Inspection on 27/02/06 for 36 Station Road

This inspection was carried out on 27th February 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 no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

36 Station Road 20/06/06

36 Station Road 09/08/05

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Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

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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 36 Station Road Petersfield Hampshire GU32 3ES Lead Inspector John Vaughan Unannounced Inspection 27th February 2006 09:45 36 Station Road DS0000064989.V284865.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 36 Station Road DS0000064989.V284865.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. 36 Station Road DS0000064989.V284865.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 36 Station Road Address Petersfield Hampshire GU32 3ES 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) 0151 420 3637 www.c-i-c.co.uk. Community Integrated Care To Be Confirmed Care Home 3 Category(ies) of Learning disability (3), Learning disability over registration, with number 65 years of age (3) of places 36 Station Road DS0000064989.V284865.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th August 2005 Brief Description of the Service: 36 Station Road is a small residential service providing care and support to three adults with a learning disability. Community Integrated Care (CIC) who took over the service on The 1st July 2005 from the previous provider now provides the care and support. The building is owned by a housing association that is responsible for the maintenance of the property. Staff are provided twenty four hours a day to support the needs of service users. The home is located on a busy road and is indistinguishable from the other houses in the street. The home is close to the shops and public transport in the town of Petersfield. 36 Station Road DS0000064989.V284865.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector met with service users and staff in the home and toured the building. A sample of records was examined during the visit. This is the second inspection of the home since the new provider, Community Integrated Care took over on 1st July 2005. The inspector spoke to the manager and deputy manager of the home during this visit and looked at what they have done to improve the service since the last visit. What the service does well: What has improved since the last inspection? What they could do better: Although there have been improvements to the information for service users more work is needed and the manager has been asked to put a more accessible service user’s guide in place. The home needs to put more detail in the plans on how to support service users and put clear information in place on how they will keep people safe. The inspector has asked that the manager makes sure staff have the right skills and abilities by putting a training and development plan in place and that staff training is updated. 36 Station Road DS0000064989.V284865.R01.S.doc Version 5.1 Page 6 The manager needs to get proof of identity for staff members and keep a record of this in the home to show that they can protect service users. The inspector has asked the manager to carry out a review of the home involving service users, their families and representatives to make sure they are providing the service people want and need. The staff need to carry out a fire drill and practice as they have not had one since the home opened. 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. 36 Station Road DS0000064989.V284865.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 36 Station Road DS0000064989.V284865.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): 1 and 2 Service users and their representatives now have more information to make informed choices about living in this home. This will be enhanced by more accessible format based on service user’s communication needs. Improved practices mean that the home can demonstrate service users needs are being assessed and documented. EVIDENCE: The home did not have a statement of purpose or service user guide at the last inspection and could not show how service users are given information about how Community Integrated Care intend to support them. At this visit the manager was able to provide a statement of purpose and service user’s guide. The inspector discussed this document with the manager and the deputy manager and advised that a more accessible format is required to ensure service users understand what the service is providing. At the last visit to the home concerns were raised about the lack of assessment information for service users. At this visit the inspector was told that the staff members have been working with service users to develop a new care plan. 36 Station Road DS0000064989.V284865.R01.S.doc Version 5.1 Page 9 The inspector saw that each person has a document in place and the deputy manager talked the inspector through these documents. The document includes information on the person’s skills, abilities and areas where they need support. 