Inspection on 07/06/05 for 145 Kingsley Road

This inspection was carried out on 7th 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 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

145 Kingsley Road 05/09/07

145 Kingsley Road 21/02/07

145 Kingsley Road 29/11/05

145 Kingsley Road 08/09/04

145 Kingsley Road 20/04/04

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

CARE HOME ADULTS 18-65 145 Kingsley Road Milton Portsmouth Hampshire PO4 8HN Lead Inspector Ian Craig Unannounced 7th June 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. 145 Kingsley Road H55H04_S12048_145 Kingsley Rd_V220245_070605.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 145 Kingsley Road Address 145 Kingsley Road, Milton, Portsmouth, Hampshire, PO4 8HN 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) 023 9229 4649 Royal Mencap Society Ms Janet Ann Herwig Care Home 8 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (8) of places 145 Kingsley Road H55H04_S12048_145 Kingsley Rd_V220245_070605.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8/9/2004 Brief Description of the Service: 145 Kingsley Road is a residential home providing care and accommodation for up to eight adults and older persons who have a learning disability. The registered provider is the Royal Society of Mentally Handicapped Children and Adults (Mencap). The property is owned by Portsmouth City Council who lease it to New Era Housing Association, who have financial responsibility for the maintenance of the majority of the physical environment. The home is located in the Milton area of Portsmouth and is close to shops, a post office and other community facilities such as a public house. The sea front, including a promenade and beach, is within walking distance of the home. All bedrooms are single. The home has one lounge and a dining room. In the view of the inspector, the home is well laid out offering service users and staff space to undertake activities. 145 Kingsley Road H55H04_S12048_145 Kingsley Rd_V220245_070605.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced although the home received prior notice about the inspection shortly before it took place. The manager and staff assisted the inspector throughout the visit. A number of residents were spoken to during the inspection. What the service does well: What has improved since the last inspection? The kitchen area has been refurbished with new units and cupboards. The staff office has been converted into a single bedroom and two residents who previously shared a bedroom now have a bedroom each. Unfortunately, this has led to the loss of one of the two lounges, which has been converted to the office. 145 Kingsley Road H55H04_S12048_145 Kingsley Rd_V220245_070605.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. 145 Kingsley Road H55H04_S12048_145 Kingsley Rd_V220245_070605.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 145 Kingsley Road H55H04_S12048_145 Kingsley Rd_V220245_070605.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) 2, 3, 4 and 5 Residents’ needs are fully assessed before admission to the home to ensure that their needs can be met. Procedures are in place so that prospective residents can move in gradually. Placement at the home is followed by a contract giving the resident tenancy rights. Staffing levels indicate that residents’ needs are not being met at weekends. EVIDENCE: The home has admitted one person to the home since the last inspection. This was a planned and gradual move that has developed into a permanent placement. The resident was able to visit the home several times as well as having overnight stays before agreeing to move in. The person’s family were fully involved in the process. The home obtained copies of the referring care manager’s assessment and care plans. Part of the admission process involves the prospective resident, accompanied by the care manager and next of kin, completing an application form for admission to the home. Unfortunately, it was not possible to interview this resident about the process of moving into the home and this evidence is taken from documents as well as discussions with the home’s management and staff. Several contracts are completed once the person is admitted: • Assured tenancy agreement with the landlord’s, New Era Housing Association 145 Kingsley Road H55H04_S12048_145 Kingsley Rd_V220245_070605.doc Version 1.30 Page 9 • Contract between social services, the home and the resident • Contract between Mencap and the resident For the person recently admitted to the home, these documents had been signed by the involved parties, including the resident. The contract between Mencap and the resident was not available at the time of the inspection. Improvements are needed to the staffing levels at weekends. It was confirmed from the staff rota, and discussions with the staff and management, that only one staff member is on duty at weekends for the month of June 2005. This is insufficient to meet the assessed needs that four of the eight residents accommodated require staff escort when going out alone. 