Inspection on 16/08/07 for 52 Abshot Road

This inspection was carried out on 16th August 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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

52 Abshot Road 07/11/05

52 Abshot Road 04/05/05

52 Abshot Road 27/09/04

52 Abshot Road 19/04/04

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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 52 Abshot Road Titchfield Common Fareham Hampshire PO14 4NB Lead Inspector Craig Willis Unannounced Inspection 16th August 2007 09:30 52 Abshot Road DS0000012369.V342893.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 52 Abshot Road DS0000012369.V342893.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. 52 Abshot Road DS0000012369.V342893.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 52 Abshot Road Address Titchfield Common Fareham Hampshire PO14 4NB 01489 582150 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) www.c-i-c.co.uk. Community Integrated Care Post Vacant Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 52 Abshot Road DS0000012369.V342893.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th November 2005 Brief Description of the Service: 52 Abshot Road is registered to provide accommodation and care for up to three adults who have a learning disability. Knightstone Housing Association supplies the housing. The registered providers are Community Integrated Care. Community Integrated Care is a national organisation with a number of homes in the area. 52 Abshot Road is a detached house within the residential area of Titchfield Common. There is a shopping centre with a library, post office and a pub within one mile of the property. All of the bedrooms are single and the home has been developed on a domestic scale. The manager reported that the current weekly fee for a place in the home is £1500. 52 Abshot Road DS0000012369.V342893.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The evidence used to write this report was gained from a review of the information the provider sent to the Commission for Social Care Inspection (CSCI) since the last visit. This information included an annual quality assurance assessment completed by the manager. No comment cards were received in respect of the home. A site visit to the home was made on 16 August 2007. During the site visit the inspector met both of the residents, although did not have a conversation due to their communication needs. The interactions between residents and staff were observed. The inspector also spoke with members of staff on duty. The manager was not present during the visit, but the inspector spoke with him by phone on the following day. All the communal areas of the building were viewed and documents relating to the running of the home were inspected during the visit. What the service does well: What has improved since the last inspection? The manager has consulted with the fire service to ensure that the home has good fire safety systems. 52 Abshot Road DS0000012369.V342893.R01.S.doc Version 5.2 Page 6 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. 52 Abshot Road DS0000012369.V342893.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 52 Abshot Road DS0000012369.V342893.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): Standard 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good systems to assess the needs of people before they move into the home, which helps to assure people their needs can be met. EVIDENCE: Both of the people living in the home moved in approximately ten years ago, following a full assessment of their needs that has been assessed at previous inspections. Evidence was seen that these assessments have been reviewed to ensure the home has accurate information about people’s current needs. Community Integrated Care (CIC) has procedures in place for assessing the needs of people who may want to move into the home. Reports from the senior manager’s monthly visit to the home indicated that CIC were not planning to fill the vacant room in the home. 52 Abshot Road DS0000012369.V342893.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): Standards 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. The care planning and risk assessment system does not inform staff practice and plans do not always provide clear information on how people’s needs should be met. EVIDENCE: The personal files of both people who live in the home were inspected during the visit. Both of these files contained a set of care plans and risk assessments that had been developed from the person’s needs assessment. These plans have been reviewed recently, although there was no evidence of how the people who live in the home or their representatives were involved in the review. The risk assessments contain action that is required to minimise the identified risks. However, it was noted that there was a conflict in the information recorded in the risk assessments and care plans for one person. The care plan said their “awareness of road safety is fair”, but their risk assessment said they had “almost no road sense”. It was also noted that the language used in one care plan was not respectful of the person. These issues 52 Abshot Road DS0000012369.V342893.R01.S.doc Version 5.2 Page 10 were discussed with the manager, who said he would take action to amend them. Staff spoken with demonstrated a good understanding of people’s needs and how they should meet them, although they said they were not involved in the care plans and risk assessments and did not use them in their day-to-day work. During the visit, staff were observed responding to people’s requests and supporting people to make decisions about the activities they took part in. This support was provided in friendly and respectful manner and was reassuring to one person who was concerned about the afternoon’s activity. Both people who live in the home have been supported to develop a person centred plan, which sets out hopes and aspirations. Due to their communication needs, these plans have been developed with people who know them, for example family members, advocates and care managers. The plans attempt to interpret people’s behaviours to say what it is thought they are communicating. 52 Abshot Road DS0000012369.V342893.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): Standards 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. The home provides good support for people to take part in activities they enjoy and meet their lifestyle choices. EVIDENCE: People who live in the home are supported to take part in a range of activities, based on the interpretation of what people like and dislike. Activities are discussed and planned with family members and advocates as part of the person centred planning process. Activities include day services, sporting interests, and community access. On the morning of the visit, both residents went out to a local café and one went to a local day service in the afternoon. Support was provided for people to choose whether or not to take part in their planned activities. People are supported to maintain contact with their family, with regular phone calls, letters and visits. Staff demonstrated an awareness of people’s rights and responsibilities and the support people required to exercise them. The 52 Abshot Road DS0000012369.V342893.R01.S.doc Version 5.2 Page 12 home has a planned menu that provides a varied and balanced diet. Staff described how people make choices about food and explained that different meals are provided where they are requested. The home was well stocked with a variety of food to enable these choices to be made. 52 Abshot Road DS0000012369.V342893.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): Standards 18, 19 and 20. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The physical and emotional needs of people are well met, however, errors in the medication records and storage of staff medicines do not demonstrate safe practice. EVIDENCE: Discussions with staff indicated they provide sensitive and flexible personal support to maximise people’s privacy, dignity, independence and control over their lives. Staff were observed supporting people to maintain their dignity and privacy during the visit. Information is provided in care plans on how support should be provided, although as reported in the individual needs and choices section of this report, some changes are needed to the language used to ensure it is respectful of the person being written about. Records are maintained of appointments with a range of health professionals and include any advice given by the practitioner. 