Inspection on 17/10/05 for 110a-c West Street

This inspection was carried out on 17th October 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

110a-c West Street 19/10/07

110a-c West Street 07/10/05

110a-c West Street 24/06/05

110a-c West Street 01/11/04

110a-c West Street 11/05/04

110a-c West Street 12/06/03

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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 110a-c West Street Havant Hampshire PO9 1LN Lead Inspector Michael Gough Unannounced Inspection 17th October 2006 10:00 110a-c West Street DS0000040862.V314143.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 110a-c West Street DS0000040862.V314143.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. 110a-c West Street DS0000040862.V314143.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 110a-c West Street Address Havant Hampshire PO9 1LN 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) 023 9249 8333 Hampshire County Council Sarah Elizabeth Cruickshank Care Home 17 Category(ies) of Learning disability (17) registration, with number of places 110a-c West Street DS0000040862.V314143.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th October 2005 Brief Description of the Service: 110 (a-c) West Street is a purpose built group of three housing units located in a residential area close to the centre of Havant. Hampshire County Council owns the premises; and the range of services are: long-stay residential care and short-term respite and emergency care and they are managed by one manager. There is a central administration unit. 110 (a-b) are both long-stay residential units for up to five service users with learning disabilities. 110c provides a respite and emergency service for up to seven service users. This includes a bed-sit that is used for accommodating and supporting individual service users who are preparing to move on to more independent living arrangements. The aim of the service is to support service users in working towards a more independent lifestyle. Fees are £777 per week and service users were responsible for purchasing their own toiletries and items of a personal or luxury nature. 110a-c West Street DS0000040862.V314143.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 4.5 hours and was unannounced. The homes registered manager was not available, however support staff working at the home assisted the inspector during the course of the inspection. The home is registered for up to 17 service users and at the time of the inspection there were 14 service users living at the home. Evidence for this report was obtained by reading and inspecting records, touring the home and from observing the interaction between staff and service users. It was also possible to speak with 3 service users and 3 members of staff. What the service does well: What has improved since the last inspection? What they could do better: There were no areas identified as needing improvement on this occasion. 110a-c West Street DS0000040862.V314143.R01.S.doc Version 5.2 Page 6 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. 110a-c West Street DS0000040862.V314143.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 110a-c West Street DS0000040862.V314143.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 Quality in this outcome area is “good”. This judgement has been made using available evidence including a visit to the service. Service users benefit from a detailed assessment of their individual needs before they move into the home EVIDENCE: There have been no new service users admitted to the home since the last inspection. The inspection report from June 2005 provided evidence that All service users had a Care Management Assessment in place and these were supplemented by the home’s own assessment and planning system. Due to the homes manager not being available this standard was not fully assessed on this occasion. 110a-c West Street DS0000040862.V314143.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 & 9 Quality in this outcome area is “good”. This judgement has been made using available evidence including a visit to the service. Service users assessed needs and personal goals are set out in their individual plan of care and they benefit from being fully involved in the care planning and review process. Staff at the home respect service users rights to be involved in all aspects of their lives and are supported to make decisions. Service users are supported to take responsible risks as part of their independent lifestyle. EVIDENCE: Care plans were seen for 3 service users and these were comprehensive documents that gave staff clear information on what support was required and how and when this should be given. Staff had received training in person centred planning and there were support profiles which gave information on the service users routines in the mornings, afternoon and evenings and service users were actively involved in the care planning process. Those service users spoken to confirmed that they have input into their care plans and were involved in the monthly reviews and also annual reviews. Care Plans seen 110a-c West Street DS0000040862.V314143.R01.S.doc Version 5.2 Page 10 reflected the aspirations and goals of service users and were written clearly and could be followed easily. Recording was clear and gave information on what support had been given and what service users had been doing during the day. Staff spoken to explained that they support service users to make their own decisions about their own lives and those service users spoken with were able to confirm that they are actively involved in decision making around the home and about their day to day lives. They were also aware that there were limits to the options available to them but were confident that staff would support them with any decisions they make. Risk assessments were clearly written and gave information to staff on what support was required to minimise any potential risks. Service users were consulted and encouraged to be involved in the risk taking process and those spoken with were clear that they had been involved in devising and reviewing their individual risk assessments. 