145 Kingsley Road H55H04_S12048_145 Kingsley Rd_V220245_070605.doc Version 1.30 Page 10 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 and 9 Assessments and care plans, including risk assessments, are of a high standard. EVIDENCE: 145 Kingsley Road H55H04_S12048_145 Kingsley Rd_V220245_070605.doc Version 1.30 Page 11 The inspector viewed the system of assessing service users needs and the recording in the service user plans as an example of good practice. Each service users has a life plan which includes pictorial diagrams for ease of communication. The life plans refer to the service user’s strengths and needs, with an accompanying action plan, both of which are linked to promoting the independence of the person. Included in the action plans are directions for staff to follow in providing care, social activities and for monitoring any special needs such as weight and behaviour. For one service user the action plans included the following areas: my nails, skin care, hair style, cooking, cooking one to one, gardening, jealousy, laundry, self injury, sexuality, my money, hair washing/scalp checking, self injury checking, my weight, shaving and room decorating. The life plan system also includes space for the service user to comment on positive things that have happened since the last review. Social, education and occupational needs are also included in the life plan. Reference is made in the life plan system to specific risk assessments, which are recorded in a separate pro forma. A score of 4 is given for the attention to detail and the wide range of needs covered in the care plans. For instance, these include plans to decorate individual bedrooms, the preferences of the service user regarding colour schemes; stencilling etc. a resident confirmed that she was able to choose the colour scheme for her bedroom. Risk assessments are also of a high standard and are reviewed and updated on a regular basis. These reflected changing needs and how staff support should be adjusted in order to develop independence. These were checked with specific reference to ‘going out alone.’ Whilst the risk assessments recorded the level of support, staffing levels severely limited the scope that residents can go out at weekends. Residents were observed taking a full role in choosing individual meals and participating in the preparation of food. Residents’ participation in the running of the home will be more fully assessed at the next inspection. 145 Kingsley Road H55H04_S12048_145 Kingsley Rd_V220245_070605.doc Version 1.30 Page 12 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) 11, 12, 13, 14, 15 and 17 The home actively promotes and facilitates residents enjoying a full social life, including employment and holidays. This includes access to community facilities, which is limited due to the home’s staffing levels. Residents maintain family and personal relationships. Leisure pursuits are either arranged or facilitated and reflect the individual choice of residents. Residents are involved in choosing and preparing meals. EVIDENCE: Residents were observed making full use of the facilities to enhance their independence. One person described how she enjoyed washing her clothes and then ironing them. Several residents were observed helping themselves to a choice of hot or cold drinks and took a full part in the preparation of the early evening meal. The majority of the residents have a programme of day service activities, which involves the development of independent living skills. One person has paid employment and also works at an allotment once a week. Two residents attend literacy classes and were reported to have achieved great progress in this according to the home’s staff and management. 145 Kingsley Road H55H04_S12048_145 Kingsley Rd_V220245_070605.doc Version 1.30 Page 13 Residents described various activities that they undertake, including theatre trips, holidays in Blackpool, Lanzorote and Corfu, barbecues at the home, watching favourite video films, etc. Family and personal relationships are promoted within safe guidelines. One resident described arrangements for her/his forthcoming 40th. birthday party, which will include the attendance of various family members. A resident also confirmed that he/she has a holiday abroad with family members. Residents access local facilities, including pubs and shops. It was identified that the residents could have far greater opportunities to attend events and activities in the local area if there was sufficient staff at weekends. Additional staff are deployed for activities arranged in advance, such as a forthcoming trips to Chessington Zoo, the Southsea Show and the Festival of the Sea, but these were not available for most weekends in June and July 2005. Fresh fruit was available for residents’ to help themselves to and included, pineapples, bananas, apples, oranges, pears and grapes. Residents helped themselves to snacks and drinks, such as hot chocolate and a Tesco ‘Finest’ yoghourt. There is a menu plan and the inspector observed the residents choosing individual meals such as curry, prawn salad, pizza and fresh salad. 145 Kingsley Road H55H04_S12048_145 Kingsley Rd_V220245_070605.doc Version 1.30 Page 14 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) 18, 19 and 20 The home ensures that each resident’s personal and healthcare needs are met. EVIDENCE: Each resident has a medical/health file to show that medical and health needs are addressed via appointments with opticians, general practitioners, dentists, specialist health professionals etc. Residents are generally independent in personal care requiring only prompting and supervision. This was evident during the inspection. Support needs were recorded. Procedures for the handling and administration of medication were examined. These were found to be satisfactory. 145 Kingsley Road H55H04_S12048_145 Kingsley Rd_V220245_070605.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 There are procedures and training to ensure the safety of resident’s welfare, but these were not being followed regarding residents’ money. EVIDENCE: It was clear that residents’ felt able to approach staff. The home has procedures for dealing with any issues of adult protection. The manager and staff were able to describe how certain personal relationship matters are dealt with in a sensitive and tactful way. Staff also receive formal training in adult protection. Training in physical interventions was provided for staff approximately 5 years ago. The manager does not feel that there is a need to ‘update’ this training as this is not a factor relevant to any of the present residents. The inspector highlighted that training in this area should also cover prevention, ‘deescalation’ and avoidance of conflict, and that this would be appropriate training. It was noted that where the home held resident’s monies for safekeeping that there was a marked lack of security. 