Inspection on 10/08/05 for 5 Paddock Way

This inspection was carried out on 10th August 2005.

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 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

5 Paddock Way 04/01/07

5 Paddock Way 17/01/06

5 Paddock Way 02/02/05

5 Paddock Way 06/07/04

5 Paddock Way 09/01/04

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

CARE HOME ADULTS 18-65 5 Paddock Way Petersfield, Hampshire GU32 3NH Lead Inspector Anita Tengnah Unannounced 10/8/05 10:00am 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. 5 Paddock Way H54 S11900 5 Paddock Way V238822 100805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 5 Paddock Way Address Petersfield, Hampshire, GU32 3NH 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) 01730 267120 steve.almond@sft.org.uk Southern Focus Trust Mr Stephen Almond CRH 8 Category(ies) of LD- Learning Disability: 8 registration, with number of places 5 Paddock Way H54 S11900 5 Paddock Way V238822 100805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 2/2/05 Brief Description of the Service: 5 Paddocks Way is a registered providing personal care for 8 persons with learning disabilities in the younger adults category. The property comprises two semi –detached houses that are connected internally, and 4 service users are accommodated in each. All service users have single bedrooms and both parts of the property have a bathroom, shower room separate toilet, lounge, kitchen /dining room and utility room. To the front of the property is a small garden and to the rear is a large enclosed well-maintained garden where seating is available. The home is situated close to local facilities and a short journey away from Petersfield. Sourhern Focus TRust owns the service and has two other homes that are registered with the Hampshire office. 5 Paddock Way H54 S11900 5 Paddock Way V238822 100805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection was undertaken over a day on the 10th of August 2005. The inspection lasted for four hours. Although there were 8 service users accommodated by the home, at the time of the inspection there were only 2 service users present and only one of them could communicate meaningfully. The inspection process included tracking care records, discussion with service users and staff and a tour of the premises. What the service does well: What has improved since the last inspection? What they could do better: The manager discussed the issue with regards to one service user that was exhibiting disruptive behaviour. One service user spoken to was distressed by the behaviour of this service user towards him and another resident. The service user was visibly distressed and stated that” he cannot take it any more and wants to move out”. The manager has contacted social services and received increased funding for an extra thirty hours regarding 1:1 care for this service user. However the situation remains that the behaviour of this service 5 Paddock Way H54 S11900 5 Paddock Way V238822 100805 Stage 4.doc Version 1.40 Page 6 user continues to impinge on the welfare and well being of other service users accommodated at the home. 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. 5 Paddock Way H54 S11900 5 Paddock Way V238822 100805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection 5 Paddock Way H54 S11900 5 Paddock Way V238822 100805 Stage 4.doc Version 1.40 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 standard(s) 1,2 The home has in place satisfactory assessment procedure to ensure that the service can meet the service users’ needs. EVIDENCE: The care records of three service users were viewed during the inspection. The manager had completed a comprehensive needs assessment for service users prior to them moving into the home. Care management assessments were also secured prior to admission. The assessment had included health, communication, educational and social needs and an assessment of risks that service users face. Information was available in suitable format including pictorial format and these included the complaint procedure, service user’s money and fire safety thus taking into account the needs of service users. The manager discussed that he was planning to introduce the service user’s guide in this format in the future. No service users had moved into the home since the last inspection. 5 Paddock Way H54 S11900 5 Paddock Way V238822 100805 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7 The home has comprehensive care plans in place reflecting needs and personal goals including risk assessments for the safety of service users. EVIDENCE: Each service user had an individual care plan, which set out how their assessed needs would be met. The home has a key-worker system in place that one service user spoken confirmed was very good. He stated that his key-worker knows him well and is always treated with respect and that all the staff are like his friend. He confirmed that he had autonomy and choice regarding the activities of daily living. Care plans were formulated with the involvement of service users/ advocate as appropriate and risk assessments were in place. Care plans were comprehensive and took into account individual abilities and reviewed at regular intervals to reflect any changes in the needs of the service users. 5 Paddock Way H54 S11900 5 Paddock Way V238822 100805 Stage 4.doc Version 1.40 Page 10 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) 11,12,14 The home offers service users a good range of educational and leisure opportunities taking into account their personal needs and aspirations. EVIDENCE: The home has a wide range of leisure activities that service users are encouraged to pursue. One service user attended college and other service users accessed college through the day care service. One service user reported that three of them went out to Paulton Park a couple of days prior to the inspection. The manager reported that staff supported service user’s individual choices and facilitated activities such as bowling, cinema and maintaining links with the local community. The manager and staff were planning the forthcoming holiday for seven service users at two different locations. One service user stated that he was looking forward to the trip but was unsure where he would be staying. Service users were supported to take part in household activities and details of the support they required was included in their care plans. 5 Paddock Way H54 S11900 5 Paddock Way V238822 100805 Stage 4.doc Version 1.40 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) 18,19 The personal and health needs of service users are met with evidence of access to a range of NHS services. However the issue with regards to the behaviour of one service user was impinging on the welfare and well being of other service users accommodated at the service. EVIDENCE: Records indicated that service users were supported to attend a range of health services including, GP, dentist, optician. The manager reported that one service user was undergoing assessment with the involvement of the community health team and this had been ongoing for a few months. One service user reported that “nothing was too much for staff” and he was supported as required and had autonomy and choice with regards to activities. The problem with the behaviour of one service user was highlighted at the inspection. One service user was distressed and reported that there are two of them that are very unhappy living at the home. There were indications that the disruptive behaviour was seriously impinging on the quality of life for other service users. The manager has been pro-active in referring this service user to the Community Healthcare Team and the care manager in resolving the problem. 