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Inspection on 25/04/05 for 17 Flaxfield Road

Also see our care home review for 17 Flaxfield Road for more information

This inspection was carried out on 25th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The manager provides a supportive and helpful leadership respected by staff. The staff are offering a friendly and caring service to the service users. The manager acts on concerns raised where the protection of service users is in question and takes action to promote the safety of service users.

What has improved since the last inspection?

The manager has been registered since the last inspection and is offering greater stability to the home. In addition recruitment has taken place and all of the permanent posts have been filled reducing the use of relief staff. The kitchen has been refurbished to a good standard and the service users are happy with the outcome. A service users guide has been produced for the home.

What the care home could do better:

The manager is just beginning to introduce a person centred planning process to the home and is planning to take action to implement the issues raised by the first service user to be involved. The home needs, through this process, to offer service users a wider range of experiences than the more limited rangethat have been used to in recent years. Although use of relief staff has reduced a review of the number of permanent posts is needed, as is a plan of training.

CARE HOME ADULTS 18-65 17 Flaxfield Road Basingstoke Hampshire RG21 8SE Lead Inspector Sue Kinch Unannounced 25 April 2005, 12:00 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. 17 Flaxfield Road H54 S11802 17 Flaxfield Road V221654 250405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 17 Flaxfield Road Address Basingstoke Hampshire RG21 8SE 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) 01256 28273 Royal Mencap Society Mrs Deirdre Bell Care Home 5 Category(ies) of Learning Disability (5) registration, with number of places 17 Flaxfield Road H54 S11802 17 Flaxfield Road V221654 250405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13/12/2004 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 H54 S11802 17 Flaxfield Road V221654 250405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place for 6.5 hours from noon and was the first visit to the home since the last inspection in December 2004. Initially, a partial tour of the premises took place and a sample of care records were inspected as all of the service users were involved in activities away from the home. All of the 5 service users returned during the inspection and were spoken to in a group. Three were spoken to separately in their rooms. Conversations were also held with the two staff on duty and the manager. What the service does well: What has improved since the last inspection? What they could do better: The manager is just beginning to introduce a person centred planning process to the home and is planning to take action to implement the issues raised by the first service user to be involved. The home needs, through this process, to offer service users a wider range of experiences than the more limited range 17 Flaxfield Road H54 S11802 17 Flaxfield Road V221654 250405 Stage 4.doc Version 1.30 Page 6 that have been used to in recent years. Although use of relief staff has reduced a review of the number of permanent posts is needed, as is a plan of training. 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. 17 Flaxfield Road H54 S11802 17 Flaxfield Road V221654 250405 Stage 4.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 17 Flaxfield Road H54 S11802 17 Flaxfield Road V221654 250405 Stage 4.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) Not assessed This section was not assessed, as there had been no new admissions to the home. EVIDENCE: 17 Flaxfield Road H54 S11802 17 Flaxfield Road V221654 250405 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9 Service users are increasingly involved in planning their care but need wider experiences and more information about how their goals will be met. EVIDENCE: Care plans for two service users were asked to be made available and were viewed. These include increasing amounts of detail and correspond to the issues referred to by the service users. There was evidence that one service user had been involved in a circle of support in person centred planning and more specific needs had been identified. The manager said that action was now needed to ensure these needs were met. In conversation with one of the service users confirmation was given of aspects of the care plan being carried out with positive outcomes. Service users have some information about their care plans but work could take place to make this more accessible and more detailed on an individual basis. The manager stated that the care needs of service users identified in the care plans were more relevant to service users than before. The inspector agreed. There was evidence of monthly and three monthly reviews of care taking place by the key-workers in both files seen. Care is needed to ensure that all are 17 Flaxfield Road H54 S11802 17 Flaxfield Road V221654 250405 Stage 4.doc Version 1.30 Page 10 signed and dated and information is needed to identify how strengths and needs are acted on in care provision. Service users are supported to make decisions about their lives. They were involved in a range of different activities outside the home based on preferences at the time of the inspection. One of the service users talked of support that he had been given to make decisions about one particular activity that he decided he did not wish to do anymore .He felt that he was able to make decisions at the home. The inspector observed flexibility in the staff and manager to a particular request made by a service user during the inspection. Another service user was given the option to join in an activity, which he was able to decide not to do. The manager reported to be aware that some of the activities that service users were involved in outside and in the home had been unchanged for some time .The inspector supported the view that person centred planning would give an opportunity to review some of these activities and offer alternatives if wished for. There is a system in the home for recording risk assessments. There was a range of risk assessments in the two files seen and a register to list those available for each person. These had recently been recorded as reviewed and staff were signing them to say that they had read them. One service user was asked about risks assessments and confirmed to have had conversations about them with the key worker. 17 Flaxfield Road H54 S11802 17 Flaxfield Road V221654 250405 Stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Not Assessed This section was not inspected. EVIDENCE: 17 Flaxfield Road H54 S11802 17 Flaxfield Road V221654 250405 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Not assessed This section was not assessed at this inspection. EVIDENCE: 17 Flaxfield Road H54 S11802 17 Flaxfield Road V221654 250405 Stage 4.doc Version 1.30 Page 13 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 Effective systems are in place in the home to promote the protection of service users. EVIDENCE: Two service users at the home said that they felt safe when at the home. One said that the staff could be talked to if they he/she was not happy. The manager has reported incidents of concern through the regulation 37 notifications since the last inspection and has reported action taken which has included involving care managers. There was evidence in the home that CRB checks and POVA checks are taking place. A member of staff confirmed to have been supervised during the period waiting for the CRB check to be completed. A member of staff was able to describe appropriate action to take if suspicious that abuse may have occurred. A second member of staff was about to start the Learning Disability Award Framework- accredited foundation training that included a section on adult protection. 