Inspection on 04/05/05 for 52 Abshot Road

This inspection was carried out on 4th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

52 Abshot Road 16/08/07

52 Abshot Road 07/11/05

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 Abshott Road Titchfield Common Fareham Hampshire PO14 4NB Lead Inspector Kathryn Kirk Unannounced 04/05/05 1.30 p.m. 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. 52 Abshott Road H54 S12369 Abshott Rd V222293 040505.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 52 Abshott Road Address Titchfield Common Fareham Hampshire PO14 4NB 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) 01489 582150 Community Integrated Care Ms S. J. Bugg CRH 3 Category(ies) of LD Learning disability registration, with number of places 52 Abshott Road H54 S12369 Abshott Rd V222293 040505.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 27/09/04 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 supply 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. 52 Abshott Road H54 S12369 Abshott Rd V222293 040505.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and is the first of two that will take place during the year March 2005-April 2006. The service is registered to accommodate up to three, although there are currently only two people living at the home. The inspector was informed that it is not the intention to admit anyone else because of the effect that this would have on the current residents. The inspection lasted for four hours. The two service users were both present for part of the time, although their needs are such that they were unable to contribute verbally to the inspection process. During this time the inspector spoke with three staff members and with the manager. Some documentation was examined. There was also a tour of the premises. What the service does well: What has improved since the last inspection? 52 Abshott Road H54 S12369 Abshott Rd V222293 040505.doc Version 1.30 Page 6 Community Integrated Care acts as appointee for service users. It has not been possible to open personal accounts on behalf of service users but Community Integrated Care now issue individual financial statements which detail interest accrued. There have been some positive changes to the environment, including some remedial work in the bathroom, lounge and hallway. The dining room carpet has been replaced, as has the boundary fence. Two staff have started to study for their NVQ level 3 and one has nearly completed it. Ms Sarah Bugg has demonstrated that she is fit to manage Abshot Road and has been formally registered as manager by the Commission for Social Care 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. 52 Abshott Road H54 S12369 Abshott Rd V222293 040505.doc Version 1.30 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 52 Abshott Road H54 S12369 Abshott Rd V222293 040505.doc Version 1.30 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 and 5 The service user guide and statement of purpose need to be improved upon as they do not contain enough information about the aims, objectives and philosophy of the home, or about the services and facilities to be provided. Any new service user would have their needs assessed before admission to the home. Contractual information needs to be improved upon. EVIDENCE: A statement of purpose was seen. This does not contain all information as listed in the Care Homes regulations (Schedule 1), for example, criteria for admission and arrangements made for contact between service users and their friends and relatives. Service users files contain a service users guide. This too does not contain all information as listed in Standard 1, for example key contract terms covering admission, occupancy and termination of contract. The copy of the complaints procedure in the files also contains incorrect information. The manager said that all service users are referred through social services and as such have a full care management assessment and care plan. Staff at the home would also carry out their own assessment to establish whether the home could meet needs. 52 Abshott Road H54 S12369 Abshott Rd V222293 040505.doc Version 1.30 Page 9 Both service users files were examined. These contained a draft updated licence agreement with Knightstone Housing Association. There was no evidence that service users have a written and costed contract issued by Community Integrated Care. It will be a requirement that both service users are issued with a statement of terms and conditions. It was discussed with the manager that reasonable efforts should be made to explain the contract to service users and that family members should be involved in the process as appropriate. 52 Abshott Road H54 S12369 Abshott Rd V222293 040505.doc Version 1.30 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 Care plans reflect the needs, aspirations and goals of each individual. Risk assessments are in place. These help staff to offer appropriate support and enable service users to take responsible risks. EVIDENCE: Information regarding service users is held securely in individual files. Both files were viewed and were found to contain assessments and care plans. The care plans, which are person centred, are reviewed formally every six months. There was written evidence that family and relevant professionals are involved in the process. The manager said that care plans are also reviewed within the home every month to ensure that they accurately reflect needs. Staff said that each service user has a keyworker and a co worker. There is written evidence that behaviour management guidelines are in place. Staff said that service users are encouraged to make decisions where possible, with staff guidance and support, for example when to go to bed, when