Inspection on 11/07/05 for 21 High Street

This inspection was carried out on 11th July 2005.

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

21 High Street 18/04/07

21 High Street 04/01/06

21 High Street 15/02/05

21 High Street 26/08/04

21 High Street 04/03/04

21 High Street 26/02/04

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Fairways

Treloar College

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Pinta

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

CARE HOME ADULTS 18-65 21 High Street Fareham Hampshire PO16 7AE Lead Inspector Laurie Stride Unannounced 11/07/05 17:20pm 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 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 Stationary 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. 21 High Street H54 S11627 21 High Street v236831 110705.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 21 High Street Address Fareham, Hampshire, PO16 7AE Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01329 232641 Mr John Fullick Mrs Sara Fullick CRH 3 Category(ies) of LD, MD registration, with number of places 21 High Street H54 S11627 21 High Street v236831 110705.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users in the categories MD and Ld are not to be admitted under the age of 18 years. Date of last inspection 15/02/05 Brief Description of the Service: Choices is a listed building in the High Street, Fareham. The providers’ accommodation is in the front of the home, with the service users having their accommodation in the extension at the back. Service users have two bedrooms and a bathroom on the first floor. The bathroom contains a shower, a washbasin and a toilet. On the ground floor there is a further bedroom together with a lounge and a kitchen containing the washing machine. The service users share a second large lounge with the providers and eat their meals in the communal kitchen/diner. There is a second toilet with hand basin by the front door. At the rear there is a courtyard that accesses onto the High Street and provides some parking space. There is also a large garden. Service users have their own entrance to the home that exits into the courtyard. 21 High Street H54 S11627 21 High Street v236831 110705.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first of two annual inspections and was unannounced. The visit lasted approximately two and a half hours, during which the inspector met and spoke with the registered providers, the three service users and visitors. Some of the home’s records were also seen as part of the inspection. There were no requirements made as a result of this visit. What the service does well: 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. 21 High Street H54 S11627 21 High Street v236831 110705.doc Version 1.40 Page 6 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 Standards Statutory Requirements Identified During the Inspection 21 High Street H54 S11627 21 High Street v236831 110705.doc Version 1.40 Page 7 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 standard(s) 2 and 5 Service users have their needs assessed prior to admission and receive written terms and conditions of residence. EVIDENCE: The homes records contained evidence of full care management assessments of service users’ individual needs, obtained prior to admission to the home. Formal contracts between the home and the funding agency were in place for each service user. Copies of signed individual terms and conditions of residence were held on file and included the rights and responsibilities of service users. 21 High Street H54 S11627 21 High Street v236831 110705.doc Version 1.40 Page 8 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 standard(s) 6 and 9 There is a clear and consistent support planning system in place to provide staff with the information they need to satisfactorily meet service user’s needs. EVIDENCE: Service users’ care plans covered all aspects of current personal and social support. For example: healthy living, living with others, handling money, planning and cooking meals, social skills for work and leisure, personal hygiene and individual goals. This included information about the level of support required as well as details of the methods used to deliver the support. Care plans are regularly reviewed to ensure service users’ changing needs are met. For example there are weekly meetings between the providers and service users, monthly care plan reviews, six monthly quality assurance reviews, and annual reviews to which care managers are invited to attend. These annual reviews support service users to look at their achievements, the things that they enjoy or find difficult, and what they would like to do. Evidence was seen in care plans that any risks relating to individuals are assessed prior to admission according to health and social services protocols, 21 High Street H54 S11627 21 High Street v236831 110705.doc Version 1.40 Page 9 and risk management strategies are agreed and reviewed as part of individual care plans. The home had also developed its own risk assessment and management framework that included sections on safety in the home for each service user. These sections incorporated elements of independent living skills development. The home had a written policy regarding service users experiencing unplanned or unexpected events and service users carried cards with staff phone numbers on them. 21 High Street H54 S11627 21 High Street v236831 110705.doc Version 1.40 Page 10 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 standard(s) 12, 14, 15 and 17 Service users have opportunities to take part in valued and fulfilling activities, maintain their relationships and have their dietary needs and preferences catered for. EVIDENCE: Care plans contained information on each individual’s goals and achievements, including independent living skills, communication, social and emotional skills. The home encourages and supports service users to look for appropriate occupational activities. There was evidence of individuals maintaining and progressing within voluntary and paid jobs and one service user talked about this. Opportunities were also available for educational activities through local colleges and information about these was available. Care plans included details of arrangements for travelling to and from college or work. Service users are encouraged and supported to pursue their interests and hobbies. One service user talked about recently taking part in the Special 21 High Street H54 S11627 21 High Street v236831 110705.doc Version 1.40 Page 11 Olympics in Glasgow and winning a gold and two silver medals. A banner and balloons had been put up outside the house in celebration of this achievement. Staff support service users to maintain family links and friendships inside and outside the home. Relatives’ involvement in service users’ activities is encouraged, with service user’s agreement. Service users had friends and relatives visiting at the time of the inspection and there was an open, inclusive and welcoming atmosphere in the home. The registered manager confirmed that menus are flexible and meals are prepared with service users’ involvement. A record is kept of the food provided to each service user, showing that the home is providing nutritious and varied meals and taking into account service users’ preferences. Mealtimes can be flexible around service users needs. Staff write weekly reports on service users’ activities, for example cooking. Twice a week service users decide what to eat and help buy, prepare and cook a meal. Service users also prepare their own lunches. Care plans contained sections on promoting healthy living. 