Inspection on 08/02/07 for 176 London Road

This inspection was carried out on 8th 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 found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

176 London Road 11/10/07

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

CARE HOME ADULTS 18-65 176 London Road Waterlooville Hampshire PO7 5SP Lead Inspector Ian Craig Key Unannounced Inspection 8th February 2007 09:30 176 London Road DS0000067246.V327634.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 176 London Road DS0000067246.V327634.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. 176 London Road DS0000067246.V327634.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 176 London Road Address Waterlooville Hampshire PO7 5SP 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) 0207 4540454 www.mencap.org.uk Royal Mencap Society Mrs Heather Edney Care Home 2 Category(ies) of Learning disability (2) registration, with number of places 176 London Road DS0000067246.V327634.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection N/A Brief Description of the Service: 176 London Road is a converted detached property with a front drive for parking plus a rear garden with facilities for the residents. The building was purchased by Mencap and was refurbished to give a bespoke environment for 2 specific service users. Each resident has her won bedroom with an en suite bathroom with a walk in shower, wash hand basin and a toilet. The home has its own vehicle to transport residents. Staff are provided for 24 hours per day. The first floor contains an office, a staff sleep-in room and a bathroom. The exact fees for the home were not known at the time of the inspection but are at least £1500.00 per week. 176 London Road DS0000067246.V327634.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection consisted of a tour of the building, examination of records and documents, discussions with the manager and an interview with a staff member. The inspection was also based on the information supplied by the home in the form of a pre inspection questionnaire and on details held on the Commission service file. Staff were observed working with the residents. It was not possible to interview residents because of their communication needs. This is the home’s first inspection since registration on 22nd August 2006. What the service does well: The home has been specifically set up, designed and staffed to meet the needs and wishes of the two residents. This involved a variety of meetings with relatives and social services, assessments and a transition plan for each person. Each resident has a programme of activities based on assessed needs including holidays with staff support. The home has its own transport specifically for the transporting the residents to activities. Health care needs are addressed. There was evidence that the move to the home has been very positive for the two residents with reports of improvements in mood and activity level for each person. The home has policies and procedures for protecting residents. Staff are subject to thorough recruitment checks and undergo an induction when they start work at the home. There is a training programme for staff and at the time of the inspection there was evidence that staff receive ongoing training. Staff are provided in sufficient numbers to meet the care and social needs of the two residents. Residents’ needs and wishes were central to the refurbishment of the home. For instance, each resident chose to have a ground floor bedroom, which has been provided. The physical environment is bright, airy and modern. Each 176 London Road DS0000067246.V327634.R01.S.doc Version 5.2 Page 6 bedroom has an en suite bathroom with a ‘walk in’ shower, wash hand basin and a toilet. Bedrooms have been decorated in colours chosen by the residents. The garden has been designed for the residents with level access and specialist matting to help prevent injury. The manager is motivated and has a positive approach to improving the quality of life for the 2 residents. A comprehensive service review has been completed since the home opened. 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. 176 London Road DS0000067246.V327634.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 176 London Road DS0000067246.V327634.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): 1, 2, 3, 4 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Improvements could be made in the way that the home communicates information to the residents. Residents’ benefit from a service that has been has been tailor made to meet their assessed needs. EVIDENCE: The home has a Statement of Purpose which gives details of the service provided. Presently, this is not supplied to residents, as they would not be able to understand it. The manager explained that plans for the Statement of Purpose to be in a pictorial format that will be easier for the residents to understand. 176 London Road DS0000067246.V327634.R01.S.doc Version 5.2 Page 9 The residents moved to the home from another Mencap home. The transition was carefully planned and involved discussions with involved professionals, such as occupational therapist and social services staff. The suitability of the two residents living together was assessed. Each person has a written transition plan demonstrating that the move into the home was planned. The physical environment was designed and refurbished to meet the individual needs of each person. The manager of the home explained that the communication with building contractors was very positive and involved attention to detail so that the environment reflected the wishes and needs of the residents. Staffing levels were also devised to meet the assessed needs of each person. Copies of reviews by social services for each resident following their admission to the home are held with care records. These showed that the move into the home has been positive for both residents with noticeably improved moods and positive activity levels. A member of the care staff team described the move to the home from the previous establishment (also run by Mencap) as very positive and there is more time for staff to engage with residents on a one to one basis. Each person has a tenancy agreement. 176 London Road DS0000067246.V327634.R01.S.doc Version 5.2 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. 