Inspection on 04/01/06 for 21 High Street

This inspection was carried out on 4th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 11/07/05

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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Dalewood Respite Care

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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 21 High Street Fareham Hampshire PO16 7AE Lead Inspector Laurie Stride Unannounced Inspection 4th January 2006 09:30 21 High Street DS0000011627.V275756.R01.S.doc Version 5.1 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 21 High Street DS0000011627.V275756.R01.S.doc Version 5.1 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. 21 High Street DS0000011627.V275756.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 21 High Street Address Fareham Hampshire PO16 7AE 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) 01329 232641 Mrs Sara Fullick Mr John Fullick Mrs Sara Fullick Care Home 3 Category(ies) of Learning disability (3), Mental disorder, registration, with number excluding learning disability or dementia (3) of places 21 High Street DS0000011627.V275756.R01.S.doc Version 5.1 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 11th July 2005 Date of last inspection 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 DS0000011627.V275756.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second annual unannounced visit and lasted five hours. The inspector had given the registered manager a courtesy telephone call prior to the inspection in order to ensure that this was an appropriate visiting time when someone would be in. The service users lead active lives and declined the opportunity to meet the inspector on this occasion. The inspector spoke with the registered manager and viewed some of the home’s records. The inspector looked at the key standards not assessed at the last inspection and therefore this report should be read in conjunction with the previous report. 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 DS0000011627.V275756.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection 21 High Street DS0000011627.V275756.R01.S.doc Version 5.1 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 the following standard(s): None of these standards were assessed on this occasion. Please refer to the previous report of 11th July 2005. EVIDENCE: 21 High Street DS0000011627.V275756.R01.S.doc Version 5.1 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 the following standard(s): 7 The home actively encourages and supports service users to make informed decisions about their lives and exceeds the standard. EVIDENCE: The ethos of the home is to support the service users as fully as possible to express their individuality and to make their own decisions. A flexible approach is taken that enables people living at the home to make decisions when they are ready to do so and each person is encouraged to take responsibility for their decisions. Staff talk through scenarios and possible consequences with service users to assist them to make informed decisions. The providers’ view is that if a person is involved in making a decision they are more likely to follow it through. Service user meetings are held every week and records of these are kept on file. The registered manager said that the home provides a framework for discussions and service users decide the content. Records showed that at these meetings there are discussions about staff, daily programmes for service users, food and menus, social interactions and any other issues. As part of the agenda service users are asked if they would like to have individual meetings with the registered manager / providers to talk about anything in private. 21 High Street DS0000011627.V275756.R01.S.doc Version 5.1 Page 9 There are also annual review meetings at the home where service users have opportunities to talk about the things they have achieved and enjoyed, things they have found difficult and things they would like to do. These meetings are then written up by the registered manager and translated into individual care plans. For example, one service user wished to continue to participate in events such as the Special Olympics with the aim of winning more medals. Service users also choose items of furniture for their bedrooms. Service users are supported to manage their own financial accounts as far as possible and this is documented and reviewed. There was evidence to show that the home has enabled individuals to further develop their skills in managing money. 21 High Street DS0000011627.V275756.R01.S.doc Version 5.1 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 the following standard(s): 13 and 16 Service users are well supported in being part of the local community and taking responsibility in their daily lives. EVIDENCE: The registered manager confirmed that service users were well integrated in the local community. For example, there were good neighbourly links with a local pub and club and two service users did voluntary work for different employers. There are regular outings during the week including taking part in a social group where service users have further opportunities to find peer support outside the home. Service users also use the cinema, leisure centre and library and go bowling. The inspector was informed that staff and service users are aware of the rights of disabled people regarding access to places. Staffing arrangements are flexible around evenings and weekends. Staff supported service users in gathering and updating information about local facilities and activities and one service user had built up a file of useful information including public services and disability support. In this way the home was supporting service users whose aim was to move on to more independent living to develop their skills. 21 High Street DS0000011627.V275756.R01.S.doc Version 5.1 Page 11 All service users were on the electoral register and were supported to understand the different political parties. All voted at the last elections. The home’s ethos is that service users run the home as much as possible and take a reasonable measure of responsibility. This is discussed in the regular meetings and the outcomes of discussions are recorded. Service users are involved in the planning of their routines and activities and are encouraged to help each other with routine tasks. Service users do their own cleaning, write shopping lists and do their own shopping, with appropriate support from staff. The home has policies regarding service users’ privacy and dignity, provides a charter of rights and promotes positive risk taking to further service user’s independence. Subject to assessed capabilities service users have a front door key and are able to go out and about in the community on their own. There is a reminder on the back door asking service users to tell people when they are going out and when they are likely to be back. 21 High Street DS0000011627.V275756.R01.S.doc Version 5.1 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 the following standard(s): 18 and 20 The home has effective systems for ensuring that service users receive personal support in the way they prefer and for the safe management of service users medication. EVIDENCE: Service users’ preferences about how they are supported are recorded and there are both male and female members of staff available to provide assistance. The inspector was informed that personal support is provided mainly in the form of verbal encouragement, for example in relation to service users getting up, washing and dressing. Getting up times can be negotiated according to the activities service users have chosen to do. Service users have access to specialist advice and support, for example the home has previously asked for the community learning disability team to provide assistance. All service users are registered at the local health centre or with a chosen doctor. Individual care plans contain information about service users healthcare and support needs, such as a record of appointments and any follow-up actions. Regular health checks are made available and the home encourages service user’s to eat healthy foods and to look after them selves. 