Inspection on 28/11/06 for 2 Farnham Road

This inspection was carried out on 28th November 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

2 Farnham Road 17/10/05

2 Farnham Road 11/04/05

2 Farnham Road 13/09/04

2 Farnham Road 23/04/04

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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 2 Farnham Road Fleet Hampshire GU51 3JD Lead Inspector Craig Willis Unannounced Inspection 28th November 2006 10:30 2 Farnham Road DS0000011541.V315846.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 2 Farnham Road DS0000011541.V315846.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. 2 Farnham Road DS0000011541.V315846.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 2 Farnham Road Address Fleet Hampshire GU51 3JD Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01256 623248 www.new-support.org.uk New Support Options Limited Mrs Monja Gregory Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 2 Farnham Road DS0000011541.V315846.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Only one named person may be accommodated in the category LD (E). Learning disability over 65 years of age. 17th October 2005 Date of last inspection Brief Description of the Service: 2 Farnham Road is registered to provide care and accommodation to five people who have learning disabilities. Each service user has a single bedroom and shares the use of two bathrooms. Service users share the use of a lounge and the kitchen / dining room. There is an enclosed garden to the rear and side of the home that service users are able to access. The home is located in a residential area, approximately half a mile from Fleet town centre. The manager provided information to the CSCI on 26/10/06 that the fees at the home are between £926.25 and £1110.00 per week. 2 Farnham Road DS0000011541.V315846.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 28th November 2006. During the site visit the inspector spoke with one of the service users, observed the interactions between two service users and staff and spoke with the staff on duty. A phone conversation was held with the manager on 30th November 2006, as she was not present during 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: There are good systems to assess the needs of service users before they move into the home. The home has good care planning and risk assessment systems, which help service users to make decisions about their lives. Service users are supported to take part in a wide range of activities, which they enjoy. The home encourages and supports service users to meet with family and friends. Service users are supported to choose the menus for the week and mealtimes are flexible to fit in with their activities. Service users like the way staff treat them and good support is provided to meet their health needs. Medication is stored safely and staff are trained in administering medication. Service users are confident their complaints will be taken seriously and staff know what action to take if allegations of abuse are made. The home is well maintained and comfortably furnished to provide a homely environment. Staff are well trained, which helps them meet the needs of service users. Thorough checks are completed on new staff before they start working in the home. The home is well run by an experienced manager and there are good systems to keep service users and staff safe. 2 Farnham Road DS0000011541.V315846.R01.S.doc Version 5.2 Page 6 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. 2 Farnham Road DS0000011541.V315846.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 2 Farnham Road DS0000011541.V315846.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): Standard 2. 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 files of three service users were inspected during the visit, including one service user who has moved into the home since the last inspection. Each contained an assessment of their needs that was completed before they moved into the home. This assessment covers the individual needs of service users, including communication, personal care and cultural needs. As part of the assessment process potential service users are encouraged to visit the home to meet with service users and staff. Service users move into the home on an initial three-month trial period. The relatives of the service user who moved in most recently have written to the manager expressing their thanks at how well staff had managed the move and the support that had been provided to their relative. 2 Farnham Road DS0000011541.V315846.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): Standards 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. The home has good care planning and risk assessment systems, which supports service users to make decisions about their lives and take managed risks. EVIDENCE: The personal files of three service users were inspected during the visit. Each service user had a care plan that was developed from their initial needs assessment. These plans are reviewed monthly and had been changed where the needs of the service user had changed. One service user has developed an excellent person centred plan, with help from their keyworker. Staff spoken with said they were supporting other service users to develop plans and were using the completed one an example of how it could be done. One service user spoken with said they regularly meet with their keyworker to review their plans. 2 Farnham Road DS0000011541.V315846.R01.S.doc Version 5.2 Page 10 Care plans contain details of how service users should be supported to make decisions. These included detailed information on how staff should present options, for example through the use of key Makaton signs and through photos and symbols. Staff were observed using these tools to explain to a service user what was for dinner and which staff were working that evening. Risk assessments were in place for all service users whose files were inspected. These documents set out the assessed hazards to service users and action to minimise the risk of harm. The risk assessments are reviewed monthly or more frequently if necessary. 2 Farnham Road DS0000011541.V315846.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): Standards 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides good support for service users to take part in suitable activities, to maintain relationships with family and friends and to have a balanced diet of food they enjoy. Staff work in a manner that respects the rights and responsibilities of service users. EVIDENCE: Service users are supported to take part in a range of educational and leisure activities, including bowling, attending a local day service, attending an art project, aromatherapy, pub visits and social clubs. Support is provided for service users who have said they would like to attend a local church service on Sundays. Service users spoken with said they enjoyed their activities and there were enough staff to support them. Service users are supported to keep in touch with family and friends. One service user spoken with said they were going to visit their mother at the weekend with support from the staff. The home has an open visiting policy and the visitors’ book demonstrated regular visits by family members. 2 Farnham Road DS0000011541.V315846.R01.S.doc Version 5.2 Page 12 Staff were observed providing support in a friendly and respectful way, which maintained the privacy and dignity of service users. The home has a planned menu that takes into account the likes and dislikes of service users and provides a varied and balanced diet. This menu is displayed in the kitchen in pictorial format to make it more accessible to service users. One service user spoken with said they were supported to plan the menu each week. Mealtimes are flexible to fit in with service users’ activities. The kitchen was well stocked with a variety of good quality food. Specific guidelines for the support one service user needs with eating and drinking were available. These had been developed in consultation with a speech and language therapist. 