CARE HOME ADULTS 18-65
Festing Grove 47 Festing Grove Southsea Hampshire PO4 9QB Lead Inspector
Lorraine Parton Unannounced 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. Festing Grove H55 H04 s11687 47 Festing Grove v218567 080605 stage 0.dot Version 1.30 Page 3 SERVICE INFORMATION
Name of service 47 Festing Grove Address 47 Festing Grove PO4 9QB Southsea Hampshire 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) 02392 832427 Community Integrated Care Miss Michelle Callard CRH 4 (LD) 4 Category(ies) of (PD) 1 registration, with number of places Festing Grove H55 H04 s11687 47 Festing Grove v218567 080605 stage 0.dot Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: A maximum of one service user in the category PD referred to above may be accommodated at any one time. Date of last inspection 6th & 17th January 2005 Brief Description of the Service: 47 Festing Grove is situated in Southsea, in Portsmouth and is managed by Community Integrated Care (CIC). The home is close to local shops and a short walk away from the sea front of Southsea. Residents of the home have access to the homes car and therefore further afield facilities can be accessed. The home is a two storey house consisting of four single bedrooms of which two are on the ground floor and two on the first floor. The home has two bathrooms both are close to service user bedrooms. On the ground floor is a lounge, kitchen and open plan dining room. To the rear of the property is a small courtyard garden and the front of the property leads directly into the road. Festing Grove H55 H04 s11687 47 Festing Grove v218567 080605 stage 0.dot Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Due to no previous legal requirements at the homes last inspection, this inspection was unannounced. The inspection took place over 6 hours and two of the three service users living at the home participated in the inspection as they wished. Service users showed the inspector their rooms and one service user showed the inspector around their home. The home was found to be homely and service user rooms reflected personalities and chosen lifestyles. The home is currently registered for four service users, however, only three service users are living at the home. The inspector spoke to three members of staff who were on duty and the homes manager who assisted with the inspection throughout. Discussions took place regarding the changes the home has undergone since the last inspection and the impact of one service user leaving the home due to illness. All staff spoken to reflected that the homes environment has improved and that individual attention can now be given to the current service users. A walk around the home took place and the inspector looked at some of the homes records appropriate to the running of the home and the provision of care for the service users living at the home. During the inspection the inspector had the opportunity to speak to two visitors, who expressed their total satisfaction with the home and the homes staff. What the service does well:
Throughout the inspection it was evident that the homes staff promote and encourage service users to be independent. Service users were witnessed by the inspector to participate within the home and this included shopping and the selection of the food list, making their own meals, answering the telephone and door, choosing staff to assist with personal care, activities and participation within the home and the use of the home facilities. From discussions with service users, visitors, staff it is evident that the home provides a service user led service that ensures service users to chose and participate both within the home and outside as they wish. Throughout the inspection service users were seen by the inspector to dictate their routine/activities and which member of staff they chose to support them. All care plans and risk assessments were found to be comprehensive and these clearly documented service users involvement in a range of activities and
Festing Grove H55 H04 s11687 47 Festing Grove v218567 080605 stage 0.dot Version 1.30 Page 6 ensured a consistency of approach to managing issues experienced by service users. All staff confirmed that CIC and the homes manager ensures that the training they receive and can access are specific to the service they are providing. CIC provide a extensive range of training courses and are committed to ensuring the staff provided at the home are trained to a high level. What has improved since the last inspection? What they could do better:
It must be recognised that although the inspector identified the following areas in which the home could do better, the home is starting to work towards making these improvements. Due to the unsettled period of time the home has experienced and due to the employment of new staff, protocols for managing specific issues have not been fully followed. On speaking to the homes staff they recognised this has an area they could improve upon and that it would benefit the service users by having a consistency in approach by all staff and a reduction in incidents within the home. The homes manager has organised several away days for staff and