36 Station Road DS0000064989.V284865.R01.S.doc Version 5.1 Page 10 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): 6, 7 and 9 Improvements to the care planning practices in the home mean that service user’s needs are being assessed and responded to. The practices of the home mean that service users are being supported to make choices about their lives. Incomplete risk assessment strategies do not demonstrate that service users are supported to take risks. EVIDENCE: The inspector examined three files to confirm that each person now has a basic plan in place. The manager stated that they are also working to develop a new format based on a person centred approach. One service user has an Essential Lifestyle Plan documenting their needs and wishes and the document provided information to confirm that the service user and their family have been involved in putting this plan together. 36 Station Road DS0000064989.V284865.R01.S.doc Version 5.1 Page 11 Goals are also being noted within the plan however there are no current strategies or guidelines in place to support service users or staff to achieve these goals. The inspector met with the service user’s key-worker and he was told about a number of areas that the staff member is planning to work on with the individual including developing independence and social contact however strategies to achieve these goals are yet to be agreed and documented. The inspector sat and talked with service users during the visit. He also observed positive and supportive interaction from staff members helping service users to make choices about daily activities. The inspector saw documentary evidence to demonstrate that service users are supported to make choices. A number of risk assessments have been put in place since the last visit to the home. These include environmental risks such as tripping, scalding and electric shock. The inspector spoke with the deputy manager and the manager about other aspects of supporting service users that involve taking risks and the manager agreed that these need to be included in the plan. Areas identified included bathing, supervision levels and restrictions on a service user’s night routine. Some assessments do not have clear guidance for staff for example the risk assessment for preventing scalds in the kitchen talks about what to do if a service user is scalded and not what to do to prevent or minimise the risk of scalding. 36 Station Road DS0000064989.V284865.R01.S.doc Version 5.1 Page 12 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): 14, 15,16 and 17 The practices within the home support service users to maintain contact with families and friends. Staff practices promote the rights of service users and support their individual wishes however the home must develop more detailed plans to demonstrate how this is consistently achieved. Service users benefit from a balanced and varied diet based on their likes and dislikes. EVIDENCE: The inspector met with service users and was told about their activities inside and out of the home. One service user returned from a morning activity at a day services centre and told the inspector that they had enjoyed their morning, Each service user has a variety of activities and the staff support is provided to maintain these activities. The deputy manager told the inspector that 36 Station Road DS0000064989.V284865.R01.S.doc Version 5.1 Page 13 additional hours are now being provided at the weekend to support a service user to engage in activities. One to one time is now planned to allow key-workers and service users to spend time together working on goals and activities. The inspector was told of trips out to the seaside, meals out and trips to the pub. All three service users attend a day service. From looking at the developing service user’s plans and talking to service users and staff the inspector was able to confirm that service users have contact with their families and friends. Staff support individuals to maintain this contact which includes visits and telephone conversations with family members. The inspector noted that the home locks its food and provisions away at night as one person will get up and eat food from the store including uncooked and frozen foods placing them at risk. The home ensures that drinks and fruit are available in the kitchen at night. The practice is not currently supported with a risk assessment or guidelines and the inspector advised that this restriction is documented and agreed. The guidelines must also demonstrate that the lifestyles and wishes of the other service users have not been affected by this practice. The inspector looked at a menu plan and talked to service users about the food provided in the home. Fresh vegetables and fruit are provided. Food likes and dislikes are recorded within the plan and alternative meals are noted on the menu. Positive comments were received and service users are supported to choose the menu and help prepare and cook meals. 36 Station Road DS0000064989.V284865.R01.S.doc Version 5.1 Page 14 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): 18, 19 and 20 The home provides support for service users to access health care professionals to meet their needs. Personal support is given in a way that respects the privacy and dignity of the individual. Medication administration practice in the home demonstrates a generally suitable and safe system is in place to support service users needs however the lack of homely remedy agreements and staff training in medication administration could undermine this practice. EVIDENCE: The inspector sampled records and confirmed that each service user is registered with a GP practice and the home keeps in contact with the doctor’s surgery to arrange suitable appointments to monitor health issues. Sections within the homes care plan document the service users health care support needs. This includes information on the medication used by each person. Service users are able to meet visitors and attend medical appointments in private. 