Inspection on 20/06/06 for 102A Brockhurst Road

This inspection was carried out on 20th June 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

102A Brockhurst Road 13/12/05

102A Brockhurst Road 06/07/05

102A Brockhurst Road 26/10/04

102A Brockhurst Road 10/05/04

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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 102A Brockhurst Road Gosport Hampshire PO12 3DG Lead Inspector Mr Ian Craig Unannounced Inspection 20th June 2006 10:30 102A Brockhurst Road DS0000028732.V298630.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 102A Brockhurst Road DS0000028732.V298630.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. 102A Brockhurst Road DS0000028732.V298630.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 102A Brockhurst Road Address Gosport Hampshire PO12 3DG 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) Hampshire Autistic Society Miss Kerrie Louisa Clark Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 102A Brockhurst Road DS0000028732.V298630.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th December 2005 Brief Description of the Service: 102A Brockhurst Road is a semi-detached property situated up a short drive and is close to local shops and amenities. The home is close to a local bus route, which runs into the town centre of Gosport and also into Fareham town centre. The home is run by the Hampshire Autistic Society (HAS) and is registered with the Commission for Social Care Inspection (CSCI) to provide support, care and accommodation for four younger adults who have a Learning Disability. The home was purpose built approximately 4 years ago and meets all of the national minimum standards with regard to the physical environment. The weekly fees for the home are £1,279.00 to £1,329.00. 102A Brockhurst Road DS0000028732.V298630.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and arranged so that the inspector could meet the residents and staff. Unfortunately, when the inspector arrived all the residents were attending day centre activities and only the acting manager was available from the staff group. This inspection is based on examination of documents, policies and procedures, the pre inspection questionnaire completed by the home, a tour of the building, as well as discussions with the acting manager and his line manager. Comment cards were sent to the service users but none were returned. What the service does well: Each of the residents has a programme of activities for education, occupation and leisure. Written assessments and care plans are comprehensive and are of a good standard with the exception that there was a lack of review and updating following an incident of aggression by a resident. The care plans detail how personal care and independence are promoted as well as how behaviours are handled. Residents are central to the home’s operation, are able to choose activities and contribute to decision making in the home. Medication procedures are of a good standard and include detailed descriptions of scenarios when staff should administer ‘medication as required.’ Residents are able to make choices about activities and make full use of community facilities such as the cinema and local pubs. Food is provided on the basis of a healthy diet and the personal wishes of the residents. The home assists residents in having an annual holiday at places such as holiday camps or with their relatives. The service contributes to the payment of the holidays. The home is purpose built and is suited to the needs of the residents. Each bedroom has an en suite bathroom, which includes a wash hand basin, a shower and a toilet. Residents are able to express themselves by decorating and personalising their rooms. There is a training programme for staff, which includes specialist areas such as dealing with challenging behaviour. Individual staff supervision takes place as well as annual staff appraisals. 102A Brockhurst Road DS0000028732.V298630.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 102A Brockhurst Road DS0000028732.V298630.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 102A Brockhurst Road DS0000028732.V298630.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Whilst the home has not admitted any new residents there is a procedure to ensure that the home only provides a service to those whose needs it can meet. EVIDENCE: Due to the home not admitting any new residents assessment of this standard is limited. From discussion with the ‘acting manager,’ it was clear that anyone referred to the home for possible admission would be assessed to determine if the home could meet the person’s needs following which there would be a process whereby the potential resident could visit and spend time at the home in order that he/she could decide if it was suitable. This process would also involve close liaison with referring social services care manager. 102A Brockhurst Road DS0000028732.V298630.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Written assessments and care plans are of a good standard with the exception of the need to review and update guidelines where there is challenging behaviour. The home operates with the residents’ involvement in decision-making and residents are able to take risks in developing independence. EVIDENCE: Records of assessments of need and care plans are of a good standard, being comprehensive and very informative. A sample of case records showed evidence of regular review, monitoring and consultation with the residents and their representatives. Case records are subdivided and include the following areas: • Behaviour profile • Current risk assessment • Current life skills • Current life plan, including reviews • Current action sheet and status report • Current guidelines training programme 102A Brockhurst Road DS0000028732.V298630.R01.S.doc Version 5.2 Page 10 • • Monthly review analysis Daily report Written risk assessments are also well recorded and show that residents are safeguarded to take risks as part of promoting independence. Strategies for dealing with specific behaviours are detailed and comprehensive, giving clear guidelines for staff in managing challenging behaviours. These are based on the principles of specialist training and advice in the ‘Strategies for Crisis Intervention Prevention’ (SCIP) supplied by trainers accredited by British Institute of Learning Disability. Following one significant incident involving challenging behaviour it was noted that, whilst staff had acted appropriately, the care plans had not been reviewed and updated to give guidance on how a similar incident would be handled. Case recording, records of Service User Meetings and discussions with the home’s management demonstrated that the residents are involved in decision making in the home, including choosing furniture, holidays, activities and menu plans. The home’s management described plans to involve residents further in decision making in the home, such as contributing the process of recruiting staff. 