Inspection on 16/08/05 for 13-15 Constitution Hill

This inspection was carried out on 16th August 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

13-15 Constitution Hill 23/01/09

13-15 Constitution Hill 01/02/08

13-15 Constitution Hill 03/08/06

13-15 Constitution Hill 19/01/06

13-15 Constitution Hill 25/02/05

13-15 Constitution Hill 02/09/04

Similar services:

Chesham House

Argyll House

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

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

CARE HOME ADULTS 18-65 13-15 CONSTITUTION HILL 13-15 Constitution Hill Norwich Norfolk NR3 4HA Lead Inspector Kim Patience Unannounced 16 August 2005 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. 13-15 CONSTITUTION HILL I55 S27382 13 Constitution Hill V244701 160805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 13-15 Constitution Hill Address Norwich, Norfolk, NR3 4HA 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) 01603 789450 Mr M Talbot Mr M Talbot Care Home 16 Category(ies) of LD Learning disability 4, MD Mental Disorder 12 registration, with number of places 13-15 CONSTITUTION HILL I55 S27382 13 Constitution Hill V244701 160805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25 February 2005 Brief Description of the Service: Constitution Hill is a Care Home that provides services and single room accommodation to 16 residents, 12 falling into the category of Adults with a Mental Disorder and 4 falling into the category of Learning Disability.It is located close to the city centre and its amenities and within easy walking distance there are a number of pubs, shops and takeaways.The home itself is made up of two semi-detached Victorian houses joined together to form one house, resulting in spacious communal accommodation and large gardens. 13-15 CONSTITUTION HILL I55 S27382 13 Constitution Hill V244701 160805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took approximately 4hrs to complete. The registered manager and the assistant manager were available throughout and helpful in facilitating the process. In order to assess the standards, a tour of the building was conducted, records relating to staff and service users were inspected and staff and service users were spoken to. In addition, a number of comment cards were left for service users and relatives to provide an opportunity to contribute to the inspection process at a later date. What the service does well: What has improved since the last inspection? What they could do better: Of the seven requirements made at the last inspection, four have been met and three have not. Staff must be provided with training specific to the role they are to undertake. This training must include the protection of vulnerable adults and specialist training needed in order to work effectively with this service user group. 13-15 CONSTITUTION HILL I55 S27382 13 Constitution Hill V244701 160805 Stage 4.doc Version 1.40 Page 6 The manager must produce a training and staff development programme that demonstrates some commitment to provide this training and seeks to identify mandatory annual training courses along with the specialist training required. The manager must introduce a plan of formal supervision that is recorded and available at the next inspection. 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. 13-15 CONSTITUTION HILL I55 S27382 13 Constitution Hill V244701 160805 Stage 4.doc Version 1.40 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 13-15 CONSTITUTION HILL I55 S27382 13 Constitution Hill V244701 160805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,5 The home ensures that service users needs are fully assessed prior to moving in and that each individual is aware of the terms and conditions of their stay. EVIDENCE: In order to assess these standards four service users files were inspected and the manager was interviewed. Each file was found to contain a referral form and a care plan provided by the Mental Health care trust. Both the documents gave good information about the individual’s history, current needs and how they should be met. When the home is commissioned to provide a service the commissioner is required by the home, to complete a referral form. This allows the home to assess whether they have the resources to meet the person’s needs and whether in principle, the individual will be suitable to live with the other people already residing in the home. All prospective service users are admitted through a multi-disciplinary process involving the individual and health and social care workers. This approach ensures that the individual is fully involved in the plan of their rehabilitation and agree to any restrictions imposed on their choice or freedom. Each file also contained a terms and conditions of residence that is issued at the time of the placement agreement. The document was signed by both parties. 