Inspection on 04/12/06 for 17 Quay Haven

This inspection was carried out on 4th December 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

17 Quay Haven 29/11/07

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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 17 Quay Haven Swanwick Southampton Hampshire SO31 7DE Lead Inspector Mrs Pat Hibberd Unannounced Inspection 4th December 2006 09:00 17 Quay Haven DS0000067324.V319781.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 Quay Haven DS0000067324.V319781.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 Quay Haven DS0000067324.V319781.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 17 Quay Haven Address Swanwick Southampton Hampshire SO31 7DE 01489 885971 01489 885971 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) www.hantspt.nhs.uk Hampshire Partnership NHS Trust Mrs Cynthia Susan Tibble Care Home 4 Category(ies) of Learning disability (4), Learning disability over registration, with number 65 years of age (4) of places 17 Quay Haven DS0000067324.V319781.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: LD Learning Disability (4) LD(E) Learning Disability – over 65 Date of last inspection New Provider 18/04/2006. Brief Description of the Service: 17 Quay Haven is a 3 bedded detached property situated in a cul de sac close to the village of Hamble and within a short car journey to the city of Southampton which has a range of leisure and shopping facilities. There is a small garden which is accessible to service users with physical disabilities. The Providers are Hampshire Partnership NHS Trust and the Registered Manager Mrs Cynthia Tibble. 17 Quay Haven DS0000067324.V319781.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The evidence used to write this report was gained from a review of the information the provider sent to the Commission for Social Care Inspection (CSCI) and a site visit to the home on 4th December 2006. During the site visit the inspector spoke with care staff on duty, the manager, and a team manager for Hampshire Partnership NHS Trust. Three service users were spoken with directly and observation of interaction between service users and staff were observed throughout the visit. A tour of the building was made and documents relating to the running of the home were inspected during the visit. What the service does well: What has improved since the last inspection? A number of bedrooms and communal areas have been redecorated and a decking area built in the garden. 17 Quay Haven DS0000067324.V319781.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. 17 Quay Haven DS0000067324.V319781.R01.S.doc Version 5.2 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 17 Quay Haven DS0000067324.V319781.R01.S.doc Version 5.2 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. 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. There are good systems to assess the needs of service users before they move into the home. EVIDENCE: The Home is currently accommodating three service users all of whom have lived in the Home for many years. The file of one service user was inspected during the visit confirming that a detailed assessment of their needs had been compiled and regularly reviewed. The assessment covers the individual needs of the service user, including communication, personal care, support and cultural needs. A copy of the service user’s care management assessment was also available. Although there has been no recent admissions the Home there is a vacancy. The manager indicated that prior to the vacancy being filled a full assessment of the prospective service user’s needs would be undertaken in consultation with all relevant parties. Although standard 1 is not a key standard due to the recent change in Provider the inspector confirmed with the manager that the statement of purpose had been updated and provided to service users. Due to the needs of individuals the inspector was unable to confirm their understanding of the changes. However, the manager indicated that staff have endeavoured to talk through issues with service users including there new terms and conditions. 17 Quay Haven DS0000067324.V319781.R01.S.doc Version 5.2 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. 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. The home has good care planning systems, which are regularly updated and reflect the support that service users need. The risk assessment system is good with assessments updated as required. Good support is provided to help service users make decisions about their lives. EVIDENCE: One service user file was viewed and the care was discussed with staff and the individual. Observations were also made throughout the visit as to how the support and care detailed within the service users file was delivered. It was evident that the care plan had been developed from the service user’s initial needs assessment and had been regularly reviewed, either monthly or when the needs of the individual changed. The care plan contained details of how the service user should be supported to make decisions. For example having a choice of activities, opportunity to cook or go out for the day. Throughout the visit staff demonstrated an excellent understanding of the support required to enable individuals to achieve their potential whatever that may be. 17 Quay Haven DS0000067324.V319781.R01.S.doc Version 5.2 Page 10 Person Centred Planning training has been undertaken by staff with one staff member indicating