102A Brockhurst Road DS0000028732.V298630.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents are able to develop independent living skills and attend a variety of activities in the local community. A healthy diet is provided. EVIDENCE: Care plans set out how residents are assisted in maintaining and developing independence for routines in personal care and daily chores in the home. Each of the residents has a full programme of daily activities. Most residents attend a day service facility also run by Hampshire Autistic Society. Residents are able to attend an alternative to the day service scheme, for instance, one person attends a cookery course at a local college. There are also opportunities for residents to develop cooking skills in the home. Various social activities are available and records of meetings with service users showed how they are able to suggest meals, outings and other activities that they would like. Community facilities are used and include the local public house and trips to the cinema. The home has access to its own transport 102A Brockhurst Road DS0000028732.V298630.R01.S.doc Version 5.2 Page 12 vehicle, owned by the Hampshire Autistic Society. There are plans for the home to have its own transport vehicle in the near future. Holidays are arranged and provided for each of the residents. These are funded partly by the service and partly by the resident. Staff took one resident to the south of France, one to Euro Disney and two went to a holiday camp accompanied by staff for 5 days. Records and discussions with the home’s management showed how residents are assisted in maintaining family relationships. Residents also have opportunities for attending events where they can socialise. One resident is assisted to use the Internet to contact his relatives by e-mail. The home’s management are aware of ensuring the rights of residents with a learning disability. Residents are able to have a key to their bedroom door if they wish, but each of the present residents has declined this. Documented consent to this is not recorded and the inspector suggested that this would further demonstrate that each person has been offered a key to his or her room. Communication aids are used in the home to assist each resident on a daily basis. Staff have access to training in disability awareness. The home’s menu plans show a varied, nutritious and balanced diet. Records of meetings of residents show that the residents are able to suggest preferred meals. Examination of the food stocks showed ample quantities of fresh fruit and vegetables as well as food and drinks for special occasions such as watching world cup football on television. Residents are supported to prepare their own packed lunch to take to day services. 102A Brockhurst Road DS0000028732.V298630.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home ensures that residents’ personal care, physical and emotional health needs are met. Policies and procedures ensure that medication needs are met, although the provision for staff training in this area could be improved. EVIDENCE: The service promotes individuals in maintaining and developing independent living skills regarding daily personal care routines. Comprehensive records and assessments detail how each person is supported with these tasks and the level of staff support required to maintain and develop independence. Each individual resident’s case records show that health needs are addressed. These include a format for monitoring that each person’s health needs are checked by the following professionals: dentist, optician, general practitioner, chiropodist and psychologist as well as other relevant health professionals. Medication policies and procedures are satisfactory with the exception of training for staff. Each new staff member’s induction includes medication procedures and a record is made to acknowledge that this has taken place. Whilst there is no suggestion that the policies and procedures for medication 102A Brockhurst Road DS0000028732.V298630.R01.S.doc Version 5.2 Page 14 are not adhering to pharmaceutical guidelines, the provision of training for staff and management in this area needs to be improved. There is no input to this training from any outside agency aside from the supplying pharmacist. The standards refer to the provision of ‘accredited training’ and whilst this is not specific regarding the type and extent of training, the service should not be solely reliant on its own ‘in house’ training. Records showed that medication is administered as prescribed. Case records detail the circumstances when medication ‘as required’ should be administered. Regular checks are made to ensure the safe storage and administration of medication. 102A Brockhurst Road DS0000028732.V298630.R01.S.doc Version 5.2 Page 15 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 the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The service ensures that residents are listened to and are protected from abuse. EVIDENCE: The provision of service users’ meetings, and the evidence of choice in many areas, leads to the conclusion that the home places residents’ views at the centre of how daily routines are organised. Staff receive training in specialist communication techniques. The complaints procedure is available to each resident in a pictorial format so that is easier to understand; a copy of the procedure was found in each person’s bedroom. There are policies and procedures as well as training for staff in the principles of protecting vulnerable persons with a learning disability from abuse. Staff receive training in dealing with physical interventions from the organisation’s own staff who have received appropriate training qualifying them to instruct staff in procedures entitled Strategies for Crisis Intervention Prevention (SCIP) which is approved by the British Institute for Learning Disability. Procedures for staff to following when dealing with challenging and aggressive behaviour is referred to in the Individual Needs and Choices section of this report. There are written policies and procedures for handling residents’ finances. This includes a system of recording of any amounts held, deposited and withdrawn. At the time of the inspection these records were not available as they were being held at the local office during the period of the manager’s maternity leave. 