Inspection on 03/01/07 for 30 Lower St Helens Road

This inspection was carried out on 3rd January 2007.

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

Other inspections for this house

30 Lower St Helens Road 19/09/05

30 Lower St Helens Road 05/04/05

30 Lower St Helens Road 08/11/04

30 Lower St Helens Road 15/06/04

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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 30 Lower St Helen`s Road 30 Lower St Helen`s Road Hedge End Hampshire SO30 0LX Lead Inspector Craig Willis Unannounced Inspection 3rd January 2007 10:00 30 Lower St Helen`s Road DS0000059969.V319580.R01.S.doc Version 5.2 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 30 Lower St Helen`s Road DS0000059969.V319580.R01.S.doc Version 5.2 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. 30 Lower St Helen`s Road DS0000059969.V319580.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 30 Lower St Helen`s Road Address 30 Lower St Helen`s Road Hedge End Hampshire SO30 0LX 01489 787449 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) ILIACE Limited Post Vacant Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 30 Lower St Helen`s Road DS0000059969.V319580.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th September 2005 Brief Description of the Service: 30 Lower St Helen’s Road is registered to provide care and accommodation to four people between the ages of 18 and 65 years with learning disabilities. The home is owned by Iliace ltd and is a four bedded detached property situated in a residential area of Hedge End, approximately half a mile from the shops and village amenities. All service users have their own bedroom and share the use of the kitchen, lounge / dining room and garden. The manager reported in a pre-inspection questionnaire that the range of fees at the home is £1416.42 to £1935.95 per week, depending on the needs of the service users. 30 Lower St Helen`s Road DS0000059969.V319580.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The evidence used to write this report was gained from a review of the information the provider sent to the Commission for Social Care Inspection (CSCI), including a pre-inspection questionnaire and incident reports, and a site visit to the home on 3rd January 2007. During the site visit the inspector spoke with one of the service users, care staff on duty and the manager. A tour of the building was made and the inspector observed the way staff were supporting service users. Documents relating to the running of the home were inspected during the visit. The home does not currently have a registered manager. A manager has been in post since October 2006 and said during the visit that she would apply to CSCI to be registered. During the visit it was identified that one requirement about care plans from the last inspection report had not been complied with. The provider must ensure that action is taken to comply with requirements within the stated time scale. What the service does well: There are good systems to assess the needs of service users before they move into the home. Service users and their relatives are involved throughout this process and are helped to make decisions about their lives. Service users take part in a wide range of activities they enjoy and are supported to maintain contact with family and friends. Service users are able to see their doctor and other health professionals when they need to. Medication is stored safely and staff help service users to take it when they need to. Service users are confident that any complaints they make will be taken seriously and acted upon. The home is well maintained and provides a safe, homely environment for service users. There is a good training programme, which helps staff meet the needs of service users. The manager makes sure that equipment in the home is well maintained and safe for service users and staff. 30 Lower St Helen`s Road DS0000059969.V319580.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 30 Lower St Helen`s Road DS0000059969.V319580.R01.S.doc Version 5.2 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 30 Lower St Helen`s Road DS0000059969.V319580.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good systems to assess the needs of service users before they move into the home. EVIDENCE: One service user has moved into the home since the last inspection and their records were inspected during the visit. Prior to the service user moving into the home a full assessment of their needs was completed, including their communication, personal care, social, cultural and religious needs. The service user visited the home several times prior to moving and assessments were completed of the visits. The service user’s care manager had noted in a review meeting that the move had been well managed and staff had communicated well with the service user’s relatives. 30 Lower St Helen`s Road DS0000059969.V319580.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has care planning and risk assessment systems, however, failure to include information about all assessed needs and keep them regularly reviewed may result in the needs of service users not being fully met. Good support is provided to help service users make decisions about their lives. EVIDENCE: The personal files of all four service users were inspected during the visit. Each service user had a care plan, which had been reviewed by the previous registered manager following a requirement made at the last inspection. However, the manager reported that she was currently in the process of reviewing them again as they did not contain details of all the support that should be provided and was meeting with members of the community health team to develop new guidelines. Examples noted include, challenging behaviour guidelines for one service user that do not contain information about how staff should verbally intervene to calm the service user before the need for physical interventions; the care plan for one service user states that they 30 Lower St Helen`s Road DS0000059969.V319580.R01.S.doc Version 5.2 Page 10 will be supported to hold a key for their bedroom door, although this has not happened and there is no information to demonstrate that it would not be safe; the care plans for one service user do not reflect their needs regarding an eating disorder and how support should be provided; and the care plans for one service user does not include their needs regarding physiotherapy exercises. Staff spoken with were aware of the needs that were not included in the care plans. Care plans did contain details of how service users should be supported to make decisions and other aspects of communication. Staff were observed supporting service users to make decisions about activities they took part in during the visit. This support was provided in a sensitive and friendly manner and included the use of Makaton sign language to aid understanding. Risk assessments were in place for all four service users whose files were inspected. These documents set out the assessed hazards to service users and actions that should be taken to minimise the risk of harm. The risk assessments had also not been regularly reviewed and some of the information, for example the fire risk assessment for one service user, related to the previous home they lived in. The manager reported that she was in the process of reviewing all of the risk assessments and would complete this by the end of February 2007. 