Inspection on 09/08/07 for 2 West Road

This inspection was carried out on 9th August 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 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 West Road 07/11/06

2 West Road 09/11/05

2 West Road 08/02/05

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 2 West Road 2 West Road Hedge End Southampton Hampshire SO30 4BD Lead Inspector Pat Griffiths Unannounced Inspection 9 August 2007 11:00 th 2 West Road DS0000061632.V343218.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 West Road DS0000061632.V343218.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 West Road DS0000061632.V343218.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 2 West Road Address 2 West Road Hedge End Southampton Hampshire SO30 4BD 023 80 470557 02380 462201 westrd@iliace.com 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) ILIACE Limited Mr Allan Diamante Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 2 West Road DS0000061632.V343218.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th November 2006 Brief Description of the Service: 2 West Road is a care home registered to provide care and accommodation for four adults with learning disabilities between the ages of 18 and 65. The service is one of several provided by Iliace Ltd in the local area. The house is situated in a cul-de-sac in a residential area of Hedge End, which is between Southampton and Portsmouth, and close to nearby facilities and amenities. The house is detached and has a large enclosed rear garden, which has a lawn, shrubs, flowerbeds and a patio area that is accessible to everyone living in the home. Each resident has a single bedroom and there is a large communal lounge with a dining or activity area and a kitchen / diner. A car is provided at the home, which is used to take the residents out and about when there is a registered driver working in the home. The manager said that the average fees for the home are approximately £1738.46 per week. 2 West Road DS0000061632.V343218.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 an unannounced visit on 9th August 2007. The information provided included an Annual Quality Assurance Audit [AQAA], which had been completed by the manager and returned to the commission as well as completed CSCI comment cards from the people living in the home and other information that has been provided since the last inspection, such as accident reports. The inspector telephoned the home on the day before the unannounced visit, to make sure that some of the residents would be at home when the inspector arrived. The registered manager was on holiday but the manager from another home in the area, who has worked in the home and knew the residents well, was available to assist the inspector. The inspector was able to talk to the registered manager on the telephone a few days after the visit, when he had returned from his holiday. During the site visit the inspector spoke with two residents, the care staff on duty, the visiting manager and the area manager who visited during the day. The inspector was able to see different parts of the home, such as the kitchen, dining room, bathrooms, the garden and some of the bedrooms. Documents relating to the residents, staff, policies and procedures and documents regarding the running of the home were seen during the visit. What the service does well: All potential residents have their needs fully assessed before they are invited to see if they would like to move into the home. Staff provide good support to the residents, helping them to make decisions about their lives, the activities that they take part in and to maintain contact with their families. Residents are encouraged to plan their own menus and shopping lists and those that wish to also do the shopping. The home also provides good support to meet the personal and health care needs of the residents, medication is stored safely and administered by suitably trained staff. A structured training programme ensures that the staff can meet the needs of the people living in the house. The manager promotes the health, safety and welfare of the residents and staff. 2 West Road DS0000061632.V343218.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 West Road DS0000061632.V343218.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 West Road DS0000061632.V343218.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. People wishing to use this service benefit from having a comprehensive preadmission assessment of their needs before moving into the home EVIDENCE: The files of the people living in the home were looked at during the visit. Each contained a full assessment of their needs, which had been completed before they moved into the home. The pre-admission assessment covers all of the individual needs of the potential resident, and includes communication, mobility, dietary and personal care needs. There have been no admissions into the home since the last inspection. 2 West Road DS0000061632.V343218.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. Care plans provide sufficient information to ensure that the people in the home, especially those with complex health care issues, have all their needs met. EVIDENCE: The personal files of the people living in the care home were looked at. Each person had a care plan, which had been developed from their initial needs assessment and has been reviewed every two months and amended where necessary. Their care plans contained details of how they should be supported to make decisions and staff were seen supporting the residents during the course of the visit in a sensitive and friendly manner. Two of the residents were out during the morning and those that were at home chose not to speak to the inspector. Each resident also had an ‘objectives’ form in their file, which outlined their goals for a variety of activities, such as personal care and 2 West Road DS0000061632.V343218.R01.S.doc Version 5.2 Page 10 managing to use an electric razor. A list of each persons ‘special’ dates is also kept, such as parents or siblings birthdays. The care plans also contained risk assessments, which set out assessed hazards and the necessary actions to be taken to minimise the risk of harm. At the last visit it was noted that risks that had been identified in the risk assessments regarding staffing numbers were not always complied with. The manager said that staffing numbers had been increased and the risks were now minimal as “two to one support” is usually provided for excursions outside the home. It was also noted that another risk assessment required all staff to have completed “SCIP-r” training [Strategies for Crisis Intervention and Prevention] to enable them to support residents who may be physically aggressive, the manager said that this training had now been organised to ensure that all staff had the appropriate skills. There is also a care-plan awareness sheet in each file, which all staff sign to indicate that they have read the care plan on their first working day after any care plan changes have been implemented and then quarterly afterwards. 