Inspection on 15/11/06 for 5 Saunton Gardens

This inspection was carried out on 15th November 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

5 Saunton Gardens 07/11/08

5 Saunton Gardens 06/01/06

5 Saunton Gardens 05/04/05

5 Saunton Gardens 02/11/04

5 Saunton Gardens 10/06/04

5 Saunton Gardens 23/02/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Pinta

Kestrel House, St Anne`s Opportunity Centre,

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

CARE HOME ADULTS 18-65 5 Saunton Gardens Farnborough Hampshire GU14 8UN Lead Inspector Liz Palmer Unannounced Inspection 15th November 2006 10:00 5 Saunton Gardens DS0000012060.V315749.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 Saunton Gardens DS0000012060.V315749.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 Saunton Gardens DS0000012060.V315749.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 5 Saunton Gardens Address Farnborough Hampshire GU14 8UN 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) 020 7454 0454 H4037@mencap.org.uk Royal Mencap Society Ms Hazel Margaret Wright Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 5 Saunton Gardens DS0000012060.V315749.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th January 2006 Brief Description of the Service: 5 Saunton Gardens is a small residential service providing care and support to five younger adults with a learning disability. The care and support is provided by MENCAP and the building is owned by a housing association that is responsible for the maintenance of the property. Staff are provided twenty-four hours a day to support the needs of service users. The home is located in a housing estate and is indistinguishable from the other houses in the street. The home is on the outskirts of Farnborough. The fees are £62.35 per week. 5 Saunton Gardens DS0000012060.V315749.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection included a visit to the service, which took five and a half hours. Other information provided by the home prior to the visit was used including a pre-inspection questionnaire. During the visit four of the service users were met and asked about their views on the home. Three were case tracked. Service users were also observed being supported by staff. Three care staff were met and were interviewed. The manager was present and assisted with the inspection. Care plans and other paperwork was sampled. What the service does well: What has improved since the last inspection? What they could do better: Care plans and risk assessments must be reviewed on a regular basis. Although staff say they feel well supported and receive supervision this must be done on a regular basis. 5 Saunton Gardens DS0000012060.V315749.R01.S.doc Version 5.2 Page 6 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 Saunton Gardens DS0000012060.V315749.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 Saunton Gardens DS0000012060.V315749.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): 2. 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 service users ensures their individual needs and aspirations can be met in the home. EVIDENCE: No new service users have moved into the home since the last inspection. This standard was assessed and met at the last inspection based on evidence relating to a service user who had moved in prior to that inspection. The manager stated that no changes had been made to the home’s policies and procedures. 5 Saunton Gardens DS0000012060.V315749.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 and 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans and risk assessments are detailed and clear, however, service users would benefit from these being kept under regular review. EVIDENCE: Three service users were case tracked and their care plans were sampled. These were very detailed and included personal care needs, daily routines and likes and dislikes. Care plans were clear and easy to follow. Details of individual preferences were noted, for example the brands of toiletries preferred and where they were kept. Staff referred to care plans when talking about service users and the plans reflected the care being given. The home approaches care planning in a person centred way and evidence of service user involvement in drawing up their plans was seen. Service users do not have a ‘working’ person centred plan, however the home is implementing this and an example of one that has been started was seen. 5 Saunton Gardens DS0000012060.V315749.R01.S.doc Version 5.2 Page 10 Some care plans were overdue to be reviewed, however, changes had been noted where applicable and the care plans appeared to reflect to current needs of service users. Service users are involved in the decision-making in the home and are supported and encouraged to have control over their lives. This was evidenced through observation of service users planning their day, through discussions with them and in their daily diaries. Risk assessments are in place and drawn up on an individual needs basis, for example, accessing the local community, night support and going out. Some risk assessments, although they appeared to be relevant were overdue to be reviewed. This was discussed with the manager who agreed and said she was aware of some of the review dates but that some care plans and risk assessments had been over looked due to key workers leaving and her not having a deputy in post to support her with the paperwork. A requirement has been made for all care plans and risk assessments to be reviewed. 5 Saunton Gardens DS0000012060.V315749.