Inspection on 08/06/05 for 123 Segensworth Road

This inspection was carried out on 8th June 2005.

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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

123 Segensworth Road 16/07/08

123 Segensworth Road 09/01/07

123 Segensworth Road 04/01/06

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 08/07/2008.

CARE HOME ADULTS 18-65 Segensworth Road 123 Segensworth Road Titchfield Fareham Hants PO15 5EL Lead Inspector Kathryn Kirk Unannounced 08 June 2005 10:00am 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. Segensworth Road v224218 h54 s12329 segensworth rd v224218 230705.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Segensworth Road Address 123 Segensworth Rd Titchfield Fareham Hants PO15 5EL 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) 01329 843934 Community Integrated Care Miss Julia Rogerson CRH 3 Category(ies) of LD Learning disability PD Physical disability registration, with number of places Segensworth Road v224218 h54 s12329 segensworth rd v224218 230705.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users may be admitted between the ages of 20 and 55 years. 2. Service users who have physical disabilities must also have learning difficulties. Date of last inspection 3/11/2004 Brief Description of the Service: 123 Segensworth Road is a detched 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. All three bedrooms are on the ground floor and all are single. Service users share the use of bathroom, kitchen, dining room and lounge. There is a small enclosed rear garden. Segensworth Road v224218 h54 s12329 segensworth rd v224218 230705.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first unannounced inspection of two that will take place during the year March 2005- April 2006. It took place on 8 June 2005 and lasted for three hours. Current service users needs are such that they are unable to contribute verbally to the inspection process. All service users were present during the inspection and time was spent with two of them. Two staff also contributed. There was a tour of the communal areas of the building and some documentation was examined. A follow up visit took place on 21 June. This lasted one hour. During this visit the manager was present and documentation that was not available on the initial visit was viewed. What the service does well: What has improved since the last inspection? Contractual arrangements have improved as Community Integrated Care have issued a new statement of terms and conditions. Community Integrated Care have issued an individual statement of account for one service user for whom they act as appointee. Segensworth Road v224218 h54 s12329 segensworth rd v224218 230705.doc Version 1.30 Page 6 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. Segensworth Road v224218 h54 s12329 segensworth rd v224218 230705.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 Segensworth Road v224218 h54 s12329 segensworth rd v224218 230705.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) 1 and 5 The service user guide needs to include some additional detail to ensure that an informed choice can be made when a move to the home is considered. Contractual arrangements have considerably improved, but still need to be validated by representatives of service users. EVIDENCE: Copies of the service user guide were seen on file for each service user. At the last inspection it was required that this document needed to contain information regarding fees charged, what they cover and the cost of extras. Although the documents have not yet been updated, this information is now available to the manager who has agreed to ensure that this information is added. A draft copy of an updated licence agreement between Knightstone Housing Association and each service user was seen on file. Since the last inspection all service users have been issued with a statement of terms and conditions by Community integrated Care. The manager said that she intends to ask next of kin to sign these documents on behalf of service users. Segensworth Road v224218 h54 s12329 segensworth rd v224218 230705.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 Assessments and care plans are maintained and reviewed appropriately. Any decision made on behalf of a service user is considered and is taken with the best interests of the service user in mind. Although risk assessments are in place and are reviewed regularly some need to be re-evaluated to ensure that they accurately reflect potential hazards. Action must be taken to ensure that identified risks are minimised. EVIDENCE: Two service user assessments and care plans were viewed. There was written evidence that these have been updated and reviewed regularly, involving as appropriate family members and relevant specialists. Files contained information regarding medical conditions. There were also guidelines for staff to follow as to how individual needs would be met. Communication needs had been reviewed in June 2005. There was evidence of positive planned interventions, for example it was identified that one service user required additional support to ensure that their nails were maintained. One member of staff has attended a podiatry course so that this need could be met within the home. Segensworth Road v224218 h54 s12329 segensworth rd v224218 230705.doc Version 1.30 Page 10 There was written evidence that any limit imposed on service users right to make a decision is documented as part of the care planning process and risk assessments and guidelines for staff are drawn up accordingly. One