Inspection on 19/04/05 for 28-30 Woolston Road

This inspection was carried out on 19th April 2005.

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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

28-30 Woolston Road 04/07/06

28-30 Woolston Road 06/09/05

28-30 Woolston Road 01/12/04

28-30 Woolston Road 26/07/04

28-30 Woolston Road 09/03/04

28-30 Woolston Road 07/01/04

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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 28 - 30 Woolston Road Butlocks Heath Netley Abbey Hampshire SO31 5FQ Lead Inspector Marilyn Lewis Unannounced 19/04/05 10:00 a.m. 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. 28 - 30 Woolston Road Version 1.10 Page 3 SERVICE INFORMATION Name of service 28 - 30 Woolston Road Address Butlocks Heath, Netley Abbey, Southampton SO31 5FQ 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) 01428 601618 Robinia Care Ltd. CRH 8 PD 3 Category(ies) of LD 8 registration, with number of places 28 - 30 Woolston Road Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named service user (date of birth 28/11/86) may be accommodated at the home. 2. Service users with physical disabilities must also have learning disabilities. 3. All service users must be between 18 and 50 years of age. Date of last inspection 01/12/04 Brief Description of the Service: 28-30 Woolston Road is a care home providing personal care and accommodation for eight younger adults who have learning disabilities. Up to three of the beds can be used to accommodate people with physical disabilities, though it is a condition of the registration that these people must also have learning disabilities. All residents are accommodated in single rooms. Six of the rooms are situated on the first floor and have en-suite facilities. The two rooms on the ground floor share an assisted bathroom. There is a large enclosed garden to the rear of the property. The home is owned and operated by Robinia Care Ltd, an organisation that has been a registered care provider since 1995, specialising in services for people with learning disabilities. The home is situated in a residential area of Netley Abbey and is close to local community facilities. 28 - 30 Woolston Road Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over six hours on the 19th April 2005. The inspector had the opportunity to tour the home and to speak to five staff members and the regional operations manager for Robinia Care Ltd. The inspector observed interaction between residents and staff and was present during lunch. What the service does well: What has improved since the last inspection? A new format is being developed for the statement of purpose to make it easier for residents to read and understand. Since the last inspection there has been some improvement in the meals offered to residents to provide a more balanced and nutritious diet. The homes’ environment has improved since the last inspection, with no broken windows and some rooms have been redecorated. Trees have been planted to the rear of the garden to provide some privacy for residents and neighbours. 28 - 30 Woolston Road Version 1.10 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 28 - 30 Woolston Road Version 1.10 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 28 - 30 Woolston Road Version 1.10 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) 1 and 2 The home does undertake detailed full needs assessments prior to admission and therefore does provide the information required for staff to make a sound decision as to whether the home is able to meet the health, social and emotional needs of the prospective resident. EVIDENCE: The homes’ Statement of Purpose and Service User Guide are being up dated and put into a more suitable format for the residents and their relatives/representatives. These documents will be assessed during the next inspection. Records seen for the most recently admitted resident, contained a full needs assessment that had been completed prior to admission. The assessment included information from a care manager and health professionals. The assessment gave details of the most appropriate method of communication, physical and mental health care needs and specific condition related needs. 28 - 30 Woolston Road Version 1.10 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 and 9 Individual care plans are in place for all residents but the lack of review when changes occur means that the care plans do not provide staff with up to date information regarding the residents’ current needs. EVIDENCE: Individual care plans were seen for the four residents. The documents contained plans for personal and social care including those for communication, socialisation and behaviour. Care plans for one resident had not been reviewed for seven months. Care plans for another resident had not been updated when changes to medication had taken place and there was no information regarding the involvement of health professionals in his care. Risk assessments had been completed for daily living and social activities including the support needed for residents to use the homes’ transport. It is the policy of the home that staff sign to confirm they have read and understood the care plans and risk assessments. A risk assessment for one resident with regard to the risks when eating, did not have a list of staff members who confirmed they had read and understood the plan. This was brought to the attention of the regional operations manager who immediately arranged for staff to read the care plan and risk assessment. 