36 Station Road DS0000064989.V284865.R01.S.doc Version 5.1 Page 15 Medication records are in place and are accurate. Medication is stored in a locked cupboard and records are kept of most medication administered and disposed of. The inspector noted that the home is not recording the amounts of medication received into the home and the deputy manager said that the recording had stopped. This was discussed with the manager and they agreed that a suitable system of recording all medication held in the home would be put in place. Medication for pain relief and cold remedies were seen in the cupboard however there was no documentation to indicate how and when this medication is used. The manager was advised that any ‘homely remedies’ must be recorded and an agreement from the service user’s GP or pharmacist must be in place to support their use. The manager was advised that they obtain a copy of the Royal Pharmaceutical Society’s guidelines for the administration of medicines in care homes, which provide clear information on homely remedies, and all aspects of medication administration in the home. When the inspector looked at staff records for training they did not have any information on medication administration training. A member of staff told the inspector that they have been instructed and supervised with administering medication by the manager and deputy manager. 36 Station Road DS0000064989.V284865.R01.S.doc Version 5.1 Page 16 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): 23 The current practice of the home does not demonstrate that systems are fully in place to protect service users. EVIDENCE: The manager did not have the Hampshire policy for the Protection of Vulnerable Adults. They were advised that a copy of this policy must be available in the home. The inspector stated that this document is the agreed strategy for responding to allegations of abuse across Hampshire and the home cannot demonstrate that they work within its guidelines if the staff team have no access to this. The staff training records did not contain evidence that staff have completed any recent training in protecting service users from abuse. The manager was advised that they must carry out training in this area. A memo seen by the inspector indicated that the organisation have a training module on protecting service users from abuse and this is to be used with all staff. Each service user has a building society account and the home keeps a record of all transactions supported by receipts for purchases. The inspector was able to confirm that service users are in receipt of their personal allowances and they are supported to manage their finances appropriately. 36 Station Road DS0000064989.V284865.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 Service users benefit from a comfortable and well-maintained home. EVIDENCE: The inspector toured the home. The house was in a generally good state of repair, clean and tidy and free from any unpleasant smells. The home has a lounge and a separate kitchen/dining room. Service users were using the communal areas during the visit to the home. The inspector noted that the bathroom has been repaired and redecorated which improved the overall look of the area. 36 Station Road DS0000064989.V284865.R01.S.doc Version 5.1 Page 18 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, 34 and 35 The home demonstrated that staff are supported to obtain suitable National Vocational Qualifications. A satisfactory level of staff is provided to meet the current needs of service users. The recruitment practices of the home are not sufficient to protect service users. The practices of the home do not demonstrate that staff members are receiving training and development to meet the needs of service users. EVIDENCE: The inspector spoke to the manager and deputy to establish the home’s approach to developing a programme of National Vocational Qualifications (NVQ). The home has one staff member with a NVQ level 3 at present. The deputy manager said that another support worker is undertaking their NVQ level 3. A further staff member is due to start their NVQ 2 award in September 2006. 36 Station Road DS0000064989.V284865.R01.S.doc Version 5.1 Page 19 The home has a small staff team and the manager said that they are committed to ensuring all staff have the opportunity to obtain a NVQ. The inspector examined the homes staffing rota. Three staff were on duty during the inspection as one service user was having one to one support. The manager reported that one staff member is on duty across the day with a second staff member working flexibly across the day. The rota indicated that this level of staff is maintained when all three service users are at home. Additional hours were also being provided at the weekend to support a service user with activities. An induction booklet is in place to demonstrate that staff are shown around the home, instructed in health and safety and general aspects of working with service users. The induction booklet currently being filled in for staff is dated 1999 and the manager provided a memo from the organisations human resources department to confirm that a newer workbook should be used. The inspector saw that this new workbook was now in the home but this has not been used yet. The manager stated that they have not had training on how to deliver this workbook and they intend to request some instruction from the training manager. The deputy manager told the inspector that they have attended a training day on food hygiene and have a two day course on health