Inspection on 02/02/07 for 17 Flaxfield Road

This inspection was carried out on 2nd February 2007.

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 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

17 Flaxfield Road 22/12/05

17 Flaxfield Road 25/04/05

17 Flaxfield Road 13/12/04

17 Flaxfield Road 11/05/04

17 Flaxfield Road 15/12/03

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 17 Flaxfield Road Basingstoke Hampshire RG21 8SE Lead Inspector Nick Morrison Unannounced Inspection 2nd February 2007 11:00 17 Flaxfield Road DS0000011802.V327547.R01.S.doc Version 5.2 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 17 Flaxfield Road DS0000011802.V327547.R01.S.doc Version 5.2 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. 17 Flaxfield Road DS0000011802.V327547.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 17 Flaxfield Road Address Basingstoke Hampshire RG21 8SE 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) 01256 328273 www.mencap.org.uk Royal Mencap Society Mr Michael Gordon Butterworth Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 17 Flaxfield Road DS0000011802.V327547.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd December 2005 Brief Description of the Service: The home is a semi-detached property set in a cul-de sac-within Basingstoke. It is within easy reach of the town centre and the local college. The home offers all single rooms on the ground and first floor. There is a lounge/diner, kitchen and ample bath and shower facilities. There is a small quiet area at the top of the stairs, which contains a computer for service users to use. The home has kitchen and laundry facilities and garden to the rear. 17 Flaxfield Road DS0000011802.V327547.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the 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 2nd February 2007 and lasted six hours. During this time the Inspector toured the premises, looked all service users’ files and met three service users. An in-depth interview took place with one service user and interaction between staff and service users was observed. All records and relevant documentation referred to in the report was seen on the day of the inspection visit. The Inspector spoke with the person in charge and a member of staff. What the service does well: What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. 17 Flaxfield Road DS0000011802.V327547.R01.S.doc Version 5.2 Page 6 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 17 Flaxfield Road DS0000011802.V327547.R01.S.doc Version 5.2 Page 7 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from having their needs assessed prior to moving into the home. EVIDENCE: Service users’ files showed that thorough assessments had been completed prior to admission for all service users. Care Management assessments were in place and these were supplemented by the home’s own, in-depth assessment. The assessments were being used to identify specific needs and to develop appropriate care plans for service users. 17 Flaxfield Road DS0000011802.V327547.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from having clear individual plans in place and from support to take decisions and risks appropriate to their development. EVIDENCE: There had been a requirement from the previous inspection that “care plans must give sufficient detail to enable staff to support service users in a consistent manner, in particular in relation to personal care and support regarding behaviour.” The care planning process had been reviewed and plans were now written with clear detail about how to provide support to each service user. This requirement has now been met. Care plans covered the whole range of need areas and all included risk assessments. Risk assessments were written in a way that emphasised the need for each person to have opportunities to develop within a planned framework where risks were minimised. The plans were focussed on individual 17 Flaxfield Road DS0000011802.V327547.R01.S.doc Version 5.2 Page 9 development for each service user and emphasised their rights. All care plans and risk assessments were reviewed on a monthly basis and were regularly recorded against. Service users were enabled and supported to be involved in the care planning process through person centred planning meetings and with the use of communication aids such as pictures, symbols and Makaton. The service user spoken with confirmed he had been involved in writing his care plan and was aware of the details of the plan. The home made good use of picture symbols and Makaton to support service users to be involved in planning their own care and in making decisions for themselves. Staff were clear about how each person communicated and had the skills to support each person to make decisions for themselves. Care plans emphasised the need for service users to make their own decisions and staff observed during the inspection visit demonstrated that they were able to follow the care plans and recognise the need to give service users time to make their own choices. 17 Flaxfield Road DS0000011802.V327547.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from being part of the community and involved in varied activities. They also benefit from regular contact with their families and a healthy diet. EVIDENCE: People living in the home had, until recently, been attending the local day service on a regular basis. Some had been using this service for many years. However, the service has recently been withdrawn from people living in residential homes with twenty-four hour staffing. Flaxfield had responded to this by developing weekly timetables of activities for people living in the home. These included in-house, group activities such as music and art as well as individual support for service users to access the community. Service users are supported to go to local clubs to maintain contact with people they have known for years through the day service. Individual timetables have been devised 17 Flaxfield Road DS0000011802.V327547.R01.S.doc Version 5.2 Page 11 with service users and are under review to ensure that service users are being involved in the kind of activities they enjoy. The service user spoken with was happy about his timetable and felt that he had enough activities throughout the week. He said that staff supported him to go out to places he enjoyed. Service users were supported to maintain contact with their families and friends and each service user’s file contained information for staff to be able to support them in this. The home has an open Visitors’ Policy that encourages visitors at any reasonable time. Records showed that some service users had regular contact with family and friends. The rights of service users were emphasised throughout the home. Care plans placed emphasis on this as did the home’s policies. Staff observed during the visit were clearly aware of service users’ rights and of their own role in ensuring that rights were respected. Service users’ files contained signed agreements about how they could expect to be supported, about whether they were happy to receive personal care from staff of both genders or not and about what valuables they had asked staff to look after for them. Each service user had a licence agreement with the Housing Association that owned the home. There had been a recommendation from the previous inspection report that more fresh vegetables are used in the home. Staff reported that this was now the case and an examination of the menus and of the food storage areas showed that fresh vegetables were used in the home. Menus demonstrated that food in the home was varied and encouraged healthy diets for service users. The service user spoken with said the food was very good and that he always had sufficient amounts. Service users were involved in menu planning. They made their own choices about what would be on the weekly menus and also had guidance from staff about what food might be healthy. Photographs were used to help all service users to be involved in the process of choosing meals. Individual preferences were considered and alternatives were offered where particular service users did not like the planned meal for the day. Service users were involved in cooking the food and took turns on each day to do this. This involved the whole process form identifying what meal was going to be cooked, writing a shopping list, going to buy the ingredients and then coming home and doing the cooking. Staff supported service users throughout each part of the process. Records of food intake were kept and demonstrated that service users had a varied and nutritious diet. 17 Flaxfield Road DS0000011802.V327547.