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. Whilst the home has comprehensive risk assessments for each person, care plans are incomplete. Residents are able to make decisions about how they lead their lives but within an appropriate system of support from staff. EVIDENCE: There are a number of documents and records for each resident detailing how care is to be provided. These include an abbreviated care plan for agency staff and monthly reports by key workers and ‘Positive Support Programme’. Comprehensive risk assessments have been recorded for each person for activities such as accessing the garden, going out, travelling in a vehicle and 176 London Road DS0000067246.V327634.R01.S.doc Version 5.2 Page 11 so on. Details of stress and anxiety are also recorded and how staff should deal with these and other behaviours requiring specific action plans, such as for aggression. Care records also showed that the home uses makaton to communicate with the residents. The home’s service review identified that the use of Person Centred Planning and communication with the residents needs to be developed. It was also noted that for one of the residents that the care plan did not detail how staff are to provide personal care. The risk assessments show that residents are able to exercise control over their lives and that any limitations are based on assessed needs. For instance, there are guidelines for residents who choose to make drinks. Care records also include a pro forma entitled, ‘what will be a good day for me,’ demonstrating that each person’s preferences are promoted in their daily living. Other examples of how residents are able to exercise choice are the pictorial diagrams used so that residents can choose their food. There is also an ‘Essential Lifestyle plan,’ which outlines the preferences, wishes and communication needs for each person. 176 London Road DS0000067246.V327634.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 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 social, recreational, educational and occupational needs are met. EVIDENCE: The home has its own vehicle, which is used to transport residents to activities and events. Presently, residents are not charged for any use of the vehicle. The vehicle allows residents to attend planned as well as more impromptu activities. Each person has an activity plan and the Essential Lifestyle Plan shows how resident’s preferences for routines, such as getting up and having breakfast, are to be catered for. It was clear from observation that staff involve residents in meaningful activities around the home. A staff member was seen to involve 176 London Road DS0000067246.V327634.R01.S.doc Version 5.2 Page 13 a resident in loading the washing machine and another staff member was playing a game with a resident. There are a variety of daytime activities for the residents, including attendance at various day centres, where residents learn cooking skills and take part in music sessions. The home has policies and procedures for involving residents in community and social activities. Records showed that residents go to the theatre, to parties, bowling, meals out, relaxation and beauty therapy. Each resident has the opportunity of a holiday. This is funded by the resident and the home. One resident had a recent holiday in a caravan accompanied by two staff. Special arrangements have to be made for residents accessing food. The home has menu plans showing a varied, nutritious and balanced diet for the residents. Nutrition reports for each resident are held with care records. A packed lunch is provided when residents go out to day services. Pictures are used to help residents choose the meals they like. Food stocks were seen and included fresh vegetables. A staff member was observed helping a resident with her breakfast. 176 London Road DS0000067246.V327634.R01.S.doc Version 5.2 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. 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. Residents’ health and personal care needs are met. EVIDENCE: Care records detail how resident’s personal and health care needs are to be met with the exception that personal care was not recorded in sufficient detail in a care plan for one resident. Appointments for treatment and checks with the optician, general practitioner and dentist were recorded for each person. More specialist health care was being provided, for instance, care records included a speech therapy report one resident. Healthcare needs assessment reports had been completed as well as a medication reviews. The home has policies and procedures for medication. Each member of the care staff team attends a one-day medication training course. Medication is stored correctly and the medication administration recording sheets showed 176 London Road DS0000067246.V327634.R01.S.doc Version 5.2 Page 15 that medication was being administered as prescribed and that staff recorded a signature each time medication was dispensed. Guidelines are recorded for staff to follow which shows when medication ‘as required’ should be dispensed. 176 London Road DS0000067246.V327634.R01.S.doc Version 5.2 Page 16 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. The home has a complaints procedure but this needs to be in a format that is easier for residents to use. The home protects residents from abuse. EVIDENCE: A copy of the complaints procedure is held with each resident’s records. Although the inspector was informed that the procedure is read to each resident additional steps need to be taken so that residents can understand how to make a complaint. The home has policies and procedures for adult protection. Staff have access to training courses in adult protection. The manager explained that each staff member will be completing the training. Each staff member is trained in dealing with challenging behaviour, including the British Institute of Learning Disability accredited course in Strategies for Crisis Intervention Prevention (SCIP). Care plans detailed how staff should recognise any ‘triggers’ for challenging behaviour and how staff should deescalate any potential crisis. 176 London Road DS0000067246.V327634.R01.S.doc Version 5.2 Page 17 There are policies and procedures for safeguarding residents’ finances and each person has a financial risk assessment. Staff act as counter signatories for dealing with bank accounts and all transactions, as well as monies held by the home, are recorded. 