Inspection on 16/07/08 for 123 Segensworth Road

This inspection was carried out on 16th July 2008.

CSCI found this care home to be providing an Good service.

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

123 Segensworth Road 09/01/07

123 Segensworth Road 04/01/06

123 Segensworth Road 08/06/05

123 Segensworth Road 03/11/04

123 Segensworth Road 04/05/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOME ADULTS 18-65 123 Segensworth Road Titchfield Fareham Hampshire PO15 5EL Lead Inspector Craig Willis Unannounced Inspection 16th July 2008 9:30 123 Segensworth Road DS0000012329.V366923.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 123 Segensworth Road DS0000012329.V366923.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. 123 Segensworth Road DS0000012329.V366923.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 123 Segensworth Road Address Titchfield Fareham Hampshire PO15 5EL 01329 843934 01329 843934 segensworthroad@c-i-c.co.uk www.c-i-c.co.uk Community Integrated Care 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) Mrs Julia Grey Care Home 3 Category(ies) of Learning disability (3), Physical disability (3) registration, with number of places 123 Segensworth Road DS0000012329.V366923.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users may be admitted between the ages of 20 and 55 years. Service users who have physical disabilities must also have learning disabilities. 9th January 2007 Date of last inspection Brief Description of the Service: 123 Segensworth Road is a detached property located in a residential area between Fareham and Titchfield. The home is registered to provide care and accommodation for up to three adults with a learning disability and physical disabilities. Community Integrated Care is the registered provider. Knightstone Housing Association manages the property. Two bedrooms are on the ground floor and one on the first floor. All bedrooms are single. People share the use of bathroom, kitchen, dining room and lounge. There is an enclosed rear garden, with a ramp from the lounge. The manager reported that the weekly fee for a place at the home is £1063.09. 123 Segensworth Road DS0000012329.V366923.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The evidence used to write this report was gained from a review of the information the provider sent to us since the last inspection. This information included an annual quality assurance assessment completed by the manager. A site visit to the home was made on 16 July 2008. During the visit we met all three people who live in the home and observed their interactions with staff. Due to people’s communication needs we did not have direct conversations with them. We received comments from two staff members and spoke with the manager and staff on duty. The communal areas of the building were viewed and documents relating to the running of the home were inspected during the visit. What the service does well: There are good systems to assess people’s needs before they move into the home. This reassures people that the home will be able to meet their needs. There are good care planning and risk assessment systems, which involve people and their representatives where possible. These documents help staff to provide the support that people need. The home provides good support for people to take part in a range of activities, to maintain contact with family and friends and to maintain a healthy diet. People’s personal and health care is well met by staff who know their needs and there are good systems to safely store and administer people’s medication. There are good systems for dealing with complaints and responding to allegations of abuse. This gives people confidence that any complaints will be taken seriously and responded to. The home is well maintained and provides a clean, comfortable and safe environment for people. Staff are well trained, which helps to give them the skills to meet people’s needs. 123 Segensworth Road DS0000012329.V366923.R01.S.doc Version 5.2 Page 6 The home is well managed, which helps to keep people safe and there are good systems to assess the quality of the service provided and make improvements. 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. The summary of this inspection report can be made available in other formats on request. 123 Segensworth Road DS0000012329.V366923.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 123 Segensworth Road DS0000012329.V366923.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good systems to assess people’s needs before they move into the home. This reassures people that the home will be able to meet their needs. EVIDENCE: The records of all three people who live in the home were inspected during the visit. All had a comprehensive assessment of their needs, which is regularly reviewed. Copies of care management assessments and reviews were also available in the records. No one has moved into the home since the last inspection and the manager reported she did not anticipate any vacancies arising in the near future. Community Integrated Care have procedures in place for the assessment of potential residents, which the manager had a good understanding of. Copies of the service users’ guide have been made available to people who use the service in a pictorial version to aid understanding. 123 Segensworth Road DS0000012329.V366923.