Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 23/01/06 for 26 Penkridge Road

Also see our care home review for 26 Penkridge Road for more information

This inspection was carried out on 23rd January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

No service user would move to Penkridge until it is established that their needs could be met. Staff work hard to ensure that family links are maintained Choice is respected at mealtimes Complaints are thoroughly investigated Management arrangements are appropriate and staff feel well supported

What has improved since the last inspection?

Most staff have received some training in mental health issues Most staff have embarked upon their NVQ level 3 There is some flexibility in staffing levels to respond to increased need

What the care home could do better:

Window restrictors still need to be fitted to first floor rooms, although there is evidence that this will happen by the end of February 2006-01-26 Accurate records regarding complaints made and action taken need to be available for inspection Clinical waste procedures need to be reviewed Paper towels need to be provided to reduce the possibility of spread of infection. There are still occasions when the needs of both service users can be met at the same time because of staffing levels. This restricts choice. All hazardous substances must be stored securely.

CARE HOME ADULTS 18-65 26 Penkridge Road Bedhampton Hampshire PO9 3LU Lead Inspector Kathryn Kirk Unannounced Inspection 23rd January 2006 10:00 26 Penkridge Road DS0000011977.V280137.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 26 Penkridge Road DS0000011977.V280137.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. 26 Penkridge Road DS0000011977.V280137.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 26 Penkridge Road Address Bedhampton Hampshire PO9 3LU 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) 023 9247 5911 www.c-i-c.co.uk. Community Integrated Care Nora Jane Fowler Care Home 2 Category(ies) of Learning disability (2) registration, with number of places 26 Penkridge Road DS0000011977.V280137.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users in the category LD are only to be admitted between the ages of 18 and 60 years 27th September 2005 Date of last inspection Brief Description of the Service: 26 Penkridge is a detached house with four bedrooms. It is registered to accommodate two adults with a learning disability. The registered providers are Community Integrated Care (CIC). Knightsone Housing Association manages the property. The two service users have lived at Penkridge since it opened. Penkridge is an unadapted house. It would not be suitable for people who use wheelchairs, or who have significant mobility or sensory needs. The house is on a hill overlooking Portsmouth and the sea. It is in a residential area. The service has a car to access local shops and other amenities. 26 Penkridge Road DS0000011977.V280137.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 inspection to take place during the year April 2005-March 2006. It lasted for two and a half hours. Time was spent with both service users and two staff members spoke about their experience of working in the house. Only standards that were not assessed and requirements raised during the previous inspection in September 2005 will be discussed in this report. As such to gain a more detailed overview of this service this report should be read in conjunction with the one dated 27 September 2005. What the service does well: What has improved since the last inspection? What they could do better: 26 Penkridge Road DS0000011977.V280137.R01.S.doc Version 5.1 Page 6 Window restrictors still need to be fitted to first floor rooms, although there is evidence that this will happen by the end of February 2006-01-26 Accurate records regarding complaints made and action taken need to be available for inspection Clinical waste procedures need to be reviewed Paper towels need to be provided to reduce the possibility of spread of infection. There are still occasions when the needs of both service users can be met at the same time because of staffing levels. This restricts choice. All hazardous substances must be stored securely. 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. 26 Penkridge Road DS0000011977.V280137.R01.S.doc Version 5.1 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 26 Penkridge Road DS0000011977.V280137.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Any prospective service user would not move in until it is established that the service could meet their needs. EVIDENCE: Both service users have been resident at Penkridge for some years. At previous inspections it has been confirmed that should a vacancy occur any new prospective service user would move to through care management arrangements following an assessment of need. 26 Penkridge Road DS0000011977.V280137.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 Action continues to be needed in respect of one risk assessment to ensure the safety of service users. EVIDENCE: One risk assessment identifies that window restrictors need to be fitted to upstairs bedrooms and that this had not been done. At the last inspection a requirement was made that this should be rectified, or that the current risk assessment need to be reviewed. Staff said that work on this would be carried out at the end of February 2006. This will remain a requirement until there is confirmation that this work has been completed. 26 Penkridge Road DS0000011977.V280137.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): 15 and 17 The importance of maintaining family links is recognised. Service users choice is respected at mealtimes and staff ensure that a healthy diet is maintained. EVIDENCE: Staff said that they escort one service user to visit family members who live some distance away about four times a year. They confirmed that visitors are welcomed. Contact is also maintained with family through regular telephone calls, letters and parcels. Staff facilitate this process. A service user asked said that he liked the food and that it was good. Food is chosen by each service user and what is eaten is recorded in the daily evaluation sheet. Records also contain a list of food likes and dislikes. Staff said that they continue to monitor fluid intake for one service user because of a medical condition. Service users were seen to choose where they wished to eat their lunch, one ate in the kitchen and one in the dining area. 26 Penkridge Road DS0000011977.V280137.R01.S.doc Version 5.1 Page 11 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): 20 There are appropriate policies and procedures in place for dealing with medication. EVIDENCE: Staff said that neither service user self medicates. Policies were viewed regarding the supply, receipt, storage, administration and disposal of medicines. These were seen to have been signed by staff. Staff confirmed that they receive training in dealing with medicines and said that this is updated every six months. Medication was observed to be appropriately stored. Risk assessments and guidelines were seen for PRN “as required” medicines. One PRN medicine that has recently been prescribed and did not have any guidelines regarding its administration. It was advised that these should be drawn up. Records and discussion