17 Flaxfield Road H54 S11802 17 Flaxfield Road V221654 250405 Stage 4.doc Version 1.30 Page 14 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 Service users have a clean and comfortable home to live in which has recently had refurbishments and there are plans for further improvement. EVIDENCE: The home was clean, light, free from odours and homely. Service users confirmed that they are involved in the cleaning and one service user spoken to specifically was happy with involvement in this. The carpets were recognised as needing cleaning by the manager but this had been postponed while the kitchen was refurbished. This had now been completed and three service users asked, said that they liked it. The shared bathrooms and toilets were all clean and free from hazards. The manager reported that the first floor bathroom, showing signs of wear and tear, was planned to be refurbished in this financial year. The bathroom lock was noted to not be working and was brought to the manager’s attention. Areas seen in the home included the shared areas and two bedrooms. All were adequately decorated. 17 Flaxfield Road H54 S11802 17 Flaxfield Road V221654 250405 Stage 4.doc Version 1.30 Page 15 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) 33,35 Service users are supported by motivated and friendly staff group who are increasingly working well as a team. This could be improved with a review of the numbers of permanent staff and planned training. EVIDENCE: The home has 4 fulltime and 1 part time member of staff in addition to the manager. The manager stated that staff from team –mates (Mencap’s relief bank) also provide hours each week equivalent to another full time post in order to meet more individual needs and particularly at the weekend. The manager agreed that home would benefit from a full review of staffing levels based on the service users needs and a decrease in reliance on relief staff. A sample of rotas was seen for three weeks in April. Use of relief staff one week included 10 short shifts of 5-6 hours and two long shifts of 11 hours. A second included 2 long shifts and 5 short shifts and a third had 3 log shifts and 4 short. More continuity was seen by the manager to be more conducive to moving forwards with person centred plans and fulfilling wishes. There have been some staff changes recently and two new staff this year have been recruited .One was following the Learning Disability Award Frameworkaccredited foundation training having just completed the induction training and the other person had already completed both. A record of the latter was recognised by the manager as needed in the home. 17 Flaxfield Road H54 S11802 17 Flaxfield Road V221654 250405 Stage 4.doc Version 1.30 Page 16 The manager viewed the staff as keen and motivated and this was apparent in the attitudes of the two staff spoken to. They felt supported by the manager and within the staff team. Interactions between staff and service users were observed by the inspector throughout the inspection. Staff were positive and supported service users, to make choices about activities, be involved in household tasks and be involved in the inspection. Conversations were held with the service users about the staff of the home. All of the comments were favourable and such words as, ’kind’ ’nice’ ‘alright’ and one person said that staff asked people to do things not tell them what to do. Staff records of training are held and show that staff are receiving training in an increasing number of areas. One person had received training in advanced medication, bereavement and dementia and Down’s Syndrome. Training records need to be developed so that the length of training is recorded. Records need to be in place for all staff and a wider range of training is needed in relation to the specific needs of the service users such as person centred planning, communication, and relationships. 17 Flaxfield Road H54 S11802 17 Flaxfield Road V221654 250405 Stage 4.doc Version 1.30 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 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) 42 The health, safety and welfare of service users is promoted in the home. EVIDENCE: No obvious hazards were noted in the home and the home was well maintained. Checks were made of window restrictors and hot water in two bedrooms and safeguards were in place. A hot water check was also made in a bathroom and was satisfactory. The manager addresses health and safety matters at the home. Written evidence is in place to support this. The inspector sampled some of the records and noted that the fire risk assessment had been reviewed on 14/12/04. The household risk assessment had been reviewed on 2/8/04. Water temperatures had last been monitored on 2/3/05. Fire records were observed and checks had been made within required timescales. All staff were reported to have received fire training in the last year with another session due before August 05.Specialist checks of fire equipment had been recorded as completed but 17 Flaxfield Road H54 S11802 17 Flaxfield Road V221654 250405 Stage 4.doc Version 1.30 Page 18 certificates were needed in the home. Service users have been involved in fire evacuations. Health and safety training is encouraged for staff especially during the induction and foundation stage of working at the home. A new member of staff confirmed to have completed the induction training that included promoting a safe environment. The member of staff also confirmed to have received training in first aid and fire prevention in the last four weeks. Other staff have been receiving training in elements of health and safety. One person had attended a course in infection control in April 2005.Another completed a moving and handling course in October 04. 17 Flaxfield Road H54 S11802 17 Flaxfield Road V221654 250405 Stage 4.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x x Standard No 11 12 13 14 15 16 17 x x x x x x x Standard No 31 32 33 34 35 36 Score x x 2 x 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 17 Flaxfield Road Score x x x x Standard No 37 38 39 40 41 42 43 Score x x x x x x x H54 S11802 17 Flaxfield Road V221654 250405 Stage 4.doc Version 1.30 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. 1. 2. Standard 33 35 Regulation 18 (1)(a) 18(1)(i) Requirement Staff levels should be reviewed in relation to service users needs . A staff training plan must be provided and followed through. Timescale for action 25/7/05 25/6/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations 17 Flaxfield Road H54 S11802 17 Flaxfield Road V221654 250405 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Hampshire Area 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 17 Flaxfield Road H54 S11802 17 Flaxfield Road V221654 250405 Stage 4.doc Version 1.30 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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