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good care planning and risk assessment systems, which involve people and their representatives where possible and helps staff to provide the support that people need. EVIDENCE: The records of all three people who live in the home were inspected during the visit. People had a care and support plan, which set out how their assessed needs should be met. The plans contained detailed information about how staff should provide support to meet people’s needs. There were particular sections on how people communicate and how personal care needs should be met. The plans have been regularly reviewed and amended where people’s needs have changed. People have been supported to develop their own person centred plan, setting out their dreams and aspirations. Staff have completed these with input from people and their representatives, for example family members. 123 Segensworth Road DS0000012329.V366923.R01.S.doc Version 5.2 Page 10 Details of how people should be supported to make decisions are set out in the care plans. Staff demonstrated a good understanding of people’s needs, their subtle communication and how to respond to it. Due to people’s needs, staff take a lot of day-to-day decisions, however, these are reviewed as part of the care planning process to assess whether they are meeting people’s needs. Risk assessments have been completed for people living in the home and those inspected included clear information about how to minimise the identified hazards. These assessments are reviewed regularly and had been amended where assessed as necessary. Staff spoken with demonstrated a good understanding of the assessments and the action they should take to minimise the identified risks. 123 Segensworth Road DS0000012329.V366923.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 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 this service. The home provides good support for people to take part in a range of activities, to maintain contact with family and friends and to maintain a healthy diet. EVIDENCE: People are supported to take part in a range of activities, including day services, visits to the local pub and shops, bowling and swimming. People are supported to maintain contact with their friends and family, with staff providing support for people to visit family where necessary. Details of people’s relationships are included in the care planning process, including the support needed to maintain them. During the visit, staff were seen to be respecting people’s right to privacy by ensuring personal care support was discreetly provided. Staff were observed interacting with people who live in the home in a relaxed, friendly and respectful manner. The daily records showed staff respond to people’s 123 Segensworth Road DS0000012329.V366923.R01.S.doc Version 5.2 Page 12 communication, for example on whether people want to participate in planned activities. The home has a planned menu, which is based on people’s likes and dislikes. The menu is displayed in a pictorial format to help people understand it and alternatives are available from a well-stocked kitchen. People are encouraged to take part in meal preparation, for example shopping for food and being in the kitchen whilst food is being prepared. Mealtimes are flexible to fit round activities and snacks are available at any time. 123 Segensworth Road DS0000012329.V366923.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s personal and health care is well met by staff who know their needs and there are good systems to safely store and administer people’s medication. EVIDENCE: Care plans contain detailed information about people’s personal care needs and how it should be provided. Staff spoken with demonstrated a good understanding of people’s personal care needs and how they should be met. People are supported to attend a range of health services, including GP, nurse, speech and language therapist, dentist and optician. Details of consultations are recorded, including any advice given by the practitioner. Each person has a health action plan, which is regularly reviewed. This identifies whether people are receiving the health services they need. 123 Segensworth Road DS0000012329.V366923.R01.S.doc Version 5.2 Page 14 Medication is securely stored in a locked cupboard in the office and most tablets are supplied in a monitored dosage system. A record is kept of medication coming into the home and returned to the pharmacist for disposal. The medication administration record for the current month was inspected and had been fully completed. All staff administering medication have received assessed training. Staff reported that none of the people who live in the home are currently able to take their medication without support. 123 Segensworth Road DS0000012329.V366923.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good systems for dealing with complaints and responding to allegations of abuse. This gives people confidence that any complaints will be taken seriously and responded to. EVIDENCE: Following the last inspection a requirement was made that records of any resident’s monies or valuables being held for safekeeping must be available. The manager reported that CIC was the appointee for one person who lives in the home. The records of transactions and accounts for this person were available. The records matched the cash held and receipts were available for expenditure. This requirement has been met. The home has a complaints procedure, which is provided to all people living at the home in a pictorial format to make it easier to understand. The manager reported that the home has not received any complaints since the last inspection. We have also not received any complaints about the home since the last inspection. Staff have completed training in safeguarding adults. Staff spoken with demonstrated a good understanding of different types of abuse and the action they should take if abuse is witnessed, reported or suspected. There is a 123 Segensworth Road DS0000012329.V366923.R01.S.doc Version 5.2 Page 16 policy and procedure on safeguarding adults and the prevention of abuse, which staff and the manager demonstrated a good understanding of. 123 Segensworth Road DS0000012329.V366923.