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): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from the arrangements for educational, social and community activities. Healthy and varied meals are provided with the involvement of service users. EVIDENCE: Service users 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, on the day of inspection one service user was attending day services, another went to college for a sewing class and one was at home having one to one support with domestic chores then going out for lunch. Service users spoken to said they had enough to do and particularly liked; ‘using the computer’, ‘going shopping’, ‘Gateway Club’ and ‘going to town’. 5 Saunton Gardens DS0000012060.V315749.R01.S.doc Version 5.2 Page 12 Service users are supported to use local shops and facilities and enjoy using public transport. Important relationships are recorded and there was written evidence of service users being supported to telephone their relatives and friends. Arrangements for visiting them are in place and service users said they invite visitors whenever they like. Service users are supported to pursue their hobbies and interests, which are clearly noted in their care plans. Their bedrooms reflect their personalities and preferences; they have keys to their rooms to promote their privacy. Support is given to service users to take responsibility for household tasks. Each has a day set aside where they have one to one staff support to achieve this. Service users are encouraged to be part of all aspects of running the home and have regular meetings where they can give their views. Service users do the weekly shopping and they are encouraged to eat a healthy and balanced diet. One service user said he enjoyed helping with the cooking. Details of specific dietary needs are recorded in care plans as well as individual needs and preferences. Meal times are flexible and service users can choose where to eat their meals. Details of individual support needed with meal times is recorded in care plans. All service users spoken to said they liked the food. 5 Saunton Gardens DS0000012060.V315749.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. Service users are supported to maintain their health and receive personal care in a way that meets their individual needs and preferences. Service users are protected by the home’s policies and procedures for storing, recording and administering medication. EVIDENCE: Service users’ individual needs and preferences regarding their personal care are recorded in their care plans. Those asked said they receive the support they need. The three staff spoken to knew service users very well and were able to describe the support that individuals need. Evidence in care plans show that emotional needs are considered individually and strategies for support are being looked into for those who need it. The home works with the Community Learning Disability Team (CLDT) when necessary to meet individuals’ needs. Service users said they could talk to staff if they are upset or worried about things. Each service user is supported to maintain their health and well being by having their own General Practitioner (GP). Support is given to keep GP’s 5 Saunton Gardens DS0000012060.V315749.R01.S.doc Version 5.2 Page 14 appointments as well as dental and podiatry appointments. Specialist healthcare professionals are involved when necessary, for example, a neurologist and a psychiatrist are involved in the care of one person’s epilepsy. Risk assessments are in place for two people who may be at risk of having a seizure at night. These have been drawn up in conjunction with care managers, the CLDT and GPs. The risk has been deemed low and the GP has said he is satisfied with the recording and management of the service users epilepsy. Procedures for storing medication were sampled and found to be secure and suitable. The home’s guidelines for administration are clear and detailed. A list of medications and their side effects is kept on file. All staff have received training in administering medication. Records were sampled and no errors or omissions were found. GPs regularly review medication. 5 Saunton Gardens DS0000012060.V315749.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. Service users are able to air their views and make complaints. Procedures are in place to protect service users from abuse, neglect and self-harm. EVIDENCE: Service users are provided with a pictorial complaints procedure. A service user has made two complaints since the last inspection. These were recorded and signed by the service user to say they were happy with the outcome. The manager and staff were asked how a service user with limited verbal communication would be supported to make complaints and air their views. Staff said they ‘would know’ if that person was unhappy and would use clues such as body language and facial expression to alert them. The manager stated that a risk assessment is also in place for this staff know service users well enough to know when they are unhappy about something. No complaints have been made to the commission about the service. Staff are trained in adult protection as part of their induction and foundation training and risk assessments are in place to protect all service users from abuse. Staff spoken to say they were familiar with the home’s adult protection policy and the Hampshire County Council one. They stated they were aware of their responsibilities with in them. Service users are all supported with their finances, they can have access to their money when they wish and support varies depending on the needs and wishes of the individuals. Monies held on behalf of service users were sampled. Cash balances matched the recorded amounts and were stored 5 Saunton Gardens DS0000012060.V315749.R01.S.doc Version 5.2 Page 16 securely and individually. There is a clear audit trail for bank withdrawals and receipts are kept for all large expenditures. 5 Saunton Gardens DS0000012060.V315749.