Inspection on 04/01/07 for 5 Paddock Way

This inspection was carried out on 4th January 2007.

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 17/01/06

5 Paddock Way 10/08/05

5 Paddock Way 02/02/05

5 Paddock Way 06/07/04

5 Paddock Way 09/01/04

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Treloar College

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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 Liz Palmer Key Unannounced Inspection 4th January 2007 09:30 5 Paddock Way DS0000011900.V319379.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 5 Paddock Way DS0000011900.V319379.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. 5 Paddock Way DS0000011900.V319379.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 5 Paddock Way Address Petersfield Hampshire GU32 3NH 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) 01730 267120 Southern Focus Trust Mr Stephen Almond Care Home 8 Category(ies) of Learning disability (8) registration, with number of places 5 Paddock Way DS0000011900.V319379.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th January 2006 Brief Description of the Service: 5 Paddock Way is a registered home 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 clients are accommodated in each. All clients 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 within walking distance of local facilities and the town of Petersfield . Southern Focus Trust owns the service and has two other own homes that are registered with the Hampshire office. 5 Paddock Way DS0000011900.V319379.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over two days. An analysis of the home was undertaken before the visit. No complaints have been made about the home. Five hours were spent in the home on the first day and one hour on the second day. During both visits the registered manager was unavailable. Two members of staff and three clients were present for the first visit and assisted with the inspection. During the second visit a team leader represented the registered manager and assisted with paperwork that was not accessible during the first visit. There were no requirements made at the last inspection and none were made as a result of this inspection. Some outcome groups have been rated excellent and all others have been rated good. Two people who live in the home were asked how they would like to be referred to in this report. They said they preferred the term client, therefore this has been used throughout the report. What the service does well: Clients can ‘test drive’ the service before choosing to live there. Staff are proactive in finding out as much as possible to help them provide suitable support to clients. Staff have all worked in the home for a long time and know the clients very well. A low turn over of staff means that clients have consistent support. Clients say it’s a nice place to live and they ‘like the staff’. Clients say staff understand their needs. Staff say it’s a great place to work. Training and support is excellent and ensures clients are supported by competent and confident staff. 5 Paddock Way DS0000011900.V319379.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. 5 Paddock Way DS0000011900.V319379.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 5 Paddock Way DS0000011900.V319379.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s approach to assessing prospective clients ensures their individual needs and aspirations can be met in the home. Clients have enough information about the home and can visit before choosing to live there. EVIDENCE: One new client has moved into the home since the last inspection. A full assessment was carried out and their last review and care plans from their previous placement were held on file in the home. The client said they had visited the home twice before moving in and records of this were kept by the home. A new care plan was drawn up and signed by the client on the day they moved in. 5 Paddock Way DS0000011900.V319379.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans and risk assessments are drawn up on an individual basis and are detailed and clear. Clients are involved in their care plans and consulted on decisions which effect their life. EVIDENCE: Three care plans were sampled. These were clear, detailed and kept under regular review. There was evidence that clients are involved in drawing up and reviewing their plans. Information such as important relationships, likes and dislikes, how to communicate with individuals and how to interpret their actions were written in the plans. There was evidence that annual reviews take place. A care plan has been drawn up for a new client, parts of which are still in a draft form. There was extensive evidence that the staff in the home had undergone training and done their own research to enable them to have a sound understanding of the needs of the new client. The client said they felt 5 Paddock Way DS0000011900.V319379.R01.S.doc Version 5.2 Page 10 that staff understood them; this was also evident through discussion with their key worker. Although care plans are focussed on the individual and staff felt the plans were person centred, clients would benefit from person centred plans produced in a format accessible to them. The staff said the home was committed to achieving this and internal training for some care staff had taken place. Through observation it was evident that clients are able to make decisions about their lives. Clients were noted to be receiving support to get up at their own pace and choosing how to spend their time. Regular house meetings are held and a record is kept of what clients discussed. Activities and trips are requested, items of furniture and favourite foods are also asked for. Clients said they are able to choose how they spend their time, when they get up and go to bed. Clients are supported to take risks and risk assessments are in place and regularly reviewed. Risk assessments are drawn up on an individual basis and the emphasis on independence and positive outcomes supports clients to achieve their goals and aspirations. 