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained and provides a clean, comfortable and safe environment for people. EVIDENCE: All of the home’s communal areas were viewed during the visit. The communal areas have recently been redecorated and the home is maintained to a high standard, with good quality, domestic furniture and fittings. People living in the home share the use of a lounge, kitchen, dining room, bathroom and shower room. Staff reported that most maintenance issues are resolved quickly. There is a bathroom on the ground floor, which is fitted with an assisted bath suitable to meet people’s needs. There is an additional shower room on the first floor. There is a garden to the rear of the home, which people were using during the visit. There is a ramp to the garden from the 123 Segensworth Road DS0000012329.V366923.R01.S.doc Version 5.2 Page 18 lounge to make it accessible for people who use a wheelchair. Adaptations and aids have been fitted to meet people’s specific needs. The home has a separate utility room that is fitted with machines capable of hygienically washing soiled clothing. The home is clean throughout. Hand washing facilities are suitably situated in the kitchen, utility, toilets and bathrooms. Staff have access to protective equipment, such as gloves and aprons, and were seen using them during the visit. 123 Segensworth Road DS0000012329.V366923.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are well trained and there are good systems to check staff before they work in the home. This helps to keep people safe and ensure staff can meet their needs. EVIDENCE: The manager reported that six of the eight staff have achieved the National Vocational Qualification (NVQ) at level 2 or above and that new members of staff would be put forward to complete the award one they have completed their induction. Staff members were observed spending time interacting with people who live in the home and responding to their communication. Staff spoken with said they felt there were sufficient staff on each shift to provide the support that people need. A requirement was made following the last inspection that staff recruitment records must be available in the home for inspection. The records of two new members of staff were inspected and both contained two written references, confirmation that a criminal records bureau disclosure had been obtained for them and details of their identity. This requirement has been met. 123 Segensworth Road DS0000012329.V366923.R01.S.doc Version 5.2 Page 20 The home has an on-going training programme and staff reported that they receive good training, which helps them meet people’s needs. Staff training records indicated people had completed an induction and courses including medication administration, first aid, safeguarding adults, food hygiene, non violent crisis intervention, moving and handling, epilepsy and fire safety. The manager has identified staff members’ training needs with them individually and planned which courses they need to attend. 123 Segensworth Road DS0000012329.V366923.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed, which helps to keep people safe and there are good systems to assess the quality of the service provided and make improvements. EVIDENCE: The registered manager of the home is currently on a period of extended leave and the provider has placed another manager in the home to cover the leave. The provider informed us of the changes. The manager is currently completing the NVQ 4 in care and has worked as a manager in similar services run by the provider. Staff spoken with said they thought the manager was very supportive. 123 Segensworth Road DS0000012329.V366923.R01.S.doc Version 5.2 Page 22 A senior manager for CIC visits the home every month and assesses the quality of the service that is being provided. Reports of these visits are made and sent to the manager. The reports contain a list of any actions that are needed and an update of actions that were required in the previous report. The manager completes regular audits of the service and reports on the home’s performance to senior managers within the organisation. There is an annual survey of people who live in the home and their relatives. The results of these quality assurance systems are used to develop an annual set of objectives for the service to achieve. Servicing and testing records for the fire detection and fighting equipment, emergency lights and portable electrical appliances were inspected and confirmed that they are regularly serviced and maintained. The manager reported that the hoists had been recently serviced, but was unable to find the certificate issued by the servicing company. It was agreed that a duplicate certificate would be obtained. 123 Segensworth Road DS0000012329.V366923.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 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 123 Segensworth Road DS0000012329.V366923.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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 123 Segensworth Road DS0000012329.V366923.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 123 Segensworth Road DS0000012329.V366923.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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