Inspection on 05/04/05 for 5 Saunton Gardens

This inspection was carried out on 5th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 but made no statutory requirements on the home.

Other inspections for this house

5 Saunton Gardens 07/11/08

5 Saunton Gardens 15/11/06

5 Saunton Gardens 06/01/06

5 Saunton Gardens 02/11/04

5 Saunton Gardens 10/06/04

5 Saunton Gardens 23/02/04

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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 Saunton Gardens Farnborough Hampshire GU14 8UN Lead Inspector John Vaughan Unannounced 5th April 2005, 10:00 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 Saunton Gardens Version 1.10 Page 3 SERVICE INFORMATION Name of service 5 Saunton Gardens Address Farnborough, Hampshire GU14 8UN 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) 020 7454 0454 Royal Mencap Society Ms Hazel Margaret Wright Care Home 5 Category(ies) of Learning Disability (5) registration, with number of places 5 Saunton Gardens Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 2nd November 2004 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 who 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. 5 Saunton Gardens Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day. The inspector looked around the home, sampled some of the homes records and talked to the staff members who were on duty. All of the service users were seen and the inspector talked to and observed their activities during the visit. What the service does well: What has improved since the last inspection? What they could do better: The manager has been asked to improve on records in the home, which include the important information on how to support each person with their day to day needs. The home also needs to report concerns promptly to other organisations such as the commission and social services. Further improvement in the decoration of the home is needed to make it more comfortable and suitable for use especially the replacement of the kitchen. The number of staff in the home at night needs to be increased to support people with their health needs. 5 Saunton Gardens Version 1.10 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 5 Saunton Gardens Version 1.10 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 Saunton Gardens Version 1.10 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, 3 and 4 on this visit. The homes approach in enabling a new service user to move in is positive and supportive however the assessment process does not demonstrate how their needs will be met. EVIDENCE: A service user guide is in place individualised for each person with details of the home, staffing and what they will be provided with if they move into the home. The document is a mixture of words and pictures to make it more interesting and accessible to service users. A new service user has moved into the home recently. The inspector talked to staff about the admission process and was told about the visits made by the service user to the house. The service user visited for a number of meals, to meet other service users and staff and they also stayed overnight. The inspector was told that the person’s advocate visited the home and was involved in helping the service user to move in and they have been to visit since. A folder was seen for the service user and this contained risk assessments and plans from the last service where the service user lived before moving into the home. An old care management agreement was also in this file. 5 Saunton Gardens Version 1.10 Page 9 The file had basic information on family contacts, date of birth and the purchasing authority. It did not contain a new assessment for this home or a relevant care manager’s assessment and the inspector could not determine how the staff were meeting this persons needs. Staff agreed that this information has not been put in place and they would be completing the assessment and care plan as a priority but staff shortages and reduced management support have made it difficult to complete administration and care planning tasks. The staff member stated that the manager has made a number of attempts to obtain a care manager’s assessment for this person but has not received it yet. The inspector stated that the assessments must be completed as part of the admission process to demonstrate that the home can meet the person’s needs. 5 Saunton Gardens Version 1.10 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 and 9 at this visit. Service users are supported to make decisions and develop their service plan to meet their needs however arrangements have not been made to document the support needs of new service user. These shortfalls have the potential to place the service user at risk EVIDENCE: The inspector looked at three care plans and spoke to all of the service users living in the home. Plans for some service users are detailed and contain information on their needs and what support is required in each area. These areas included personal care, communication, activities and daily routines. The home has not set up a care plan for the new service user and no information was available to show how this individual’s needs have been identified or met. The service user spoke to the inspector on their return from day services and said they were enjoying living in the home. The inspector observed positive interaction between the new service user and staff. 