Inspection on 27/06/06 for 4 Seafarer`s Walk

This inspection was carried out on 27th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

4 Seafarer`s Walk 23/05/07

4 Seafarer`s Walk 12/09/05

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 4 Seafarer`s Walk Sandy Point Hayling Island Hampshire PO11 9TA Lead Inspector Kathryn Kirk Unannounced Inspection 27 June & 5th July 2006 10:30 th 4 Seafarer`s Walk DS0000064985.V295977.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 4 Seafarer`s Walk DS0000064985.V295977.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. 4 Seafarer`s Walk DS0000064985.V295977.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 4 Seafarer`s Walk Address Sandy Point Hayling Island Hampshire PO11 9TA 0151 420 3637 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) www.c-i-c.co.uk. Community Integrated Care Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 4 Seafarer`s Walk DS0000064985.V295977.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th September 2005 Brief Description of the Service: The home is situated in a quiet residential area to the southeast of Hayling Island and within easy each of the beach. Local shops and amenities can be accessed but to use a wider range of facilities travel is necessary to locations off the island such as in Portsmouth, Southsea and Havant. The home is purpose built and is situated next to a similar registered home .The homes share the front car park. All of the facilities are provided on one level with the exception of the garden. This slopes away to the front and rear of the home making independent use difficult and restricting the amount of usable space. The home is suitable for people who have physical as well as learning disabilities. All of the service users have single rooms. They have use of the kitchen /diner, a lounge and another room known as the recreation room. The home has one bathroom and a separate WC. The current fees, as given in April 2006 are £1312 per week 4 Seafarer`s Walk DS0000064985.V295977.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Visits to this service took place on 27 June 2006 and 5 July 2006. At the time of the visits, five service users were living at 4 Seafarers Walk. They were all present during part of the inspection, their needs are such that they were unable to verbally give their views about life in the home. Evidence gathered for this report was obtained through talking to the staff, spending time with residents, touring the building and by looking at some paperwork in the home. Other evidence was gathered from a pre inspection questionnaire, which had been completed by the manager and sent to CSCI, from reports of monitoring visits by senior mangers of Community Integrated Care and from written information about significant events in the home provided by staff. The findings of the previous inspection report of September 2005 were also reviewed. What the service does well: What has improved since the last inspection? A lot has improved since the last inspection, with the service either meeting or making significant progress in addressing all but one of the 13 requirements issued at the last inspection. A statement of purpose and service user guide has been developed. This provides service users and their supporters with more information about what is provided. Some work has started to increase 4 Seafarer`s Walk DS0000064985.V295977.R01.S.doc Version 5.2 Page 6 choice, for example by looking at different methods of conveying information. There are more opportunities for service users to take part in activities they like. The environment has improved, flooring has been replaced and rooms have been repainted. Staff recruitment records contain information necessary to help to demonstrate that procedures for employing staff are thorough. Staff now have regular supervision sessions 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. 4 Seafarer`s Walk DS0000064985.V295977.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 4 Seafarer`s Walk DS0000064985.V295977.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 and 5 Quality in this area is good. The judgement has been made using available evidence including a visit to the home. A system is in place to ensure that prospective residents needs are assessed. Information available to residents and their supporters is better and is being reviewed to allow for further improvements. Contracts provide a lot of information but could be clearer in some areas. EVIDENCE: The current residents have lived at the home since 1990. At the last inspection an admissions policy was seen in which it was made clear that no prospective service user would come to live at the home without having had their needs and wishes assessed. A Statement of purpose and service user guide has been developed since the last visit to the home. The Service user guide contains a statement of purpose and information about terms and conditions of residence. Those seen had been signed by a representative of the service user. It was discussed with staff that as only two wheelchair users can be accommodated at any one time, this information should be included in the service user guide. Documents are in written form and are also available in pictorial form. The manager said that she intends to provide an audio service user guide for the benefit of service users who are partially sighted. One contract was seen. This provided information about the rights and responsibilities of both parties. It had been signed by a representative of the 4 Seafarer`s Walk DS0000064985.V295977.R01.S.doc Version 5.2 Page 9 service user. It stated what services are included in the fees but did not give very detailed information about how some activities are paid for, for example , that CIC will pay for a holiday up to a certain amount but any additional cost must be met by the service user.The contract did not also give any information about the room to be occupied by the service user. This was discussed with the manager who agreed to follow this up. 4 Seafarer`s Walk DS0000064985.V295977.R01.S.doc Version 5.2 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 9 and 10 Quality in this area is adequate. This judgement has been made using available evidence including a visit to the service. Systems for care planning have improved but need to be further developed to help to meet residents’ needs and wishes. Risks are documented and reviewed appropriately. Some work has been done to increase choice within the home. More is needed. Records are secure and are largely confidential. EVIDENCE: Three care plans were seen. One was a person centred plan and had been completed in consultation with relatives and identified goals to be achieved. Through discussion it was evident that goals identified in the plan were being followed through. The other two were up to date but did not contain as much useful information about how staff could effectively support residents. Staff said that person centred planning would be implemented for all service users and that one member of staff had been recently trained in this area. The manager said