2 West Road DS0000061632.V343218.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. People who use this service are encouraged to choose a balanced diet and their diverse activities are well supported. EVIDENCE: The people living in the home are encouraged and supported to take part in a range of educational and leisure activities, although there are now fewer educational services available to them. On the day of the visit two residents had gone ‘crabbing’ on the beach at Bournemouth, which is a popular activity in the summer. The inspector saw a list of activities that are planned for the rest of the summer and it included local rambles, art therapy, swimming, emailing their parents, numeracy and literacy sessions. Some of the residents go to the QE11 day centre, which is in a country park and provides outdoor activities such as archery, climbing and canoeing. The manager said that the residents enjoy fun cooking, making biscuits, cakes and puddings as well as some ‘foods of the world’. One of the residents attends horticultural college, 2 West Road DS0000061632.V343218.R01.S.doc Version 5.2 Page 12 and with his colleagues from college, was involved in improving the homes garden for a ‘best garden’ competition within the local Iliace group. The residents also have chores to complete and details of the support they need to complete these household jobs, such as cleaning and cooking, are detailed in their care plans. The home has a planned menu, which is planned by the people living in the house, that takes into account their likes and dislikes and provides a varied and balanced diet. The residents said the food was good and they could always have something different if they wanted to. Mealtimes are flexible to fit in with their various daily activities. Having decided in their weekly meeting what they would like the menu to be for the week, the shopping is then done at a local supermarket. The kitchen was well stocked with a variety of good quality food. 2 West Road DS0000061632.V343218.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. Staff medication practices protect the people living in the home and good support is provided to meet their personal care and health needs. EVIDENCE: Each of the residents in the home had their care and support needs set out in their individual care plans. People living in the home who spoke to the inspector said that staff provided support in the way they wanted it. In the comment cards they indicated that they felt that the staff treated them well, listened to them and acted on what they said. A record is kept of the resident’s visits to healthcare services, including GP, dentist, optician, occupational therapist, psychiatrist and speech and language therapist. None of the residents manages their own medication, but are supported by the staff. All medication was stored in a locked cabinet in the office. The home uses a monitored dosage system for regular medication and all medication 2 West Road DS0000061632.V343218.R01.S.doc Version 5.2 Page 14 administration records [MAR sheets] that were seen had been signed when medication had been taken. The MAR sheet is also used to record medication coming into the home, providing an audit trail. Each resident has their own MAR sheet, which contains their photograph to ensure that new or agency staff know who they are supporting with their medication. All staff had completed medication training, which included an assessment of their knowledge. There is also a sheet of names and signatures at the front of the MAR sheet folder, so that it is easy to know who has signed for what medication. 2 West Road DS0000061632.V343218.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. People living in the home are confident their complaints will be taken seriously and acted upon and are protected by staff training EVIDENCE: The complaints procedure has been supplied to all of the people living in the home in an accessible pictorial format, as well as a pictorial reminder on what they can do when they are not happy. The manager said that any issues, concerns and complaints that are raised are dealt with within the timescale laid out in the procedure. The returned comment cards indicated that all of the residents were happy living in the home and three indicated that they knew how to make a complaint. The home has an adult protection policy in place and a copy of the local authority adult protection procedures. Staff have undertaken adult protection training and those spoken with demonstrated a good understanding of abuse and the action to be taken if abuse was reported or suspected. The home holds a small amount of cash for some of the residents, which is kept in individual plastic wallets. The records seen contained details of individual expenditure, which matched receipts and the balances were correct. 2 West Road DS0000061632.V343218.