Festing Grove H55 H04 s11687 47 Festing Grove v218567 080605 stage 0.dot Version 1.30 Page 7 issues such as communication and managing situations are currently been developed. Several comments were received from staff regarding the home being a calmer environment since the home has only accommodated three service users. The home is small with minimum communal areas, accommodates service users with particular issues that have an effect on each other and further more since the discharge of one service user the number of incidents occurring at the home have significantly reduced. A recommendation has been made for the home to review its current numbers of service users permitted at the home. All service users are able to express their views either verbally or by non verbal communication skills. Many of the staff have worked at the home and are aware of service user needs and their methods of expressing points of views, however, the home has not implemented alternative methods of ensuring that important information can be communicated and in a format that is understood by the service users living at the home. This includes for example the complaints procedure and contracts. A requirement has been made for the home to implement alternative methods of communication for the service users requiring this. 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. Festing Grove H55 H04 s11687 47 Festing Grove v218567 080605 stage 0.dot Version 1.30 Page 8 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 Festing Grove H55 H04 s11687 47 Festing Grove v218567 080605 stage 0.dot Version 1.30 Page 9 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) none EVIDENCE: None of the standards were checked during the inspection, however, matters of contracts will be addressed with CIC in a separate meeting and will be fully assessed at the next inspection. Festing Grove H55 H04 s11687 47 Festing Grove v218567 080605 stage 0.dot Version 1.30 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 standard(s) 6,7,8,9 All service users living at the home have a comprehensive and personalised care plan, which identifies and promotes consistency towards meeting needs. Service users displayed their awareness and involvement in the care planning process, and care plans reflected chosen lifestyles of service users. Service users participate within the home and all risks identified have been risk assessed and incorporated into care plans. EVIDENCE: On the day of the inspection two service users care plans was audited. One service user plan was audited with the assistance of the service user. Service users and staff confirmed that they had been involved in the production of the service user plan. The plan is signed by the staff involved, but not the service user. The inspector had the opportunity to discuss with the service user about their chosen lifestyles, activities, work and leisure, choices and health and personal care. From these discussions the inspector on audit of the care plan, was able
Festing Grove H55 H04 s11687 47 Festing Grove v218567 080605 stage 0.dot Version 1.30 Page 11 to identify that it reflected the service users views and needs. Care plans were found to be extensive. Throughout the service user plan it was evident that the plan includes all relevant information and the home had involved relevant health care professions to assess any health care needs. This includes general practitioners, dieticians, speech therapists, learning disability teams and the mental health team when necessary. All service user plans had been reviewed since the last inspection and any changes or advice from relevant professionals incorporated into the service user plan and guidelines required for managing specific issues. The home had assessed service user risks with regards to participation within the home and for community access and these had been documented and incorporated into service user plans. Staff were seen to be encouraging service users to participate in their home and to make decisions regarding their lifestyles throughout the inspection. Service users were confident and relaxed and this is evident when the inspector witnessed a service user go into the kitchen and help their selves to snacks and drinks without asking staff first. Visitors confirmed that their relatives had developed in that they had become more independent and happier since living in the home. Festing Grove H55 H04 s11687 47 Festing Grove v218567 080605 stage 0.dot Version 1.30 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 standard(s) 12,13,14,15,16,17 Service users have established good links and social lives within the community. Activities are based on service user choices and support is given to access these by the homes staff. Service users have good relationships with people they choose. Staff support service users decisions to not have contact with people they do not wish to have as part of their lives. Appropriate advice and support is obtained to assist service users in areas of relationship difficulties. Service users are encouraged and supported to maintain a healthy lifestyle. EVIDENCE: All service users interests and hobbies were clearly documented in their service user plans. Service users were found to have different interests and staff support individual choices of leisure activities. The home provides adequate staffing levels to provide and support individual service user choices in leisure
