Inspection on 21/02/06 for 14 Mengham Avenue

This inspection was carried out on 21st February 2006.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

14 Mengham Avenue 12/09/06

14 Mengham Avenue 13/10/05

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Dalewood Respite Care

Orchard,The

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Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

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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 14 Mengham Avenue Hayling Island Hampshire PO11 9JB Lead Inspector Ms Sue Kinch Unannounced Inspection 21st February 2006 15:00 14 Mengham Avenue DS0000064990.V283197.R01.S.doc Version 5.1 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 14 Mengham Avenue DS0000064990.V283197.R01.S.doc Version 5.1 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. 14 Mengham Avenue DS0000064990.V283197.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 14 Mengham Avenue Address Hayling Island Hampshire PO11 9JB 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) 0151 420 3637 www.c-i-c.co.uk Community Integrated Care Mr William Scoales Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 14 Mengham Avenue DS0000064990.V283197.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th October 2005 Brief Description of the Service: This is a home set in an attractive residential area of Hayling Island. The property cannot be distinguished as a residential service. The local shops are within walking distance. There are four single bedrooms on the first floor and one on the ground floor. One bathroom is available on the first floor with a separate WC. A shower room with WC is available to the rear of the ground floor and is accessed through the laundry. Residents have an adequately sized kitchen/diner and separate lounge for recreation and leisure. A garden is also available and residents are encouraged to use it. Staff support residents to attend a variety of activities and use facilities in the local area. 14 Mengham Avenue DS0000064990.V283197.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second visit to the home since Community Integrated Care (CIC ) registered in July 2005. The previous visit took place on 13th October 2005. One inspector carried the inspection, which started at 15:00 and took 4.5 hours. Key standards not inspected during the last visit were assessed. Action required after the last report was monitored. To obtain an overview of the standards achieved in the home this year the last report should also be read. At the start of the inspection all of the residents were out at day services or being supported by staff. Initial discussions were held with the manager. All of the residents were spoken with, some individually and together. Two staff were interviewed. Some time was spent observing care practices and interactions. Shared areas of the home were seen and a selection of documents and records were viewed. What the service does well: What has improved since the last inspection? What they could do better: Work has taken place on updating care plans but further work is needed to ensure that person-centred planning has been implemented and individual goals set for residents. Staff training is encouraged but sufficient numbers have yet to obtain NVQ level 2. The manager has not been trained to NVQ level 4 in care or completed the Registered Manager’s Award. Attainment of these qualifications is advised. Attention is given to improvements to the home but not all areas are decorated to an adequate standard. 14 Mengham Avenue DS0000064990.V283197.R01.S.doc Version 5.1 Page 6 Ensuring that proof of identity of agency staff is held in the home is needed. 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. 14 Mengham Avenue DS0000064990.V283197.R01.S.doc Version 5.1 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 14 Mengham Avenue DS0000064990.V283197.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not Assessed The key standard was assessed in the report of 13/10/06. EVIDENCE: 14 Mengham Avenue DS0000064990.V283197.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 Residents benefit from effective care planning but this would be enhanced further by identifying personal goals through person centred planning. EVIDENCE: Three care plans were observed with a member of staff. Two of them covered a comprehensive range of areas of support needed. They had been recently reviewed and the CIC format introduced. Further work is needed to ensure that the third plan is updated. It was unclear as to when it had been written. The staff said that the care plans had been developed based on consultation with the residents. Evidence of this could be included in the care plans. The manager reported that these and risk assessments were being developed further. He also reported that all residents had received joint reviews with the local authority adult services since July 2005 and it was his intention to ensure that a person centred approach was developed for each resident by June 2006. This would include developing individual goals. There is evidence that residents wishes are being taken into account and that they are doing activities that they prefer. Conversations with residents confirmed this and examples were also received from staff. Key worker 14 Mengham Avenue DS0000064990.V283197.R01.S.doc Version 5.1 Page 10 monthly reviews also take place and records of these are held. Those sampled showed that residents had been supported in things they like doing. 14 Mengham Avenue DS0000064990.V283197.