Inspection on 16/06/05 for 4 Homeground

This inspection was carried out on 16th June 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

4 Homeground 05/09/06

4 Homeground 03/11/05

4 Homeground 17/03/05

4 Homeground 16/11/04

4 Homeground 15/03/04

4 Homeground 16/12/03

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Homeround (4) 4 Home Ground Wootton Bassett Wiltshire SN4 8NB Lead Inspector John Hurley Unannounced 16 June 2005 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. Homeround (4) D51 D01 s28669 Homeground v 233591 160605 Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Homeground (4) Address 4 Home Ground 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) 01793 849495 01793 849495 White Horse Care Trust Mrs Barbara Ann Wild PC Care Home only 3 3 Category(ies) of LD Learning Disability registration, with number of places Homeround (4) D51 D01 s28669 Homeground v 233591 160605 Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 17th March 2005 Brief Description of the Service: 4 Homeground is run by White Horse Care Trust. It offers accommodation and personal care to three people with learning disabilities. The home itself is a detached house in a residential estate on the outskirts of Wootton Bassett. Each service user has a single room on the first floor. There is a lounge, dining room and a garden to the rear of the property. The bathroom is on the first floor and there is a toilet on each floor.The service users receive personal care and support throughout the day from a permanent staff team. There are two members of staff on duty throughout the day, one in the evening and one sleeping in. The philosophy of care emphasises the importance of an ordinary, domestic type home environment and the involvement of people with a learning disability within the wider community. Each service user is offered a range of daytime and leisure activities. Homeround (4) D51 D01 s28669 Homeground v 233591 160605 Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector carried out this unannounced inspection over three hours. They viewed all areas of the home and observed one-service user who was at home at the time. The inspector spoke with the three care staff on duty and the registered person. The inspector did not have an opportunity to meet with any relatives on the day of the inspection. Due to the service users limited ability to communicate with the inspector was not able to include their comments in this report. A number of records were examined including three service users care plans, risk assessments, health and safety records and staff rota’s. What the service does well: 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. Homeround (4) D51 D01 s28669 Homeground v 233591 160605 Stage4.doc Version 1.30 Page 6 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 Homeround (4) D51 D01 s28669 Homeground v 233591 160605 Stage4.doc Version 1.30 Page 7 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) As there have been no new admissions since the last inspection this group of standards were not inspected. EVIDENCE: Homeround (4) D51 D01 s28669 Homeground v 233591 160605 Stage4.doc Version 1.30 Page 8 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) 6,9 The recording and care planning is good and gives the reader informative instructions on the delivery of care on an individual basis. EVIDENCE: The inspector briefly looked through the files. Each service user has a comprehensive service user plan generated from the assessment information. Their nominated key worker has reviewed these plans with the service user on a monthly basis. Each person had an annual individual plan. Restrictions on freedom of movement were recorded in the service user plans as well as a well laid out risk assessment. Homeround (4) D51 D01 s28669 Homeground v 233591 160605 Stage4.doc Version 1.30 Page 9 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) 11,13,14,17 Through discussions with staff, looking at the recording in the service user files and by assessing the daily staffing rotas it is clear that some of the goals set in the individual plans are not being met due to staff shortages. EVIDENCE: It is recorded that the service users attend a range of day time activities and outings. Two service users attend a resource centre and a day centre, whilst all service users have opportunities to participate in a wide range of leisure and community based activities. On the day of the unannounced inspection the activity rota stated that the service user who does not attend the day centre would be going swimming that afternoon. There was insufficient staff on duty to allow this activity to take place. The inspector observed that there was enough food stocks of both fresh and other foods to provide the basis for a nutritious meal. Due to the numbers of service users the home caters for (three): menus are used for guidance allowing personal choice where possible. Staff informed the inspector that they Homeround (4) D51 D01 s28669 Homeground v 233591 160605 Stage4.doc Version 1.30 Page 10 were aware of the individuals likes and dislikes and provided that the choices made by the individual ensured a degree of a balanced diet their wishes would be met. Homeround (4) D51 D01 s28669 Homeground v 233591 160605 Stage4.doc Version 1.30 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) The records observed demonstrate that the service users health care needs are acknowledged and acted upon in a proactive way. EVIDENCE: The records observed evidence that service users have regular health care checks from the GP and community nurse. They also see other professionals including a psychiatrist, psychologist and physiotherapist. The inspector viewed the relationship between the only service user present at the time of the inspection as both empathetic and professional. It was also observed that staff use positive encouragement to gently assist the individual when making choices. Homeround (4) D51 D01 s28669 Homeground v 233591 160605 Stage4.doc Version 1.30 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) No complaints have been made to either the home or directly to the regulator, similarly no vulnerable adults issues have been raised either. Therefore, these