13-15 CONSTITUTION HILL I55 S27382 13 Constitution Hill V244701 160805 Stage 4.doc Version 1.40 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) 6,7,8,9 Service users are central to the planning of their care and rehabilitation and involved in the process at every stage. Service users are encouraged to be autonomous within a structured support Network. Service users are provided with opportunities to maintain or develop their independent living skills and to express their wishes and feelings in respect of life in the home. Service users are encouraged to live as independently as possible within a risk management framework. EVIDENCE: As described in standard 2, service user files were inspected and the staff and manager were interviewed in order to assess these standards. Because of the nature of the service offered at Constitution Hill and the close working relationship with commissioners, individual’s rehabilitation programmes involve a high level of support of key professionals outside of the home. Records relating to service user plans were generated from multi13-15 CONSTITUTION HILL I55 S27382 13 Constitution Hill V244701 160805 Stage 4.doc Version 1.40 Page 10 agency planning and agreements. Therefore, evidence of care management assessments were seen and regular reviews were conducted. Evidence of service user involvement was seen by way of signatures on the plans and agreements made and where necessary family members had been involved. Staff interviewed demonstrated a good understanding of peoples rights and the need for them to make their own decisions in respect of daily living, except where a limitation have been agreed through the care planning process. Service users spoken to and observed during the inspection, clearly had the freedom to make decisions of their own and were encouraged to do so if appropriate. The home maintains a daybook for each resident in which they record detailed information about daily activities. This provides further evidence that people are autonomous within a risk management framework. A plan of residents meetings has recently been established. So far the primary focus has been on activities, however, the plan is to expand upon this and incorporate other aspects of the service, such as meal planning and quality assurance. It is important that residents are empowered to become more involved in the planning of the service. Service user plans contained detailed risk assessments, again, generated through the care management process. 13-15 CONSTITUTION HILL I55 S27382 13 Constitution Hill V244701 160805 Stage 4.doc Version 1.40 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) 12,13,14,15,17 The home provides the opportunity for service users to be involved in the planning of activities that meet their individual and collective requirements. Service users are encouraged and supported, where appropriate, to engage in community life. Service users are supported to build and maintain positive relationships with friends, family and partners. The meals offered are healthy and appropriate for the service user group. EVIDENCE: The manager has re-established residents meetings with a primary focus on activities and offering people the opportunity to choose activities that they enjoy individually and collectively. A cinema club has been formed and those involved discuss and plan films they would like to see. In addition, summer barbecues have been planned and friends and family are welcome to attend. Residents are encouraged to integrate with the local community and some regularly visit the local public house and other community facilities. The home 13-15 CONSTITUTION HILL I55 S27382 13 Constitution Hill V244701 160805 Stage 4.doc Version 1.40 Page 12 is very close to the city centre and residents spoken to talked of going out shopping and visiting friends. The home encourages the maintenance of positive relationships and evidence of this could be read in the day books relating to each individual. Care plans showed details of significant relationships that should be maintained and those that should not be encouraged. The home has changed the way in which meals are offered. They no longer employ a chef and meals are prepared and cooked by staff working at the home. The range of choice offered is wide and varied, a menu book was available for inspection and showed that peoples individual requirements were being met. Service users spoken to confirmed that they enjoyed the food provided. The residents meetings provide an opportunity for people to say what they want to see on the menu, however each person is able to choose what they wish on a daily basis. New staff working in the kitchen need to receive training in basic food hygiene as soon as possible to ensure that the correct standards are maintained. See standard 32. 13-15 CONSTITUTION HILL I55 S27382 13 Constitution Hill V244701 160805 Stage 4.doc Version 1.40 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) 20 The arrangements for the safe storage and administration of medicines are appropriate for the protection of people living in the home. EVIDENCE: The medication arrangements in the home were inspected and found to be in good order. The previous issues about the arrangements for service users taking medication out of the home have been resolved following some negotiation with the local pharmacy to find a more suitable way of dispensing medicines for these occasions. Medication administration records are provided by the local pharmacy and maintained for each individual. Medication requirements are recorded in the service user care plans and are monitored and reviewed by the health professionals involved. 13-15 CONSTITUTION HILL I55 S27382 13 Constitution Hill V244701 160805 Stage 4.doc Version 1.40 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) 22,23 Service users are given the opportunity to voice their opinion about the service provided and their comments or complaints are taken seriously. The home has a policy on the protection of vulnerable adults. However, the management cannot fully demonstrate that all staff are aware of adult protection due to the lack of proper training. EVIDENCE: The home has a complaints policy and procedure. No formal complaints have been made in the last 12 months. However, the manager records and monitors all comments made. Residents are given the opportunity to raise concerns at meetings or through discussion with the manager and other staff. The home has a policy on the protection of vulnerable adults that includes the whistleblowing procedure. The policy is contained within the staff handbook and staff are made aware of adult protection during their induction. However, staff have not received any formal training as yet and it is recommended that they do so as soon as possible. The home has recently purchased a video in order to provide staff with training in adult protection. See requirements. 