5 Paddock Way DS0000011900.V319379.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Clients are supported to access a broad range of educational, social and community activities. Diversity is promoted and clients are supported to express their individuality. Healthy and varied meals are provided with the involvement of clients. EVIDENCE: Clients are supported to access a range of leisure and educational activities. These are arranged on an individual needs basis and with reference to personal preferences. For example, attending day services where they can do cooking, sport, gardening and art and crafts. Clients can also attend college courses and pursue their hobbies and interests. One client spoken to said they had enough to do and documented evidence showed that all clients have a varied and active social life. Equality and diversity is promoted in the home and good 5 Paddock Way DS0000011900.V319379.R01.S.doc Version 5.2 Page 12 examples of this were available. Clients are supported to express their individuality through a range of social activities, for example, attending places of worship and being members of specific interest groups. Clients are active in their local community and attend local church groups, clubs and use the local shops, pubs and restaurants. Important relationships are recorded, there was written evidence of clients being supported to maintain links with families and friends. One client spoke of keeping in touch with friends from his previous home and both clients spoken to said they could invite friends to the house when they like. Support is given to clients to take responsibility for household tasks and be involved in all aspects of running the home. Healthy and varied meals are provided and clients said they enjoyed helping with the cooking. Details of specific dietary needs are recorded in care plans as well as individual needs and preferences. Meals and meal times are flexible and whilst looking at the menu plan one client said he did not like what was on planned for that night so would choose something else. Clients spoken to said they liked the food. 5 Paddock Way DS0000011900.V319379.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Clients are supported to maintain their health and receive personal care in a way that meets their individual needs and preferences. Clients are protected by the home’s policies and procedures for storing, recording and administering medication. EVIDENCE: Clients’ individual needs and preferences regarding their personal care are recorded in their care plans. Those asked said they receive the support they need and that staff ‘always help’ them. The staff spoken to knew clients very well and were able to describe the support that individuals needed. Evidence in care plans show that emotional needs are considered individually and strategies for support are in place those who need it. Clients said they could talk to staff if they are upset or worried about things. Each client is supported to maintain their health and well being by having their own General Practitioner (GP). Support is given to keep GP’s appointments as well as dental and podiatry appointments. Specialist healthcare professionals 5 Paddock Way DS0000011900.V319379.R01.S.doc Version 5.2 Page 14 are involved when necessary, for clients with specific health needs, systems are in place to monitor and review these. It was evident that staff had researched and were knowledgeable about specific healthcare needs relating to a client. One client sometimes needs to spend time in hospital and ‘round the clock’ support is provided by the staff. Procedures for storing medication were sampled and found to be secure and robust. The home uses corporate guidelines for administration, the staff spoken to were clear about the home’s procedures, however specific guidelines for the home might be beneficial for use in an emergency situation. Currently only regular and trained staff administer medication. Staff are trained by Southern Focus Trust (SFT) and a national pharmacist. All staff undergo a written assessment every six months to ensure their competence. Records were sampled and no errors or omissions were found. No controlled drugs are currently used and no-one self-administers. 5 Paddock Way DS0000011900.V319379.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Clients are able to air their views and make complaints. Procedures are in place to protect clients from abuse. EVIDENCE: Clients are provided with a pictorial complaints procedure. No complaints have been made since the last inspection. The staff were asked how a client with limited verbal communication would be supported to make complaints and air their views. They said they ‘would know’ if an individual was unhappy by their body language or change of behaviour and staff would initiate exploring this and support the person to help them express themselves. Clients were asked about how they complained and made their concerns known. They said they knew who they could talk to and said that staff and the manager listen to them and sort out their problems. Staff spoken to said they were familiar with the home’s adult protection policy and the Hampshire County Council one. They stated they were aware of their responsibilities within them. Clients are all supported with their finances, they can have access to their money when they wish. Receipts and written records of transactions are kept. Monies held on behalf of three clients were sampled. Three cash balances were sampled, all were accurate, however, two had hand written notes for cash being taken out but no change or receipts had been brought back. In the 5 Paddock Way DS0000011900.V319379.R01.S.doc Version 5.2 Page 16 case of one it was the manager who had taken cash to support a client with Christmas shopping. The manager became unwell that day and had not since returned to work. In the second case a large amount had been taken to support a client whilst in hospital and the staff member had not returned to the home as had been working waking nights at the hospital. The team leader stated this would not normally occur but these were both unusual circumstances. On the second visit the receipts and change had been added but another large sum had been taken to support the same person in hospital. Ways of better protecting clients were discussed, for example, two signatures on the paperwork stating money was being taken out. The team leader agreed the home would look into this. 5 Paddock Way DS0000011900.V319379.