that the process enables you to “think about the individual service user rather than the service as a whole”. Risk assessments were in place in the file inspected. These documents set out identified risks to the service user in relation to an activity they may wish to partake in for example and action to minimise the risk of harm. The risk assessments had also been regularly reviewed. In discussion with staff it was evident that they had a good understanding of the contents of the care plans of all service users accommodated and thought that the actions set out in the risk assessments helped to keep service users safe. They further indicated that they were involved in the review of service users’ care plans and felt confident in the support they provided. There was further evidence in the file viewed that care provided has been captured through a continuous process of monitoring /observation by the staff team. Time was spent with the individual to enable the inspector to observe practices in the Home with particular emphasis placed on staff communication with the individual in relation to how they were to spend their day and how it reflected identified needs in their care plan. It was evident that staff were aware of the service user’s needs and care plans were being implemented. Service users were observed verbally confirming how they were to be spending their day although due to anxiety experienced by one of the service users feedback as to the quality of service provision was limited. The manager confirmed that Care Management assessments had been provided for a number of service users and that Community Health Teams were involved with individuals as necessary. Daily records are completed for all service users with shift “handovers” and regular staff meetings taking place with a view to ensuring continuity of care. 17 Quay Haven DS0000067324.V319781.R01.S.doc Version 5.2 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. 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. The home provides good support for service users to take part in suitable activities, to maintain relationships with family and friends and provides good food. EVIDENCE: Service users are supported to take part in a range of educational and leisure activities including day services, college, trips out to local shopping and garden centres and in house activities including flower arranging and cooking. One service user spoken with showed the inspector the kitchen and explained how they made themselves a drink. Another service user described a recent holiday taken on a cruise ship with support from staff in the Home. All service users have an opportunity to go on holiday or have trips out as one individual chose this year. The Home has a car available for the use of service users. There is a mileage charge that is detailed in the statement of purpose and service user guide. 17 Quay Haven DS0000067324.V319781.R01.S.doc Version 5.2 Page 12 One service user has their own car of which staff are insured to drive. Due to all the service users accommodated being over 65 years of age the manager explained that staff are monitoring activities undertaken by individuals for many years to ensure they are activities service users continue to enjoy. One example being day services of which one service user has recently changed from one whole day to two half days which has proven to be more suitable to their current needs. On the day of the visit, two service users were at Home and one went out to shop for foodstuff with staff support. The file viewed of one service user contained details of activities they had taken part in, including attending day services, shopping trips and cooking. Service users are supported to keep in touch with family and friends if they so wish. Details of the support service users need to complete household jobs, such as cleaning and cooking, are detailed in their care plans with staff indicating that they encourage service users to remain as independent and mobile as possible. The home has a planned menu that takes into account the likes and dislikes of service users and provides a varied and balanced diet. The meal service users had during the visit included different options. Service users are encouraged to take part in preparation of their meals. Mealtimes are flexible to fit in with service users’ activities and the kitchen was well stocked with a variety of good quality food. Dietary needs would be catered for although the manager indicated that there are no service users currently accommodated who require a special diet. 17 Quay Haven DS0000067324.V319781.R01.S.doc Version 5.2 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. 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. The home provides good support to meet the personal care and health needs of service users. The medication systems in the home are good and protect service users. EVIDENCE: Details of the personal care support service users need are set out in their care plans. Staff spoken with demonstrated a good understanding of the needs of service users and how they should be met. For example there is one service user accommodated who has a visual impairment. In discussion with staff it was evident that they had received some training as to how to support the individual and were able to describe environmental changes that had been made in the Home to enable the individuals mobility. Staff were observed supporting service users in a discreet, dignified and respectful manner with their personal care needs. Records are maintained of service users’ visits to health services, including GP, dentist, optician, community nurse and speech and language therapist. The records kept included details of any advice given by the practitioner. 