Inspection on 12/09/06 for 19 Chilgrove Road

This inspection was carried out on 12th September 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 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

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 19 Chilgrove Road Drayton Portsmouth Hampshire PO6 2ER Lead Inspector Clare Hall Unannounced Inspection 11th September 2006 10:00 19 Chilgrove Road DS0000067318.V305806.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 19 Chilgrove Road DS0000067318.V305806.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. 19 Chilgrove Road DS0000067318.V305806.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 19 Chilgrove Road Address Drayton Portsmouth Hampshire PO6 2ER 023 92 210602 023 92 210602 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) Hampshire Partnership NHS Trust Mrs Ann Mitchell Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 19 Chilgrove Road DS0000067318.V305806.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: NONE Date of last inspection NA Brief Description of the Service: 19 Chilgrove Road is a registered care home providing care and accommodation for up to four younger adults (aged 18 to 65 years) with learning disabilities. The home is formed of two residential houses to make one detached home at the end of a cul de sac. There are small front, side and rear gardens as well as off road parking. The home provides four single bedrooms of good proportions, two with en-suite facilities on the first floor and two without en suite facilities on the ground floor. Mrs Ann Mitchell manages the home. 19 Chilgrove Road DS0000067318.V305806.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was the first of this inspection year and was undertaken unannounced. The manager was not available but the care staff and service users were very supportive in all aspects of the visit. All key standards were inspected along with additional non-key standards. The inspection lasted four hours during which a tour of the building was undertaken. Discussions were held with the care staff on duty. All service users living within the home were met during the inspection however due to physical and cognitive disabilities it was not possible to discuss the home with the service users. Service users appeared happy, relaxed and well cared for. Care and other records and documentation identified in the report were viewed. What the service does well: What has improved since the last inspection? What they could do better: The manager will need to be aware of the forthcoming changes in the Fire Regulations and ensure she develops the appropriate risk assessment. 19 Chilgrove Road DS0000067318.V305806.R01.S.doc Version 5.2 Page 6 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. 19 Chilgrove Road DS0000067318.V305806.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 19 Chilgrove Road DS0000067318.V305806.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2, Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Prospective service users have the information they need to make an informed choice about where to live. No new service users have been admitted in this home for a number of years. EVIDENCE: The home is owned by the Downland Housing Association and this service is a part of the Trusts Learning Disabilities and Social Care Directorate and since the registration of this service the organization has developed a services users’ guide which sets out clear and accessible information for service users. It has been adapted in pictorial format and could also be further improved by enlarging the text. It clearly details the complaints procedure and was seen held on each service users personal files. All clients within the home had lived together for between nine and fifteen years. There have not been any new admissions and therefore all assessments have been audited previously and no issues have been raised. 19 Chilgrove Road DS0000067318.V305806.R01.S.doc Version 5.2 Page 9 19 Chilgrove Road DS0000067318.V305806.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. 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 and are consulted on, and participate in, all aspects of life in the home. EVIDENCE: The inspector was able to read the clients’ care records in their presence and it was noted the quality of the information was excellent. The plan indicated it had been generated from many years of assessment and through consultation with support workers and the client. The plan sets out how current and anticipated specialist requirements will be met (for example, emotional wellbeing, communication, lifestyle, preferences, choices, how interactions are made). The records were clear consise and up to date. Decision making, sexual and physical health matters were also recorded. 19 Chilgrove Road DS0000067318.V305806.R01.S.doc Version 5.2 Page 11 Records identified the planned interventions, rehabilitation and therapeutic Programs, structured environments, development of language and communication, adaptations and equipment, one-to-one communication support and the support from befrienders. The plan describes the specialist interventions taking place from other health and social care professionals. Behaviour plans were clearly recorded and the plan indicated individualized procedures for service users likely to be aggressive or cause harm or self-harm, focusing on positive behavior, ability and willingness, which was observed being implemented by staff. The records identified that the plans and reviews are undertaken with the involvement of the service user together with family, friends and/or advocate as appropriate, and relevant agencies/specialists. The plans seen were also made available in a language and format is also a combined pictorial format so the service user can understand. Records on observation and discussion with staff clearly indicated that staff respect service users’ right to make decisions, and that right is limited