CARE HOME ADULTS 18-65
1 Ford Road Gosport Hampshire PO12 3ET Lead Inspector
Michael Gough Unannounced 26 July 2005 - 1:30pm 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 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 Stationary 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. 1 Ford Road H54 S11676 1 Ford Road V240807 260705 FINAL 240805.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service 1 Ford Road Address Gosport Hampshire PO12 3ET Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 023 9250 1001 Hampshire Autistic Society Miss Nicola Chartlotte Hobbs CRH 5 Category(ies) of LD - Learning Disability (5) registration, with number of places 1 Ford Road H54 S11676 1 Ford Road V240807 260705 FINAL 240805.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Service users in the category LD not to be admitted under 18 years. Date of last inspection 7 December 2004 Brief Description of the Service: 1 Ford road is a small home for up to 5 younger adults, with autism and associated learning disabilities. It is run by the Hampshire Autistic Society (H.A.S). The home is situated in a quiet residential area of Gosport and is close to local shops and is on a regular bus route to both Gosport and Fareham town centres. Accommodation is over two floors with all service users having their own bedroom on the first floor. There is a large newly fitted kitchen, dining room and large lounge, which provides communal space in excess of the National Minimum Standards (NMS). There is an enclosed rear garden laid to lawn with a patio area, which has a table and chairs for use in the warmer months. 1 Ford Road H54 S11676 1 Ford Road V240807 260705 FINAL 240805.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. An unannounced inspection was carried out on the 26 July 2005. The homes manager was not available at the time of the inspection and the 2 care workers on duty assisted the inspector throughout. The inspection was carried out over 3 hours and the inspector received comment cards from 4 relatives of service users and also cards from 4 Service users, further evidence for the inspection was obtained by touring the premises, viewing records, it was also possible to speak with 2 of the 5 service users currently living in the home and 2 members of staff who were on duty. What the service does well: What has improved since the last inspection? What they could do better:
The inspection report will make 1 requirement and 1 recommendation to the home, which will help improve the service provided for residents. It was noted
1 Ford Road H54 S11676 1 Ford Road V240807 260705 FINAL 240805.doc Version 1.40 Page 6 that care plans are formally reviewed at six monthly intervals and that monthly reviews are undertaken by key workers, however there is no record kept that monthly reviews have taken place. It is a requirement that care plans must be reviewed monthly and that theses reviews are recorded. It was also noted that service users have 3 hours per month allocated as one to one support sessions, service user’s files contained some reports of these one to one support sessions, however more accurate recording of these sessions are required to fully evidence that this support takes place every month. It is recommended that accurate records of one to one support session be kept by the home. 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. 1 Ford Road H54 S11676 1 Ford Road V240807 260705 FINAL 240805.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection 1 Ford Road H54 S11676 1 Ford Road V240807 260705 FINAL 240805.doc Version 1.40 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 Prospective service users are given the information they need to make an informed choice about the home to enable them to decide if they would like to move in. EVIDENCE: The homes statement of purpose contained all of the information required in the National Minimum Standards and a copy of the statement of purpose, together with the Service Users Guide is kept at the home and copies are available to service users or their family on request. 1 Ford Road H54 S11676 1 Ford Road V240807 260705 FINAL 240805.doc Version 1.40 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8 & 9 Service users assessed needs and personal goals are reflected in their individual plan of care, 1 requirement and 1 recommendation was made to ensure that care plans are reviewed monthly and that records of one to one support sessions are recorded. Service users are able to make decision about their lives with assistance give by staff as required. Service users are consulted on and participate in all aspects of life in the home with support given as required and they are supported to take responsible risks as part of an independent lifestyle. EVIDENCE: Care plans were seen for 3 service users and these have been slimmed down as a result of a recommendation made at the last inspection. Care plans were clear and easy to follow and they contained all relevant information, formal reviews were carried out at six monthly intervals and review notes were kept on file, however there were no records of monthly reviews taking place and a requirement was made to address this issue. It was also noted that service users should have a 3 hour one to one session with their key worker once per month, records in one service users file showed that these session only took place in January, March and April of this year, there was no evidence that these session had taken place for February, May or June. A recommendation was made for accurate recording of these one to one sessions. Service users
1 Ford Road H54 S11676 1 Ford Road V240807 260705 FINAL 240805.doc Version 1.40 Page 10 have their own meetings and this gives them the opportunity to be involved in decision making within the home. Service users confirmed that they are able to make decision about their lives. There was evidence that service users are consulted on a one to one basis at their 1-1 sessions. Staff was observed interacting with service users and service users were seen to be consulted. Risk assessments are undertaken for all service users and these are contained in the individual service users file. Service users are supported to be involved and participate in all aspects of life in the home and give feedback through questionnaires, one to one and through their own meetings. Risk assessments are kept in a separate file at the home and these are currently being amended to give more information to staff on how to minimise any potential risks. 