Inspection on 27/09/05 for 26 Penkridge Road

This inspection was carried out on 27th September 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

26 Penkridge Road 07/10/08

26 Penkridge Road 09/10/07

26 Penkridge Road 11/05/06

26 Penkridge Road 23/01/06

26 Penkridge Road 23/02/05

26 Penkridge Road 07/09/04

26 Penkridge Road 21/01/04

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

CARE HOME ADULTS 18-65 26 Penkridge Road Bedhampton Hampshire PO9 3LU Lead Inspector Kathryn Kirk Unannounced 10:00 a.m. 27 September 2005 th 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. 26 Penkridge Road H54 S11977 Penk Ridge v231519 270905.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 26 Penkridge Road Address Bedhampton Hampshire PO9 3LU 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) 023 9247 5911 Community Integrated Care Nora Jane Fowler CRH 2 Category(ies) of LD Learning Disability registration, with number of places 26 Penkridge Road H54 S11977 Penk Ridge v231519 270905.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Service users in the category LD are only to be admitted between the ages of 18 and 60 Date of last inspection 23rd February 2005 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 H54 S11977 Penk Ridge v231519 270905.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and is the first of two that will take place in the year April 2005-March 2006. It lasted for two and a half hours. Time was spent talking to both service users and to the two staff on duty. All parts of the house were seen, with the exception of an upstairs room, currently not used and the bathroom. Some documentation was also seen. Three requirements and one recommendation were made as a result of this inspection. What the service does well: What has improved since the last inspection? What they could do better: 26 Penkridge Road H54 S11977 Penk Ridge v231519 270905.doc Version 1.30 Page 6 One risk assessment has identified that restrictors should be fitted to upstairs windows. This had not been addressed. Current staffing levels should be reviewed to establish whether service users could be offered meaningful and enjoyable activities on a more regular basis, for example at weekends. Current arrangements for smoking should be reviewed to ensure that the rights of all are considered. Staff must be offered training in mental health issues. 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 H54 S11977 Penk Ridge v231519 270905.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection 26 Penkridge Road H54 S11977 Penk Ridge v231519 270905.doc Version 1.30 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 standard(s) No standards were assessed on this occasion. EVIDENCE: 26 Penkridge Road H54 S11977 Penk Ridge v231519 270905.doc Version 1.30 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 standard(s) 6 7 and 9 Care planning accurately reflects changing needs. Service users can make some decisions about their lives. Where choice is restricted reasons are recorded. Risk assessments are up to date although one has not been acted upon appropriately. It will be a requirement that this is addressed. EVIDENCE: 26 Penkridge Road H54 S11977 Penk Ridge v231519 270905.doc Version 1.30 Page 10 Both service users have an individual essential lifestyle plan (ELP). These are written from the perspective of the service user and cover what is essential to them, what is important to them and what they would like out of life. There is information for staff about what they need to know, or to do, in order to provide appropriate support. Ways in which each service user can be communicated with effectively are also documented. The current plans were drawn up in consultation with each service user, family and keyworkers. In June 2005, both service users also had updated assessments and care plans drawn up in conjunction with social services. These addressed longer term needs and as a result, one service user may be moving to alternative registered accommodation in the near future. Needs are reviewed every month and a daily record is kept of activities and events of the day. Service users were observed to exercise some choice, with staff support in their daily lives, for example when to get up, who to support them with their personal care and what activities to do within the home. The needs of one service user are such that certain restrictive practices are carried out within the home. (Examples of this are that the bathroom door is kept locked and the water supply is sometimes turned off) Staff said that the other service user is not adversely affected by these situations. Up to date risk assessments were seen regarding these practices. One service user is a member a self advocacy group. All risk assessments seen had been reviewed at least every year and staff had signed to confirm that they had read them. It was noted that one risk assessment identified that window restrictors should be fitted to upstairs bedroom windows and that this had not been done. It was discussed with staff that this action must be completed, or that the risk assessment must be reviewed and amended if the situation had changed. Records show that one service user has on occasion left the building without escort and against the advice of staff. A risk assessment and guidance for staff in the event of such an occurrence is in place. The staff member that this was discussed with during the inspection was fully aware of what action to take. It was identified during the care management review meeting in June 2005 that current procedures should be reviewed as part of a multi disciplinary meeting. There is no evidence that this has yet taken place. 26 Penkridge Road H54 S11977 Penk Ridge v231519 270905.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, and 16 Staffing levels affect the nature and frequency of activities that are offered. It is recommended that a further review of staffing levels be conducted to ensure that both service users have appropriate and fulfilling lifestyles. Service users rights are recognised. It is recommended that current arrangements for smoking are reviewed to ensure that every-ones rights are recognised in this respect. EVIDENCE: One service user has formal day care provided one day a week. They said that they went swimming during this time and that they liked to do this. The other service user does not have any formal day care. Daytime activities were discussed as part of the care management review. Staff provide some opportunities and for example, take service users out to lunch or to local cafes, to the beach. Examination of the staff rota showed that there are two staff on duty weekdays until 3.30 after this there is only one and one staff member is on duty at all times during the weekend. As neither service user is able to go out without an 26 Penkridge Road H54 S11977 Penk Ridge v231519 270905.doc Version 1.30 Page 12 escort, when one staff member is on duty they have to go out together or not at all. There is a car provided. Bedroom doors are lockable. Service users were observed open their own mail and staff offer assistance to help them understand the contents. Staff were observed to talk and to interact with service users in a friendly and respectful manner. Through discussion it was evident that service users can choose to spend time alone and that staff are very sensitive to their needs in this respect. Service users are able to keep pets within the home. One service user smokes in the house. It continues to be a recommendation that current arrangements for smoking are reviewed and that staff work towards providing an appropriate smoking area in the home. 26 Penkridge Road H54 S11977 Penk Ridge v231519 270905.