Inspection on 19/11/08 for 14 Bruce Road

This inspection was carried out on 19th November 2008.

CSCI found this care home to be providing an Excellent 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

14 Bruce Road 14/03/07

14 Bruce Road 10/01/06

14 Bruce Road 20/01/05

14 Bruce Road 21/12/04

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REACH Upton Court Road

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Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 14 Bruce Road 14 Bruce Road Southsea Hampshire PO4 9RL     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Nick Morrison     Date: 1 9 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: 14 Bruce Road 14 Bruce Road Southsea Hampshire PO4 9RL 02392738698 Telephone number: Fax number: Email address: Provider web address: paulaharris2003@yahoo.co.uk Name of registered provider(s): Name of registered manager (if applicable) Mrs Paula Jackson Type of registration: Number of places registered: Copsewood Associates care home 15 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 15 The registered person may provide the following category of service only: Care home only(PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Learning disability (LD) Date of last inspection Brief description of the care home 14 Bruce Road provides care and support to up to 15 service users with learning disabilities. The home is a detached Edwardian house within close proximity to Southsea and Eastney promenade. Bruce Road is in a relatively quiet residential street, but is close to shops, pubs, restaurants, etc. The homes physical environment was found to be well maintained and clean. There are 11 single bedrooms and 2 double bedrooms. There are facilities for residents to have exclusive use of a kitchen area, bathroom, and separate toilet. This allows these service users to exercise a degree of independence and to develop daily living skills. The residents attend a variety of daytime activities including paid employment, college courses and day services. The Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 15 Brief description of the care home homes staff and management also promote independence in the residents? leisure time, with individuals accessing local facilities according to assessed need. The home is staffed 24 hours per day, and has a registered manager. Weekly fees range from #322 - #425. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This report represents a review of all the evidence and information gathered about the service since the previous inspection. This included a site visit that occurred on 19th November 2008 and lasted five hours. During this time we toured the premises, looked at the files of all service users, met most of them, had detailed discussions with three of them and observed the support they were receiving. We also met the Manager, the Provider and two members of staff and observed interaction between staff and service users. All records and relevant documentation referred to in the report were seen on the day of the inspection visit. We also referred to services own self assessment of the home. Current fees in the home range from 338.24 to 446.53 pounds per week. Care Homes for Adults (18-65 years) Page 6 of 27 Care Homes for Adults (18-65 years) Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from having clear care plans and risk assessments in place and from being supported to make their own decisions. Evidence: The home requires a full care management assessment for each person before they move into the home. In addition to this, the home does its own comprehensive assessment. Records showed that all assessments were in place prior to the person moving in and that service users and their families had been involved in the assessment process. We spoke to one person who had recently moved into the home. He told us his move had gione smoothly and that he had visited the home for tea once and stayed for a weekend before actually moving in. He said he ahd been involved in his assessment and was aware that his care plan was still being developed and staff were getting to know him so that they could complete this. Care Homes for Adults (18-65 years) Page 10 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from having clear care plans and risk assessments in place and from being supported to make their own decisions. Evidence: All service users had care plans in place and records demonstrated that these were being reviewed on a regular basis. Staff spoken with were aware of the care plans and were involved with them on a daily basis. Care plans were reviewed between the Keyworker and the service user on a monthly basis and both had signed to say they agreed with the plan. All care plans were reviewed every three months by the Manager and were fully reviewed on an annual basis. The home also liaised with other services the person used so that there was some coordination between reviews. The home has begun to introduce a person centered planning approach and is liaising with the local partnership board to ensure this is implemented in a positive way. Some good work had begun on this and service users were involved in identifying their own aspirations. Recorded evidence and Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: evidence from service users demonstrated that plans identified things that were important to service users and that the service responded to them well. Care plans also contained risk assessments that were kept up-to-date and reflected the current needs of service users. Risk assessments were used to ensure that people were supported to take risks that were important to their personal development but that this was done in a managed way and involved them fully. The home demonstrated a very positive approach to helping service users manage risks. The care plans also emphasised the need for service users to make their own decisions and observation of staff interactions with service users throughout the day demonstrated that staff understood this and were able to support people to make their own decisions rather than making decisions for them. When showing the Inspector around the building the Manager knocked on a service users door and waited for a reply before. She then asked if the service user wanted the Inspector to come into her room or she would prefer it if he did not. It was made clear to the service user that it was entirely her choice as to whether or not the Inspector went into her room and that she could easily say no if she wanted to. Care Homes for Adults (18-65 years) Page 12 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from having their rights respected and from balanced and nutritious meals. They also benefit from having the opportunity to engage in a wide range of activities both inside and outside of the home. Evidence: The home encourages and supports service users to be involved in a wide range of community facilties and liesure pursuits according to their own individual needs and preferences. Records of activities and discussion with staff showed that service users were supported to make use of a wide variety of local facilities and to be involved in the activities they had chosen. People did make some use of local day services for part of the week. The home liaised well with day services to ensure that peoples needs were met. Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: Individual preferences about activities were recorded in peoples care plans and it was clear that the activities arranged for each person reflected their interests. Service users spoken with said they had full and busy weeks and were spending their time doing the things they wanted to do. Employment was arranged for people who wanted it and one person spoken with works at a stables. People living in the home were supported to maintain contact with their friends and families. Service users were encouraged to have visitors at any time that was suitable to them. Staff spoken with said that understood that this is the service users home and they should have visitors whenever they wanted to. There was a payphone in the hall which received incoming calls for service users and there was also a hand held phone so that people could make and take calls in the privacy of their own room. The home had a very positive approach to supporting people with their relationships. Previously two people, who met while living at the home, had got married and moved onto more independent accommodation together. The home liaised with the Community Learning Disabilities Team (CLDT) to ensure that people had access to appropriate information about relationships. Menus in the home were devised in consultation with service users during house meetings. The menu for the week was displayed in a book and each person chose the meal they wanted for each day on a weekly basis. They could also change their mind and have an alternative if they did not fancy the meal they had chosen for a particular day. Menus showed that the food was varied and nutritious and records were kept of individual food intake. Service users spoken with were very positive about the food in the home and said they always received sufficient portions. The food on the day of the inspectionvisit was prepared from fresh ingredients. There were also tea and coffe making facilities in the rear hall so that service users could help themselves during the day. The mealtime observed was a sociable occasion. Service users used the time to catch up with each other on what they had been doing during the day and making plans about what they were going to be doing in the evening. Staff acted as a good example in generating discussion and consequently people living in the home showed an interest in each others activities and shared stories about their day. Care Homes for Adults (18-65 years) Page 14 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from having their healthcare needs met and are protected by the homes medication policies and practices. Evidence: Care plans contained information on how people preferred to be supported with their personal care. The files of people living in the home demonstrated that healthcare needs were monitored and that people were supported to use healthcare services as necessary. There were comprehensive records relating to each persons health. Each persons healthcare needs were monitored and recorded on a regular basis. Where people had used healthcare services there were detailed records and all issues were followed up. Staff in the home liaised closely with healthcare professionals in the interests of people living in the home. The level of liaison with external professionals was impressive and very good records were kept. All service users were registered with a local GP and visited regularly. There were also regular visits to other healthcare services such as opticans and dentists. The home had arranged for regular visits to the home from an audiologist and a chiropodist so that service users had good access to these services when they needed it. Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: The service also liaised closely with the CLDT, advocacy services Care Managers. On the day of the inspection visit we observed the Manager negotiating very well with a Care Manager in the interests of a service user and this demonstrated a good working relationship and a willingness to ensure that the needs of the people living in the home were attended to in detail. The system for administering medication in the home was clear and safe and was stated in the homes policies. Staff spoken with who were involved in administering medication said they had received good training and demonstrated that they had a good understanding of medication issues. Medication records were clear and up-todate and all medication was stored appropriately and safely. There was a comprehensive system in place for monitoring medication with regular checks and crosschecking to minimise the possibility of any errors occurring. Care Homes for Adults (18-65 years) Page 16 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from having their views listened to and are protected by the homes policies and practices Evidence: The home has a complaints policy in place and a system forrecording and responding to complaints, but none had been received. The Manager thought the reason for this was that the home responded very well to the requests and needs of service users and issues never got to the stage of people needing to complain. This was confirmed in discussion with service users who said they knew how to make a complaint if they needed to but had never needed to. A paper copy of the Complaints Policy, along with the Service User Guide and Statement of Purpose, was available to service users in the rear hall next to the tea and coffee making facilities. With these were also audio versions of each document to make them as accessible as possible to people living in the home. The person who had only just moved into the home told us he was aware of how to make a complaint if he needed to and had been given good information when he moved in. The home has good policies and procedures in place for dealing with allegations or suspicions of abuse. Staff had received relevant training and had read the homes policies. Staff were aware of the importance of potential abuse issues and of the need to ensure that incidents were well recorded. Staff in the home had demonstrated in the past that they knew how to report concerns through the local reporting procedures and Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: had done so. They liaised closely with the Social Services Department to ensure that issues were dealt with thoroughly and in the best interests of people living in the home. Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from living in a clean, comfortable and safe environment. Evidence: The house is very homely and comfortable. There are pictures of service users throughout the house. Service users are able to move freely around the home and appeared to feel comfortable and at home. The house is very large and there were sufficient rooms so that people could spend time with each other when they wanted to but could also have personal space when they wanted to as well. Service users bedrooms are well equipped and they have been able to bring their own possessions with them to the home. Service users spoken with felt that it was their home and that they could use it as they wished. The home was clean throughout, while remaining comfortable and homely. There were cleaning rotas in place for each day of the week to ensure that cleanliness was maintained and clear records were kept of what cleaning had been done. Service users were supported to be involved in the cleaning of the house if they had identified this as something they had wanted to do. Hygiene policies and practices in the home were observed and monitored. Care Homes for Adults (18-65 years) Page 19 of 27 Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from being supported by adequate numbers of well-trained staff and are protected by the homes recruitment policies and practices. Evidence: Recruitment records in the home demonstrated that all staff were employed within the homes recruitment policy and that all necessary pre-employment checks had been undertaken prior to them beginning work in the home. Staff spoken with confirmed they had been required to provide all relevant information prior to beginning work in the home. The Manager demonstrated that she took the recruitment process very seriously and was aware of the need to ensure that people working in the home could demonstrate they were suited to the work and to the needs of people living in the home. Additional references were sought on occasions where the Manager thought it necessary. Staff training was well managed and good records were kept of the training that each member of staff had received, what training they still needed to do and when updates were required. Staff spoken with said the training was useful and relevant to their role and that access to training was good. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: Discussion with staff on the day of the inspection visit, as well as reference to staff files, demonstrated that all staff received regular support and supervision sessions with the Manager and that records were kept of these sessions. We were also told that the Manager was always available for advice and support and that staff found her to be very supportive throughout their work. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from living in a well managed home that is safe and responsive to their needs. Evidence: The current Manager has been in post for five years and demonstrates a good understanding of her role in ensuring that the home is well managed around the needs of the people living there. Discussion on the day of the inspection visit demonstrated that she kept her training up to date and that she also kept herself up to date with developments within social care for people who have learning difficulties. We received very positive feedback about the from staff, service users and the Provider. The Managers office is situated in the cellar of the building and is accessible only through the garden. This is to ensure that the office does not impinge on the service users home. Examination of the fire logbook demonstrated that it was kept up-to-date. There were effective systems in place for monitoring and managing health and safety issues in the Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: home. Good records were kept of all health and safety issues including fire, appliance servicing, substances hazardous to health, accidents and electrical testing. All staff received initial training in health and safety as part of their induction as well as regular updates. Regular checks and records were kept relating to health and safety aspects of the home. There was a good syste in place for managing maintenance issues in the home and observation of the building throughout the inspection visit demonstrated that it was well maintained as and when necessary. The quality assurance process in the home is being developed and is focussed on the people living in the home and will use their feedback as the basis for improvements to the service. The Manager has a good understanding of quality assurance processes and plans to develop the system further and fully implement it so that it becomes an annual cycle of gathering and analysing information from a wide range of sources and then developing a plan for the development of the service based on what people have said and making this plan avilable to all people who have an interest in the service. There are regular house meetings where people living in the home have the opportunity to voice their opinions and service users spoken with confirmed that these were lively and interesting meetings and that staff listened and responded to what was brought up. There is a service user representative in the home, voted for by the other service users, who is responsible for representing the views of anyone who is unable to attend a house meeting. This person is also responsible for representing service users views during interviews for new staff. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - 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!