that she is looking at ways to ensure that person centred planning training is provided to other staff members. As previously discussed, all service users have lived at the home since 1990. It was evident through discussion and through records that there may be some question about how compatible service users are. The manager said that she 4 Seafarer`s Walk DS0000064985.V295977.R01.S.doc Version 5.2 Page 11 had requested a reassessment of need for all to establish whether service users are suited to live together and to ensure that all individual needs could be met. The manager said that ways in which choices could be increased would be developed through the person centred planning system, for example, staff have started to compile pictures of meals to show to residents, and have identified that some service users respond better to texture or smells than to visual or verbal prompts. Risk assessments seen were up to date and had been signed by staff members to confirm that they had been read. Information held about those who live at 4 Seafarers was observed to be mainly securely stored, although there was some information on display in the kitchen that related to one particular service user. The manager said that this would be removed and placed in their individual file. 4 Seafarer`s Walk DS0000064985.V295977.R01.S.doc Version 5.2 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): 12, 13, 15, 16 and 17 Quality in this area is good. This judgement has been made using available evidence including a visit to the service. Opportunities to maintain fulfilling lifestyles have improved. Daily routines promote a degree of choice although this could be developed further when person centred planning is properly implemented for all. EVIDENCE: At the last inspection in September 2005 it was identified that much work was needed to improve residents lifestyle. Two requirements were made that residents must have more opportunities to participate in a range of activities and that they must have increased opportunity to use the community. Staff said that activities have increased since then. The home has an activities coordinator who is employed for twenty hours every week. They support each resident to go out to their chosen activity, for example, one resident was observed to be going out to a local snooker club. This was identified as an interest in their person centred plan. Staff also said that a local buddies group is now being accessed. Residents go swimming individually, staff said that this 4 Seafarer`s Walk DS0000064985.V295977.R01.S.doc Version 5.2 Page 13 is an activity that they all enjoy, although they each only do this once every five weeks. All residents also go to Chichester College, although at the time of the visit, college courses had finished for the summer. Staff said that family involvement is encouraged and there was evidence for example, that family members are included in the person centred planning process. Staff were observed to use service users preferred form of address and to talk and interact freely with residents. Residents were also observed to choose where to spend time, in their bedrooms, in communal areas or outside. There is a four weekly menu in the kitchen, which shows that residents have a snack at lunchtime and their main meal at night. Staff said that if service users wanted something different from the planned meal this would be provided. Staff said that they have recently changed the menus, to ensure that they contain what residents like to eat. Some were able to say what they wanted on the menu, for those who were unable to say, staff said that they included what they had observed them to enjoy. Records showed that dieticians have been involved where needed and the manager said that staff encourage residents to eat healthily. Residents were observed to eat where they chose and were offered appropriate support from staff. Staff said that some residents are able to help with the preparation of food and said that this is encouraged. 4 Seafarer`s Walk DS0000064985.V295977.R01.S.doc Version 5.2 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 Quality in this area is good. This judgement has been made using available evidence including a visit to the service. Appropriate healthcare support is provided. Current bathing provision should be reviewed to ensure that it meets the needs and preferences of all. EVIDENCE: Records show that service users have specialist support and advice as needed from health care professionals, for example, community nurses, occupational therapists and psychiatrists. Some technical aids and equipment was evident in the home. Through discussion with staff it appears that equipment currently provided for bathing needs to be reassessed to ensure that all have access to appropriate facilities. Staff said that no service users are able to administer their own medication. Most medicine is dispensed using a monitored dosage system. Medicines were observed to be securely stored and records checked of medicines administered tallied with stocks held. Records also showed that all Community Integrated Care staff have had training in the safe handling of medicines. 4 Seafarer`s Walk DS0000064985.V295977.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this area is good. This judgement has been made using available evidence, including a visit to the service. More evidence is needed to demonstrate that any complaint would be responded to appropriately. Appropriate procedures are in place to help to protect residents from abuse. EVIDENCE: A copy of the complaints procedure is posted in the front hall. No complaints have been received by CSCI about this service. Records at the home indicated that one complaint had been received. Though discussion with the manager indicated that this had been responded to appropriately, written records did not specify what the outcome was and what actions had been taken. The manager agreed that this would be done for any future complaint. Money held on behalf of service users is securely stored and records kept regarding this were accurate and up to date. The procedure regarding the funding of the house vehicle was looked at. The arrangements appear to be that each service user pays a set amount as part of a vehicle car agreement, which is signed on their behalf by a representative of CIC. All pay the same. The manager said that the use of this vehicle is about equal in all residents. Records and discussion indicates that all staff have either completed training in Crisis prevention and Intervention or that they have been nominated for the course. This provides them with strategies for managing challenging behaviour. 