Festing Grove H55 H04 s11687 47 Festing Grove v218567 080605 stage 0.dot Version 1.30 Page 13 activities. All service users have access to a wide range of community facilities and these include pubs, cafes, shops, local facilities for sport and leisure, theatres, cinemas and visiting friends and families. One service user has weekly manicures by a visiting beautician. Service users were seen dictating their wishes as to the activities they wished to participate in and with which member of staff they wished to go with. Staff confirmed that if service users choose not to see friends or family that they would support their decisions. The home has documented appropriate protocols for managing sexuality and implemented guidelines for staff to work within. These guidelines have been completed in conjunction with relevant advice from health care professionals. On service users family confirmed that their relationship with their relative was supported and that the home facilitates the service users choice to visit the family home. The home has involved a dietician in the meals provided by the home. Menus appear balanced and nutritious. Service users advised the inspector that they are involved in the menu planning, shopping for the food and preparation of meals. This was also witnessed during the inspection, as service users picked the lunch menu, one service user went shopping with the support of staff and then assisted in the preparation of their meal. Festing Grove H55 H04 s11687 47 Festing Grove v218567 080605 stage 0.dot Version 1.30 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 standard(s) 18,19 The health needs of the service users are being met, in consultation with other health care professions. EVIDENCE: All personal care needs are documented in the service user plans. All staff spoken to were aware of service users choices of the preferred staff to support with personal care. Service users were seen to dictate who assisted them with personal care and service users confirmed that this is always maintained. The home has involved relevant health care professionals to ensure needs have been assessed and the provision of correct equipment is provided to ensure service users are able to be as independent as possible when receiving personal care. All service user plans where relevant include moving and handling assessments carried out following consultation with a occupational therapists. All service users are registered with a general practitioner and therefore can access a wide range of healthcare professions when necessary. Festing Grove H55 H04 s11687 47 Festing Grove v218567 080605 stage 0.dot Version 1.30 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 standard(s) 22,23 Service users were aware of how to make a complaint and to whom. The home has a complaints procedure, however, this is not in a suitable format for all service users living at the home. Staff displayed their awareness of the Adult Protection Procedures implemented by the home. EVIDENCE: The home has a complaints procedure, which service users confirmed they were aware of. Service users confirmed that they would tell the staff either in the home or at day services if they were unhappy. Service users confirmed that the manager had gone through the complaints procedure with them. On discussion with the homes staff it was agreed that the procedure should be completed in a format that would be easier for service users to understand. The home agreed to research alternative ways to produce documented procedures. Two visitors confirmed that they were aware of the homes complaints procedure and that if they had any concerns then they would speak to the homes manager who they found approachable and willing to resolve any issues they have. The home (key worker) on a monthly basis holds a meeting with each service user to discuss any issues they may be experiencing. These meetings are documented and appropriate action taken to resolve any issues raised within the meetings.
Festing Grove H55 H04 s11687 47 Festing Grove v218567 080605 stage 0.dot Version 1.30 Page 16 The homes staff were aware of the adult protection procedures and whistle blowing policies adopted by the home. All staff receive training in adult protection issues. Festing Grove H55 H04 s11687 47 Festing Grove v218567 080605 stage 0.dot Version 1.30 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 standard(s) 24,25,26,28,29,30 The home was clean, homely and decorated in accordance with service user choices. Service user bedrooms are decorated and furnished to reflect individual needs and choices. The home has provided specialist equipment following consultation with relevant health care professions that promotes independence where possible. The home provides as safe an environment as possible and this is supported by documentation. The home is lacking in shared space. EVIDENCE: The home has been redecorated and refurnished since the last inspection. Service users and staff confirmed that service users had been involved in the selection of the furniture and colours of the new decoration. Festing Grove H55 H04 s11687 47 Festing Grove v218567 080605 stage 0.dot Version 1.30 Page 18 The home is homely in appearance and service users advised the inspector that they like their home and the way that they have chosen to have their rooms. The inspector did not identify any issues with the environment that would pose a risk to service users. The home has completed a range of risk assessments, which covered all identified risks and has implemented suitable controls for the identified risks. The inspector audited the homes certificates and found these to be satisfactory and up to date except for the homes insurance certificate, which was out of date. The home agreed to forward a copy of the new certificate to the Commission for Social Care Inspection. The home is a small house, which consists of shared space of lounge and dining/kitchen on the ground floor. To the rear of the property is a small courtyard garden directly off the dining area. The home offers accommodation to four service users in single bedroom accommodation over two floors. The home has two bathrooms one on each floor of the home. The