Inspection on 26/09/05 for 102 London Road

This inspection was carried out on 26th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

102 London Road 14/12/06

102 London Road 06/02/06

102 London Road 01/02/05

102 London Road 28/09/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 102 London Road Widley Portsmouth Hampshire PO7 5AB Lead Inspector Pat Hibberd unannounced 26/09/05 9.00am 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. 102 London Road H54 S56837 102 London Road V218686 260905.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 102 London Road Address Widley, Portsmouth, Hampshire, PO7 5AB 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 9232 7220 Mr David Rodgers Mrs Julie Denise Champion CRH 4 Category(ies) of LD registration, with number of places 102 London Road H54 S56837 102 London Road V218686 260905.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 01/02/05 Brief Description of the Service: 102 London Road is a care home providing accommodation for 4 adults with a learning difficulty. It is owned by Mr and Mrs Rodgers, who also own other registered premises, and managed on a daily basis by Mrs Champion. The home is located on the main Portsmouth to Waterlooville road with there being easy access to the local shops and public transport services.There is accommodation on the ground and first floors with bedroom accommodation comprising of four single rooms , one having an ensuite. Day space within the home is provided for by way of a combined lounge/dining room with an adjoining conservatory.It is a detached property with front and rear gardens, the rear garden providing opportunities for service users to pursue light horticultural activities if they wish. There is readily available car parking immediately to the side of the property for two to three vehicles. 102 London Road H54 S56837 102 London Road V218686 260905.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over three hours and was the first of the 2005/2006 inspection programme. Thirteen of the forty-three standards relating to younger adults were assessed. There were two areas of improvement identified on this occasion, details of which can be found in the main body of the report. The inspection included a tour of the home and garden. Discussions were held with two residents and two staff members on duty. The Registered Provider David Rodgers assisted the inspector throughout the inspection due to the Registered Manager Julie Champion being on holiday. Prior to the inspection the Home was sent a self-assessment questionnaire relating to care provision, staffing, the environment and health and safety in the home. This was completed and returned to the Commission prior to the inspection and contributed to the findings as detailed in this report. Three comment cards were received from relatives. All praised the service in terms of communication with the staff team and the overall care provided. A further four comment cards were received from residents. Residents advised that they liked living in the home, felt involved in decisions reached about their home and, that they considered the staff treat them well. One resident indicated that they “liked sky TV ,felt well cared for and would know who to talk to if they were unhappy”.. Three resident’s files were viewed which further contributed to the findings of the inspection. What the service does well: What was evident throughout the inspection was the commitment to ensuring residents are central to all care provided and lead a full and positive life style. Residents are involved in a range of community based activities and are encouraged to be as independent as possible within a risk management framework of care. 102 London Road H54 S56837 102 London Road V218686 260905.doc Version 1.30 Page 6 The Home was comfortably furnished with a planned programme of redecoration in some communal areas to shortly take place. Staff indicated that they feel well supported , receive ongoing training and regular supervision. 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. 102 London Road H54 S56837 102 London Road V218686 260905.doc Version 1.30 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 102 London Road H54 S56837 102 London Road V218686 260905.doc Version 1.30 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) 2 There is a comprehensive assessment process ensuring residents’ needs are identified by the Home prior to admission. EVIDENCE: There have been no new admissions to the Home since the last inspection. However, the provider confirmed that there are systems in place to ensure prospective residents needs are assessed by a suitably experienced and competent person from the home. The information was not available and will be followed up at the next inspection. A care management assessment would also be obtained. 