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 and 19 Personal support is provided in a sensitive and flexible way. Healthcare needs have been identified and addressed. EVIDENCE: One service user has a preference for male carers and his views had been considered in the selection of the most recent member of staff. Service users receive continuity of support through having designated keyworkers and care plans reflect preferred routines and likes and dislikes. Service users do not currently need any technical aids or equipment. Records reflected that service users receive support to access their GP and other primary health care professionals, for example, dentist, psychiatrist and community nurse. A health profile has been completed detailing health needs for both service users. These are written from the prospective of each individual. Advice is also provided where a need has been identified, for example from a continence advisor. 26 Penkridge Road H54 S11977 Penk Ridge v231519 270905.doc Version 1.30 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 standard(s) Neither standard was assessed on this occaison. EVIDENCE: 26 Penkridge Road H54 S11977 Penk Ridge v231519 270905.doc Version 1.30 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 standard(s) 24 Penkridge is homely, but there are some restrictions in place and one that needs to be in place to ensure as far as possible that it is a safe environment for current service users. EVIDENCE: The premises were toured and were found to be comfortable, bright and clean. Service users have single bedrooms, both of which have been furnished in a way that reflects their needs and tastes. Both service users said that they liked their bedrooms. Service users share a kitchen, bathroom and lounge dining area. As discussed in previous sections not all parts of the building are always accessible, for example the bathroom, because of the needs of one service user. Since the last inspection all windows have been replaced. This meets a previous requirement. As discussed in a previous section action needs to be taken regarding the fitting of window restrictors to first floor windows. Furnishings and fittings were seen to be of reasonable quality. 26 Penkridge Road H54 S11977 Penk Ridge v231519 270905.doc Version 1.30 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 Staff training provided provides staff with the skills to support service users in terms of health and safety issues but all would benefit from additional training in mental health. EVIDENCE: CIC have a designated training officer who is responsible for organising the staff training programme. Records reflected that all staff are offered and have undertaken training in medication issues, first aid, food hygiene, fire safety and Crisis Prevention Intervention. Moving and Handling is also a core course One member of staff who had been employed fairly recently confirmed that they had completed a structured induction programme. Records indicate that staff are offered at least five paid training days per year. There was documentary evidence that one service user has some mental health needs. Staff said that two current staff members had received some training in mental health issues. It was discussed that it would be beneficial to current service users if all staff could be offered training in this area. 26 Penkridge Road H54 S11977 Penk Ridge v231519 270905.doc Version 1.30 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 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) 39 There are processes in place to ensure that service users are consulted about the service provided. EVIDENCE: One service user may be soon moving to a different registered home within the same organisation. Through discussion with them and with staff it was evident that they were fully consulted and that they were given opportunity to visit the prospective new home a number of times, to get to know staff and residents. Family members have also been consulted. Community Integrated Care have completed a quality audit as an organisation. Views were sought from service users, relatives and staff. The most recent results were published in December 2003. One to one sessions are held with each service user every month during which time their views about the service are discussed and recorded. 26 Penkridge Road H54 S11977 Penk Ridge v231519 270905.doc Version 1.30 Page 18 A senior manager from Community Integrated care visits the home every month. During this time they talk to service users and staff in order to form an opinion of the standard of care provided within the home. A written report of the results of the visit is sent CSCI. 26 Penkridge Road H54 S11977 Penk Ridge v231519 270905.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x x Standard No 11 12 13 14 15 16 17 x 2 2 x x 2 x Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 26 Penkridge Road Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x 3 x x x x H54 S11977 Penk Ridge v231519 270905.doc Version 1.30 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 9 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. Review of staffing levels to ensure that service users are supported in their choice of activity, seven days a week All staff must be provided with some training in mental health issues. Timescale for action 1.11.05 2. 12 18(1) 30.11.05 3. 35 18(1) 31.1.06 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. 2. 3. Refer to Standard 16 Good Practice Recommendations A review of current smoking arrangements to ensure that the rights of all are respected.. 26 Penkridge Road H54 S11977 Penk Ridge v231519 270905.doc Version 1.30 Page 21 Commission for Social Care Inspection 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 H54 S11977 Penk Ridge v231519 270905.doc Version 1.30 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. 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