to spend time alone. There are some restrictions within the home, for example the front door is kept locked. This is to safeguard one service user and a risk assessment has been completed. There was evidence that risk assessments 52 Abshott Road H54 S12369 Abshott Rd V222293 040505.doc Version 1.30 Page 11 have been completed to ensure that one service user can go swimming, which was an identified goal in the care planning process. Some other limitations on choice are discussed in the next section. A number of other risk assessments were seen. These have been regularly reviewed and updated. They are signed by staff once read. There is a procedure in place to follow in the event of any service user going missing, although the manager said that this has never happened. Some information within the home is provided in pictorial form, for example, the staff rota. There is also a communication board in the dining room. Records show that maketon is used within the house to facilitate communication. 52 Abshott Road H54 S12369 Abshott Rd V222293 040505.doc Version 1.30 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, 15 and 16 Staff help service users to engage in appropriate daytime activities. Staff support service users to maintain family links and friendships. Although service users rights and responsibilities are generally recognised, some practices within the home need to be reviewed, in consultation with service users, their relatives and relevant professionals and the decision making process needs to be formally recorded. This will ensure that any limitations continue to be made in the persons best interest. EVIDENCE: One service user attends day services on a part time basis. Staff said that he is offered a programme of activities, which has been tailored to meet his needs. On the day of inspection he had been out bowling. The other service user does not have any formal day service provision. Staff support the service user to go out every morning. On the day of inspection he had gone out for a walk on the beach and had visited a local café. There was documentary evidence that family members are involved in the care planning process. The home has an open visiting policy and staff said that 52 Abshott Road H54 S12369 Abshott Rd V222293 040505.doc Version 1.30 Page 13 service users receive visitors in the lounge, dining room or their bedroom. Service users are also supported to keep in touch with relatives by telephone or by visiting the family home. One service user has an advocate whom he sees regularly. Staff were observed to enter service users bedrooms only with their permission. All bedroom and bathroom doors are lockable, although there is an override device in case of an emergency. Staff were observed to talk to and interact with service users and not exclusively with each other. It was observed that a monitor has been installed in one service users room. This is because of a medical condition. Records also showed that one service user was not given a newspaper one day because the money was needed to be put towards a ripped article of clothing. The manager said that in both these practices had been agreed following consultation with service users and their supporters. Since the last inspection a specially built swing for one service user has been installed in the garden. Staff report that this has been much used and enjoyed. 52 Abshott Road H54 S12369 Abshott Rd V222293 040505.doc Version 1.30 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) 19 Staff ensure that appropriate health care support is provided to service users. EVIDENCE: Records show that staff assist service users to access NHS healthcare facilities in the locality, for example dentist, optician and podiatrist. Service users health is monitored and recorded in a document called “my health checklist” Staff said that any potential health concerns for example fluctuations in weight is monitored. Both service users are registered with a local GP and the manager confirmed that consultations with the GP and other health care professionals take place in private. 52 Abshott Road H54 S12369 Abshott Rd V222293 040505.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 Although the complaints procedure contains appropriate information, it is not at present very accessible to service users. Staff need to ensure that copies of previous procedures, which do not contain accurate information are removed, to avoid possible confusion. Procedures are in place to help to protect service users and staff are offered appropriate training in this regard. EVIDENCE: The home has a complaints procedure. This has been slightly amended to include the information that complaints would be responded to within twenty eight days. Information about how to make a complaint is displayed in the office and is in written form. The manger said that she intends to make an audio tape containing this information which would be more accessible to service users. Service users files also contain a complaints procedure although this does not contain up to date information. The manager said that she has not received any complaints about the service since the last inspection and none have been received by The Commission for Social Care Inspection. Records and discussions indicated that episodes of physical or verbal aggression by service users are documented and evaluated. Guidelines have been drawn up to manage behaviours and these are reviewed in consultation with the community learning disability team. 52 Abshott Road H54 S12369 Abshott Rd V222293 040505.doc Version 1.30 Page 16 The manager said that Community Integrated care run a course in adult protection, which all staff attend. Training in non restrictive technique for crisis intervention (CPI) has been undertaken as a group by all current staff. Service users are provided with information about adult protection. Records showed that staff have discussed this subject with service users. Records show that Community Integrated Care acts as appointees for service users. Individual financial statements were seen which detail expenditure, income and interest accrued over a twelve month period. 