102 London Road H54 S56837 102 London Road V218686 260905.doc Version 1.30 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 and 9 Some improvement is required to ensure residents needs are fully assessed, care plans are reflective of those needs and risk assessments are compiled in areas identified. Staff support residents to make decisions as to their chosen lifestyle. EVIDENCE: Three resident’s files were viewed and the care was discussed with staff and the Registered Provider, David Rodgers. Observations were also made about how care was delivered in the Home. The care plans had a range of information relating to the individuals and the support required to ensure their needs are being met including risk assessments which are constantly monitored and reviewed . However, when discussing further the medical support needs of one resident at night it was evident that the current risk assessment did not contain sufficient detail and is required to be re written . Mr Rodgers indicated that he would be contacting all professionals involved in the individual’s life on the day of the 102 London Road H54 S56837 102 London Road V218686 260905.doc Version 1.30 Page 10 inspection to arrange a multi disciplinary meeting to address the needs identified. This will be followed up at the next inspection. Time was spent with two residents to enable the inspector to observe practices in the Home. Particular emphasis was placed on staff communication with the two residents in relation to how they were to spend their day and how it reflected identified needs in their care plan. It was evident that staff were aware of resident’s needs and care plans were being implemented with choice and support being offered to enable residents to make decisions as to their day ahead. One resident was able to explain how they had choices as to how their bedroom was decorated and how staff supported them to wash their hair in the shower. Resident meetings are held regularly when service provision is discussed . There is a key worker system in operation in the Home and in discussion with staff it was evident that they were aware of resident’s needs , were involved in the review of their care and felt confident in the support they provided. They indicated that the manager endeavoured to ensure care plans were easily accessible, information shared on a daily basis and daily records completed for all residents with shift “handovers” taking place with a view to ensuring continuity of care. To ensure staff are fully aware of resident’s needs in the event of a fire evacuation risk assessments must also be undertaken for all individual residents and kept under review. 102 London Road H54 S56837 102 London Road V218686 260905.doc Version 1.30 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) No standards were inspected on this occasion. EVIDENCE: 102 London Road H54 S56837 102 London Road V218686 260905.doc Version 1.30 Page 12 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) 18,19 and 20 There is evidence of good multidisciplinary working taking place on a regular basis although some improvement is required to ensure all health needs of residents are met. The Home has a satisfactory medication policy and procedure . EVIDENCE: All residents have access to a GP, dentist, optician and chiropodist with two care plans viewed confirming that residents have access to health professionals as required including the local Community learning disability health team. Details of preferred personal support needs for residents were found in the three files viewed and were generally very detailed and informative and demonstrated that the information was based on observation and knowledge of individuals by the staff team. Staff were not observed supporting residents with their personal care although one resident explained that staff help them with washing their hair which they find very helpful. 102 London Road H54 S56837 102 London Road V218686 260905.doc Version 1.30 Page 13 However, as detailed in section 2 of the report one file viewed indicated that consultation is required to take place with relevant professionals to ensure a care plan and risk assessment is reviewed and rewritten where necessary for one resident in relation to their specific medical needs at night. Due to the needs of one resident who is prescribed rectal diazepam the manager is also required to ensure that there is documented evidence to confirm that staff have undertaken rectal diazepam training by a suitably trained professional who is responsible for the monitoring and reviewing of that training. There are currently no residents who self medicate . The provider indicated that this is due their specific needs . All eight staff members have received training in safe handling of medication with records confirming that medication administered is signed for on a daily basis. Medication is securely stored in a lockable cupboard with the manager or senior member of staff on duty responsible for holding the key. There are satisfactory systems in place for the receipt and disposal of medication. The medication policy and procedure for the home was viewed and was satisfactory. 102 London Road H54 S56837 102 London Road V218686 260905.doc Version 1.30 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 and 23 The home has a suitable complaints policy and procedure ensuring residents know what to do if they have a complaint. Arrangements for protecting residents are satisfactory. EVIDENCE: The Home has a detailed complaints policy and procedure of which all residents have a copy in a format suitable for their individual needs. One resident spoken to indicated that they would talk to the staff or Home’s manager if they were unhappy. Details of the Commission’s telephone number and address is available if residents wished to speak to an inspector. It is acknowledged however, that they would require support to do so and advocates and families are involved where required. There had been no complaints made since the last inspection. The staff team have undertaken abuse training and were able to demonstrate an understanding of the reporting procedures. Mr Rodgers indicated that a copy of the joint Hampshire Adult protection policy and procedure was available to staff and held in the Home of which staff confirmed they were aware of. Residents have access to their weekly personal allowance with the manager being appointee for one resident. All residents have lockable storage in their bedrooms. 