only through the assessment process, involving the service user, and as recorded in the individual service user plan. It was observed and indicated through discussion with staff that staff enable service users to take responsible risks, ensuring they have good information on which to base decisions, within the context of the service user’s individual plan and of the home’s risk assessment and risk management strategies. Discussions with staff and a tour of the premises identified that service users hold and manage their own finances with the necessary support and assistance given for budgeting and lockable space for valuables. One clients program for limitations on use of kitchen facilities was observed and it was observed how staff support this client again through a risk assessment framework with the support of the mental health team. It was further established during the visit that service users are able to participate in the day-to-day running of the home. Service users undertake cleaning, washing and shopping, making food and drinks. The menus are drawn up each week based on the preferences and choices of the clients and within a budget. 19 Chilgrove Road DS0000067318.V305806.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Service users have opportunities for personal development and are encouraged to be a part of the local community. Service users’ rights are respected and responsibilities recognized in their daily lives. EVIDENCE: Records and discussions identified that service users have opportunities to maintain and develop social, emotional, communication and independent living skills. All service users have a weekly social plan and this demonstrates participation in leisure, social and sporting activities and sensory support. Staff support service users to become part of, and participate in, the local community in accordance with assessed needs and the individual plans. 19 Chilgrove Road DS0000067318.V305806.R01.S.doc Version 5.2 Page 13 Two of the clients have regular lunch dates on a Friday supported by staff. Staff further enable service users’ integration into community life through encouraging their participation in club which promotes community presence. The service users can undertake activities such as swimming and bowling, funded by social services. At the time of the visit two care workers had taken service users on holiday and one care staff member was talking about how one of the clients was supported to go to India and how they were currently arranging another vacation for her. The service does have access to an adapted vehicle and they are currently arranging for two clients to have carer-assisted wheelchairs which have motors so that they can access the local community easier as it is quite hilly. During the visit, three of the current accommodated service users were visited, two of them in their rooms and one client took the inspector to her room to show her the accommodation. One service user was observed enjoying her music through her own personal music deck and one other was watching Asian television and then a music channel through her digital television line. The daily routines seen during the visit do promote independence and individual choice. Records sent to the commission pre inspection and discussion with staff identified that there was freedom of movement for all clients bar one which did have restrictions which were agreed in the individual plan. Service users did have suitable locks on their doors so they could lock their doors if they wished and all service users preferred form of address was recorded in their individual plan. When the inspector arrived staff were observed talking to and interacting with service users respectfully and the staff were also respecting one service users choice to be alone in her room. Staff explained how they support the service users to budget and undertake the homes weekly shopping and how the meals are prepare. Care records identified that nutritional needs are assessed and regularly reviewed including risk factors associated with low weight, obesity, and eating and drinking disorders. The mealtimes in the home are flexible and in line with the preferences of the service users. 19 Chilgrove Road DS0000067318.V305806.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20, Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Overall, service users do receive personal support in the way they prefer and require and their physical and emotional health needs are being met. The home’s policy allows service users to retain their own medication. EVIDENCE: The inspector was impressed by the quality of the records and assessments in respect of recording service users’ preferences about how they are like to be supported and their individual needs and preferences. Times for getting up/going to bed, baths, meals and other activities were recorded and flexible to the needs of individuals. Service users choose their own clothes, hairstyle and makeup and their appearance reflects their personality as their records identify their preferences. During a tour of the house it was observed that service users have the technical aids and equipment they need for maximum independence. 19 Chilgrove Road DS0000067318.V305806.R01.S.doc Version 5.2 Page 15 One service user’s records indicated psychiatric specialist support being provided. Records set out the preferred routine, likes or dislikes of service users who cannot easily communicate their needs and preferences; it was stated by one member of staff that all staff have been with the clients for many years so staff are able to interpret verbal cues to consent and pleasure through the tone of a raised pitch or cry. Specialist communication aids are being sought for one client and one some staff have undertaken Makaton training Service users care plans also identify the healthcare needs of individuals and well women appointments were seen recorded. Records referred also to sexual health, contraceptive advice and routine health checks. Service users’ physical and emotional health needs are being met and all service users within the home were seen to be given the support to retain, administer and control their own medication with the necessary support. 