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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a clean, homely and safe environment. EVIDENCE: A tour of the home was undertaken. There was adequate communal space and these areas were clean and comfortable. Photographs and personal items around the home made it homely and service users clearly felt relaxed. The service users bedrooms seen were decorated and furnished to reflect individuals’ needs and preferences. Notices in home promoted health and safety for service users. Risk assessments are in place for the environment and staff are trained in Health and Safety, Food Hygiene and Fire Safety. 5 Saunton Gardens DS0000012060.V315749.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are protected by robust recruitment procedures, however they would benefit from improvements to the training and supervision of staff. EVIDENCE: The three 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 service users. They spoke about service users in a sensitive and positive manner and wee seen interacting in this way too. Service users said they liked the staff and a natural and relaxed rapport was noticed between staff and service users. One staff member who has been in post for six months said she had received an in depth induction and foundation course. There is a corporate training programme in place, which ensures staff have the mandatory training as well as the opportunity to do National Vocational Qualifications (NVQs). As part of the foundation course staff are trained in subjects relevant to the care needed in the home, for example, Epilepsy, Autism and Makaton. However, the home has not met the timescales for having 50 of the staff team with an NVQ award. The manager stated that this is partly due to staff with qualifications leaving. Currently one care 5 Saunton Gardens DS0000012060.V315749.R01.S.doc Version 5.2 Page 19 staff has an NVQ award. The manager is planning for one staff member who is on maternity leave to start an NVQ when she returns and another staff member to start in 2007. Recruitment procedures in the home are robust to ensure that only suitable staff work in the home. Three staff files were sampled and found to contain an application form, two references, criminal record checks and protection of vulnerable adult checks. Staff spoken to said they felt well supported to do their jobs. They said they could talk to the manager about anything and felt she would resolve any issues. All staff spoken to said they received formal supervision, one had received it recently. The member of staff who has been in post for six months said she received three so far. Staff said they were planned for every six weeks but due to staff shortages they did not always happen. Staff made very positive comments about the support and supervision they get. Saying such things as, ‘I am totally happy’, ‘I can talk to the manager about anything’ and ‘she is always wiling to listen’. The manager said that due to recent staff vacancies and not having a deputy in post she had not always made the formal supervisions a priority. The requirement made at the last inspection for all staff to receive regular supervision could not be evidenced; it appeared to be random rather than regular. The negative impact of this on service users was not evident other than possibly ensuring care plans and risk assessments had been reviewed. 5 Saunton Gardens DS0000012060.V315749.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. 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. Service users benefit from a safe and well run home where their views are part of the overall and day-to-day development. EVIDENCE: The manager has completed her NVQ level four and has many years experience of running a care home. Staff and service users say the home is well run and they have confidence in the manager. Staff say they feel well supported and can talk to the manager openly and honestly, however they would benefit from more structured and regular supervision. A structured program for reviewing care plans and risk assessments would ensure that they are kept up to date. 5 Saunton Gardens DS0000012060.V315749.R01.S.doc Version 5.2 Page 21 Service users are consulted on a daily basis and at house meetings where their views are listened to and acted on. Regulation 26 monitoring visits take place monthly where staff and service users are consulted. The company undertakes an annual quality audit. This was assessed and met the standard at the last inspection. This years’ is due but has not yet taken place. The health and safety of service users is promoted through the ongoing training and procedures in the home. Food and fridge temperatures were seen to be recorded and records are kept of fire safety checks, alarm testing, gas servicing and electrical testing. 5 Saunton Gardens DS0000012060.V315749.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 X 2 3 3 X 4 X 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 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 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 Saunton Gardens DS0000012060.V315749.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 YA6 Regulation 15 Requirement The registered person must ensure that service users care plans and risk assessments are regularly reviewed. The registered manager must ensure that all staff have regular supervision. This is a repeated requirement from inspections on 06/01/06 and 05/04/06 Timescale for action 15/12/06 2. YA36 18 15/12/06 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 5 Saunton Gardens DS0000012060.V315749.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: 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 Saunton Gardens DS0000012060.V315749.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. 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