example is that one service user has medication disguised in a drink. There was evidence that this decision had been taken after considerable consultation with relevant medical professionals and that the decision had been reviewed. A form was seen, which had been issued by social services, which when signed would provide consent to share information about the service user with other organisations. The manager said that she intends to ensure that service users next of kin see a copy of this form and sign it if in agreement, as service users are unable to sign for themselves. A number of risk assessments were viewed. These included moving and handling of service users, slips trips and falls, fire risk assessment, use of agency staff, uncovered radiators and the risk of one service user being aggressive towards another service user. There was evidence that these are reviewed and updated regularly. Action that needs to be taken to minimise identified risks and hazards will be discussed in subsequent sections. Staff said that there was also a risk assessment in place in which it is stated that service users must not be left unattended at any time in a vehicle. It was discussed with the manager that some risk assessments need to be reviewed and possibly updated, for example, the assessment regarding unguarded radiators concluded that service users had a low risk of injury occurring, although on the day of inspection one service user was observed to be leaning regularly against the radiator in the hallway. Staff said that the service user regularly stood in this spot. It was also discussed that a risk assessment needs to be completed for some equipment left in the driveway which is awaiting collection and for a drain cover, which staff said becomes very slippery in wet weather. The manager agreed to ensure that the areas of risk discussed would be addressed. Segensworth Road v224218 h54 s12329 segensworth rd v224218 230705.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) 12 and 16 Daytime activity needs to be reviewed to ensure that all service users spend their time is a fulfilling way. Daily routines are detrimentally affected on occasion because of current staffing levels. EVIDENCE: All service users attend specialist day services for some sessions during the week. Records show that sometimes these sessions coincide and that sometimes they do not. An examination of the staff rota cover for two weeks showed that two staff are on duty for a significant proportion of daytime shifts. When this happens, staff said that it is necessary for all service users to travel to the day centre, regardless of whether they are attending. Staff also said that for a very short period of time, it is also necessary to leave a service user unattended in the vehicle, whilst others are escorted into the building. It was discussed that this practice goes against the guidelines in the risk assessment for this procedure, therefore placing service users at risk. Staffing levels must be reviewed to ensure that this practice does not continue. Segensworth Road v224218 h54 s12329 segensworth rd v224218 230705.doc Version 1.30 Page 12 Staff were observed to knock before entering bedrooms and were seen to talk and interact with service users in a friendly and respectful manner. Any restrictions in access parts of the home have been documented in risk assessments, for example, some cupboard doors in the kitchen are kept locked. On the day of inspection there were two staff on duty. One service user was unwell and was in bed. Both staff were needed to attend to this service users personal care needs. The other two service users were left unsupervised for thirty minutes, during which time one dropped a ceramic mug, which smashed. Staff were unaware of this potential hazard until they returned to the communal area. The planned day care which was due to take place was cancelled due to the lack of staff and the inability to meet individual service users needs. Segensworth Road v224218 h54 s12329 segensworth rd v224218 230705.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 The healthcare needs of service users are assessed and recognised EVIDENCE: Records kept show that staff ensure that service users have access to health care facilities and to health care professionals. There is information on file regarding specialist medical conditions. Both files examined contained a document entitled ‘my health’. This provides details of health care needs of the individual and had been completed in June 2005. Segensworth Road v224218 h54 s12329 segensworth rd v224218 230705.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 There is an accessible complaints procedure. Service users financial interests are safeguarded. EVIDENCE: The needs of current service users are such that they would be unable to make a formal verbal complaint. There is a complaints procedure in written and in pictorial form. The statement of terms and conditions contains information about how to make a complaint as does the service user guide. Staff said that there have been no complaints received about this service since the last inspection at the home and no complaints have been received by CSCI. One risk assessment which details action to be taken in the event of one service user hitting another service user does not contain information about the vulnerable adult procedure. The manager agreed to review this and to include necessary information. Community Integrated Care act as financial appointees for one service user. Since the last inspection CIC have issued them with an individual statement of account that details interest accrued. This meets with the requirement issued as a result of the last inspection. Segensworth Road v224218 h54 s12329 segensworth rd v224218 230705.