1 Ford Road H54 S11676 1 Ford Road V240807 260705 FINAL 240805.doc Version 1.40 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 12, 14, 15, 16 & 17. Service users are supported to take part in age, peer and appropriate activities and they access the local community on a daily basis. Service users engage in appropriate leisure activities and the homes visiting policy supports service users to maintain family links and friendships both inside and outside the home and service users rights are respected. Relationships with family are appropriate and sexuality/sexual relationships are respected. The daily routines and house rules promote independence, individual choice and freedom of movement, subject to restrictions agreed in the individual Plan. Service users are offered a healthy diet and meal times are unhurried. EVIDENCE: All service users attend a local day service and all have individual programmes, which include woodwork, arts and crafts, swimming, attending an outdoor activities centre and gardening. Service users spoken to stated that they enjoyed going to day service and service users files contained day service reviews which showed that activities are changed on a regular basis. Service users are supported to go on holiday with staffing arrangements agreed with the area manager on an individual basis to ensure that service users receive
1 Ford Road H54 S11676 1 Ford Road V240807 260705 FINAL 240805.doc Version 1.40 Page 12 the support they require. Staff and service users confirmed that service users walk down to the local shops and are well known in the local area. All service users are on the electoral register and are able to vote if they so wish. Visitors to the home are welcome at any time and the home has a visiting policy, which gives clear information. There are appropriate policies and procedures in place with regards to sexuality/sexual relationships. Staff at the service were seen to treat service users with dignity and respect, they always used the service users preferred form of address and staff and service users were seen to get on well together. Service users receive their mail unopened and are supported by staff as required. Service users spoken to said that they enjoyed their meals at the home and liked to be involved in the planning and preparation of meals. Staff supports service users to make up their own packed lunch, which they take with them to day service. 1 Ford Road H54 S11676 1 Ford Road V240807 260705 FINAL 240805.doc Version 1.40 Page 13 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 20 Service users are supported with their medication and are protected by the homes policies and procedures. EVIDENCE: The home operates the Boots blister pack system and the local pharmacist has provided training to staff at the home with regard to medication. The corporate medication policy is currently being reviewed, however the home has developed an “in house” medication and administration policy that gives clear guidance to staff on the procedure to be carried out when administering medication. Administration records were clearly recorded and up to date. 1 Ford Road H54 S11676 1 Ford Road V240807 260705 FINAL 240805.doc Version 1.40 Page 14 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 Service users views are listened to and acted upon and service users are protected from abuse, neglect and self-harm. EVIDENCE: The home has a comprehensive corporate complaints procedure, which includes details of who would investigate complaints together with timescales. The complaints procedure also gave details of how to contact the Commission for Social Care Inspection. There is also a simple to follow “in house” complaints procedure for service users, which has pictures and symbols and this is used in conjunction with the corporate policy. Service users and staff were aware of the homes complaint procedure. The home has a copy of the Hampshire Adult Protection procedure and has a whistle blowing policy and a copy of the department of health guideline “No Secrets” staff also receive training with regard to adult protection and POVA as part of their induction. Staff members spoken to were aware of their responsibilities in this area. 1 Ford Road H54 S11676 1 Ford Road V240807 260705 FINAL 240805.doc Version 1.40 Page 15 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: 1 Ford Road H54 S11676 1 Ford Road V240807 260705 FINAL 240805.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were inspected on this occasion. EVIDENCE: It was not possible to view recruitment records at this inspection as these were kept in locked cabinets and the care staff did not have access to these files, as they were confidential. It was therefore not possible to establish if the requirement made at the last inspection with regard to staff records being kept at the home has been addressed and this issue will be followed up at the next inspection. However should the home fail to have appropriate records as described in schedule 4 of the Care Home Regulations in place at the next inspection, the Commission for Social Care Inspection would view this as a matter of serious concern. 1 Ford Road H54 S11676 1 Ford Road V240807 260705 FINAL 240805.doc Version 1.40 Page 17 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 The home is aware of its responsibilities with regard to the health, safety and welfare of staff and service users, and these are promoted and protected. EVIDENCE: The inspector looked at fire records and these were accurate and up to date with regard to training, there were also records of fire alarms test, emergency lighting and fire fighting equipment tests. Test certificates were in date for the homes electrical system and associated equipment and the next test dates due are: Gas Safety Certificate in October 2005, the home Electrical Wiring in February 2010 and for Portable Electrical Equipment April 2006. 1 Ford Road H54 S11676 1 Ford Road V240807 260705 FINAL 240805.doc Version 1.40 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 x x x x Standard No 22 23
ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 2 3 3 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
1 Ford Road Score x x 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x H54 S11676 1 Ford Road V240807 260705 FINAL 240805.doc Version 1.40 Page 19 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 6 Regulation 15 Requirement It is a requirement that care plans must be reviewed monthly and that theses reviews are recorded Timescale for action 10/9/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 6 Good Practice Recommendations It is recommended that accurate records of one to one support session be kept by the home. 1 Ford Road H54 S11676 1 Ford Road V240807 260705 FINAL 240805.doc Version 1.40 Page 20 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton Hampshire SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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