downstairs bathroom has been adapted to meet the assessed needs of the service users. Staff had raised concerns during previous inspections regarding the lack of communal space when all service users are in the home. During this inspection and due to one service user leaving the home, staff and service users expressed their satisfaction, that the homes environment now permits service users to have space within their home, reduction in incidents and service users having more opportunities to be supported on a one to one basis outside of the home. Festing Grove H55 H04 s11687 47 Festing Grove v218567 080605 stage 0.dot Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,36 Staff have received training and undergone a thorough induction programme based on the identified needs of the service users living at the home. The home had implemented recruitment practices that ensure nobody working at the home poses an obvious risk to service users. Service users are supported by staff who are aware of their roles and responsibilities and work has part of an effective team. EVIDENCE: The inspector had the opportunity to speak to three members of staff and the homes manager, who all stated that they were aware of their roles and responsibilities. Staff advised the inspector that the homes manager supports their ideas and encourages their development in areas relating to the service they provide. Through discussions it was evident that staff had been disrupted by events that had been out of their hands relating to one service users illness. Staff advised the inspector that they felt they had not been listened to by outside agencies and this had had an impact on the homes morale. On speaking to staff they advised the inspector that morale was getting better and that team away days were helping to support the team. Staff also receive monthly supervision which was found to be documented and the home holds regular team meetings.
Festing Grove H55 H04 s11687 47 Festing Grove v218567 080605 stage 0.dot Version 1.30 Page 20 The inspector found the staff to be motivated in their work and knowledgeable on service user needs. Service users and visitors described the staff as helpful and approachable. The inspector audited two new staff files, which were found to contain all relevant information required. This included CRB and POVA, two references, identification and details of application and interviews. All files also contained the training the staff had undertaken. Many of the staff employed have completed both the NVQ 2 and 3 and several staff are booked on the NVQ training this year. Community Integrated Care (CIC) are committed to staff training and as such provide a wide range of training courses for staff to attend. Staffing rota’s indicate that the home is well covered at all times with a minimum of three staff on duty during the day and one staff during the night. Service users and families stated that they are able to go out when they wish and participate in a range of activities due to the good staffing level being provided by the home. Festing Grove H55 H04 s11687 47 Festing Grove v218567 080605 stage 0.dot Version 1.30 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 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) 37,38,42, The home provides a safe environment for service users to live, and this is supported by documentation. Service users live in a well run home that promotes independence and encourages self expression. EVIDENCE: Service users confirmed that they like living at the home and that they feel totally involved in the running of the home. The home holds monthly meeting with each service user to discuss any difficulties they may be experiencing. Staff and visitors confirmed that the manager is approachable and that she promotes good relationships with service users, other professionals and visitors to the home. Staff also stated that the manager promotes and encourages staff in their personal development. Festing Grove H55 H04 s11687 47 Festing Grove v218567 080605 stage 0.dot Version 1.30 Page 22 The home has undertaken risk assessments and has documented policies and procedures, which were found to be satisfactory. The home ensures that all certificates and insurances are in place to protect the welfare of the service users living at the home. Festing Grove H55 H04 s11687 47 Festing Grove v218567 080605 stage 0.dot Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23
ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 3 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 3 x 2 3 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Festing Grove Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x 3 x H55 H04 s11687 47 Festing Grove v218567 080605 stage 0.dot Version 1.30 Page 24 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 22,5 Regulation 5 Requirement Provide a complaints procedure and service user contracts in a suitable format for the service users living at the home. Timescale for action 31/9/05 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. Refer to Standard 7 27 Good Practice Recommendations Develop and involve service users in the production of suitable communication systems that enable service users to make informed choices. For example menus, activities. Review the service provided to the amount of people living in the home, taking into account the amount of space available and the size of the home. Festing Grove H55 H04 s11687 47 Festing Grove v218567 080605 stage 0.dot Version 1.30 Page 25 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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