102A Brockhurst Road DS0000028732.V298630.R01.S.doc Version 5.2 Page 16 102A Brockhurst Road DS0000028732.V298630.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 27, 28 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. b The home’s physical environment is clean and well suited to the needs of the residents who are able to express their individual tastes and preferences in bedrooms and communal areas. EVIDENCE: The home is purpose built. Each bedroom has an en suite bathroom, which includes a toilet, shower and washbasin. In addition to this the home has communal bathrooms including a bathroom with a bath. Each resident’s bedroom was seen, and reflected the individual tastes and interests of the occupants with rooms personalised with items related to hobbies such as music equipment, posters, etc. Each bedroom is decorated according to the individual tastes of the resident. Communal areas are comfortable and residents are also able to choose furniture and décor for these areas. There is a rear garden with seating and a lawn. Residents look after the home’s pet rabbits. There is an office in the first floor and a staff ‘sleeping in’ room. 102A Brockhurst Road DS0000028732.V298630.R01.S.doc Version 5.2 Page 18 There is a laundry and the home was found to be clean. Staff are trained in infection control. 102A Brockhurst Road DS0000028732.V298630.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents are supported by sufficient numbers of trained and qualified staff. The home’s recruitment procedures protect residents. EVIDENCE: The staff rota and information given by the home’s management shows that there are always two staff on duty when residents are in the building. Nighttime staffing consists of one ‘waking’ and one ‘sleep in’ staff member. Training for newly appointed members of staff was assessed and showed that an induction procedure is followed with records of instruction, and acknowledgement of competency, in areas such as medication, health and safety, fire safety and meeting residents’ needs. There is a training programme for staff and records showed attendance at courses in Person Centred Planning, moving and handling, report writing and health and safety. Records of individual staff supervision with a member of the management team were available. Individual staff appraisals take place and are well recorded showing that the needs of the individual residents are central in planning future training. Due to a turnover of staff the home has not achieved the national minimum standard of 50 of staff trained to NVQ 2 standard by 2005. The home is, however, actively working towards this with new staff members registering to start the qualification. 102A Brockhurst Road DS0000028732.V298630.R01.S.doc Version 5.2 Page 20 Recruitment procedures were examined and showed that checks are carried out on persons applying for posts at the home. These include criminal record bureau and Protection of Vulnerable Adults (POVA) checks, as well as obtaining written references from previous and current employers. The service has policies for equal opportunities as part of its recruitment process. 102A Brockhurst Road DS0000028732.V298630.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home is well managed, and run in the best interests of the residents, although there is a need for a more systematic method of ensuring that the views of residents and their representatives are incorporated into the home’s development plans. The health and safety of the service users is promoted. EVIDENCE: At the time of the inspection the home had interim management arrangements due to the registered manager’s absence from the home. This consists of additional support from the manager’s senior and a senior member of the home’s care staff team filling an ‘acting up’ role. As previously mentioned, the home has service user meetings, records of which demonstrated that the residents are able to directly contribute to the 102A Brockhurst Road DS0000028732.V298630.R01.S.doc Version 5.2 Page 22 decision making in the home, for instance in choosing group activities and meals. However, the home has not implemented a quality assurance system involving a more systematic method of obtaining the views of residents, residents’ relatives, involved professionals etc. regarding the running of the home. The inspector was informed that this is in the process of being developed and implemented. This standard will therefore be inspected again at the next inspection. Records were satisfactorily maintained with the exception of the absence of the records of residents’ monies being held for safekeeping. Staff receive training in first aid, food hygiene, and infection control. Appliances and equipment in the home are regularly serviced, although there was no evidence that the gas heating system had been checked by a qualified engineer and the questionnaire completed by the home prior to the inspection failed to indicate when this was last serviced. At the time of the inspection it could not be ascertained when this was last carried out. 102A Brockhurst Road DS0000028732.V298630.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 3 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 X 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 2 X 2 2 X 102A Brockhurst Road DS0000028732.V298630.R01.S.doc Version 5.2 Page 24 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA6 Regulation 15 Requirement Following incidents of aggression the individual care plans must be reviewed and updated to include guidance on how staff should deal with this type of event in the future. Records of monies held by the home for safekeeping must be available and held in the home. The home must ensure that the gas heating system is serviced by a qualified engineer. Timescale for action 15/08/06 2 3 YA41 YA42 17 schedule 2 23 (2) 15/08/06 15/08/06 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 YA20 Good Practice Recommendations External ‘accredited’ training should be provided in for the home’s management and staff. 102A Brockhurst Road DS0000028732.V298630.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton 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 102A Brockhurst Road DS0000028732.V298630.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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