110a-c West Street DS0000040862.V314143.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): 12, 13, 15, 16 & 17 Quality in this outcome area is “good”. This judgement has been made using available evidence including a visit to the service. Service users are encouraged and supported to be part of the local community and to be involved in appropriate activities. Service users benefit from support to maintain social contacts and daily routines at the home respect their rights and responsibilities. Meals at the home are flexible and service users benefit from a healthy diet. EVIDENCE: The majority of service users can access the local community independently and staff offer support to those service users who need it. Staff have supported one service user to find employment carrying out gardening tasks and all service users have planned day service activities and these include cooking skills, literacy, numeracy, gardening, independent living skills and arts and crafts. Service users are encouraged to be part of the local community and are supported to be aware of what events are happening locally, they are well known in their local community and regularly go shopping, visit local pubs 110a-c West Street DS0000040862.V314143.R01.S.doc Version 5.2 Page 12 and cafes and attend community events in the local area. On the day of the inspection 10 of the 14 service users currently living at the home were out taking part in different activities. Service users are supported to maintain and expand their social networks. Families visit regularly and some service users go home to their parents for weekend stays. Where service users have little or no contact with their families, staff ensure that additional effort is put into helping them expand their social networks. Staff provide support in managing risks associated with personal relationships. Daily routines in the home promote independence as much as possible, all service users have a key to their rooms and also a front door key, they are involved in all aspects of the day to day running of the home and staff were observed knocking on service users doors before entering and seeking permission for them to enter their rooms. Staff were observed interacting with service users and their preferred form of address was used. All of the service users spoken to, say that they are happy at the home and liked being involved in decision making. Service users are able to access all areas of the home and are able to choose if they wish to be alone in their rooms or be in the company of other service users and staff. Service users meet to decide what meals they were going to eat for the coming week. The menu is written out and the name of the service users who chose the meal for that day is recorded. Staff offer support to service users with this process to ensure that meals are nutritious and not repetitive. Service users are encouraged to go out to buy day to day shopping for the home. 110a-c West Street DS0000040862.V314143.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 & 20 Quality in this outcome area is “good”. This judgement has been made using available evidence including a visit to the service. Service users receive personal support in the way they prefer and service users physical, emotional and health needs are met. The homes policies and procedures with regard to medication provide protection for service users. EVIDENCE: Care plans for individual service users gave information on personal care needs and this is offered by care staff of the same gender wherever possible and there is information that service users are involved in decisions about this. The staff team are flexible round the times when service users want their personal support and there are no set routines, however there is a daily routine for service users to help with consistency. The majority of the service users only require verbal prompts to ensure that personal hygiene is maintained. Service users are registered with a number of different GP’s at Havant Health Centre and dental, hearing and sight checks are carried out regularly and staff at the home have attended a course in oral hygiene and mouth care. 110a-c West Street DS0000040862.V314143.R01.S.doc Version 5.2 Page 14 Service users are encouraged and supported to write any health care appointments in the house diary and staff at the home monitor service users health and support service users to access appropriate healthcare professionals and to attend any appointments. The home has clear policies and procedures in place for the receipt, storage and administration of medication. Each unit has a suitable cabinet to store medication appropriately and records were kept of all medication administered. There was clear information for staff for administering when required medication. One service user self medicates and there was a clear policy and risk assessment in place to enable this to be monitored. 110a-c West Street DS0000040862.V314143.