Care Home: Conniburrow Boulevard (207)

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What the care home does well People using the service are thoroughly assessed prior to admission and are given opportunity to visit the home beforehand to ensure it meets their needs. There is good regard for the diverse needs of the people living at the home and their requirements related to their disabilities, lifestyle choices and personal preferences are sought, recorded and met by the staff team, respecting their rights, choices and individuality. People using the service are involved in a wide range of activities to provide them with stimulation and contact with family, friends and the community is supported to maintain social links. Varied meals are prepared to make sure that nutritional needs are met and respecting people`s preferences and medical requirements. The health and personal care needs of people living at the home are well met, promoting health, well-being, taking into account their preferences and religious or cultural requirements and ensuring that they receive medication in a safe and consistent manner. Complaints and safeguarding of vulnerable adults are effectively managed to listen to the views of people who live at the home and reducing the risk of harm to them. The home is clean, well decorated and maintained to a good standard, promoting a positive environment for the people who live there. The home provides staff cover to meet needs and undertakes thorough recruitment procedures, coupled with effective training to ensure staff have the right skills and competencies to support the people who live there. The management and administration of the home promotes continuity and quality of care for the people who live there and ensures that risk is safely managed to reduce the likelihood of injury or harm. What has improved since the last inspection? Two recommendations made at the last inspection had been attended to, regarding training and policies and procedures. What the care home could do better: Only one recommendation has been made as a result of this inspection. A copy of the local authority`s inter-agency safeguarding procedures should be obtained for reference. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Conniburrow Boulevard (207) Conniburrow Milton Keynes Bucks MK14 7AD     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Chris Schwarz     Date: 2 9 0 5 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Conniburrow Boulevard (207) Conniburrow Milton Keynes Bucks MK14 7AD 01908 692524 01908 612524 manager.conniburrow@fremantletrust.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): Type of registration: Number of places registered: The Fremantle Trust Mrs Maria Couch care home 6 Conditions of registration: Category(ies) : People with Learning disability Additional conditions: Number of places (if applicable): 6 Date of last inspection Brief description of the care home 1 7 1 1 2 0 0 6 207 Conniburrow Boulevard is a detached property located close to the city centre in Milton Keynes. There are good transport links and leisure, recreation and shopping facilities are nearby. The home is registered to provide accommodation for up to six adults with learning disabilities and is owned and staffed by The Fremantle Trust. The property has six single bedrooms, one of which is on ground floor level. There are sufficient toilets, baths and showers and communal areas are arranged to reflect a large family type environment. There are front and rear garden areas and parking spaces are available. Care Homes for Adults (18-65 years) Page 4 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support peterchart Concerns, complaints and protection Environment Staffing Conduct and management of the home Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection was conducted over the course of a day by Chris Schwarz and covered all of the key National Minimum Standards for younger adults. The last key inspection of the service took place on 17th November 2006. Prior to the inspection, a detailed self-assessment questionnaire was sent to the manager for completion and comment cards were sent to a selection of people living at the home, staff and visiting professionals. Any replies that were received have helped to form judgements about the service. Information received by the Commission since the last inspection was also taken into account. The inspection consisted of discussion with the manager and other staff, opportunities to meet with people using the service, examination of some of the home’s required Care Homes for Adults (18-65 years) Page 5 of 27 records, observation of practice and a tour of the premises. A key theme of the visit was how effectively the service meets needs arising from equality and diversity. Feedback on the inspection findings and any areas needing improvement was given to the manager at the end of the inspection. The manager, staff and people who use the service are thanked for their co-operation and hospitality during this unannounced visit. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk.You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line – 0870 240 7535. Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection care home Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are thoroughly assessed prior to admission and are given opportunity to visit the home beforehand to ensure it meets their needs. Evidence: A statement of purpose and service users guide were in place, outlining the scope of the service and how it aims to meet the needs of people with learning disabilities. Information was also available in pictorial format. There have not been any new admissions to the home since the last inspection. At that time, the details of the last person joining the service were looked at and found to be in good order with full assessment of care needs undertaken before the person moved in. Fees for the service were £533.82 per week. Care Homes for Adults (18-65 years) Page 10 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is good regard for the diverse needs of the people living at the home and their requirements related to their disabilities, lifestyle choices and personal preferences are sought, recorded and met by the staff team, respecting their rights, choices and individuality. Evidence: Care plans were in place for each person living at the service and followed a corporate format. Essential information such as religion, ethnic origin, next of kin and doctor details and preferred form of address had been recorded, as had people’s preferred daily routine and likes and dislikes. Care needs were detailed for areas such as mobility, washing and bathing, continence, personal grooming, management of finances, general physical health, family and friends, spiritual beliefs, leisure and recreation and social activities. Information on how people communicate had been