176 London Road DS0000067246.V327634.R01.S.doc Version 5.2 Page 18 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): 24, 26, 27, 28 and 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents benefit from a bright, modern and airy home that has been purposely refurbished and decorated to meet their needs and wishes. EVIDENCE: 176 London Road is a converted detached house set on two floors. The refurbishment was tailored to meet the needs and wishes of the two residents. The decoration and facilities are of a good standard. Each bedroom is decorated in colours chosen by the resident and has an en suite bathroom with a walk in shower, a wash hand basin and toilet. Bedrooms are brightly decorated with numerous items of personal possession. Both the residents 176 London Road DS0000067246.V327634.R01.S.doc Version 5.2 Page 19 chose to have their bedrooms on the ground floor. There is ample storage space in the bedrooms with a safe place for the residents to store valuables. Each bedroom has a ‘communication’ notice board, which were being used to display photographs. The communal areas consist of a lounge – diner, which has access to a garden with level access to a lawn and area where residents can use swings. Specialist ‘soft’ flooring is used in this area to reduce the impact should a resident fall. The kitchen has been specifically designed to reflect the needs of the residents and to prevent injury. Low surface temperature radiators have been installed to prevent any possible burns to residents. A call point system has been installed but is not currently needed. Areas for improvement, which were raised with the manager, include consideration of bedside lighting and tidier storage of equipment. The first floor of the home has a staff sleep in room, a bathroom, an office and a room presently not used other than for storage. The home was found to be clean and hygienic. 176 London Road DS0000067246.V327634.R01.S.doc Version 5.2 Page 20 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, 33, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides sufficient numbers of well-trained staff to meet the needs of residents. Residents are protected by the recruitment procedures. EVIDENCE: The staff rota confirmed the provision of two care staff in the morning with one staff member on duty from 12 noon to 2.30pm and two staff on duty again from 2pm to 9.30pm. At night time there is ‘waking’ staff member as well as a ‘sleep in’ staff member who covers 176 and 178 (a 3 bedded home also run by Mencap) London Road. Two staff were observed to be on duty in the morning and in the afternoon. At weekends there are two staff on duty. Recruitment procedures were examined for a recently appointed staff member. These showed that appropriate identity checks had been carried out as well as 176 London Road DS0000067246.V327634.R01.S.doc Version 5.2 Page 21 other checks such as obtaining two written references, and criminal record bureau (CRB) and protection of vulnerable adults (POVA) checks. Staff records showed that the person had been interviewed. This same person had a 6 week induction which was recorded and is based on the Learning Disability Awards Framework (LDAF). Each staff member has a supervision contract and records showed that supervision takes place on a regular basis. Each staff member has mandatory training in first aid, moving and handling, epilepsy, fire safety, medication, Strategies for Crisis Intervention Prevention (SCIP) and food hygiene. In addition to this staff are able to undertake other training. Two of the five staff have NVQ 3 and two staff will be completing the training shortly. One staff member will be studying NVQ 2. Staff described their work in a positive manner and that the move to the home from the previous establishment has meant that staff are able to spend more time with the residents. It was also confirmed by staff that regular supervision takes place and that there is an appraisal of training needs. 176 London Road DS0000067246.V327634.R01.S.doc Version 5.2 Page 22 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, 41 and 42 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 managed with a system of review and development for the year ahead. Health and safety procedures are generally of a good standard with the one exception. EVIDENCE: The manager has qualifications in NVQ 4 and the Registered Manager’s Award. She is an NVQ assessor, an instructor in Strategies for Crisis Intervention 176 London Road DS0000067246.V327634.R01.S.doc Version 5.2 Page 23 Prevention (SCIP) and has completed other courses relevant to the management of the home, such as, training and support, and, discipline and grievance. Mencap regional management has carried out a service review of the home, which identifies the home’s strengths and those areas in need of improvement. Residents records are kept in an unlocked cupboard in the lounge and need to be securely locked when not in use in order to safeguard confidentiality. The home’s appliances and equipment are serviced and maintained according to safety standards. The fire logbook showed that the fire safety equipment is tested to fire safety regulations. Staff receive training in key areas regarding health and safety: infection control, first aid, food hygiene and moving and handling. A toilet cleaning chemical was not securely stored and had been left in a resident’s en suite bathroom. 176 London Road DS0000067246.V327634.R01.S.doc Version 5.2 Page 24 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 2 2 3 3 4 4 3 5 3 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 4 25 X 26 4 27 4 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 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 2 X 2 176 London Road DS0000067246.V327634.R01.S.doc Version 5.2 Page 25 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 YA6 YA7 Regulation 15 4, 5, 15 and 22 Requirement Each resident must have a care plan that records how personal care is to be provided. Information, such as the Service Users’ Guide and complaints procedure, must be provided to residents in a format that they can comprehend. Resident’s records must be securely stored when not in use. Cleaning chemicals must be securely stored when not in use. Timescale for action 08/05/07 08/05/07 3 4 YA41 YA42 17 13 08/03/07 08/03/07 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 176 London Road DS0000067246.V327634.R01.S.doc Version 5.2 Page 26 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 176 London Road DS0000067246.V327634.R01.S.doc Version 5.2 Page 27 - 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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