13-15 CONSTITUTION HILL I55 S27382 13 Constitution Hill V244701 160805 Stage 4.doc Version 1.40 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) 24,30 The home provides a clean, comfortable, safe environment for people to live in that offers a relaxed and homely atmosphere. EVIDENCE: A tour of the premises was carried out. Single room accommodation is situated on two floors. Each room is equipped with the essential items and meet the required standard. Rooms are fitted with a lock and residents have a key to their door. The rooms entered appeared to be homely and many personal items were seen. The home has a large communal lounge with comfortable furniture suitable for use by younger adults, the lounge is equipped with a TV, video, books and games. In addition, there is a large conservatory, which leads out to the rear garden. The rear garden is pleasantly landscaped with a patio area featuring a large patio table and chairs. In general, the home was found to be nicely furnished and decorated to a fair standard. The staff working at the home are responsible for ensuring that it is kept clean and tidy. Where possible and as part of a care management programme residents are encouraged to participate in maintaining good standards of cleanliness and hygiene. The home was found to be clean and tidy throughout. 13-15 CONSTITUTION HILL I55 S27382 13 Constitution Hill V244701 160805 Stage 4.doc Version 1.40 Page 16 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) 31,32,34,35,36 Staff working at the home are aware of their role and responsibilities. However, the management cannot fully demonstrate that staff are equipped with the necessary knowledge to fulfil the role they are employed to undertake due to the lack of a proper training programme. The home cannot demonstrate that staff are adequately supervised due to the lack of a formal process. EVIDENCE: The management has recently appointed four new members of staff from overseas. Each new employee was provided with an induction pack that includes the job description and other key information. The home has an induction programme that new workers were in the process of completing. However, at the time of inspection there was no staff training and development programme showing what further training would be provided. The manager is in the process of planning future training and it is hoped that this will be finalised at the next inspection. It is essential that all staff receive mandatory training that is appropriate to the work that they are doing ie. Food hygiene, health and safety. In addition to mandatory training staff should receive training that is specific to the needs of people living in the home ie. working with people who have mental health issues and people with learning disabilities. It is required that the management develop a training programme as soon as feasibly possible in order to ensure a competent workforce. See requirements. 13-15 CONSTITUTION HILL I55 S27382 13 Constitution Hill V244701 160805 Stage 4.doc Version 1.40 Page 17 The matter of supervision was discussed with the manager and it was found that whilst frequent supervision takes place on an informal basis, there is no formal one to one supervision. It is required that all staff receive formal one to one supervision six times a year. See requirements. The matter of staff appraisal was not discussed during this inspection and will be assessed on the next occasion. 13-15 CONSTITUTION HILL I55 S27382 13 Constitution Hill V244701 160805 Stage 4.doc Version 1.40 Page 18 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) NA Standards not assessed on this occasion. EVIDENCE: N/A 13-15 CONSTITUTION HILL I55 S27382 13 Constitution Hill V244701 160805 Stage 4.doc Version 1.40 Page 19 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 N/A 3 N/A N/A 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 N/A Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 N/A N/A N/A N/A N/A 3 Standard No 11 12 13 14 15 16 17 N/A 3 3 3 3 N/A 3 Standard No 31 32 33 34 35 36 Score 3 3 N/A 3 2 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 13-15 CONSTITUTION HILL Score N/A N/A 3 N/A Standard No 37 38 39 40 41 42 43 Score N/A N/A N/A N/A N/A N/A N/A I55 S27382 13 Constitution Hill V244701 160805 Stage 4.doc Version 1.40 Page 20 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. Standard 23 Regulation 13(6) Requirement The registered person must ensure that all staff receive training in adult protection matters.This is repeated for the second time The registered person must produce a staff training and development programme. This is repeated for the second time. The registered person must introduce a plan of formal supervision. This is repeated for the second time Timescale for action 1/11/05 2. 35 18(1) 1/11/05 3. 36 18(2) 1/11/05 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 13-15 CONSTITUTION HILL I55 S27382 13 Constitution Hill V244701 160805 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 3rd Floor Cavell House St Crispins Road Norwich NR3 1YF 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 13-15 CONSTITUTION HILL I55 S27382 13 Constitution Hill V244701 160805 Stage 4.doc Version 1.40 Page 22 - 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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