17 Quay Haven DS0000067324.V319781.R01.S.doc Version 5.2 Page 14 PRN (as required) medication was stored in a locked cabinet in the office and medication administration records including a record of medication entering and leaving the home are fully completed by trained staff. One care plan viewed had detailed guidance regarding the administration of PRN of which staff had a thorough awareness of. Staff have received medication training and indicated that they felt confident with the training provided. There are currently no service users accommodated who self medicate. However, medication (with the exception of PRN) is kept in a locked drawer in service users’ bedrooms with a risk assessment in place that is regularly reviewed. The manager explained that this procedure has been in place for many years and enables individuals to have a sense of “ownership” of their own medication that can be administered in the privacy of their bedroom by staff. Although the inspector was unable to confirm with service users as to whether they were happy with this arrangement from observation of service user interaction with staff it was evident that they would feel comfortable in expressing any dissatisfaction with aspects of their care. 17 Quay Haven DS0000067324.V319781.R01.S.doc Version 5.2 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. 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. The complaints policy and procedure is accessible to all service users ensuring their concerns are addressed. Arrangements for protecting service users are satisfactory. EVIDENCE: The home has a complaints procedure available, which sets out who will deal with a complaint and how long the provider will take to respond to a complaint. The procedure has been supplied to all service users in both a written and pictorial format to aid understanding. Service users spoken with said they would speak to staff if they wanted to make a complaint and were confident they would be taken seriously. There have been four complaints made to the Home since the last inspection. These were viewed and seen to have been appropriately dealt with by the manager. Three related to parking issues raised by neighbours that were quickly resolved at the time. However, there is limited parking on the drive and the manager indicated that she will be discussing the possibility of extending the drive with the Trust with a view to accommodating additional cars. The home has an adult protection policy and a copy of the local authority adult protection procedures. All staff have received adult protection training and one staff member spoken with demonstrated a good understanding of abuse and action to take if abuse was reported or suspected. 17 Quay Haven DS0000067324.V319781.R01.S.doc Version 5.2 Page 16 The money of service users was not inspected on this occasion. However, the manager explained that service users hold their own money in a lockable drawer in their rooms that is audited weekly by the manager and quarterly by the team leader. All transactions require two signatures and a receipt to support expenditure. There is a safe in the office that can be used to secure service users money and valuables with their permission. The Manager demonstrated that she is aware of the Hampshire Adult Protection policy and procedure and her role in the event of an allegation of abuse. Staff spoken to were also aware of their role and responsibilities and had undertaken Adult protection training. Due to there being service users accommodated who can become anxious and exhibit challenging behaviour Strategies in Crisis for Prevention and Intervention training is undertaken by all staff. Details of approaches to be taken were detailed in the service user file viewed although the manager explained that the Home does not practice any form of physical “ restraint” preferring to utilise strategies complied with the community health team. Strategies that include redirection techniques and touch control with PRN administered as a last resort. 17 Quay Haven DS0000067324.V319781.R01.S.doc Version 5.2 Page 17 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. The home is well maintained and provides a safe, homely environment for service users. EVIDENCE: The Home was clean, bright and hygienic with policies and procedures and systems in place including infection control /Control of Hazardous to Health (COSHH)/food hygiene and moving and handling training for staff. Staff spoken to confirmed that they were aware of their responsibilities in relation to hygiene in the Home, were provided with gloves and aprons as required and had received infection control training. Hand washing facilities were seen all around the Home. There is a separate laundry. 17 Quay Haven DS0000067324.V319781.R01.S.doc Version 5.2 Page 18 Some of the communal areas and service users’ bedrooms have been redecorated and the manager confirmed that service users have been involved in the choices made . There are proposals to change the bathroom to a wet room although this has not been confirmed. There has been one visit made by the Environmental Health Officer since the last inspection when one requirement was made. The manager has addressed the requirement that related to guidelines as to systems in place in the kitchen being documented and shared with all staff. In discussion with staff they were aware of the guidelines and application to their practice. There have been no visits from the Statutory Fire officer. 