Care Homes for Adults (18-65 years) Page 11 of 27 recorded and staff training records showed that some of the team had attended a signing course to improve how they communicate. Staff were seen using preferred communication methods when engaging with service users. All documents were up-to-date to reflect current care needs and had been signed by staff and the service user. Pictorial plans had also been produced, focusing on people’s daily lives and activities. Risk assessments were in place to accompany care plans and had also been signed and kept up-to-date. The home was supporting people to take acceptable risks, such as going out independently, staying overnight at friend’s homes and being involved in relationships. All of the people living at the service required assistance with managing their money. Service users were making use of ordinary high street banks/building societies and withdraw money on a regular basis for purchases. Each person had a wallet kept in the office for safe keeping. Records were being maintained of expenditure, with receipts kept to verify spending. Money was kept secure and a check of a couple of wallets showed that actual balances tallied with recorded ones. People using the service were seen to make decisions in their everyday lives, such as what to do on their home days, where to go on holiday, what activities to participate in and what meals to have. House meetings are held regularly and minutes kept of matters discussed. The minutes showed that topics such as keyworker responsibilities, menu planning, fire safety training and safeguarding vulnerable adults had been talked about, to fully involve people in how their care is delivered. care home Page 12 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are involved in a wide range of activities to provide them with stimulation and contact with family, friends and the community is supported to maintain social links. Varied meals are prepared to make sure that nutritional needs are met and respecting people’s preferences and medical requirements. Evidence: People using the service have busy lives and make good use of the city centre for accessing shopping, leisure and recreational facilities. Since the last inspection, an activities folder has been established which notes what people have been doing. It showed a lot of community involvement, attendance at day services, shopping, holidays here and abroad, meals out, seeing family and friends and going to church. Care Homes for Adults (18-65 years) Page 13 of 27 Those people who were around during the inspection shared in looking at the folder and enjoyed a retrospective look back at what they had done and where they been and initiated conversation and laughter about memorable events. A holiday was booked for later in the year to Majorca which they were looking forward to and had made decisions about who they wanted to share a room with. People were receiving varied meals and had chosen not to plan their menus in advance but to see what was available each day and make a decision that way. This seemed to work well for the service, with a range of foods available in stock to facilitate choices and lists of people’s likes and dislikes known by staff and recorded. There was a good selection and ample quantity of fresh fruit in the dining room that people were free to help themselves to. People going to day services take a packed lunch with them and had a choice of items to add to their lunch box such as biscuits, crisps, yogurt and fruit, as well as their sandwiches. Healthy options were available at the service, such as low fat spreads, sugar substitute, low fat milk and sugar free jam. care home Page 14 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care needs of people living at the home are well met, promoting health, well-being, taking into account their preferences and religious or cultural requirements and ensuring that they receive medication in a safe and consistent manner. Evidence: Care plans provided up-to-date details of any assistance people needed with daily living tasks. Weights were being monitored and recorded and nutritional risk assessments were in place. In the file of one person who is diabetic there was useful information about the condition and how it is managed plus nutritional information to make sure an appropriate diet is followed. Staff were also maintaining records of blood glucose levels and liaising with the diabetic specialist nurse. A recommendation made at the last inspection regarding training in the use of an insulin Epipen was being met, with further training planned to keep skills refreshed. None of the people using the service requires use of a hoist or adapted bath. There Care Homes for Adults (18-65 years) Page 15 of 27 are showers or baths to choose from. One person with limitations to mobility has a downstairs bedroom with a bathroom next door to it. People living at the home were making use of community health care facilities, such as doctors, dentists, opticians and the consultant psychiatrist in learning disabilities. Routine health screening was being undertaken regularly and preventative measures such as influenza vaccination was taking place where people wanted this. Medication was being managed using a monitored dose system whereby the pharmacist pre-packs tablets into blister packs. The medication cabinet was secure and kept locked when not in use. A medication fridge was in place for storage of insulin and was being maintained within an appropriate temperature range. There was a medication policy in place to provide guidance to staff. All staff handling medicines had been trained to a good standard and medication administration records were up-to-date; a photograph of each person was in the medicines folder, for easy identification. One person who had been diagnosed many years ago with epilepsy had been successfully withdrawn from anti-convulsive treatment under medical supervision. care home Page 16 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints and safeguarding of vulnerable adults are effectively managed to listen to the views of people who live at the home and reducing the risk of harm to them. Evidence: The service had a complaints procedure and whistle blowing procedure in place. In the pre-inspection self-assessment the manager said that there had not been any complaints since the last inspection and the complaints log verified this. No complaints have been made direct to the Commission in this time. People using the service and their families have been given a copy of the complaints procedure and a pictorial version is also available. Staff said in surveys that they were aware of what to do in the event of anyone raising concerns about care practices. A safeguarding procedure was in place in the event of any suspected or actual abuse. No incidents of abuse had been reported to the Commission by the home or any other source, and