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. People who use this service live in a safe, well maintained, clean and hygienic home. EVIDENCE: During the course of the visit the inspector was able to see various parts of the home, such as the kitchen/diner, sitting room, quiet room and one of the four bedrooms. The home is generally well maintained and decorated throughout, with domestic and good quality furnishings. The people living in the home have personalised their bedrooms with pictures, televisions, ornaments and one of the residents has chosen to have their bedroom windows covered with white opaque film for privacy. The home has a large enclosed rear garden, which the residents are able to access. There are lawns, a patio with chairs and umbrellas and the borders are well stocked with shrubs and plants. The front garden has also been 2 West Road DS0000061632.V343218.R01.S.doc Version 5.2 Page 17 attractively filled with shrubs and flowers and hanging baskets. One of the residents attends horticultural college and with some of his college friends has spent a lot of time attending to the gardens as there was a competition in the group of homes for ‘best garden’, which unfortunately was won by another home. There were plans to develop a sensory area in part of the quiet lounge, there are some pieces of equipment in place that have been chosen by the residents, but it has not yet been completed. The home has domestic washing and drying machines in the laundry room, which is off the corridor so that dirty laundry is not taken through the kitchen to access the laundry room. At the last visit it was noted that the upstairs bathroom did not have any lavatory paper or soap, due to the particular needs of one resident and this has been rectified with a liquid soap dispenser on the wall and a secure lavatory paper dispenser, frosted glass has also been fitted in the windows. It was noted during this visit that the floor in the bathroom was not sealed properly around the lavatory basin or beside the bath, which has allowed some water damage to occur. The manager said that arrangements had been made for new flooring to be laid in the week following the inspection. The downstairs shower room looked grubby and tatty and the manager said that this was due for refurbishment in September, when it will be changed into a ‘wet room’. The maintenance book was seen and all repairs are up to date. 2 West Road DS0000061632.V343218.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. Robust recruitment practices protect the people living in the home EVIDENCE: The home has four residents who are supported by six full time and one part time members of staff. The staff roster showed that there are two staff on each daytime shift and one at night. The manager said that spare shifts are usually covered by staff from the home or other homes in the group. The notice board in the hallway has a pictorial roster system so that the people living in the home know who will be working with them for the day. It was noted at the last visit that not all staff files in the home contained the necessary and relevant paperwork. The manager said that staff recruitment is now done via the home, so all documentation such as application forms, references and checks such as Criminal Records Bureau [CRB] disclosures are on file in the home and available for inspection. The manager said that potential new staff are invited to work a shift in a ‘shadow’ or supernumerary 2 West Road DS0000061632.V343218.R01.S.doc Version 5.2 Page 19 capacity so that the people living in the home and the staff could provide feedback to the manager regarding the persons suitablitiy for work in the home. The manager said that the staff team is nearly complete, there is a vacancy just one night support worker to be filled and recruitment is on-going . Staff spoken with said that they received good training, which helped them to meet the needs of the residents. A record is kept of all training that staff have undertaken which includes induction, first aid, medication administration, food hygiene, fire safety, health and safety, infection control, adult protection, autism, challenging behaviour and crisis intervention and prevention. All new staff are having the Learning Disabilities Awards Framework [LDAF] induction which is a national programme designed to ensure that all staff in learning disability services have the approriate training. Senior staff in the home have completed updates or appropriate training for their skills and responsibilities in the house. All new agency staff receive an inhouse induction, which is recorded. The manager said that guidelines are in place regarding SCIP-r or safe ‘Break-Away’ practices to support any new or agency staff who are not yet trained, so that they can still be confident in working and supporting the residents, whilst keeping themselves safe. 2 West Road DS0000061632.V343218.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 residents live in a well run home, and their health, safety and welfare is promoted. EVIDENCE: The registered manager has been in post since 2006, having completed registration with the commission since the last inspection. He is working towards the Registered Managers Award and NVQ assessors award, hoping to complete them by the end of 2007. The manager said he receives good support from the senior management staff and is able to speak with them whenever he needs to. Regular supervision meetings are held with the area manager who also visits the home each month 2 West Road DS0000061632.V343218.R01.S.doc Version 5.2 Page 21 to review the quality of service in the home, chatting with residents and staff and looking at different parts of the home. The reports of the monthly visits do now reflect what is happening in the home and action is taken to remedy any defects or shortfalls that are noted. These reports are kept in the home and are available to the inspector when they visit. The manager said that the home now has ‘house objectives’, which provides a better structure of support for the residents, with a well structured home management team. Staff have also been given a firm objective of what is expected of them in supporting the people living in the home. The visiting manager said that the house is a lot calmer and relaxing as the residents are more settled and happy, and any problems or issues are addressed immediately. Staff morale is good and staff are confident with their roles and responsibilities within the home. Staff and residents were seen to interact well, and it was apparent that they have all established good relationships. The home has a fire risk assessment and regular checks are made of the fire warning system and the safety equipment. The gas system is serviced annually and annual tests of portable electrical appliances are completed. Risk assessments have been 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. 2 West Road DS0000061632.V343218.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 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 2 West Road DS0000061632.V343218.R01.S.doc Version 5.2 Page 23 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 2 West Road DS0000061632.V343218.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. 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