28 - 30 Woolston Road Version 1.10 Page 10 28 - 30 Woolston Road Version 1.10 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, 14 and 17 The programme for daily activities is lacking in a detailed structure which could reduce the risk of behavioural issues, however some improvement has been made in providing residents with a more balanced, nourishing diet. EVIDENCE: One resident attends an education centre on four days of the week and another resident attends on one day. Residents’ care plans provided information on their likes and dislikes for activities. The residents at the home have been assessed as requiring a very structured day and each resident has a daily flow chart recording their activities for the day. The activities are entered for the morning and afternoon, with occasional sessions booked for the evenings. Although the structure is in place there are times when an activity may take far less time than at another. The flow chart does not provide any direction of how to fill the time if an activity is cut short This led to some residents having little to do on occasions, which can escalate some challenging behaviours. During the inspection one resident roamed the house constantly and was only involved in any form of activity for a very short time. This resident rarely leaves the home, although his care plan indicates 28 - 30 Woolston Road Version 1.10 Page 12 that he enjoys being outdoors and is able to tolerate using the homes’ transport for short periods. Following concerns raised by some parents, the menus for residents have been reviewed to provide a more balanced, nutritious diet with less fast, snack type foods. On the day of the inspection residents were served a tuna salad for lunch with yoghurt and fresh fruit to follow. There was a good supply of fresh fruit and vegetables in the fridge. Meals taken by the residents are documented in their records. Records for one resident are being forwarded to the Commission on a weekly basis for monitoring. 28 - 30 Woolston Road Version 1.10 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) 19 and 20 Advice is sought from health professionals, which ensures the appropriate care is delivered to meet the health needs of the residents. EVIDENCE: All the residents are in the care of one GP practice. The GP and the district nurse visit the home on request. Records seen indicated that a dentist visits the home, although residents have not been seen for over six months, which may allow a dental problem to go unnoticed. One resident has declined to allow a dentist to examine him. An optician also visits the home as required. Community psychiatric nurses, psychologists and psychiatrists are involved in the care of some of the residents and provide advice for staff with regard to the emotional needs of residents as required. The deputy manager stated that a request for a dietician to visit for one resident had recently been processed. Medication records seen had been completed appropriately. Six of the nine staff members had received training in dealing with medicines. Changes in medication for one resident did not follow through to his care plan. At the time of the inspection there were no residents who self-administered medication. 28 - 30 Woolston Road Version 1.10 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) 22 and 23 Many of the staff team have been recently recruited and have not received the full induction programme, including abuse, which potentially puts residents at risk from abuse. EVIDENCE: The complaints procedure available at the home at the time of the inspection informed complainants of who would investigate the issue and timescales for the process but still required up dating to ensure people where aware that they could also complain to the Commission at any time in the process. The inspector was notified following the inspection, that the up to date version of the complaints procedure was now in place in the home. Staff receive training on abuse awareness during their induction, however six members of staff have yet to attend day five of the induction programme which includes abuse training. Two staff members asked about abuse procedures were aware of the procedures and indicated that they would report any concerns immediately to the person in charge of the home. The home records all incidences of aggressive behaviour, noting where and how long the aggressive behaviour lasts, any triggers for the incidents and the support required to calm the situation. All staff employed at the home have attended training in Strategies in Crisis Intervention. 28 - 30 Woolston Road Version 1.10 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, 25, 26, 28 and 30 The residents live in a homely, comfortable environment, which has improved since the last inspection due to the ongoing improvement programme. EVIDENCE: The homes’ environment has improved since the last inspection. The home looked clean and there were no broken windows or holes in the plaster on the walls. The regional operations manager said that new furniture and carpets were on order for the lounges that would provide a more comfortable, homely atmosphere. Trees have been planted to the rear of the garden to provide a screen allowing residents and neighbours some privacy for outdoor activities. Residents’ bedrooms looked clean and some contained personal items such as music systems, posters and photographs. The home has three lounges, one of which is used as a music/quiet area. A dining area is provided in two of the lounges. The kitchen and laundry room are domestic in style and both rooms were clean at the time of the visit. The home does not allow smoking on the premises. 