showed that staff monitor the condition of service users on medication and liaise with relevant health professionals if there is any change in condition 26 Penkridge Road DS0000011977.V280137.R01.S.doc Version 5.1 Page 12 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 and 23 Complaints are taken seriously and acted upon, although records need to reflect this. Appropriate adult protection procedures are in place. EVIDENCE: There is a complaints procedure. This contained all relevant information, for example who to complain to, that complaints would be responded to within twenty eight days and the address and telephone number of CSCI Staff said that this was usually on display and that they would ensure that it is put up again in a prominent place. A record is kept of complaints. One recent complaint made was not recorded but there was evidence through correspondence with CSCI that it is being investigated thoroughly. Staff said that they felt it unlikely that service users would complain if they were unhappy about any aspect of the service provided, but that they may show their concern in other ways. Staff said that they had attended a training course regarding the protection of vulnerable adults. Through discussion it was evident that staff were aware of whistle blowing procedures. Any money or valuables held on behalf of service users was observed to be securely and individually stored and staff said that balances are checked by two staff every day. 26 Penkridge Road DS0000011977.V280137.R01.S.doc Version 5.1 Page 13 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): 24 and 30 Although the home is clean some changes need to be made to ensure service users safety. EVIDENCE: It was an outstanding requirement of the previous inspection that window restrictors must be fitted to first floor windows. This had not been completed at the time of inspection although the manager said that she had received notification that they would be fitted by the end of February 2006. It will remain a requirement until CSCI receive confirmation that work has been completed. As this has been an outstanding requirement since January 2004, enforcement action will be considered if the timescale of 1/3/06 is not met for this work to be completed. On the day of inspection the home appeared clean and tidy. Since the last inspection the home has been supplied with a new washing machine and tumble dryer. Laundry floors were seen to be impermeable and walls are readily cleanable. 26 Penkridge Road DS0000011977.V280137.R01.S.doc Version 5.1 Page 14 Staff confirmed that they have a regular supply of plastic gloves and aprons. Clinical waste was found not to be disposed of appropriately. This was subsequently discussed with the service manager who stated that this would be rectified the following day. Staff were advised that paper towels need to be provided in the toilet area. 26 Penkridge Road DS0000011977.V280137.R01.S.doc Version 5.1 Page 15 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 33 and 34 Staff seen have the skills and qualities required to meet service users needs although low morale may have a negative effect upon service delivery. Staffing levels have been responsive to changing needs but there are still times when the number of staff employed at the home limits residents opportunity and choices. There is an effective staff recruitment policy. Although the practice to not involve service users in the process may be historic, the service needs to ensure that service users are actively supported to be involved in staff selection in the future. EVIDENCE: Staff on duty demonstrated that they were approachable and comfortable with service users and showed that they had a good understanding of their needs. Four of the staff team are studying for their NVQ level 3 and one has already completed this award. Since the last inspection staff said that most of them have undertaken training in mental health issues. Staff described morale as low. At the last inspection it was a requirement that staffing levels should be reviewed to ensure that service users are supported in their choice of activity seven days a week. There was evidence that staffing levels have been provided more flexibly where a need has arisen, for example when a service user has 26 Penkridge Road DS0000011977.V280137.R01.S.doc Version 5.1 Page 16 been unwell or has needed a higher level of support because of their emotional needs. Staff said that there are still occasions where both service users have to go out together or not at all because of the amount of staff support available. One staff record was checked. This contained a completed application form, evidence of identity, two satisfactory references and evidence that a CRB check had been undertaken. One staff asked who had been employed for some time said that service users were not involved during their recruitment process. 26 Penkridge Road DS0000011977.V280137.R01.S.doc Version 5.1 Page 17 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 42 Management arrangements are appropriate. Health and safety procedures are largely in place but some alterations are needed to ensure that the welfare of service users is promoted. EVIDENCE: The registered manager is currently suspended. An acting manager is covering the position at present. They are experienced and staff on duty said that they have been supportive and helpful. Staff said that the same could be said of the service manager. The following records were sampled in relation to health and safety issues: A certificate to show that the boiler had been serviced 0n 15/11/05 Fire Risk Assessment (updated 11/8/05) Fire Instruction for staff August 05 PAT testing 2/11/05 Fire Drill 24/10/05 26 Penkridge Road DS0000011977.V280137.R01.S.doc Version 5.1 Page 18 Staff on duty confirmed that they had been trained in moving and handling. Staff on duty confirmed that a record was maintained of all accidents. As discussed in the environment section window restrictors have yet to be fitted. Some cleaning materials were observed to be stored in an unlocked cupboard. Staff on duty said that this would be rectified that day. 26 Penkridge Road DS0000011977.V280137.R01.S.doc Version 5.1 Page 19 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 2 23 3 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 1 STAFFING Standard No Score 31 3 32 2 33 X 34 2 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X 2 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 X 3 X X X X 2 X 26 Penkridge Road DS0000011977.V280137.R01.S.doc Version 5.1 Page 20 YES 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 YA9 Regulation 23(2)(b) Requirement Window restrictors need to be fitted to upstairs windows, or the current risk assessment needs to be reviewed. This is an outstanding requirement from 21/1/04 Paper towels must be available Timescale for action 01/03/06 2 3 YA30 YA30 13(4) 13(4) 30/01/06 Suitable arrangements must be 30/01/06 made in respect of clinical waste. 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 26 Penkridge Road DS0000011977.V280137.R01.S.doc Version 5.1 Page 21 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. Extracts may not be used or reproduced without the express permission of CSCI 26 Penkridge Road DS0000011977.V280137.R01.S.doc Version 5.1 Page 22 - 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!