Inspection on 12/03/09 for 21 Searing Way

This inspection was carried out on 12th March 2009.

CSCI found this care home to be providing an Good service.

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 Searing Way 26/09/06

21 Searing Way 28/12/05

21 Searing Way 04/10/04

21 Searing Way 10/05/04

21 Searing Way 12/09/02

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Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 21 Searing Way 21 Searing Way Tadley Hampshire RG26 4HT     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Kim Rogers     Date: 1 2 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: 21 Searing Way 21 Searing Way Tadley Hampshire RG26 4HT 01189817929 F/P01189817929 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Dimension (NSO) Ltd Name of registered manager (if applicable) Mrs Suzanne Nolan Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 5. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home 21 Searing Way is registered to provide care and accommodation to five people between the ages of 18 and 65 who have learning disabilities. Each service user has a single bedroom and shares the use of a bathroom and a shower room. Service users share the use of a lounge and the kitchen, which has a dining area. There is an enclosed garden to the side and rear of the home that service users are able to access. The home is located in a residential area of Tadley, approximately 300 metres from local shops. Care Homes for Adults (18-65 years) Page 4 of 29 care home 5 Over 65 0 5 Brief description of the care home The fee for the home is about £1500 per week. For more information about the fees and services please contact the Provider. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was a key inspection of the service, which included a site visit. This means that all of the key minimum standards were assessed. The last key inspection was 26.09.06. We carried out an Annual Service Review, ASR, on 5.12.07. This is our way of monitoring the service. Copies of these reports are available from the Provider. We made an unannounced site visit to the service as part of this key inspection. One inspector spent about four hours at the home. We spoke to the senior staff and other staff, friends of a service user and service users. We sampled records and looked around the home. We made observations. We looked at surveys sent to us by service users and staff. We had a telephone Care Homes for Adults (18-65 years) Page 6 of 29 conversation with the manager after the visit as the manager was not present for the visit. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Adults (18-65 years) Page 8 of 29 following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Assessments will be completed or obtained before a person moves in. There is good information about the home, which helps people know more about the service. Evidence: We found that no one has moved into the home for some time and as there are no vacancies there are no plans for anyone to move in. This is because most people have lived at 21 Searing Way since it opened or moved in soon after some ten years ago. This means we could not test the assessment process. However the senior staff spoke about this process in that a detailed assessment of the persons needs would be carried out before they moved in. This is to ensure they could meet the persons needs. Staff said that compatibility with other service users would be considered. Assessments have been carried out with service users and their significant others, called the circle of support, to establish peoples hopes and dreams for the future. Staff Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: then work with the person and staff team to develop a support plan so staff know what to do and by when to help people achieve their hopes and dreams. We found that there is information about the service. This has large print and colour photographs making it meaningful to service users. This is included in an information pack, which has lots of information that may help a person decide about moving in. Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know that their personal goals and needs will be recorded and supported in a person centred way. People have the support they need to make choices and decisions about their lives. Evidence: We found that peoples needs are recorded in individual support plans. This shows the persons need and what staff need to do to support the person. We found that these plans are reviewed regularly so staff know their support is still needed and any changes in need are picked up early. We found that work has started on developing individual person centred plans. We saw one that is meaningful to the person and includes lots of colour photos and information about what life the person wants to lead and their aspirations for the future. This is supported by staff and by the persons circle of support. This is a group of people who know the person well and get together with the person to help support their hopes and Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: dreams for the future. This is especially important and beneficial as some of the people at Searing Way have communication needs and may be unable to speak up for themselves. There are plans for everyone to have a person centred plan that is meaningful to them. We found that the environment supports communication in that there are photos of the staff who are on duty, meal choices of the day are pictured and each person has a board showing their activity choices of the day. This means that people can find out for themselves what is going on rather than have to rely on staff telling them. We found that choice making is supported in that people have been given the support they need to make a choice about this years holidays. Staff used various tools to support this including brochures, pictures and other visual information. This support enabled people to choose where they want to go on holiday and who they want to go with. We found that potential risks to people are identified and assessed showing what action staff should take to reduce risks. The assessments sampled have an emphasis on enabling people rather than restricting them which means people can be involved and do not miss out on opportunities. We found that daily notes are completed for each person by staff. We saw that on two consecutive days, by different staff, the word mischievous had been used to describe a persons mood or behaviour. This is ambiguous and staff need to be factual in their recording to protect and respect service users. The manager agreed to address this. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have the support they need to take part in a range of activities and to be part of the local community. Relationships are supported and the food is wholesome and nutritious. Evidence: We found that people have the opportunity to take part in a variety of activities, held in house and in the community. For example some people enjoy aromatherapy sessions in house. Each person has an individual activity plan so they know what they are doing from day to day and do not have to rely on staff telling them. Peoples preferences about activities and hobbies are recorded so staff know what people like to do. On the day of the visit one person was out with friends and another person had Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: support to go out for lunch. Everyone had enjoyed a disco in aid of Comic Relief the night before the visit. We found that relationships are supported. Family and friends are involved in peoples circle of support networks and meetings. People have the support they need to keep in touch with their family and friends. The home has a mini bus so people to get out into the community. Staff said they go to the local shops, clubs, cafes and pubs etc. There are separate staff employed to support activities and skill development. We found that people are involved in planning the menu. Peoples likes and dislikes are recorded so staff know what food people do and do not like. We found fresh fruit readily available if people are hungry between meals. There was a delivery of food on the day of the visit, which included fresh vegetables and a wide variety of foods. Staff said that service users go to local shops for everyday items like bread and milk. The kitchen is spacious and accessible to everyone so everyone has the opportunity to take part in cooking and clearing away. Everyone eats together and we observed service users being encouraged to be part of the meal and part of the clearing up afterwards. We found that people are given the time they need for their meal and staff offer support discreetly if needed. We found that diet and nutritional needs are monitored so any changes can be identified quickly and acted on. We found that needs relating to eating and drinking are recorded and supported. Staff spoke with knowledge about a persons detailed nutritional needs which corresponded with what is recorded. People are encouraged to take part in the cleaning and things like laundry. This means that everyone is involved in the day to day running of the home. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know that their personal and health needs will be supported. Medication practice is safe protecting service users. Evidence: We found that personal care needs are recorded in individual plans. This means that staff know how people prefer to be supported. We found good detailed information ensuring that people get the support they want and need. Bathrooms and toilets are sited close to bedrooms and are adapted to meet peoples needs. We found that health needs are recorded. We found that staff work closely with health professionals, seeking advice and making referrals for support to ensure that people get the support they need to remain well and healthy. We sampled one service user plan and found that health information is kept in a separate file to the persons plan. The manager agreed that it might be better to have Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: all of the information in one place and will review this. We found guidelines in place to support specific health needs. This means that staff have clear guidance about how to support specific needs. Work has started on implementing individual health action plans. This means people will have control and responsibility over their health with the right support. We found that health needs are monitored so staff can pick up any changes and act on them quickly. We found that people have support to attend health appointments and records are kept on the outcomes of any appointments. We sampled medication administration records and observed staff administering medication. We found that records are well recorded and up to date with no gaps. We found that administration is person centred in that a persons medication was taken to them while they were eating their lunch rather than the person having to come to where the medication is stored. We found that staff have training in how to manage medication safely. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know their complaints will be listened to and acted on. People are protected from harm and abuse. Evidence: We found that there is a complaints procedure displayed in the home. This has photographs and pictures making it more meaningful to people. This means that more people can use it. We found that they listen to complaints and take steps to address them. The AQAA shows they have had one complaint in the last year. The Commission have had no complaints about the service since the last inspection. Staff said they look out for gestures and expressions to establish if people are not happy about something. This means that they can deal with things at an early stage. Three out of five service user surveys received by us said that they know who to talk to and they are confidant staff would listen and act. We found that there is a policy in place to safeguard vulnerable people. There is also a whistle blowing policy which protects staff should they disclose concerns. Staff had good knowledge of what abuse is when we asked and could say correctly Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: who they would report any concerns to. Staff have training in how to safeguard people from harm and abuse. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is safe, homely and well maintained. Evidence: We found that the home is clean and well maintained. There is support from a maintenance company who address minor and major repairs. We found that there is a spacious kitchen diner, which enables everyone to sit and eat together and see what is going on like the cooking. There is a large lounge with doors to the garden, which has a patio and seating area. All bedrooms are single with bathrooms and toilets close by. Bathrooms and toilets are suitable for the needs of everyone. We found that the home feels homely, as there are photographs of service users individually and as a group enjoying things like holidays, meals out and outings. All parts of the home are accessible to service users and there are currently no restrictions so people have control over their environment. There are picture signs on doors so people can find their way around. Care Homes for Adults (18-65 years) Page 21 of 29 Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough competent trained staff to meet peoples needs. Recruitment checks are robust protecting service users. Evidence: We found that there are enough competent trained staff on duty to meet peoples needs. We found that staffing is flexible in that extra staff can be called on when necessary for things like one to one activities and evening discos. We found that staff have access to mandatory training like food safety, first aid and fire awareness as well as training relating to service users needs like communication and person centred support. This means that staff have the skills and competencies they need to support service users. We found that staff attend a two day course about communication and a two day course on how to make a difference. These courses have a person centred focus and give staff the skills they need to give better support. We talked to staff about their induction and saw their induction booklet. We found that the induction is in line with the Minimum Standard and checks a persons competency by getting them to answer written questions. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: Staff said they have contracts of employment and job descriptions and have the support they need with regular one to one meetings with the manager and staff meetings. One to one meetings are planed in advance so staff get to talk about work and any issues they have and have the opportunity for mentoring, support and coaching. Staff said they get regular feedback from the manager about how they are doing. This means by getting feedback, they get a chance to improve their practice. We found that staff morale is good; one staff said this is the best job I have ever had. The AQAA shows that recruitment checks like references and police checks are carried out before a person starts work at the home. This protects service users. The home is fully staffed and has some longstanding staff members who know service users well. They occasionally use agency staff to cover things like long term sick leave. The senior staff said they use the same agency so there is continuity for people. We observed staff enabling and encouraging service users to do as much for themselves as possible. This gives people more control and develops skills and confidence. Comments on staff surveys we received include we work well as a team, the manager is supportive and the training has really helped me in my day to day duties. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and is managed in service users best interests. People know that their views will be listened to and that their health and safety is assured. Evidence: We found that the manager is qualified and has several years experience in managing homes. The manager is registered with us, which means that people know she is a fit person to run the home. Staff said that the manager is supportive and approachable. There are systems in place to ensure staff have the opportunity to have one to one meetings with the manager for feedback, mentoring and support. We found that people have support to air their views about the service. Service users meetings are held and these are planned to meet peoples needs. For example staff said they would organise a fun group session like art and craft so they involve Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: everyone. Staff said they use a range of ways to listen to views like sign language, body language clues and pictures. Views of stakeholders are sought at circle of support and review meetings. The company also send out surveys to people. Responses are collated and results published. Staff said they have had feedback from this exercise. There is a development plan for the home and for the region the home is in. This plan focuses on improving outcomes for service users. The AQAA shows that they know what could be better and have plans to ensure the home improves for people. The AQAA shows they have identified barriers to improvement and have creative ideas to overcome these barriers. The AQAA shows they understand and support issues relating to equality and diversity. We found that staff have the training they need in areas of health and safety including safe moving and handling, food safety and fire awareness. Staff said they have regular fire practices so they all know how to evacuate the building in an emergency. We found the fire instructions displayed in text and symbols so people should know what to do if there is s fire. The AQAA shows that checks are carried out on the premises and equipment to keep people safe. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!