52 Abshot Road DS0000012369.V342893.R01.S.doc Version 5.2 Page 14 Neither of the people living at Abshot Road currently administers their own medication. Medication is stored in a locked cabinet in the office and most tablets are received in a monitored dosage system. A record of medication administered to people is kept, although it was noted that there had been five occasions in the last month where the medication administration record had not been completed. The deputy manager reported that the manager was aware of the problem and was addressing it with the member of staff concerned. The manager reported that he has checked with the member of staff concerned and been assured that the medication was administered, but the record not signed. All staff administering medication have completed assessed training in safe administration of medication and have to complete a re-assessment every six months. During the visit it was noted that three packets of tablets were stored in a post tray in the office, unlocked. It was reported that this medication belonged to a member of staff and action was taken to remove it to a safe place during the visit. 52 Abshot Road DS0000012369.V342893.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): Standards 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good systems for dealing with complaints and keeping people safe from abuse. This gives people confidence any complaints will be taken seriously. EVIDENCE: The home has a complaints procedure and the manager reported in the annual quality assurance assessment for CSCI that this has now been supplied to people in a format they can understand, with a symbol and audio version. Evidence was seen that family members and advocates are involved in planning meetings, where they have the opportunity to express concerns about the service that is provided. No complaints have been received by the home or CSCI since the last inspection. The home has safeguarding adults procedures in place. Staff have received training in these procedures and demonstrated a good understanding of types of abuse and action they should take if abuse is witnessed, reported or suspected. No allegations have been referred to adult social services for investigation under the safeguarding adults procedures in the last year. 52 Abshot Road DS0000012369.V342893.R01.S.doc Version 5.2 Page 16 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): Standards 24 and 30. 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 maintained and provides a comfortable, clean and safe environment for people. EVIDENCE: All of the communal areas of the home were inspected during the visit. The home was clean throughout and was well maintained. Staff spoken with said CIC have a maintenance person who completes work quickly when requested. This was confirmed by entries in the maintenance book. There are two bathrooms in the home, one on each floor close to bedrooms. There is a domestic kitchen that is accessible to people who live in the home. The home has a separate laundry room and staff reported that all equipment was working effectively. Staff also confirmed that there are procedures in place to prevent laundry being taken through the dining area when meals are being eaten. Protective clothing is available for staff. 52 Abshot Road DS0000012369.V342893.R01.S.doc Version 5.2 Page 17 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): Standards 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good staffing arrangements, which helps to ensure people are protected and their needs are met. EVIDENCE: The manager reported that one of the six staff have achieved the National Vocational Qualification (NVQ) in care at level 2 or above and two staff are booked to start the award in September 2007. The manager reported in the annual quality assurance assessment for CSCI that they obtain Criminal Records Bureau (CRB) checks and references for all staff before they start working in the home. The manager was not present during the visit so no records were sampled, as they were locked to maintain confidentiality. The manager confirmed in a phone call on 17 August 2007 that all these checks had been completed. The home has a training programme and staff spoken with said they felt the training provided was good and helped them to meet people’s needs. Courses staff have completed include principles of care, first aid, food hygiene, person 52 Abshot Road DS0000012369.V342893.R01.S.doc Version 5.2 Page 18 centred planning, fire safety, moving and handling, adult protection, autism awareness, epilepsy and safe administration of medication. The manager reported in the annual quality assurance assessment that he planned to provide additional training in effective team working. 52 Abshot Road DS0000012369.V342893.R01.S.doc Version 5.2 Page 19 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): Standards 37, 39 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are systems to promote the health, safety and welfare of people who live in the home and staff, however, the lack of a registered manager does not help to ensure that the home improves in a planned way. EVIDENCE: The manager reported that he has worked at the home for approximately four years and was appointed the manager in November 2006. He has completed the NVQ level 3 and is completing the registered manager’s award. Staff spoken with said they received good support form the manager and were able to raise ideas or concerns with him. The manager has not submitted an application for registration with CSCI and must do this as a matter of urgency. 52 Abshot Road DS0000012369.V342893.R01.S.doc Version 5.2 Page 20 A senior manager from CIC visits the home each month to assess the quality of the service provided. During these visits observations are made of the support people are receiving. Reports of these visits are sent to the manager and include any actions that are required. The manager reported that there is an annual survey of people who use CIC services and their relatives and that the results are used to plan improvements in the service provided. The manager reported in the annual quality assurance assessment for CSCI that equipment in the home, such as fire detection and fighting equipment and the gas system were regularly serviced and maintained to ensure they were safe. A sample of these records was checked during the visit and confirmed that maintenance was up to date. Assessments are completed for chemicals used in the home and hazardous substances are securely stored when not in use. Since the last inspection the manager has consulted with the local fire service regarding an open hatch in the laundry room that looks out into the dining room. The manager reported that the fire service was satisfied with the fire safety arrangements in place. 52 Abshot Road DS0000012369.V342893.R01.S.doc Version 5.2 Page 21 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 X 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 2 X 2 X 3 X X 3 x 52 Abshot Road DS0000012369.V342893.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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 13 (4c) Requirement The registered person must ensure that information in care plans helps to protect the health and safety of people who live in the home and does not contradict the information in risk assessments. The registered person must ensure that accurate records are kept of medication administered to people who live in the home. The registered person must ensure that a manager is registered with the Commission for Social Care Inspection. Timescale for action 30/09/07 2 YA20 13 (2) 31/08/07 3 YA37 8 30/11/07 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 52 Abshot Road DS0000012369.V342893.R01.S.doc Version 5.2 Page 23 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 52 Abshot Road DS0000012369.V342893.R01.S.doc Version 5.2 Page 24 - 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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