2 Farnham Road DS0000011541.V315846.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): Standards 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. The home provides good support to meet the personal care and health needs of service users. The system for storing and administering medication is good and protects service users. EVIDENCE: Details of the personal care support service users need are set out in their care plans. Service users spoken with said that staff treat them well and listen to them. Staff spoken with demonstrated a good understanding of the needs of service users and evidence was seen that agency and bank staff were provided with this information on their first shift in the home. Records are maintained of service users’ visits to health services, including GP, dentist, chiropodist, psychiatrist, speech and language therapist and occupational therapist. The records kept included details of any advice given by the practitioner. One service user spoken with said they were able to see their doctor when they needed to. Medication is stored in a locked cabinet in the office and records are maintained of medication brought into the home, administered and returned to the pharmacist. Medication is regularly checked to ensure that the balance 2 Farnham Road DS0000011541.V315846.R01.S.doc Version 5.2 Page 14 recorded matches the stocks held and that all administration records have been fully completed. All staff administering medication have undertaken assessed training, which is updated every six months. 2 Farnham Road DS0000011541.V315846.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): Standards 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are confident their complaints will be taken seriously and acted upon and the home has good adult protection systems, which helps to keep service users safe. 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. The procedure has been supplied to all service users in an accessible pictorial format. One service user spoken with said they know what to do if they want to make a complaint. No complaints have been received since the last inspection. The home has an adult protection policy and a copy of the local authority adult protection procedures. Staff have received adult protection training and those spoken with demonstrated a good understanding of abuse and action to take if abuse was reported or suspected. 2 Farnham Road DS0000011541.V315846.R01.S.doc Version 5.2 Page 16 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): Standards 24 and 30. 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: A tour of the communal areas of the home was made during the visit. The home is well maintained and decorated throughout. Furnishings are domestic and of good quality. The home has an enclosed rear and side garden that service users are able to access. Two of the bedrooms have recently been redecorated. A new assisted bath has been fitted in the downstairs bathroom, enabling service users with mobility difficulties to more easily get into and out of the bath. Staff reported that service users particularly enjoy the Jacuzzi facility on the bath. Staff reported that there is a maintenance contract with the Housing Association that owns the building, and action is taken to ensure outstanding maintenance issues are followed up. There are currently no outstanding maintenance issues. The home has a separate laundry room, which means laundry is not taken through food preparation of storage areas. 2 Farnham Road DS0000011541.V315846.R01.S.doc Version 5.2 Page 17 There are hand-washing facilities in the kitchen, laundry room, bathrooms and toilets. 2 Farnham Road DS0000011541.V315846.R01.S.doc Version 5.2 Page 18 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): Standards 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good systems to protect service users and meet their needs through the staff training programme and recruitment procedures. EVIDENCE: The manager reported that four of the eleven staff employed have achieved the National Vocational Qualification (NVQ) at level two or above and two are currently working towards the qualification. During the visit, staff were observed interacting with service users in a friendly and respectful manner. The manager reported that two new staff have been employed since the last inspection in October 2005 and confirmed that Criminal Records Bureau disclosures and references were obtained before they started work. These records were not viewed during the visit as the manager was not present and documents were kept locked to maintain confidentiality. Staff spoken with said that they received very good training, which helped them to meet the needs of service users. A record is kept of all training that staff have undertaken and staff appraisals include a training needs assessment. Staff complete an induction based on the Learning Disability Awards Framework. Courses staff have completed include first aid, medication 2 Farnham Road DS0000011541.V315846.R01.S.doc Version 5.2 Page 19 administration, moving and handling, food hygiene, fire safety, health and safety, adult protection, autism, ageing and dementia, mental health and challenging behaviour. 2 Farnham Road DS0000011541.V315846.R01.S.doc Version 5.2 Page 20 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): Standards 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run by a competent manager and there are good systems to promote the health, safety and welfare of service users and staff. EVIDENCE: The manager has completed an NVQ level 4 in Care and the Registered Manager’s Award. The manager said she receives good support from the senior management staff and is able to speak with them whenever she needs to. Staff spoken with said they receive very good support from the manager. The home has sent out questionnaires to relatives to gain their views of the quality of the service that is being provided. Service users spoken with confirmed they have monthly meetings, when they can say what they think about the way the home is managed. The information from service users and their relatives is used to feed into a service plan, which includes goals for the service to achieve over the year. Senior managers from the organisation visit 2 Farnham Road DS0000011541.V315846.R01.S.doc Version 5.2 Page 21 the home each month to review the service quality. Reports of these visits contain actions that are required to improve the service. The home has a fire risk assessment and regular checks are made of the fire warning system and the equipment. There are risk assessments for the building, which are regularly reviewed and contain actions that should be followed to minimise the identified risks. The gas boiler is serviced annually and annual tests of portable electrical appliances are completed. Assessments are completed for chemicals used in the home, which are stored in a locked cupboard. The temperatures of the fridge and freezer are taken daily and recorded. Accidents and incidents to service users and staff are recorded and reported where necessary. Information from incident reports is also used to trigger reviews of risk assessments. 2 Farnham Road DS0000011541.V315846.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 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 4 X 3 X X 3 X 2 Farnham Road DS0000011541.V315846.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 2 Farnham Road DS0000011541.V315846.R01.S.doc Version 5.2 Page 24 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 2 Farnham Road DS0000011541.V315846.R01.S.doc Version 5.2 Page 25 - 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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