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 & 23 Quality in this outcome area is “good”. This judgement has been made using available evidence including a visit to the service. Service users are protected by a simple, clear and accessible complaints procedure and the homes policies and procedures protect service users from any form of abuse. EVIDENCE: The home has a clear complaints procedure and the home keeps clear records of any complaints made and also records of its responses. Service users spoken were aware that there was a complaints procedure and said that they would speak to a member if staff if they were unhappy, they also said they would bring this up at their monthly service users meeting and they were confident that staff would respond to them appropriately. Staff members were aware of the homes complaints procedure and said that they would support any service users to make a complaint. Staff have received training in the protection of vulnerable adults and were clear about their responsibilities and the procedure to follow. Service users spoken to did not have any concerns and they said they were always treated well and that they felt safe in the home. 110a-c West Street DS0000040862.V314143.R01.S.doc Version 5.2 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 the following standard(s): 24 & 30 Quality in this outcome area is “good”. This judgement has been made using available evidence including a visit to the service. Service users live in a well-maintained environment and have access to comfortable indoor and outdoor facilities and the home was clean, pleasant and hygienic and free from offensive odours and this provided a pleasant environment for service users and staff. EVIDENCE: The inspector toured the building and all areas were kept safe and secure. Furniture and fittings were of good quality and the home was in a good state of repair. Service users are encouraged to take part in cleaning tasks and staff offer support to service users to do this. Service users spoken to were happy to be involved in cleaning tasks and were proud of their home. All areas were clean and there were no offensive odours. Each unit has a laundry with tumble drier and a washing machine that can wash clothing at appropriate temperatures. Service users are supported to do their own laundry and each service users has a set laundry day, although they can wash clothing at other times if they wish. Staff offer support to service users to do their laundry as appropriate. 110a-c West Street DS0000040862.V314143.R01.S.doc Version 5.2 Page 17 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, 34 & 35 Quality in this outcome area is “good”. This judgement has been made using available evidence including a visit to the service. The home supports and encourages staff to undertake relevant care qualifications and service users are effectively supported by trained staff. Service users are protected by the home’s staff recruitment procedures. EVIDENCE: There is a good mix of staff both male and female across the 3 units and a total of 12 care staff are employed. All staff are encouraged and supported to undertake NVQ training and currently the home has 6 members of staff who have completed NVQ. On the day of the inspection the homes manager and the administrator were on a first aid course and it was not possible to look at recruitment records as these were locked away in the filing cabinet in the office for confidentiality reasons. However there have been no issues regarding recruitment practise identified at the last 2 inspections. Hampshire County Council manages the home and they have a training coordinator who arranges training for all staff. The home keeps a training log for each staff member and staff training records were inspected these showed 110a-c West Street DS0000040862.V314143.R01.S.doc Version 5.2 Page 18 that appropriate training is carried out to enable staff to provide the support needed by service users. A training calendar is produced each year with a range of courses staff can request to go on and this also provides dates for refresher training and updates. Staff spoken to confirmed that they receive the training they need to enable them to do their jobs effectively. 110a-c West Street DS0000040862.V314143.R01.S.doc Version 5.2 Page 19 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 & 42 Quality in this outcome area is “Good”. This judgement has been made using available evidence including a visit to the service. The management arrangements in place at the home provide service users with a well run home and service users can be confident that their views are taken into account when developing the home. The homes policies and procedures promote and protect the health safety and welfare of service users and staff. EVIDENCE: The manger of the home was not available at this visit, however previous reports stated that she has the skills and experience needed to manage the home effectively and that she has received training appropriate to her role. Staff members spoken to were confident in her ability and said that she provided good leadership. 110a-c West Street DS0000040862.V314143.R01.S.doc Version 5.2 Page 20 The inspector was told that the home has regular service user and staff meetings and this gives the opportunity to feedback any concerns to the manager in how the home is performing. Questionnaires are sent out to staff, service users and relatives at 6 monthly intervals and the manager collates any replies. Staff spoken to said that they speak to relatives when they visit. Health and safety records were looked at and all records inspected were found to be in order, accurate and up to date. The fire logbook was inspected and this confirmed that all relevant training, and testing is carried out. Private electrical equipment was last tested in April 2006, fixed electrical wiring was last tested in March 2003 and the approved gas safety engineer called in April 2006. 110a-c West Street DS0000040862.V314143.R01.S.doc Version 5.2 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X 110a-c West Street DS0000040862.V314143.R01.S.doc Version 5.2 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 110a-c West Street DS0000040862.V314143.R01.S.doc Version 5.2 Page 23 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 110a-c West Street DS0000040862.V314143.R01.S.doc Version 5.2 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!