5 Saunton Gardens Version 1.10 Page 11 The inspector observed service users engaging with staff members to make decisions on activities. A record of meetings was seen demonstrating consultation with service users about the running of the home. Subjects covered arranging holidays, the visits of a potential new service user and the arrangement of new activities. The service users were also informed of visits from potential new staff to the home as part of the recruitment process. 5 Saunton Gardens Version 1.10 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) 12,13,15 and 17 at this visit. A well-structured recreational and developmental activity programme is in place providing meaningful and interesting activities for service users. The home provides a well-balanced menu derived from service user consultation. EVIDENCE: Service users told the inspector about recent and up and coming events including trips to the theatre, shopping and trips out to watch trains. An activity plan was seen documenting the activities for each service user. The inspector spoke to service users and staff about the menus and meals provided in the home. A new plan has been put in place since the last visit to the home. This has been generated from choices made by the service user group and is used on a four-week rotation. Service users plan for meals, go shopping for the ingredients and on their individual one to one days they help to prepare these meals. One service user 5 Saunton Gardens Version 1.10 Page 13 told the inspector about their favourite foods and these are included in the menu plan. Fresh fruit and vegetables are included in the plan and on the day of the inspection these were evident in the kitchen. The inspector talked to a service user and the staff supporting them with their activities during the day. As it was a structured day at home activities focused initially on domestic tasks cleaning, hoovering and tidying up their bedroom. They had a trip out to shop for the evening meal, had a coffee and returned for lunch. The service user said they enjoy these days. Service users told the inspector about important relationships and this information was also found in the persons care plan. Regular contacts are maintained and the inspector observed staff reassuring and supporting individuals in relation to visits from families. 5 Saunton Gardens Version 1.10 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 and 19 at this visit. The home provides support for service users to access health Care professionals to meet their needs. Personal support is given in a way that respects the privacy and dignity of the individual. EVIDENCE: The home has clear statements on providing support to service users in ways that uphold privacy and dignity. This was observed in the interaction of staff and service users. Each person is offered keys to keep their room locked and a number of service users use this facility. The inspector saw staff reminding service users to keep their room locked and staff stated they would only enter service user’s rooms with the permission of the individual. A number of monitoring activities are underway at present to gather more information on specific health needs of service users. This information is being provided to healthcare professionals to develop intervention plans. Each person is registered with a General Practitioner and a health check assessment is carried out in the home. One service user recently had a fall in 5 Saunton Gardens Version 1.10 Page 15 the garden and went to the hospital as a precautionary measure. The deputy manager stated they are reviewing the individuals risk assessment and support needs for when they are in this area. 5 Saunton Gardens Version 1.10 Page 16 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 and 23 at this visit. Procedures to protect service users from abuse are in place however the home cannot demonstrate that these are being used effectively. EVIDENCE: The inspector confirmed that a complaints procedure is in place and a record is maintained of any complaints made. From reading the complaints log and talking to staff no complaints have been made since the last inspection. During the inspection information was provided to indicate that an incident took place, which should have been reported under the agreed protocol for the protection of vulnerable adults. There has been a significant delay in reporting this incident, which has potentially placed service users at risk. The home was advised to take action to report this incident and provide information to determine what course of action the adult protection panel should take. 5 Saunton Gardens Version 1.10 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, 28 and 30 at this visit. There has been little improvement in the condition and décor of the communal areas of the home since the last inspection. This does not provide people living in the home with comfortable suitable facilities and does not give a positive image of the service. EVIDENCE: Requirements made at the last inspection have not been met. The kitchen has deteriorated further drawers have fallen off and are unusable. Utensils are now kept on the top of the fridge, as there is nowhere else to store them. The inspector noted that plaster in the lounge has chipped off the walls. The paintwork on walls and woodwork is in need of repainting and the carpet on the stairs and hallway is worn and shabby. Staff members were observed cleaning the house and the overall environment is clean and tidy. 5 Saunton Gardens Version 1.10 Page 18 The inspector was informed by staff members that some agreements have been made on what work the housing association will undertake and colour choices are being made at present for the hallway. 