standards were not assessed. EVIDENCE: Homeround (4) D51 D01 s28669 Homeground v 233591 160605 Stage4.doc Version 1.30 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,28,30 The home continues to replicate a normal domestic dwelling. It provides a safe clean and comfortable environment. EVIDENCE: At the time of the unannounced inspection the home was found to be clean and comfortable. The service users rooms are personalised to reflect their individual tastes and preferences. The communal areas are domestic in nature and proved comfortable seating and dinning facilities. The bathroom on the first floor and downstairs toilet were both observed as clean and hygienic. The domestic style kitchen is adequate to provide for the needs of the service user group. Homeround (4) D51 D01 s28669 Homeground v 233591 160605 Stage4.doc Version 1.30 Page 14 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) 31,34,36 Staff were unsettled due to the departure of the manager and reported that morale was low. Staffing levels were also insufficient to meet the needs of a service user EVIDENCE: On beginning the unannounced inspection the inspector was told by the staff member that the morale of the home was poor but would not explain their comments. Similarly when two other members of staff came into the home they informed the inspector that there had been an incident but would not discuss the incident explaining it was confidential. The inspector briefly left the home in order for the staff to consider their position returning within three minutes. The staff group informed the inspector that they did not feel it was their place to discuss the incident and that they felt that a senior member of the Trust should inform the inspector. They did say that they were fed up and felt that they were overworked since the Trust had said that the home could no longer use agency staff. The Registered person was telephoned by staff and agreed to attended the home and explain what was going on. The registered person explained that the manager had resigned for personal reasons and that the staff were unhappy with how this had been dealt with. The registered person went onto explain that the Chairman of the Trust had met with the staff team and heard their grievances but could not alter what had happened. Staff later confirmed that this had happened. Homeround (4) D51 D01 s28669 Homeground v 233591 160605 Stage4.doc Version 1.30 Page 15 The registered person explained that they had appointed a new manager and they were due to take up their post within the next 10 days. They acknowledged that the staff were unhappy but did not consider they were being made to work excessive hours. The staff later agreed that they were not under any duress to work extra hours and had done so because they wished to offer continuity to the service users. The registered person explained that whilst there was a review relating to the use of agency staff there was no bar on using staff when needed. The registered person explained that a senior member of the Trust had been managing the home since the previous manager had left. Their role had been to supervise staff and ensure the smooth running of the home. Homeround (4) D51 D01 s28669 Homeground v 233591 160605 Stage4.doc Version 1.30 Page 16 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) 37,38,43 At the time of the inspection the management arrangements failed to ensure a needs led service. The inspector is not minded to make requirements relating to this, as the registered person was able to demonstrate that action had been taken to address this ie the appointment of a new manger and revised senior management structure within the home, see the staffing section. EVIDENCE: There was no registered manager in post at the time of the inspection. A senior member of staff from the Trust had been providing supervision and support to the staff team. The registered person was able to demonstrate that a new manager had been appointed subject to the approval of the regulator. They explained further a change to the management structure of the home, which would introduce a senior role. The present staff group were unaware of these changes at the time of the inspection. The registered person acknowledged the inspectors observations that needs were not being met due to staff shortages and interim management Homeround (4) D51 D01 s28669 Homeground v 233591 160605 Stage4.doc Version 1.30 Page 17 arrangements. They further acknowledged that the interim management arrangements had not taken into account the service users care plans. The recommendations to move the files from overcrowded shelves have been considered and alternative arrangements sought. Homeround (4) D51 D01 s28669 Homeground v 233591 160605 Stage4.doc Version 1.30 Page 18 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 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x x 3 x 3 Standard No 11 12 13 14 15 16 17 3 x 3 2 x x 3 Standard No 31 32 33 34 35 36 Score 3 x x 2 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Homeround (4) Score x x x x Standard No 37 38 39 40 41 42 43 Score 2 2 x x x x 2 D51 D01 s28669 Homeground v 233591 160605 Stage4.doc Version 1.30 Page 19 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 14 Regulation 18 (1)(a) Requirement The registered person must ensure that there are significant staff on duty to meet the agreed activities of the service users Timescale for action 30/07/05 2. 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 36 43 Good Practice Recommendations The registered person needs to consider the trianing implications for staff with regards to issues of confidentuality The registered person needs to consider how they monitor the effectiveness of the care plans following the resignation or absence of key managerial staff. Homeround (4) D51 D01 s28669 Homeground v 233591 160605 Stage4.doc Version 1.30 Page 20 Commission for Social Care Inspection Suite C, Avonbridge House Bath Road Chippenham Wiltshire SN15 2BB 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 Homeround (4) D51 D01 s28669 Homeground v 233591 160605 Stage4.doc Version 1.30 Page 21 - 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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