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15, 17. Residents’ lives are enhanced by positive and helpful support from staff with personal and social relationships. Residents are encouraged to make choices and be involved in decisions about food at the home and are offered a varied diet, which they enjoy. EVIDENCE: Contact with families and friends is encouraged and examples were discussed with the residents, manager and staff. All interactions observed were respectful and friendly. Residents and staff dealt with more challenging communication in positive and sensitive ways. Staff see supporting social skills and personal relationships as part of their daily role in the home. An example of how a particular relationship was monitored and worked with was discussed. Staff were considering and promoting rights within this and assisting residents to speak for themselves. The manager does seek support from external professionals as specific needs arise and gave examples of recent referrals to help with family and personal relationships. Staff confirmed that these issues are discussed in team meetings and aspects are recorded in care plans. 14 Mengham Avenue DS0000064990.V283197.R01.S.doc Version 5.1 Page 12 Food was discussed with residents who enjoy the food at the home. A varied menu is provided and residents are included in preparation of them. A resident and staff member went shopping for food during the inspection. The resident particularly enjoyed the experience and said that the residents take it in turns to help with this. They are also involved in preparing meals. When shopping residents are involved in choices. A member of staff said that health options are promoted by staff. 14 Mengham Avenue DS0000064990.V283197.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Residents are provided with sensitive personal care taking independence and personal wishes into account. EVIDENCE: Policies and procedures are in the home for supporting residents in personal care. Individual support with personal care was given to residents during the inspection. Privacy is promoted. A staff member said that care needs were documented in care plans and that support varies according to levels of independence. An example of this was discussed. Support needed with personal care was recorded in care plans sampled. 14 Mengham Avenue DS0000064990.V283197.R01.S.doc Version 5.1 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 the following standard(s): 22,23. The manager encourages an open culture in the home so that residents can raise issues but not all formal complaints have been resolved promptly by the organisation. Effective systems are in place to promote the protection of service users. EVIDENCE: Staff were listening and supporting residents during the inspection. Both staff said that resident’s views are taken into account. Examples such as going shopping, to the pub or on holiday were given. One member of staff gave examples of how residents with fewer verbal skills are observed to see how they respond to things to assess needs. The house meeting is a place where residents can also raise issues. There is a formal complaints procedure but it is still not provided in an accessible format for residents. The complaint log held a record of one complaint being made since the last inspection. The complaint was logged on 29th November 2005 and a recent letter from CIC dated 10th February 2006 informed the manager that CIC was re–investigating. The manager reported that the complaint still needed to be resolved. Policies and procedures to promote the protection of residents are in the office for staff and management use. Those viewed included dealing with violence and aggression, management of challenging behaviour, the use of restraint, risk-taking and assessing, dealing with abuse and whistle blowing. Arrangements are made for staff to be given training in the protection of vulnerable adults. Of the two staff members spoken with, one had completed the training and it was planned for the other. Both were aware of the types of 14 Mengham Avenue DS0000064990.V283197.R01.S.doc Version 5.1 Page 15 abuse that can occur in a care home and of their responsibilities in reporting suspicions or incidents. 14 Mengham Avenue DS0000064990.V283197.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30. Residents have a comfortable, safe, clean and homely environment with regular improvements but a bathroom refurbishment is needed. EVIDENCE: The home is clean. Action is taken to improve the environment. The residents and staff discussed some of the recent improvements to the home. Since the last inspection the dining room floor has been replaced and two residents have had new carpets in their bedrooms. A new carpet is planned for another room. Two bedrooms have been redecorated in the last two months. Staff also reported of plans to replace dining and sitting room chairs. A requirement was made in the last inspection report to redecorate the bathroom. Some of the varnish and paint is worn exposing worn wood. This has yet to be attended to and the manager reported that there were no specific plans in place to address this. Consideration is also needed to improve the limited space in the bathroom. Staff have access to various policies and procedures about infection control. These are held in the office and include, guidance about dealing with laundry, MRSA, lice and scabies. Written evidence that infection control is included in the induction process was viewed. A new member of staff agreed that it had been included in induction and gave examples of issues covered such as 14 Mengham Avenue DS0000064990.V283197.R01.S.doc Version 5.1 Page 17 protective clothing, cleaning up bodily fluids, hand washing and elements of clinical waste. 14 Mengham Avenue DS0000064990.V283197.