52 Abshott Road H54 S12369 Abshott Rd V222293 040505.doc Version 1.30 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 and 30 The house is comfortable, clean and homely and there is evidence of ongoing maintenance. A number of repairs still need to be made, however, to ensure good hygiene. EVIDENCE: Since the last inspection a number of repairs and improvements have been made. These include the replacement of some missing and cracked tiles in the bathroom, renewal of the plasterwork in the lounge and hallway and the replacement of the carpet in the dining area. The fence at the front of the property has also been replaced. On a tour of the communal areas the following issues were noticed. 1.Tiles are coming away from the wall and the seal is broken between the tiles and worktop in the laundry area. 2. Flooring is not sealed in the laundry area. 3. Flooring in the kitchen is not sealed. 4. In the upstairs bathroom flooring is not sealed, paint is peeling, there are holes in the walls and grouting around the tiles is dirty. 52 Abshott Road H54 S12369 Abshott Rd V222293 040505.doc Version 1.30 Page 18 The property was clean and free from offensive odour. Furnishing and fittings are good quality and are domestic in character. There is a large enclosed garden to the rear of the property which is accessible to service users. There is a separate laundry room which contains a washing machine and a tumble dryer. The manager said that sluicing facilities are not required. Policies procedures and information regarding infection control were seen to be available in the house. Handwashing facilities are prominently sited and paper towels and liquid soap are provided. 52 Abshott Road H54 S12369 Abshott Rd V222293 040505.doc Version 1.30 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 35 Current staffing levels appear adequate to meet current needs of service users. Training opportunities for staff are good. EVIDENCE: The staff rota reflects that there is a minimum of two staff on duty at any time during the day and that one staff member sleeps in each night. The staff team comprises a manager a deputy and three care staff. All are employed full time. One bank staff is also employed full time at the home. Three weeks of rota examined reflected that between five and seven shifts per week have been covered by agency or by other bank staff. The manager said that they are all familiar with the home. Regular staff were also observed to cover any gaps in shifts and staff described morale as “ok”. One said that they were “all pulling together.” All who work at Abshot Road are over 21 and staff confirmed that staff meetings take place. Community Integrated Care has a designated training officer who co ordinates training opportunities and refresher courses. The manager confirmed that new staff receive a structured induction programme, which also includes some equal opportunities training. Records show that all staff are offered training in health and safety courses, including medication assessments, moving and handling, first aid, and food hygiene. Training which reflects identified needs of 52 Abshott Road H54 S12369 Abshott Rd V222293 040505.doc Version 1.30 Page 20 service users, for example, in autism awareness is also available. The manger said that all staff received training as a group over a particular area which had been identified as an issue, this was getting service users safely out of the homes transport. Since the last inspection two staff members have embarked on NVQ level 3 and one has almost completed it. 52 Abshott Road H54 S12369 Abshott Rd V222293 040505.doc Version 1.30 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) Neither of these key standards were assessed on this occasion. EVIDENCE: Although neither key standard was assessed, the manager confirmed that monthly visits were still being undertaken by a senior manager, as required under Regulation 26 of the Care Home Regulations 2002. She agreed to ensure that copies of these reports are forwarded to CSCI as none have been received since August 2004. 52 Abshott Road H54 S12369 Abshott Rd V222293 040505.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 x x 1 Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 2 Standard No 11 12 13 14 15 16 17 x 3 x x 3 2 x Standard No 31 32 33 34 35 36 Score x x 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 52 Abshott Road Score x 3 x x Standard No 37 38 39 40 41 42 43 Score x x x x x x x H54 S12369 Abshott Rd V222293 040505.doc Version 1.30 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 5 Regulation 5 Requirement Service users must be issued with a statement of terms and conditions in line with National Minimum Standards A record of any limitations agreed must be kept with regard to freedom of choice, liberty of movement or power to make decisions Flooring and tiling needs to be repaired or replaced (Details listed on p18 of this report) Timescale for action 1/8/05 2. 16 17 1/8/05 3. 24 23 30/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations 52 Abshott Road H54 S12369 Abshott Rd V222293 040505.doc Version 1.30 Page 24 Commission for Social Care Inspection 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 52 Abshott Road H54 S12369 Abshott Rd V222293 040505.doc Version 1.30 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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