21 High Street DS0000011627.V275756.R01.S.doc Version 5.1 Page 13 The home has written policies and procedures that detail the arrangements for the recording, handling, safekeeping, self-administration and disposal of medicines received into the home as required. At the time of the inspection only a small amount of service user medication was held in the home, for example skin creams and hay fever tablets. These were stored individually and securely and appropriate administration records were kept. 21 High Street DS0000011627.V275756.R01.S.doc Version 5.1 Page 14 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 The home’s approach to managing service user’s concerns and complaints ensures these will be taken seriously and acted upon. EVIDENCE: The home has a written complaints procedure that includes timescales for the process of responding to complaints and the address and telephone number of the Commission for Social Care Inspection. The procedure is included in the Service User Guide and is also provided in an easy to read format. The registered manager said she encourages service users to think about talking about any concerns as a positive thing to do. This was reflected in the way service user meetings are held, which the inspector had observed on previous occasions. There is a system for recording any complaints and the outcomes. The registered manager said that the home had received no complaints. The Commission for Social Care Inspection (CSCI) had also received no complaints about the home. 21 High Street DS0000011627.V275756.R01.S.doc Version 5.1 Page 15 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): None of these standards were assessed on this occasion. Please refer to the previous report of 11th July 2005. EVIDENCE: 21 High Street DS0000011627.V275756.R01.S.doc Version 5.1 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 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 and 34 Service users are supported and protected by skilled staff and the home’s thorough recruitment practices. EVIDENCE: A small staff team operate a flexible rota so that there is always sufficient staff on duty to ensure appropriate care and support is available to the service users. The staff team consists of Mr and Mrs Fullick who are the registered providers and two part-time support staff. The current service users have largely independent lifestyles and are often engaged in activities outside of the home that do not require the registered manager’s or staff supervision. The registered manager said that the team worked very well. The inspector had previously had the opportunity to meet one of the support workers and found them to be well motivated with a good understanding of service users individual needs. One of the support staff was nearing completion of an NVQ2 training course and supports service users on some weekday evenings, promoting their independence in food budgeting and cooking skills and encouraging healthy eating. Both staff members had recently completed a half-day training course in relation to Protection of Vulnerable Adults (POVA) and had also undertaken health and safety training. The registered manager said she was planning further training for staff in relation to professional boundaries as she felt this was important for staff working in the home’s small and friendly environment. 21 High Street DS0000011627.V275756.R01.S.doc Version 5.1 Page 17 Staff recruitment records for both support workers were seen and contained all the required information. Each file included completed application forms, two written references, proof of satisfactory Criminal Records Bureau (CRB) checks, photographic proof of identity, and statements of employment. The registered manager had developed a staff recruitment file that included an employment record checklist to ensure checks would be carried out in line with current legislation. This also included information and record formats in relation to written statements of staff employment, application forms, probation period reviews and service user feedback, staff training and development profiles including prior learning and identified training needs. The home’s induction procedure was being developed in line with the Skills for Care induction standards. 21 High Street DS0000011627.V275756.R01.S.doc Version 5.1 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 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 and 39 Service users benefit through the effective day-to-day management of the home and the atmosphere of openness and respect fostered by the providers and staff. EVIDENCE: The registered manager has been running the care home for almost ten years. Mrs Fullick has an honours degree in education and a post-graduate diploma in special education. In addition to qualifications and experience in education and special education she has more recently completed a ‘top up’ of relevant units of the Registered Managers Award (RMA). Mrs Fullick has also recently attended a two-day supervision course and does training with staff. Through discussion with the registered manager, observation of working practice and previous conversations with service users, it was evident that the personal development and quality of life of each service user is given high priority. A policy statement was in place in relation to the home monitoring service user’s feedback about the service provided. Service users meetings are facilitated on a regular basis and the minutes recorded. A questionnaire has 21 High Street DS0000011627.V275756.R01.S.doc Version 5.1 Page 19 also been used to obtain and record the views of service users. A regular sixmonth review asks about and looks at the service provided, reliability of services, continuity of care, the attitude and skills of carers and managers, any complaints and other comments. The inspector was informed that letters are sent out to service users’ relatives inviting feedback prior to the reviews and letters and cards had been received from relatives giving positive comments about the service. All policies and procedures had recently been reviewed. 21 High Street DS0000011627.V275756.R01.S.doc Version 5.1 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 Standard No Score 1 X 2 X 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 X ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 4 X X X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 X 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X 3 X 4 X 3 X X X X 21 High Street DS0000011627.V275756.R01.S.doc Version 5.1 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. 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 21 High Street DS0000011627.V275756.R01.S.doc Version 5.1 Page 22 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. 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