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35. Protection is offered to residents through the staff recruitment system, which includes appropriate checks. However ensuring that proof of identity is obtained for agency staff would enhance this protection. Staff are encouraged to attend training to enhance their ability to meet residents’ needs but more work is needed to ensure that they have the range of skills required. EVIDENCE: A requirement was made in the last report regarding records held in the home for relief and agency staff. Evidence sampled for a relief member of staff at this inspection was in place. A discussion was held about information held about agency staff. The manager did not have a letter from the agency stating the nature of checks that they completed before commencement of employment and there was no proof of identity for agency staff that had been used at the home. This is required to be at the home for inspection. The home has an induction programme for staff. The manager said that he had recently supported new staff to start working through the induction and foundation workbooks provided by CIC. The manager reported that these are based on the Skills for Care and Learning Disability Award Framework national guidance for staff. Written evidence was available to support this and a member of staff confirmed that they were working through the books. The 14 Mengham Avenue DS0000064990.V283197.R01.S.doc Version 5.1 Page 19 member of staff also confirmed that number of training days had been attended in the early months of employment and that topics such as moving and handling, first aid, food hygiene, challenging behaviour, person-centred planning and pova had been covered. Fire evacuation had been covered through in-house training. A record of training is held for each member of staff and the manager said that these are updated monthly. Checks are made to ensure that key areas of training take place. Training in dementia, epilepsy and autism awareness were identified by the manager as the next areas to train staff in. The manager reported that plans were being made to register staff on courses to assist them in achieving NVQ level 2 or above. He stated that four were planned to start in September 2006 as there had been difficulties in organising this locally more quickly. Sufficient numbers of staff assessed to NVQ level 2 or above is needed to meet this standard. 14 Mengham Avenue DS0000064990.V283197.R01.S.doc Version 5.1 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Residents benefit from the home being managed by an experienced manager but this would be enhanced by further management training. There are effective systems in place for seeking and acting upon residents’ views. The manager is proactive in ensuring that the health, safety and welfare of residents are promoted in the home. EVIDENCE: The manager has had recent opportunities to attend training courses. This has included CIC management induction, moving and handling, first aid and dealing with challenging behaviour. He is also attending a five-day course on leadership in person-centred planning. However, the National Vocational Qualification level 4 and Registered Manager’s Award or equivalents have yet to be achieved. The manager said that there was no specific plan to achieve this. The manager has several years of experience in relation to this work and 14 Mengham Avenue DS0000064990.V283197.R01.S.doc Version 5.1 Page 21 overall standards are mostly achieved in this home. Therefore it is advised that the courses are taken but no requirement has been made. Staff confirmed that feedback is actively sought from residents on a day-to-day basis. They also have regular key worker meetings with residents and these are recorded. The manager and staff said that there were monthly house meetings, which residents attend where they are consulted. Issues are then taken to the staff meeting for discussion and follow up. Records demonstrating this were viewed. During conversation with residents it was confirmed that some of the issues raised had been addressed. Discussion was held with the manager about monitoring practices in the home. He reported that as well as the monthly visits to the home carried out by a representative of CIC, a monitoring form is also completed and submitted following some quality audit checks. He reported both activities to include resident issues. Following the last inspection a requirement was made to review a risk assessment regarding a resident’s use of electrical equipment. Records at this inspection showed that this had been completed. Other elements of health and safety were evaluated and sampled to check that the health and safety of residents in the home is promoted. This was supported in the evidence seen. CIC have health and safety booklets for all new staff to work through. The manager said that the three most recently appointed staff were working in this. This was supported in the documentation sampled and in discussion with a member of staff. The manager does monitor health and safety issues in the home and spoke of the need to have the annual gas check completed by the end of February 2006 and the hardwire electrical checks by the end of March 2006. He was also planning to review the fire evacuation plan with the fire officer. Residents had been reminded of evacuation procedures at the last house meeting. Fire training was planned for the staff and staff records demonstrated that attention is given to training related to health and safety such as moving and handling, first aid, and food hygiene. The manager was aware of future training needs in these areas. 14 Mengham Avenue DS0000064990.V283197.R01.S.doc Version 5.1 Page 22 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 x 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 2 23 3 ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 2 33 x 34 2 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 x x x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 3 16 x 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 x x x 2 x 3 x x 3 x 14 Mengham Avenue DS0000064990.V283197.R01.S.doc Version 5.1 Page 23 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 YA24 Regulation 23(2)(d) Requirement The registered manager must ensure that the bathroom is decorated. This is a repeated requirement from the inspection of 13/10/06. The registered manager must ensure that proof of identity is held in the home for agency staff. This is an amended requirement from the inspection of 13/10/06. Timescale for action 21/06/06 2. YA34 19(1)(b) 21/03/06 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 YA22 Good Practice Recommendations It is advised that complaints are addressed promptly. 14 Mengham Avenue DS0000064990.V283197.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 14 Mengham Avenue DS0000064990.V283197.R01.S.doc Version 5.1 Page 25 - 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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