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Clients live in a clean, homely and safe environment. EVIDENCE: A tour of the premises was undertaken with the assistance of two of the clients. The home was found to be comfortable, clean and safe. A system is in place to report repairs and improvements needed. Petersfield Housing Association carries these out. Bedrooms seen were suitably decorated with adequate furniture and personalised to reflect the preferences and needs of the individuals occupying them. There was adequate communal space and these areas were clean and comfortable. Notices in home promoted health and safety for clients. Risk assessments are in place for the environment and staff are suitably trained, for example; in Health and Safety, Food Hygiene and Fire Safety. 5 Paddock Way DS0000011900.V319379.R01.S.doc Version 5.2 Page 18 5 Paddock Way DS0000011900.V319379.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Clients are supported by a well established, trained, competent and supervised staff team. Staff showed a good understanding of the needs of individuals and are able to meet their individual and joint needs. EVIDENCE: The staff spoken to during the inspection were confident and competent. They said they enjoyed their work and showed an in depth knowledge of the individual needs of clients. They spoke about clients in a sensitive and positive manner and were seen interacting in this way. Staff have the skills to communicate with all the clients on an individual needs basis. For example, Makaton, and picture symbols are used in the home. Some of the clients who don’t need to use Makaton themselves are able to use it communicate with others. Clients said they liked the staff and a natural and relaxed rapport was noticed between staff and clients. 5 Paddock Way DS0000011900.V319379.R01.S.doc Version 5.2 Page 20 Southern Focus Trust provide a comprehensive training programme which includes all the mandatory training, such as, Health and Safety, Fire and First Aid. All care staff are automatically enrolled on National Vocational Qualification level 3. Currently 7 of the 8 staff in the home have achieved this level and one is in the process of completing it. The team leader is waiting for confirmation of NVQ level 4. Staff spoke highly of the training and said they could request training specific to the clients they support. Evidence that this had been provided for a new client was available. The rota was seen and reflected the staff on duty that day. Photographs of who is sleeping in each night are put up on the clients’ notice board so that they know who will be supporting them. No new staff have been employed at the home since the last inspection and only one person has been employed in the last three years. The stable staff team offers consistency to the clients and staff say make it a great place to work. Staff shortages due to sickness are covered by the staff or by staff from Premier Crew, SFT’s own agency. They aim to use staff already known to the home used from Premier Crew to provide continuity for clients. Premier Crew staff do not work alone, administer medication or sleep in at 5 Paddock Way. They are recruited and trained by SFT. 5 Paddock Way DS0000011900.V319379.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run and the health and safety of clients is promoted and their views are part of the overall and day-to-day development. EVIDENCE: The home has a registered manager who has been in post for 7 years. Staff and clients expressed confidence in the manager and felt able to talk to him and be listened to. Staff said their supervision was important to them because they could speak to their manager in confidence. Staff also said they feel well supported by the team and can talk to each other openly and honestly. 5 Paddock Way DS0000011900.V319379.R01.S.doc Version 5.2 Page 22 Clients benefit from the office being well organised and paperwork being kept accurate and up to date. Evidence of regulation 26 visits taking place was available. Regulation 37 forms are sent to the commission to inform us of events detrimental to the well being of clients. Clients are consulted on a daily basis and at house meetings where their views are listened to and acted on. A client survey is carried every 6 months by the manager or team leader. Clients receive this in an accessible format based on their individual needs. An annual quality audit is also carried out however this was not available for inspection. The home has policies, procedures and risk assessments in place to promote the health and safety of clients and staff. 5 Paddock Way DS0000011900.V319379.R01.S.doc Version 5.2 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 Standard No Score 1 3 2 3 3 X 4 4 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 3 34 3 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 4 12 4 13 3 14 X 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X 5 Paddock Way DS0000011900.V319379.R01.S.doc Version 5.2 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. 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. Refer to Standard Good Practice Recommendations 5 Paddock Way DS0000011900.V319379.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 5 Paddock Way DS0000011900.V319379.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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