4 Seafarer`s Walk DS0000064985.V295977.R01.S.doc Version 5.2 Page 16 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 and 30 Quality in this area is adequate. This judgement has been made using available evidence, including a visit to the service. Some improvements to the environment have been made but others are still needed to improve the quality of life of service users and to prevent the risk of spread of infection, particularly with regards to the bathroom. EVIDENCE: The last inspection report noted a number of deficits regarding the environment. Since then flooring has been replaced in corridors lounge and dining areas. The report also noted that parts of the bathroom were in poor state of repair and presented a risk of infection. There is only one bathroom in the home and this was felt by staff to be insufficient for them to support residents effectively, particulaly on days where a number of residents attend college. Requirement was made for the registered person to provide an action plan in respect of the environment. Community Integrated Care responsed that negotiations have begun with the housing association as this is the landlords responsibility. No improvements were seen to have been made and so it will remain a requirment that bathing facilities must be improved. The previous report noted that the garden is uneven and offers little usable space for service users. At the time of this visit although the garden remained 4 Seafarer`s Walk DS0000064985.V295977.R01.S.doc Version 5.2 Page 17 uneven, good use was being made of the level outside space. Staff also said that it was the intention to build a patio to increase the usable space. Staff said that all communal and individual rooms have been completely redecorated since last inspection. Staff were observed to use plastic gloves and aprons. Paper towels were seen to be supplied in the bathroom areas. Laundry facilities were seen to be appropriate for the size and purpose of the home. 4 Seafarer`s Walk DS0000064985.V295977.R01.S.doc Version 5.2 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, 34, 35 and 36 Quality in this area is adequate. This judgement has been made using available evidence, including a visit to the service. Although overall available staff time has declined, service users benefit from being supported by a consistent staff team in just sufficient numbers. Recruitment records have improved and so protect service users more effectively. Staff receive adequate training to help to protect health and safety. The service may improve still further if more staff are trained in areas that are relevant to particular needs of service users. The staff supervision programme has improved. EVIDENCE: Since the last inspection, the number of allocated staff hours in the house have been reduced by 80 per week. Staff said that there are three staff on duty during the day and that there is one waking night staff. One member of staff also sleeps in .A recent rota seen reflected this. Staff asked said that there was generally enough time available for them to do what they needed to do and they were observed to be supporting and interacting with service users in a calm and unhurried manner. The manager said that there could be some difficulties in maintaining enough cover, particularly when staff are sick or on annual leave but said that adequate staffing numbers are being maintained. Records showed that 52 shifts have been covered by bank /agency staff over an eight week period. Staff said that the same workers are used regularly and that they know the service users well. 4 Seafarer`s Walk DS0000064985.V295977.R01.S.doc Version 5.2 Page 19 Staff meetings are held in the home. The manager said that there are generally sufficient staff to work with service users whilst meetings are taking place. At the last inspection a requirement was made that sufficient staff records must be held in the home for each member of the permanent, relief and agency staff. Community Integrated Care responded that staff records would be held in personal files at the home. This was found to be the case when two staff files were checked. Records and discussion with the manager and the staff team indicated that all staff have been trained in moving and handling. The manager confirmed that agency staff have also had this training. The two bank staff that are employed by Community Integrated Care have received induction training and have been trained in all basic health and safety areas. Staff confirmed that they have attended recent training in health and safety issues. Three members of staff have been nominated for NVQ level 3 courses to start in September. As discussed in a previous section, service users would benefit from more staff having training in the development of person centred plans. Staff said that one staff member who knew maketon was using this method of communication with one service user. This member of staff has now left and other members of staff said that they have not had training in this area. Staff confirmed that they receive regular supervision. This has improved since the time of the last inspection. 4 Seafarer`s Walk DS0000064985.V295977.R01.S.doc Version 5.2 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 Quality in this area is good. This judgement has been made using available evidence, including a visit to the service. There have been a number of improvements to the service since the last visit to the home. It would benefit further from more quality assurance monitoring to ensure that it continues to develop in the best interests of service users. EVIDENCE: The manager is currently applying for registration. At the time of these visits, she had been given additional responsibility to temporarily oversee the sister home next door. Community Integrated Care have since written to inform CSCI of other arrangements that they have made and so now the manager is responsible only for 4 Seafarers. Feedback from service users is mostly non-verbal and obtained through staff and relatives. A monitoring visit takes place every month by a senior manager. It was discussed with the manager that this is an area that could be expanded upon particularly with the further development of person centred plans. With the exception of remedial work to the bathroom, action has been taken to address identified requirements from the previous inspection. 4 Seafarer`s Walk DS0000064985.V295977.R01.S.doc Version 5.2 Page 21 Records seen indicated that, with the exception of the bathroom, checks of the building and maintenance of equipment are undertaken to maintain a safe environment. 4 Seafarer`s Walk DS0000064985.V295977.R01.S.doc Version 5.2 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 3 2 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 3 2 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 3 X 3 X 2 X X 3 X 4 Seafarer`s Walk DS0000064985.V295977.R01.S.doc Version 5.2 Page 23 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 YA24 Regulation 23(2)(j) &(o), 13(3) Requirement The registered person must provide suitable bathing facilities to meet the needs of service users. This is a repeat requirement of 12/11/05, previous requirement partially met. Timescale for action 31/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 4 Seafarer`s Walk DS0000064985.V295977.R01.S.doc Version 5.2 Page 24 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 4 Seafarer`s Walk DS0000064985.V295977.R01.S.doc Version 5.2 Page 25 - 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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