5 Paddock Way H54 S11900 5 Paddock Way V238822 100805 Stage 4.doc Version 1.40 Page 12 However the service user spoken to feels that he cannot take this situation anymore and he stated to the inspector that he wanted to leave the service. It was evident that the present situation did impact on the autonomy, choices and lives of service users accommodated. Hence it was concluded that the emotional needs of some service users were not met at the present time. All efforts are being made by the manager in order to resolve this situation. 5 Paddock Way H54 S11900 5 Paddock Way V238822 100805 Stage 4.doc Version 1.40 Page 13 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 The home has a robust complaint procedure in a suitable format that ensures the welfare and safety of service users. EVIDENCE: The home has a complaint procedure in place. There has been no complaint recorded since the last inspection. One service user spoken to was aware of the procedure and indicated that he would approach the manager or his keyworker with any issues. He stated he had already done so with regards to the present problem with one service user at present. The manager had put in place a complaint procedure in pictorial format and this was available in service users care plans. The manager deals with all complaints and refers these to his manager as appropriate. The adult protection procedure was available. The manager reported that he had recently attended an update on adult protection and was planning similar training for all other staff. 5 Paddock Way H54 S11900 5 Paddock Way V238822 100805 Stage 4.doc Version 1.40 Page 14 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) 24,25,30 The home presented a warm and comfortable environment for service users to live in. Bedrooms were personalised and appropriate to service users needs. The home has satisfactory infection control procedures in place to ensure the welfare of service users. EVIDENCE: The service was in good decorative order and was well maintained. The fixtures and fittings in the home are domestic and of good quality and all parts of the home were accessible to the present service users accommodated. Service user’s bedroom seen was highly personalised and it was evident that service users are encouraged and supported in bringing into the home items of personal belonging. One service user invited the inspector to view his room and said that he liked his room. The standard of furnishing was good and the service user stated that this was appropriate to his needs. Call bell access was available and a single lever lock was fitted. There is a planned programme of maintenance and the manager reported that two communal bathrooms had been recently refurbished and the communal kitchens in each unit were due for refurbishment soon. It was noted that the 5 Paddock Way H54 S11900 5 Paddock Way V238822 100805 Stage 4.doc Version 1.40 Page 15 furnishing in one of the lounge was frayed and in a poor state of repair and would benefit being reviewed/ replaced. This was discussed with the manager at the time of the inspection. The service has a small garden to the front and a large and well -maintained and enclosed garden at the back where seating was available. The home has a utility room where washing machine and dryer were available. The area was well maintained and clean. Satisfactory infection control procedure was in place. 5 Paddock Way H54 S11900 5 Paddock Way V238822 100805 Stage 4.doc Version 1.40 Page 16 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) 31,36 The training and supervision of staff are well managed and ensures that care delivery meet the needs of service users. There are clear lines of accountability within the home that ensures that the home is run for the benefit of service users. EVIDENCE: The home had a staff rota, indicating that there was at least two staff between 7.30am and 10pm and a member of staff sleeping overnight. Amendments were made to the rota to provide a record of who had actually covered shifts. It was evident that the manager reviewed staffing requirements to reflect the needs of service users. The manager had secured 30 hours extra funding from social services to manage the care of one service user. An effective staff team who have worked at the home for a long time supported service users. It was evident that the staff and service users had developed good relationships and a service user stated that all the staff were very good and kind. The service has on ongoing training programme. There are 5 staff who had completed the National Vocational Qualification (NVQ) in care and one staff member was undertaking this course at present. One staff was planning to 5 Paddock Way H54 S11900 5 Paddock Way V238822 100805 Stage 4.doc Version 1.40 Page 17 commence this course by the end of this year. Another staff member was planning to undertake the NVQ level 4 in October 2005. The manager had recently attended a course in person centred planning and sexuality. There are clear lines of accountability within the home. The home has robust system in place for staff supervision that is undertaken on a regular basis. The training and supervision programmes ensure that staff have the skills in delivering care in a way that benefits service users. 5 Paddock Way H54 S11900 5 Paddock Way V238822 100805 Stage 4.doc Version 1.40 Page 18 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) 39. The service has a good process of internal auditing in place to ensure that the service meets the needs of service users. EVIDENCE: The home has an internal audit system in place and included newsletter published by the trust on a three monthly basis. The last audit was undertaken in October 2004 and another one is planned for this year. The inspector saw a sample of service users’ comment cards that had been developed in pictorial format. The manager reported that as part of the service delivery, he also audited care plans on a six monthly basis. 5 Paddock Way H54 S11900 5 Paddock Way V238822 100805 Stage 4.doc Version 1.40 Page 19 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 3 3 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 x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x x x x 3 Standard No 11 12 13 14 15 16 17 3 3 x 3 x x x Standard No 31 32 33 34 35 36 Score 3 x x x x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 5 Paddock Way Score 3 2 x x Standard No 37 38 39 40 41 42 43 Score x x 3 x x x x H54 S11900 5 Paddock Way V238822 100805 Stage 4.doc Version 1.40 Page 20 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 Regulation Requirement Timescale for action 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. Refer to Standard Good Practice Recommendations 5 Paddock Way H54 S11900 5 Paddock Way V238822 100805 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 4th Floor- Overline House Blechynden Terrace Southampton Hampshire 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. 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