102 London Road H54 S56837 102 London Road V218686 260905.doc Version 1.30 Page 15 A discussion was held with a staff member as to how one resident is supported to access their money on a weekly basis. The process was deemed to be satisfactory. 102 London Road H54 S56837 102 London Road V218686 260905.doc Version 1.30 Page 16 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) 24 and 30 Residents live in a clean, well maintained, suitably furnished comfortable environment which will be further enhanced on completion of the planned decoration. EVIDENCE: The Home was clean, bright and hygienic with policies and procedures and systems in place including infection control /Control of Substances Hazardous to Health ( COSHH )/food hygiene and moving and handling training for staff . Mr Rodgers indicated that staff were aware of their responsibilities in relation to hygiene in the Home, were provided with gloves and aprons as required and had received infection control training. This was confirmed from one staff member spoken to. Hand washing facilities were seen in the kitchen and bathroom of the Home. One resident explained that the Home environment is very comfortable with suitable furnishings to meet their needs including ample seating in the communal area, a large conservatory and separate dining room. 102 London Road H54 S56837 102 London Road V218686 260905.doc Version 1.30 Page 17 The Home is located close to shops, leisure facilities and public transport although the Home has their own transport available for residents. The statutory fire officer has not inspected the Home this year . However, there was evidence throughout the Home of clear signage in relation to fire instruction /evacuation and exits. Smoke alarms are fitted as is a fire alarm system. One resident and one staff member spoken to explained the procedure in the event of a fire in the Home. Some of the communal areas of the Home required decoration. However, there is a planned maintenance and renewal programme in place for the fabric and decoration of the premises with David Rodgers indicating that decoration in some communal areas is to shortly take place. This will be followed up at the next inspection. 102 London Road H54 S56837 102 London Road V218686 260905.doc Version 1.30 Page 18 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) 35 and 36 The Home has a well trained and supervised staff team ensuring residents needs are appropriately met. EVIDENCE: The Home has a staff development and training programme with the manager ;alongside the Registered Provider, Mr Rodgers having responsibility for the budget and training programmes. The Home has a staff team of eight. Two have completed NVQ ( National Vocational Qualification) 2 and two are currently undertaking the qualification. All new staff receive a thorough induction with one staff member indicating that the process had been very informative and supported by the manager. The majority of staff have undertaken a range of training which includes : moving and handling, first aid , fire safety, food hygiene, medication administration , COSHH, infection control, rectal diazepam /epilepsy, Adult Protection and health and safety. 102 London Road H54 S56837 102 London Road V218686 260905.doc Version 1.30 Page 19 One staff member spoken to confirmed that they feel well supported , receive regular supervision, yearly appraisals and ample training opportunities. Please refer to Standard 20 in relation to the documenting of rectal diazepam training. There have been no agency staff used in the Home since the last inspection. David Rodgers confirmed that both himself and the manager are undertaking the Registered Manager’s Award and NVQ level 4 in care. 102 London Road H54 S56837 102 London Road V218686 260905.doc Version 1.30 Page 20 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) No standards were assessed on this occasion. EVIDENCE: 102 London Road H54 S56837 102 London Road V218686 260905.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 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 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x x x x x x x Standard No 31 32 33 34 35 36 Score x x x x 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 102 London Road Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x x x H54 S56837 102 London Road V218686 260905.doc Version 1.30 Page 22 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. 2. Standard Regulation Requirement Timescale for action 20 13 3. 9 13 The Registered Providers must 10/10/200 ensure there is documented 5 evidence to confirm that staff have undertaken rectal diazepam training by a suitably trained professional who is responsible for the monitoring and reviewing of that training. This must be kept under review. The Registered Providers must 27/9/2005 ensure fire evacuation risk assessments are undertaken for all individual residents and kept under review. 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 Good Practice Recommendations 102 London Road H54 S56837 102 London Road V218686 260905.doc Version 1.30 Page 23 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 © 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 102 London Road H54 S56837 102 London Road V218686 260905.doc Version 1.30 Page 24 - 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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