none were indicated in the pre-inspection self-assessment. Minutes of house meetings showed that people using the service are reminded of complaints and safeguarding procedures. Staff training records showed that staff were up-to-date with safeguarding training and the manager is a trained facilitator. The only matter raised with the manager was a need to obtain a copy of the local authority’s interagency safeguarding procedures, for reference. A recommendation is made to this Care Homes for Adults (18-65 years) Page 17 of 27 effect. One of the care plan files that was looked at on this occasion contained details of known challenging behaviour, possible triggers and intervention. Incidents of challenging behaviour were reported to be reduced for one person who has been case tracked over previous inspections of the service. The stability of the staff group and the acquired skills and knowledge staff have of service users and their behaviours is a significant factor in this reduction. care home Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean, well decorated and maintained to a good standard, promoting a positive environment for the people who live there. Evidence: The home is within walking distance of the city centre where there are a wealth of shops, leisure, recreation and sports facilities and good transport links. Closed circuit television has been added to the front and rear of the building to deter troublesome individuals in the area. The home is a detached property with single bedrooms, one of which is on the ground floor, and has two bathrooms and a shower room plus a separate toilet. Bedrooms had been personalised by each person and were in a good state of décor. Each room had plenty of light and radiators were covered to prevent accidental injury. Décor was in good condition, with various parts of the home re-decorated since the last visit. The lounge was looking very modern with the purchase of new furniture that was comfortable and good quality. The dining room is adjacent to the kitchen and provides a comfortable and homely area for people to eat their meals and also to just sit and talk in. The kitchen had some improvements such as new sinks and worktops Care Homes for Adults (18-65 years) Page 19 of 27 and is a good size for the home. The laundry was in good order and clean with cleaning products locked away safely. Standards of cleanliness were good with kitchen, bathroom and laundry areas kept clean and staff showing good regard for infection control. care home Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides staff cover to meet needs and undertakes thorough recruitment procedures, coupled with effective training to ensure staff have the right skills and competencies to support the people who live there. Evidence: The service had a stable staff group and there had not been any newly recruited people since the last inspection. One person had retired. The previous inspection showed that recruitment was being done thoroughly with all required checks carried out as necessary before new staff started at the service. Staff act as keyworkers and those people met during the course of the inspection knew who their keyworker was and had been advised of keyworker responsibilities in one of their house meetings. All staff had achieved National Vocational Qualification level 2, three had done level 3 as well and another two people were doing it. One person was also doing the assessor’s award. The manager had achieved level 4 in care. Rotas were being maintained to provide safe levels of staff support and to facilitate Care Homes for Adults (18-65 years) Page 21 of 27 service users going out and accessing the community. No agency staff have been needed. Staff said in surveys that they are ‘always’ given up-to-date information about people using the service. They said they had been given a good induction to equip them with the skills they needed and receive good amounts of training to help support service users and understand their needs. They said they ‘regularly’ have opportunities to meet with the manager to discuss their work and for support and described good communication at the home. They considered there are ‘always’ enough staff to meet individual needs. Training records of five staff showed that mandatory courses were up-to-date. Staff had attended training on non-aggressive intervention for people who challenge the service and infection control, the health and safety representative had attended appropriate training and all medication handlers had done good quality training. Two staff had attended a signing workshop and two had attended a course on promoting positive interventions for people with autistic spectrum disorder. The manager is a safeguarding adults facilitator and is also a moving and handling trainer. care home Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home promotes continuity and quality of care for the people who live there and ensures that risk is safely managed to reduce the likelihood of injury or harm. Evidence: The home’s manager is registered with the Commission and has extensive experience of social care. She has achieved the Registered Managers Award and National Vocational Qualification level 4 in care. Staff and people using the service were at ease with her. She had attended to the two recommendations made at the last inspection and had notified the Commission recently when one person needed to be admitted into hospital. The provider monitors the service on a regular basis and the operations manager carries out additional monitoring as well. Copies of reports of these visits were Care Homes for Adults (18-65 years) Page 23 of 27 available to see in the office. A quality audit had been carried out in February this year although the report had not been sent to the home at the time of this visit. Health and safety was in good order. In the kitchen, core food temperatures were being monitored and recorded, temperature checks of frozen food shopping were noted and fridge and freezer temperatures were being monitored daily. Descaling of taps, the kettle and shower heads was taking place and a pest control contractor wrote in his annual inspection in October 2007 that ‘hygiene conditions are good.’ There was an up-to-date gas safety certificate and a certificate of satisfactory electrical installation. Portable electrical appliances had been tested in July last year and thermostatic valves had been serviced earlier this year. There was a generic risk assessment and fire based risk assessment in place and only one accident since the start of 2007. care home Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 16 23 A copy of the local authority’s inter-agency safeguarding procedures should be obtained for reference. Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - 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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