5 Saunton Gardens Version 1.10 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) 33 and 36. A positive, knowledgeable and enthusiastic staff team supports Service users. A lack of effective supervision and insufficient staffing mean that service users needs are not fully met. EVIDENCE: The home has seen three staff leave recently and this has halved the staff team. The inspector saw evidence of the use of MENCAP’s ‘Team-mates’, which is their casual staff bank service. These staff members are filling the hours that are vacant. Health concerns requiring specific emergency intervention recorded in service users plans indicate that the current staffing arrangements of one sleep in staff do not provide adequate support for these individuals at night. The deputy manager stated that the manager is discussing these issues with care managers at present. The inspector met with staff on duty and talked about their work and experiences in the home. Interactions between staff and service users were observed by the inspector throughout the visit. Staff were positive and supported service users to 5 Saunton Gardens Version 1.10 Page 20 participate in the inspection, make choices about activities, meals and preparing for trips out. Staff stated that they are finding it difficult to carry out all of the tasks they are responsible for at present due to the shortage of permanent staff. The inspector was also told that communication is not good at present and supervision sessions are not taking place regularly. A system of supervision is in place and a chart is completed to record when these sessions are carried out however this does not indicate that all staff are having regular supervision. The discussions with staff indicated that current management arrangements are having a detrimental affect on the staff team and staff very stretched at present. The feedback from staff who spoke to the inspector indicated that staff feel supported by the manager and deputy manager in the home. Staff stated that the current management arrangements, which involve the manager being split between two registered homes, have had an affect on the staff team. 5 Saunton Gardens Version 1.10 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) 39. Systems for monitoring the quality and development of the service are in place supporting the service user to raise concerns and comment on the running of the home. However these have not had any impact on the delivery of the service EVIDENCE: The home has service user meetings, staff meetings and one to one service user meetings. The inspector looked at records and talked to staff and service users, which confirmed that service user questionnaires are completed. The feedback from service users was positive in these documents. Regulation 26 visits are undertaken and a report is sent to the commission. At the last visit the inspector was informed that a service audit had taken place however the report was not available at the time of the inspection. 5 Saunton Gardens Version 1.10 Page 22 The deputy manager was unable to find this report and staff did not appear to be aware of the audit. The inspector advised that it would be useful for staff to know the results of this process and they would look to see what action has been taken to used this information for service development at the next inspection 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 x x x Standard No 22 23 ENVIRONMENT Score 2 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 5 Saunton Gardens Score 2 x x 2 x Standard No 24 25 26 27 28 29 30 STAFFING Version 1.10 Score 2 x x x 2 x 3 Page 23 LIFESTYLES Standard No 11 12 13 14 15 16 17 Score x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x 2 2 x 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x x x x x 3 5 Saunton Gardens Version 1.10 Page 24 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 3 Regulation 12 Requirement The registered manager must ensure that each service user has a full assessment of their needs. The registered manager must ensure that each service user has a plan to provide clear guidence to staff on actions they need to take to meet their health and welfare needs. The registered manager must ensure that service users have risk assessments in place. The registered manager must ensure that all allegations of misconduct and abuse are reported promplty. The registered manager must ensure that the kitchen is repaired or replaced. Previous timescale of 2 March 2005 not met. The registered manager must demonstrate how they are going to ensure communal areas of the home are redecorated by sending an action plan with clear timescales for this work to be completed. Timescale for action 5 May 2005 5 May 2005 2. 6 15 3. 4. 9 23 13 13 5 May 2005 5 May 2005 5 July 2005 5. 24 23 6. 28 23 5 May 2005 5 Saunton Gardens Version 1.10 Page 25 7. 33 18 8. 36 18 Previous timescale of 2 March 2005 not met. The registered manager must review the staffing levels at night and increase these to provide adequate support for service users The registered manager must ensure that all staff have regular supervison. 5 June 2005 5 June 2005 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 39 Good Practice Recommendations The manager should communicate the outcome of the service audit to the staff and service users and make a copy of the report available in the home. 5 Saunton Gardens Version 1.10 Page 26 Commission for Social Care Inspection Hampshire Area Office 4th Floor, Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 5 Saunton Gardens Version 1.10 Page 27 - 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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