19 Chilgrove Road DS0000067318.V305806.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Service users are protected from abuse, neglect and self-harm. EVIDENCE: The organization has robust procedures for responding to suspicion or evidence of abuse or neglect (including whistle blowing) to ensure the safety and protection of service users. When asked staff were aware of abuse procedures and whistle blowing. The organization has a complaints leaflet and refers to its complaints process in its service guide in brief suitable format for clients. No complaints have been received by the Commission since the last inspection. 19 Chilgrove Road DS0000067318.V305806.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29,30 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Service users’ bedrooms suit their needs and lifestyles and the homes toilets and bathrooms provide sufficient privacy and to meet their individual needs. Shared spaces complement and supplement service users’ individual rooms and the home is clean and hygienic. EVIDENCE: The inspector was shown around the premises and into the service users rooms accompanied by the service users. The home is a large residential property providing accommodation for fourservice users, two of whom on the first floor have large bedrooms and en suite facilities. A large bathroom is located on the ground floor with specialist bathing facilities for service users who have a level of physical disability. The environment is like a family home and appears comfortable. The premises are well decorated and furnished by the residents. The home is bright, 19 Chilgrove Road DS0000067318.V305806.R01.S.doc Version 5.2 Page 18 cheerful, and airy, clean and free from offensive odours, and provides sufficient and suitable light, heat and ventilation. The home does offer limited access to local amenities and staff find it difficult to use the manual push wheelchairs up the hill from the shops but are addressing this. Service users have furnished their rooms with their own possessions to their own tastes and have music centres, digital television, and nice soft furnishings. All rooms were clean and tidy and were of a good size. One service user visited was enjoying sensory lighting and music on the television while seated in her own chair with the support of pillows. Later the staff member was seen chatting with her about a possible holiday. The home provides outdoor space. Bushes and trees were in need of attention and the patio required weeding but improvements have been made recently to widen the path access around the garden as it is on an incline. There is a separate laundry room and separate kitchen, both of which are suitable for the needs of the four clients. The home also has provision of the environmental adaptations and disability equipment necessary to meet the home’s stated purpose and the individually assessed needs of all service users. 19 Chilgrove Road DS0000067318.V305806.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Staff are provide a good level of mandatory training but this could be expanded to include more service specific subjects regarding the needs of the client group. EVIDENCE: The manager was not present during this visit and so the inspector was not able to audit the staff recruitment records. Despite this pre inspection information and discussions by staff indicate that there have been no new staff employed to care for the client group. Staff records indicated staff receive core training and regular updates for manual handling, basic life support, SCIP, fire and food hygiene. The manager had also undertaken a number of courses including risk assessment, health action, adult protection and person centered care planning. Annual assessments for staff in the safe administration of medicines were observed on files. 19 Chilgrove Road DS0000067318.V305806.R01.S.doc Version 5.2 Page 20 Through discussion it was identified staff would like the opportunity to undertake more client based courses regarding learning disabilities, communications and behaviours. 19 Chilgrove Road DS0000067318.V305806.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,42 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. The health, safety and welfare of service users are promoted and protected. EVIDENCE: The manager was not available during the visit but records, staffing and visit outcomes would indicate that a very competent manager who keeps herself updated runs the home. Service user records indicated that their opinions and level of satisfaction are sought. They have regular reviews and regular consultation. The evidence so far received for a visit to the premises would indicate that the registered manager has ensured there are safe working practices and the fire log would indicate regular training and checks. The new fire regulations will 19 Chilgrove Road DS0000067318.V305806.R01.S.doc Version 5.2 Page 22 need now to be addressed and the manager will need to set about doing her fire risk assessment ready for October 2006. All chemicals were being stored appropriately and safely in lines with COSHH regulations. 19 Chilgrove Road DS0000067318.V305806.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 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 x 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 3 3 x x 3 x 19 Chilgrove Road DS0000067318.V305806.R01.S.doc Version 5.2 Page 24 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 19 Chilgrove Road DS0000067318.V305806.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: 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 19 Chilgrove Road DS0000067318.V305806.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!