30 Lower St Helen`s Road DS0000059969.V319580.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides good support for service users to take part in suitable activities, to maintain relationships with family and friends and to have a balanced diet of food they enjoy. Staff work in a manner that respects the rights and responsibilities of service users. EVIDENCE: Service users are supported to take part in a range of educational and leisure activities. Service users spoken with said they like to go to local pubs and on trips out. Service users’ files contained details of activities they had taken part in, including attending an outdoor activity centre, college courses and local day trips. One service user works in a charity shop one day a week. Service users are supported to keep in touch with family and friends, including visits to relatives. The visitors’ book demonstrated that service users receive regular visitors. Service users spoken with said that staff maintain their privacy and treat them well. 30 Lower St Helen`s Road DS0000059969.V319580.R01.S.doc Version 5.2 Page 12 Some details of the support service users need to complete household jobs, such as cleaning and cooking, are included in their care plans, although as reported in the individual needs and choice section, care plans need to contain more information. Service users spoken with said that staff helped them to do their household jobs. Service users plan the menu each week, with each person taking a turn to cook the meal with support. The menus are displayed in a pictorial format to aid understanding. Service users spoken with said the food was good and they could always have something different if they wanted to. Mealtimes are flexible to fit in with service users’ activities. The kitchen was well stocked with a variety of good quality food. 30 Lower St Helen`s Road DS0000059969.V319580.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides good support to meet the personal care and health needs of service users. The system for storing and administering medication is good and protects service users. EVIDENCE: Service users spoken with said that staff treat them well and listen to them. Staff spoken with demonstrated a good understanding of the needs of service users and evidence was seen that agency and bank staff were given an induction on their first shift in the home. Records are maintained of service users’ visits to health services, including GP, dentist, chiropodist, psychiatrist, neurologist and community nurse. The records kept included details of any advice given by the practitioner. The manager reported that she was working with members of the specialist health team in the review of all care plans and risk assessments. One service user spoken with said they were able to see their doctor when they needed to. Medication is stored in a locked cabinet in the office and records are maintained of medication brought into the home, administered and returned to the pharmacist. Medication is regularly checked to ensure that the balance 30 Lower St Helen`s Road DS0000059969.V319580.R01.S.doc Version 5.2 Page 14 recorded matches the stocks held and that all administration records have been fully completed. All staff administering medication have undertaken assessed training. Currently none of the service users administer their own medication. 30 Lower St Helen`s Road DS0000059969.V319580.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are confident their complaints will be taken seriously and acted upon and the home has good adult protection systems, which helps to keep service users safe. EVIDENCE: The home has a complaints procedure available, which sets out who will deal with a complaint and how long the provider will take to respond. The procedure has been supplied to all service users in an accessible pictorial format. One service user spoken with said they know what to do if they want to make a complaint. One complaint has been received since the last inspection. This was from a service user who was concerned at the way a member of staff spoke to them. Following a referral to the local adult protection team, the manager investigated it as it was decided the allegation did not constitute abuse. The complaint was partially substantiated and the member of staff subsequently resigned from their post. Records of the investigation were inspected during the visit. The home has an adult protection policy and a copy of the local authority adult protection procedures. Staff have received adult protection training and those spoken with demonstrated a good understanding of abuse and action to take if abuse was reported or suspected. An incident of aggression from one service user towards another was referred to the adult protection team, which resulted in a strategy meeting being held. Following this, new risk assessments and guidelines were developed to ensure that the service user was kept safe. Staff 30 Lower St Helen`s Road DS0000059969.V319580.R01.S.doc Version 5.2 Page 16 spoken with had a good understanding of these guidelines and felt they were sufficient to keep the service user safe. 30 Lower St Helen`s Road DS0000059969.V319580.