21 High Street H54 S11627 21 High Street v236831 110705.doc Version 1.40 Page 12 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 standard(s) 19 The health needs of service users are well met with relevant professional consultation on a regular basis. EVIDENCE: Individual care plans contain information about service users healthcare and support needs, such as a record of appointments and any follow-up actions. Through discussion it was evident that service users have access to professional healthcare advice and support when needed, and that the home actively seeks specialist guidance as required. Each has a named care manager who is invited to their support reviews. 21 High Street H54 S11627 21 High Street v236831 110705.doc Version 1.40 Page 13 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 standard(s) 23 Training, policies and procedures are in place to ensure a proper response to any suspicion or allegation of abuse. EVIDENCE: The home has the Hampshire Adult Protection Procedures and a whistle blowing procedure, and has provided staff with the appropriate guidance. The registered manager had recently completed formal training for trainers in adult protection issues in order to further protect service users welfare and interests. This information was being shared with the staff team. Service users are supported to manage their own finances, and the home has procedures for looking after service user’s money. A signed and dated record of transactions is maintained and individuals are encouraged to obtain receipts. Money is individually and securely stored. 21 High Street H54 S11627 21 High Street v236831 110705.doc Version 1.40 Page 14 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 standard(s) 24, 28 and 30 The service provides a homely, clean and comfortable environment, with suitable infection control procedures to safeguard residents. EVIDENCE: The Choices building is some 200 years old and has been decorated and furnished to reflect the period it was built in. It is well maintained both inside and out. All the required modern facilities are available for the use of service users. As it is in the centre of Fareham all local facilities are within a short distance. There is a large covered shopping mall just round the corner. The owners had previously contacted the fire safety officer with regard to obtaining guidance on fire regulations for small care homes, and there had been no requirements resulting from this. Service users have the use of a small lounge on the ground floor as well as shared use of the large lounge, also on the ground floor. Both the providers and the service users use the kitchen diner for their main meals. Snacks and drinks may be prepared in an additional small kitchen provided for service users. The home has an attractive and well-maintained garden that provides 21 High Street H54 S11627 21 High Street v236831 110705.doc Version 1.40 Page 15 sufficient outdoor space for the number of service users and staff on duty. Barbeques are held here in the summer months. The level of cleanliness and hygiene in the home was found to be of a high standard. Infection control policies are in place. 21 High Street H54 S11627 21 High Street v236831 110705.doc Version 1.40 Page 16 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 and 36 Service users are supported by the home’s trained and regularly supervised staff. EVIDENCE: A staff training and development programme was being implemented and recorded. This included first aid, moving and handling, health and safety, food hygiene, NVQ and training in relation to Aspergers syndrome. Training on drug free protection from depression that looked at support structures had been attended. The Learning Disability Team had also previously facilitated some training in dealing with challenging behaviour. The home’s induction procedure for staff includes guidance on the role of the worker, health and safety, how to recognise signs of abuse, and managing issues specific to individual service users. The providers had obtained information about the Learning Disability Award Framework (LDAF) induction standards and these were being incorporated into the induction programme. Staff supervision was formalised and recorded in accordance with the national minimum standard. The registered manager had recently attended training in supervision skills and confirmed that individual staff members have regular supervisions. 21 High Street H54 S11627 21 High Street v236831 110705.doc Version 1.40 Page 17 Supervision includes, for example, discussion of individual concerns, service users’ general wellbeing, behaviour management, events and activities. Staff receive information about the home’s disciplinary and grievance procedures. 21 High Street H54 S11627 21 High Street v236831 110705.doc Version 1.40 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 The home is well organised and has systems in place to promote safe working practices for staff and service users. EVIDENCE: Inspection of the policies and working practices within the home provided evidence that the registered manager ensures so far as is possible the health, safety and welfare of both service users and staff. Risk assessments of the building are undertaken and recorded and there is a policy on health and safety in place. The providers have risk assessed service users in relation to domestic cleaning materials in use in the home. All staff receive instruction in fire safety and take part in regular fire drills that are recorded. Service users are aware of the fire procedures. A record is kept of weekly fire alarm tests. There is ongoing training for staff in first aid and food hygiene. Service contracts are in place for domestic appliances such as gas boilers. 21 High Street H54 S11627 21 High Street v236831 110705.doc Version 1.40 Page 19 21 High Street H54 S11627 21 High Street v236831 110705.doc Version 1.40 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x 3 Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 4 x x x 3 x 3 Standard No 11 12 13 14 15 16 17 x 4 x 4 3 x 3 Standard No 31 32 33 34 35 36 Score x x x x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 21 High Street Score x 3 x x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x H54 S11627 21 High Street v236831 110705.doc Version 1.40 Page 21 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. 1. 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. 1. Refer to Standard Good Practice Recommendations 21 High Street H54 S11627 21 High Street v236831 110705.doc Version 1.40 Page 22 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton, Hants 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. 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