145 Kingsley Road H55H04_S12048_145 Kingsley Rd_V220245_070605.doc Version 1.30 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 standard(s) 24, 25, 26, 28 and 30 The home’s environment promotes the dignity of residents, being clean, bright, airy, clean, well maintained and comfortable. Bedrooms are personalised and comfortable. Resident’s make use of communal areas for meals and socialising. EVIDENCE: Since the last inspection the kitchen has been refurbished. The home’s only remaining double bedroom has been ‘decommissioned.’ One of the residents has moved to a bedroom converted from the staff office/sleep in room. The resident showed the inspector her new bedroom and described how much she liked the independence and how she has personalised the room. The resident stated how she was able to choose the colour scheme for the room. The bedroom was suitably furnished. One of the home’s two lounges has been converted into the new office/sleep in room. The manager acknowledges the loss of a lounge, but feels that this is justified as all the residents now have a single room. The inspector agreed with this. As compensation, a small seating area has been created in the dining room. Another resident has brought her own furniture into the home. 145 Kingsley Road H55H04_S12048_145 Kingsley Rd_V220245_070605.doc Version 1.30 Page 17 Residents were observed socialising with each other, and with staff, in the lounge. Several residents described how they enjoyed a recent barbecue in the garden. The home was found to be clean and hygienic. 145 Kingsley Road H55H04_S12048_145 Kingsley Rd_V220245_070605.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 34 Staffing is not provided at levels that meet the needs of the residents. Recruitment procedures safeguard residents’ welfare and safety. EVIDENCE: The staff rota was examined, and discussed with the manager and a staff member, for the month of June 2005. For the week commencing 5th. June 2005 156 staff hours were provided. During week days at least one staff member is on duty with periods where there are two or three staff. At weekends the rota showed only one staff member on duty from 7am on Friday 11th June to 1000am 13th. June 2005. Risk assessment show that four of the eight residents’ cannot go out without staff support. Whist these residents may go out with relatives at weekends, the provision of one staff member severely limits the ability of the home to take any of these residents out during this period. The single staff member on duty also has to prepare meals and clean during this period. For the month of July 2005 there are two weekend periods where 2 staff are on duty. The inspector was informed that additional staffing is arranged for planned trips at weekends. Staffing hours, if considered by the Department of Health Residential Forum Guidance give a required staffing hours total for a week of 201.19, which the home does not meet. This was calculated on the basis of four residents with a ‘low’ need level and four with a medium level, plus an adjustment for 249.5 hours spent outside the home at day services etc.. 145 Kingsley Road H55H04_S12048_145 Kingsley Rd_V220245_070605.doc Version 1.30 Page 19 Residents’ benefit from a stable staff group with a low turn over of staff. Staff were observed to interact well with the residents who felt comfortable approaching and interacting with staff. The home has not recruited any new staff since the last inspection. Previous inspections have found the recruitment of staff to be satisfactory. 145 Kingsley Road H55H04_S12048_145 Kingsley Rd_V220245_070605.doc Version 1.30 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 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) None of the standards in this section were assessed at this inspection. EVIDENCE: 145 Kingsley Road H55H04_S12048_145 Kingsley Rd_V220245_070605.doc Version 1.30 Page 21 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 x 3 2 3 3 Standard No 22 23 ENVIRONMENT Score x 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 x 4 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 x 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 2 3 3 x 3 Standard No 31 32 33 34 35 36 Score x x 2 3 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 145 Kingsley Road Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x x x H55H04_S12048_145 Kingsley Rd_V220245_070605.doc Version 1.30 Page 22 N/A 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. Standard 23 33 and 13 Regulation 13 (6) 18 (1) (a) Requirement Residents monies must be securely stored. Sufficient staff must be deployed at weekends, and any other times, so that residents can access community and leisure facilities. Timescale for action 7th. July 2005 7th. September 2005 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 23 Good Practice Recommendations It is recommended that staff have further updates in training for possible physical interventions. 145 Kingsley Road H55H04_S12048_145 Kingsley Rd_V220245_070605.doc Version 1.30 Page 23 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 145 Kingsley Road H55H04_S12048_145 Kingsley Rd_V220245_070605.doc Version 1.30 Page 24 - 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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