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are protected by the home’s medication policy and practices and benefit from having their health and support needs met appropriately. EVIDENCE: Service users’ individual care plans were devised with their involvement and contained explicit information throughout about the way in which each person preferred to be supported. Plans also described the physical and health needs of service users and records demonstrated that these were regularly monitored and that service users were supported to access relevant healthcare services as necessary. Records were kept of all healthcare appointments and of what action needed to be taken. Care plans included sections on the physical and emotional needs of each person and records demonstrated that these were monitored on a regular basis and that service users were supported to access relevant healthcare services whenever necessary. Appropriate medication policies and procedures were in place in the home. Staff involved in administering medication had received training. Clear records 17 Flaxfield Road DS0000011802.V327547.R01.S.doc Version 5.2 Page 13 were kept of all medication administered in the home and of all medication going in and out of the home. Medication in the home was appropriately stored. The home keeps information on the different medications each service user takes so that staff can be aware of how they might affect the person and what issues to look out for. There had been a recommendation from the previous inspection report that the home reviewed its Medication Policy and Procedures. This has now been met. 17 Flaxfield Road DS0000011802.V327547.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a clear complaints policy and were protected by the home’s abuse policies and practices EVIDENCE: The service user spoken with confirmed that staff listened and responded to his views. There was a clear complaints policy in place, which was available to each service user. Service users were encouraged to highlight any issues they were not happy with and these were recorded and responded to. Records were kept of any complaint made. There were also regular house meetings where service users were encouraged and supported to raise issues they were not happy about. Each service user also had monthly meetings with their keyworker and these were used to review the care the person was getting, but also to highlight any areas they were not happy about. The home has adequate policies in place regarding responding to issues of potential or suspected abuse. Staff at the home had had adult protection training. Care plans contained guidelines on preventing self-harm where necessary and risk assessments for each person to ensure they were protected from abuse as far as possible. The service user spoken with said that he felt safe living in the home and felt that staff would deal with any worries he might have about his own safety. 17 Flaxfield Road DS0000011802.V327547.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from living in a comfortable, safe and clean home. EVIDENCE: Flaxfield is homely and comfortable throughout. The house is bright and airy and all parts are accessible to all service users. Furniture in the home was of good quality and well maintained. Service users’ bedrooms were well equipped and individually decorated to their own tastes. The home was also clean and hygienic throughout and procedures were in place to maintain cleanliness and hygiene. The laundry area is well situated and well managed and service users can be supported to do their own laundry if they want. 17 Flaxfield Road DS0000011802.V327547.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from being supported by competent, trained staff and are protected by the home’s recruitment policies and practices. EVIDENCE: Staff training records were clear and demonstrated that training is a large feature of the organisation and that there is a commitment to ensuring that staff are well equipped for their role. Staff spoken with confirmed that the training available is very good and that they did not have any outstanding training needs that were not being dealt with. Staff files were well-kept and demonstrated that staff did not begin working in the home before all necessary checks had been undertaken. Staff had a clear induction when they began work and this was welldocumented. Staff spoken with confirmed that their induction programme was useful and gave them a good understanding of their role as well as covering basic training issues. Supervision sessions were used to highlight ongoing training needs for individual staff members and records showed that those needs were responded to quickly by the organisation. 17 Flaxfield Road DS0000011802.V327547.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from living in a well run home and are protected by the home’s Health and Safety policies and practices. Services users’ views are included in the planning and monitoring of the service. EVIDENCE: The Registered Manager in the home is experienced in managing homes for younger people with disabilities and is suitably qualified. The home has good quality assurances processes in place and has a Continuous Improvement Plan to ensure that quality issues are highlighted and responded to. The improvement plan specifies how each issue was raised and this demonstrated that issues were being identified in a number of different 17 Flaxfield Road DS0000011802.V327547.R01.S.doc Version 5.2 Page 18 ways including Inspection Reports, monthly visits from the Area Manager, support and supervision sessions, complaints, reviews of care plans, input from the local community health team, analysis of incident and accident records, service users’ meetings and service user questionnaires. The most recent service user questionnaire was December 2006. Issues highlighted in the improvement plan were prioritised and responded to in a timely manner. All staff had received health and safety training and workplace risk assessments were in place and regularly reviewed. Records were kept to show that all equipment was regularly serviced. All accident and incident records were clear and the manager regularly monitored and reviewed these in order to look for patterns and plan to decrease future occurrence of these. Monthly health and safety checks were undertaken and records were kept. 17 Flaxfield Road DS0000011802.V327547.R01.S.doc Version 5.2 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 Standard No Score 1 X 2 3 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 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X 17 Flaxfield Road DS0000011802.V327547.R01.S.doc Version 5.2 Page 20 No 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 17 Flaxfield Road DS0000011802.V327547.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 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 © 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 17 Flaxfield Road DS0000011802.V327547.R01.S.doc Version 5.2 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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