and safety planned for March. Staff records did not indicate that any other staff have received training or are booked to attend any training courses to update mandatory training. A staff member who spoke to the inspector was not aware of any planned training. They were also able to confirm that they have had the new induction workbook however they don’t know how this is going to be used. Staff members confirmed that they are receiving supervision and support. Staff recruitment records were examined and the inspector was able to confirm that an application form, two written references and a Criminal Records Bureau check has been taken up for each person. Two of the staff files did not contain proof of identity and the manager was required to obtain this. 36 Station Road DS0000064989.V284865.R01.S.doc Version 5.1 Page 20 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, 39 and 42 Although there have been improvements the manager must achieve much more in order to demonstrate that service users benefit from a well run home. The lack of a quality assurance system means that the home cannot demonstrate that the service is reviewed and developed involving service users and their representatives. The home is well maintained and all equipment is regularly serviced However the lack of fire training and drills has the potential to place service users at risk. EVIDENCE: The home has a manager who has applied to the commission for approval as the registered manager. They are also managing another small registered care home. The manager has experience of working in senior role within another registered home and they have started their registered manager’s award at college. 36 Station Road DS0000064989.V284865.R01.S.doc Version 5.1 Page 21 The inspector has noted that improvements have been made within the home however a number of areas require work to meet standards including care planning and risk assessment, training and recruitment. The manager must address these areas to demonstrate that the home is well run. The inspector discussed quality assurance with the manager. The inspector was told that this is an area that needs to be worked on. A quality assurance policy is in place and this outlines the procedures to follow including service user and family consultation. This has not taken place. The manager said that regular contact is maintained with family members and representatives of service users and they welcome any comments on how the service can be improved. Regulation 26 visits take place each month and a copy of this report is sent to the commission. The manager was required to put in place a system for reviewing and developing the service which included the views of service users, their representatives and other parties involved in the service. The inspector examined servicing and maintenance records, which demonstrated regular servicing of the electrical, heating and fire alarm systems, take place. The deputy manager told the inspector that they are updating all of the guidelines for handling hazardous products in the home. Records indicate that weekly and monthly checks are carried out on the fire alarm systems. The home has not undertaken a fire drill and the manager was advised that they must complete a minimum of twice over a twelve month period. Staff training is required in fire safety. An induction booklet is in place to ensure staff are aware of health and safety in the home. 36 Station Road DS0000064989.V284865.R01.S.doc Version 5.1 Page 22 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 2 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 X 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 1 36 3 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 X 13 X 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X 2 X X 2 X 36 Station Road DS0000064989.V284865.R01.S.doc Version 5.1 Page 23 No 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 14 Requirement The registered person must ensure that each service user has a plan, which fully documents their assessed needs and includes clear methodologies for supporting these needs. Repeated requirement previous timescale 9/11/05 partly met. 2. YA9 13 The registered person must 27/03/06 ensure that service users are supported by clear risk assessments for daily activities. This must also include any restrictions placed upon a service user. The registered person must ensure that the use of homely remedies is fully documented in the home. The registered person must ensure that proof of identity is in place and on file for all staff. Repeated requirement previous timescale 9/11/05 partly met. 27/04/06 Timescale for action 27/04/06 3. YA20 13 4. YA34 19 27/03/06 36 Station Road DS0000064989.V284865.R01.S.doc Version 5.1 Page 24 5. YA35 18 The registered person must ensure that staff have training to meet the needs of service users and the service. 27/04/06 6. YA39 22 The registered person must 27/04/06 ensure that systems are put in place to carry out a review of the quality of care involving service users and their representatives. The registered person must ensure that regular fire drills and practices take place in the home. 27/03/06 7. YA42 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. Refer to Standard Good Practice Recommendations 36 Station Road DS0000064989.V284865.R01.S.doc Version 5.1 Page 25 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 36 Station Road DS0000064989.V284865.R01.S.doc Version 5.1 Page 26 - 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. 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