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 30 The home is comfortable but some alterations and upgrading needs to be undertaken to make the environment as safe as possible. EVIDENCE: On the day of inspection the home was clean, tidy and free from offensive odour. Wheelchair users have access to their bedroom, communal areas and bathing and toilet facilities. Access to the building for those in a wheelchair is to the rear of the property, where a ramp has been installed. The manager said that the premises met with the requirements of the fire authority at their last visit although this was some time ago. The following was noted, that no bedrooms have fire doors and there is only one exit with a ramp out of the building for wheelchair users. The building is fitted with smoke alarms. The fire door between the kitchen and lounge was observed to be propped open. The manager said that this was usual practice during the day and that this was for ease of access for service users. It was discussed that staff need to consult with the fire department for further advice. A visit from the Environmental Health Officer in May 2005 found food hygiene practices to be good, but advised that the refurbishment of the kitchen should Segensworth Road v224218 h54 s12329 segensworth rd v224218 230705.doc Version 1.30 Page 16 receive attention in the very near future. An occupational therapy assessment seen dated 3 April 2005 concluded that the kitchen is not safe. The manager produced documentary evidence that she has been liaising with Knightsone Housing regarding this matter. Letters were seen dated 28 April 2005 and 15 June 2005 in which it is stated that Knightstone is tendering for these works. Risk assessments have been completed regarding unguarded radiators in the house. Staff said that they considered two to be a potential hazard, one in the bathroom and one in the hallway. At the last inspection the poor drainage of the front driveway was identified as a possible hazard. The manager said that Knightstone Housing Association have agreed to resurface it. The manager did not have anything in writing to confirm a timescale for when these works would start. Segensworth Road v224218 h54 s12329 segensworth rd v224218 230705.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 Staffing levels do not always appear to be adequate to meet assessed needs of all service users at all times. EVIDENCE: Staff on duty demonstrated a commitment to their role and a good knowledge of service users’ needs One service user has been assessed as needing two staff to assist with personal care and staff said that other service users sometimes require this ratio to meet their needs. As discussed in other sections the following situations can arise when two staff are on duty: 1. Some service users are unsupervised for periods of time when one service user is having their personal care needs attended to. 2. All service users go out in the transport to day services, regardless of whether they have a session that day 3. At weekends, when two staff are on duty at all times during the day, service users have to go out together , or not at all. Staff confirmed that staff meetings take place. Segensworth Road v224218 h54 s12329 segensworth rd v224218 230705.doc Version 1.30 Page 18 It was noted that one staff member who regularly sleeps in is under the age of 21. The standards stipulate that no person under the age of 21 is left in charge. The manager has written to CSCI to inform of the arrangements in place to support this staff member. These arrangements will be discussed further with senior managers separate to this inspection. Segensworth Road v224218 h54 s12329 segensworth rd v224218 230705.doc Version 1.30 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 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: Segensworth Road v224218 h54 s12329 segensworth rd v224218 230705.doc Version 1.30 Page 20 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 2 x x x 2 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 2 Standard No 11 12 13 14 15 16 17 x 2 x x x 2 x Standard No 31 32 33 34 35 36 Score x x 1 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Segensworth Road Score x 3 x x Standard No 37 38 39 40 41 42 43 Score x x x x x x x v224218 h54 s12329 segensworth rd v224218 230705.doc Version 1.30 Page 21 Yes 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. 3. Standard 24 24 24 Regulation 23 23 23 Requirement The refurbishment of the kitchen must be undertaken. This is an outstanding requirement. Covers to be fitted to two radiators which have been identified as a possible hazard. The resurfacing of the front driveway must be undertaken. This is an outstanding requirement from 31/3/05 A review of staffing levels to ensure that the number of staff on duty meet assessed needs. The fire service must be consulted for advice regarding current fire safety arrangements. Timescale for action 31/10/05 31/08/05 31/10/05 4. 5. 33 24 18 13, 23 31/08/05 31/08/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Segensworth Road v224218 h54 s12329 segensworth rd v224218 230705.doc Version 1.30 Page 22 Commission for Social Care Inspection 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 Segensworth Road v224218 h54 s12329 segensworth rd v224218 230705.doc Version 1.30 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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