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained and provides a safe, homely environment for service users. EVIDENCE: A tour of the communal areas of the home was made during the visit. The home is well maintained and decorated throughout. Service users spoken with said the home was always clean and fresh. Furnishings were domestic and of good quality. The home has an enclosed rear garden, which service users are able to access. Since the last inspection a handrail has been fitted on the step from the back door to enable one service user to safely access the garden. The manager reported that an occupational therapist was consulted about the positioning of the rail. A handrail has subsequently been fitted on the step from the front door. The manager reported that the provider has a maintenance team and she has no problem getting work done when it is required. The maintenance record book showed that most jobs were 30 Lower St Helen`s Road DS0000059969.V319580.R01.S.doc Version 5.2 Page 18 completed the day after they were reported. There were no outstanding maintenance issues. The home has a domestic washing machine and dryer in the utility room off the kitchen. There are infection control procedures in place to prevent laundry being taken through the kitchen whilst food is being prepared or eaten. There are hand-washing facilities in the kitchen, bathrooms and toilets. 30 Lower St Helen`s Road DS0000059969.V319580.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34 and 35. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has good systems to protect service users and meet their needs through the staff training programme however, action is required to demonstrate that recruitment procedures are sufficiently robust. EVIDENCE: The manager reported that two of the six staff employed have achieved the National Vocational Qualification (NVQ) at level two or above, and three are currently completing the qualification. During the visit, staff were observed interacting with service users in a friendly and respectful manner. The manager reported that two new members of staff have been employed since the last inspection in September 2005. The recruitment records of these staff were inspected and did not contain written references or an enhanced disclosure from the Criminal Records Bureau. The manager said that she thought these records were being held at head office and had requested that they be sent through to the home. One of these members of staff was spoken with during the visit, and said they did not know whether they had a work permit for the UK. The manager said she was aware that there may be a problem and has asked her head office for more details. Action is needed to 30 Lower St Helen`s Road DS0000059969.V319580.R01.S.doc Version 5.2 Page 20 demonstrate that the home’s recruitment procedures are robust and protect service users. Staff spoken with said that they received good training that helps them to meet the needs of service users. A record is kept of all training that staff have undertaken. Training staff have completed includes first aid, medication administration, food hygiene, fire safety, health and safety, infection control, adult protection, autism, epilepsy and crisis intervention and prevention. 30 Lower St Helen`s Road DS0000059969.V319580.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are good systems to promote the health, safety and welfare of service users and staff. The home’s quality assurance system is not sufficiently robust to ensure improvements to the service provided are implemented. EVIDENCE: The manager started in post in October 2006, having previously worked at the home as a shift leader and reported that she is due to start work on the Registered Manager’s Award in the week following the inspection. The manager is aware of the need to apply for registration with CSCI and said she would be submitting an application by the end of January 2007. The manager said she receives good support from the senior management staff and is able to speak with them whenever she needs to and has regular supervision meetings with the area manager. 30 Lower St Helen`s Road DS0000059969.V319580.R01.S.doc Version 5.2 Page 22 Senior managers from Iliace visit the home each month to review the service quality. Reports of these visits contain actions that are required to improve the service, although the last one available was from November 2006. The report of the November visit did not assess the care plans or risk assessments, despite this being highlighted in the report of the October visit as an area for action and being a requirement in the previous inspection report. Action is needed to ensure that areas for improvement are identified and followed up in the provider’s visits. The manager was not aware of any development objectives for the home, other than those she has drawn up herself. The manager was aware that a survey of service users and staff had taken place prior to her appointment, although did not have any details of action points that had been developed from the collated results. The home has a fire risk assessment and regular checks are made of the fire warning system and the equipment. The gas system and portable electrical appliances are checked each year. Assessments are completed for chemicals used in the home, which are stored in a locked cupboard. The temperatures of hot water and the fridge and freezer are taken daily and recorded. Accidents and incidents to service users and staff are recorded and reported where necessary. 30 Lower St Helen`s Road DS0000059969.V319580.R01.S.doc Version 5.2 Page 23 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 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 2 X X 3 X 30 Lower St Helen`s Road DS0000059969.V319580.R01.S.doc Version 5.2 Page 24 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 Regulation 15 Requirement The registered person must ensure care plans are in sufficient detail to provide clear guidance to staff on how to meet service users’ health and welfare needs. Care plans must be kept under review. This requirement is repeated, as the previous timescale of 19/10/05 was not complied with. The registered person must ensure that the information and documents specified in Schedule 2 of the Care Homes Regulations 2001 are obtained before staff are employed to work in the home, and are available for inspection at all times. Timescale for action 28/02/07 2. YA34 19 28/02/07 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 30 Lower St Helen`s Road DS0000059969.V319580.R01.S.doc Version 5.2 Page 25 30 Lower St Helen`s Road DS0000059969.V319580.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 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 © 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 30 Lower St Helen`s Road DS0000059969.V319580.R01.S.doc Version 5.2 Page 27 - 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!