that each person has their own hobbies and interests such as fishing, fish keeping, boating, music, keep fit, piano keyboard, cars, cycling, watching television soaps and visiting/helping the local lifeboat. 43 Freeman Street DS0000065466.V370422.R01.S.doc Version 5.2 Page 12 Other activities noted included walking, going to the cinema, cricket, bowling, time on the beach, shopping, gardening, helping in and around the house and looking after the household pets. Two people were observed washing and vacuuming the home’s car during the inspection, a task they appeared to enjoy and take a great deal of pride in. Each person said that they enjoyed their food and observations confirmed that they were able to choose what they wanted to eat, with people seen choosing and preparing their own breakfasts and lunches. 43 Freeman Street DS0000065466.V370422.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. Each of the three people living at 43 Freeman Street receives personal care and support in the way they choose and their physical and emotional healthcare needs continue to be met. Medication is handled appropriately and these, together with medication records, are stored securely. This judgement has been made using available evidence including a visit to this service. EVIDENCE: As with previous inspections, all three people continue to be capable of carrying out most of their own personal care needs and generally only require encouragement and prompting from Miss Marshall. Each person continues to be registered with the local doctor and dentist and visits to other healthcare professionals such as optician and psychiatrist were also noted. The care plans were seen to be regularly updated and include information regarding all healthcare issues and appointments. Medication and the relevant records were seen to be stored securely, with no errors or omissions noted. 43 Freeman Street DS0000065466.V370422.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. The service users feel safe and know who to talk to if they have any problems or concerns and they are protected from abuse, neglect and self-harm as much as is possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussions and information contained in the AQAA confirmed that no complaints have been made or received since the last inspection. All three people appear to continue to be settled at 43 Freeman Street and discussions confirmed that they were happy and felt safe there. Miss Marshall confirmed that she is aware of the need to report any concerns and has continued to be proactive in notifying the Commission and social workers accordingly when any issues have arisen. Miss Marshall also confirmed that she continues to keep herself up to date with regard to adult protection and will continue to pursue relevant training for herself in this area. 43 Freeman Street DS0000065466.V370422.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26 & 30 Quality in this outcome area is good. 43 Freeman Street is a homely, comfortable and safe environment, which is clean and hygienic and people’s bedrooms suit their needs and lifestyles and promote their independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All three people living at the home have their own bedroom, one on the ground floor and two on the first floor. Two lounges provide a choice of communal areas and the kitchen provides access to a small but pleasant garden. Interior improvements have been completed since the last inspection and the whole environment is comfortable and homely. Each person’s bedroom is individual and has been personalised and one person was particularly proud of their fish tank and new music system. Overall, the home was found to be clean, hygienic and free from hazards. 43 Freeman Street DS0000065466.V370422.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33 & 35 Quality in this outcome area is adequate. Residents are well supported by the owner/manager and, following the recent resignation of the regular part-time staff member, Miss Marshall has made positive steps to recruit new staff, to help ensure people’s individual and joint needs continue to be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: It was confirmed during this inspection that the part time member of staff, who also did some sleep-in duties, would be leaving very shortly and no other staff members were currently employed. As was the situation at the previous inspection carried out on 6th April 2006, it was acknowledged that, although the three residents enjoy good levels of independence and require encouragement rather than physical help with personal care and day to day matters, it is undoubtedly tiring and unacceptable for Miss Marshall to be the sole carer on a full time basis. 43 Freeman Street DS0000065466.V370422.R01.S.doc Version 5.2 Page 17 However, following the field-visit, discussions were held and confirmation was received from Miss Marshall that a new member of staff is currently in the process of being recruited. Additionally, contact has been made between Miss Marshall and a local ’floating-support’ organisation, to provide further back-up and support if needed. As stated at the previous inspection, the need for time off and relaxation is a necessary requirement for everyone and arrangements also need to be in place to allow Miss Marshall to continue with her personal training and development. Nevertheless, as stated at the previous two inspections, it was apparent that the service users continue to be well supported in a family environment where they are respected as adults and take part in daily decision making within their home. 43 Freeman Street DS0000065466.V370422.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. Miss Marshall has commenced relevant management training and record keeping has improved greatly since the last inspection, which helps to ensure 43 Freeman Street is a well run home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection Miss Marshall has commenced training for her management qualification and a discussion, together with completed coursework, confirmed that she had completed two thirds of the required work. It was evident from observations during the inspection that the home continues to be very well run and the atmosphere felt happy, comfortable and relaxed. 43 Freeman Street DS0000065466.V370422.R01.S.doc Version 5.2 Page 19 Paperwork and record keeping have improved greatly since the last inspection and a written record, which demonstrates the involvement of residents in activities, contact with friends and family, healthcare appointments and general well being is now maintained on a regular basis, in line with a previous requirement. In respect of quality assurance, Miss Marshall confirmed in discussions and within the AQAA that team meetings, which include the residents, are held on a regular basis, daily life is structured around the wishes of the clients wherever possible, activities are centred around the requests of each individual and family are consulted to obtain and discuss their views, wherever possible. 43 Freeman Street DS0000065466.V370422.R01.S.doc Version 5.2 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 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 3 25 3 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 2 34 X 35 2 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 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X 43 Freeman Street DS0000065466.V370422.R01.S.doc Version 5.2 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. 1. Standard YA35 Regulation 9 Requirement Miss Marshall needs to create personal recreation time as well as time for continuing relevant personal training and development, by recruiting and maintaining support staff. Regular support staff need to be recruited and maintained to ensure people’s individual and joint needs can be met consistently. Timescale for action 31/10/08 2. YA33 18 31/10/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 43 Freeman Street DS0000065466.V370422.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 43 Freeman Street DS0000065466.V370422.R01.S.doc Version 5.2 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. 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