28 - 30 Woolston Road Version 1.10 Page 16 28 - 30 Woolston Road Version 1.10 Page 17 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) 32, 33, 34, 35 and 36 There is a high staff turnover, and staff lack experience, training and supervision, which has the potential to put residents safety at risk. EVIDENCE: There has been a large turnover of staff at the home since it began accommodating young people in September 2003. At the time of the inspection, the manager’s post was vacant. The home employs two deputy managers but the inspector was told that one of the deputies was leaving at the end of the week and the other on the 6th May. The four staff on duty had all been recently employed, although one of them had worked at the home for ten months previously. Six staff members have not attended a full induction programme and none of the staff on duty apart from the deputy manager, had received training in autism awareness. No staff member working in the home held an NVQ. The regional operational manager said that staff employed by Robinia Care Ltd are eligible to apply for NVQ training when they had been employed for six months, however due to the high turnover of staff there was no member of staff on an NVQ course at present. She also said that one staff member was booked to attend autism training later in the month and two were due to attend in July. 28 - 30 Woolston Road Version 1.10 Page 18 It was also noted that only three staff members had attended training in communication methods. Records seen for four staff members contained two written references and proof of identity. The home had recently employed staff prior to obtaining CRB checks and had been notified by the Commission that these staff members were not to work unsupervised and that CRB checks must be obtained for future employees. Staff are not receiving formal supervision at least six times a year. One staff member has not received additional supervision on a two weekly basis as directed in the employment statement. 28 - 30 Woolston Road Version 1.10 Page 19 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) 37, 41 and 42 Residents’ safety is put at risk by the lack of an experienced, qualified manager and poor record keeping and staff training in fire safety. EVIDENCE: Due to managerial staff leaving the present staff employed, if left in charge, would not have the necessary qualifications and experience required to support the staff team and the residents. When the deputy managers leave there will be no managerial staff that are known to the residents, who require a stable environment. The regional operations manager stated that until a new manager was recruited she would be supporting the home. This would however, still leaves gaps in the rota when sufficiently experienced and qualified staff would not be available to lead the staff team. The regional operations manager is to inform the Commission within seven days of the inspection as to how the home will be staffed. Regulation notices are forwarded to the Commission as required. 28 - 30 Woolston Road Version 1.10 Page 20 Records seen for fire drill practice and fire equipment checks were not up to date and indicated that the required checks were not taking place and that eight staff members out of twelve, including agency staff had not attended fire drill practices. The regional operations manager stated that fire drills would be arranged for all staff. 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score 2 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 x 3 x 3 Standard No 28 - 30 Woolston Road Standard No 31 32 Version 1.10 Score x 1 Page 21 11 12 13 14 15 16 17 x 3 x 3 x x 3 33 34 35 36 1 3 1 1 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 2 3 x Standard No 37 38 39 40 41 42 43 Score 1 x x x 3 1 x 28 - 30 Woolston Road Version 1.10 Page 22 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 YA6.10 Regulation 15(2)(b) Requirement Care plans must be reviewed at least six monthly and more frequently if required to reflect the current needs of the resident. The registered person must ensure that at all times suitably qualified, competent and experienced persons are working in the home. The member of staff in charge of the home must be suitably qualified, competent and experienced. This is an outstanding requirement of the inspection dated 01/12/04 All staff must receive supervision at least six times a year and one member of staff on a two weekly basis while in the probationary period. All staff must attend fire drill practices and records for fire safety training, drills, checks of fire equipment must be kept in the home. Timescale for action 31/05/05 2. YA32.3 18(1)(a) 30/04/05 3. YA36 18(2) 31/05/05 4. YA42.2 23(4) 30/04/05 28 - 30 Woolston Road Version 1.10 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations 28 - 30 Woolston Road Version 1.10 Page 24 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. 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