17 Quay Haven DS0000067324.V319781.R01.S.doc Version 5.2 Page 19 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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff receive a range of training ensuring the needs of service users are met. Documentation held in the Home does not indicate that recruitment procedures protect service users. EVIDENCE: The home has a rota that demonstrates there are two staff on duty during the day and one sleep in staff member between 9.30pm and 8am. The manager said that additional staffing from a regular team of bank workers was provided if necessary to support service users to go out to events in the evenings. In discussion with two staff they indicated that there were sufficient staff to support the current needs of service users. The manager reported that there have been no staff appointed in the last two years. The recruitment records of four staff were inspected. However, although the manager produced a number of folders with documentation relating to staff recruitment she was not familiar with what the folders contained or, the requirements of the Care Homes Regulations 2001. 17 Quay Haven DS0000067324.V319781.R01.S.doc Version 5.2 Page 20 It was evident during the inspection of two of the files that there was only one reference held. Another file held a reference that did not correspond with the referee detailed in the application form. One file indicated that the staff member was no longer employed although the manager confirmed that she was a permanent member of staff. During the inspection documentation confirming the staff member was employed on a permanent basis was faxed to the Home from the Human Resources Department. The manager agreed that she needs to familiarize herself with the Care Homes Regulations 2001 including the recent amendments relating to staff records. She further indicated that she would contact the Human Resources Department that afternoon to ensure staff files were up to date. The manager reported that 50 of the seven staff employed have achieved the National Vocational Qualification (NVQ) at level two or above. One staff member is currently working towards the qualification. Staff spoken with said that they had undertaken a range of training with their previous provider which helped them meet the needs of service users. However, they indicated that there had been some difficulties obtaining places on training courses since the change of provider although this was now improving. A record is kept of all training that staff have undertaken and a training needs assessment has been completed for all staff this year. All staff complete an induction course and additional courses, including first aid, medication administration, food hygiene, moving and handling, fire safety, health and safety, adult protection, sensory loss, mental health, challenging behaviour and strategies for crisis intervention and prevention (SCIP). 17 Quay Haven DS0000067324.V319781.R01.S.doc Version 5.2 Page 21 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): 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 safe and well run home which reflects their individual choices and preferences. EVIDENCE: The Registered Manager Mrs Cynthia Tibble has been in post for two years and has many years of experience of working alongside individuals with a learning disability. She has achieved NVQ level 4 and is due to commence the registered managers award. She allocates herself management time to complete administrative work as well as working hands on with service users. 17 Quay Haven DS0000067324.V319781.R01.S.doc Version 5.2 Page 22 Staff said they felt well supported and that it was a good home to work in. Service users also said they had confidence in the manager. This was evident during the inspection where service users freely made requests and expected to have their needs met. Quality assurance systems in place include monthly regulation 26 visits which ensure service users are consulted as part of this process. Service users are regularly consulted at house meetings and the atmosphere in the home reflects the wishes and preferences of the individuals who live there. Health and safety is maintained in the home via staff training and suitable notices and instructions for service users. Risk assessments highlight any health and safety issues are procedures are in place to support service users. 17 Quay Haven DS0000067324.V319781.R01.S.doc Version 5.2 Page 23 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 3 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 2 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 Quay Haven DS0000067324.V319781.R01.S.doc Version 5.2 Page 24 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 Standard YA34 Regulation Requirement Timescale for action 11/12/06 19,schedule The Registered Provider must 2 ensure staff files hold all information as required in the Care Home Regulations 2001. 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 Quay Haven DS0000067324.V319781.R01.S.doc Version 5.2 Page 25 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 Quay Haven DS0000067324.V319781.R01.S.doc Version 5.2 Page 26 - 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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