Inspection on 07/11/05 for 52 Abshot Road

This inspection was carried out on 7th November 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

52 Abshot Road 16/08/07

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 Kathryn Kirk Unannounced Inspection 7th November 2005 10:30 52 Abshot Road DS0000012369.V261988.R01.S.doc Version 5.0 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.V261988.R01.S.doc Version 5.0 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.V261988.R01.S.doc Version 5.0 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) Community Integrated Care Ms S J Bugg Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 52 Abshot Road DS0000012369.V261988.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th May 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. 52 Abshot Road DS0000012369.V261988.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second unannounced inspection of two that have been carried out during the year March 2005-April 2006. Standards that were met at the previous inspection in May 2005 have not been assessed again and therefore to gain a more detailed overview of this service, this report should be read in conjunction with the report dated 4/5/05. This inspection was carried out on 7/11/05 and it lasted for one hour. Both residents were present, although their needs are such that they did not contribute verbally to the inspection process. Discussion took place with two staff members. The inspection resumed for two hours on 10/11/05 when the manager was present. What the service does well: What has improved since the last inspection? As information about the service is now on audiotape, it is more accessible to service users. Contractual information has also improved, so that rights and responsibilities are clarified. Some environmental improvements have been made. 52 Abshot Road DS0000012369.V261988.R01.S.doc Version 5.0 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. 52 Abshot Road DS0000012369.V261988.R01.S.doc Version 5.0 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.V261988.R01.S.doc Version 5.0 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 the following standard(s): 1 and 5 Information about the service is more accessible to service users and their relatives. Contractual information has improved but consideration needs to be given as to how contracts can be agreed. EVIDENCE: The statement of purpose and service user guide was expanded and updated in July 2005.The manager has made an audiotape of this information so that it is more meaningful to residents. The manager said that since the last inspection both service users have been issued with a statement of terms and conditions by Community Integrated Care (CIC). Ms Bugg said that service users would not be able to meaningfully sign these contracts themselves. She therefore agreed that she would forward a copy to each resident’s next of kin so that if in agreement they could sign as representatives. 52 Abshot Road DS0000012369.V261988.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): No standards were assessed on this occasion. EVIDENCE: 52 Abshot Road DS0000012369.V261988.R01.S.doc Version 5.0 Page 10 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 the following standard(s): 13, 16 and 17 Staff support is flexibly provided and enables service users to participate in activities outside the house. Any restrictions agreed in an individual plan of care continue to be reviewed. Meals are nutritious and are provided in a congenial setting. EVIDENCE: The manager said that both service users go out every day and this was observed to be the case on both days of inspection. The manager said that additional staff are provided on duty one day a week to support a service user to attend a hydro pool session. Examination of the rota indicates that staffing levels are the same at weekends as during the week. The service has its own transport. Staff said that one resident uses public transport with staff support. The manager said that she is continuing to review any limitations in rights, and instances where decisions have been made on behalf of residents; through the care planning process. This takes place in consultation with supporters of service users. An example of this would be where a monitor has been installed in a bedroom to monitor a medical condition. 52 Abshot Road DS0000012369.V261988.R01.S.doc Version 5.0 Page 11 There is a written menu and a sample of this was seen. The manager said that she intends to laminate pictures of food types to help service users to choose what they wish to eat on a particular day. Residents can choose when they wish to have breakfast. They generally have a snack for lunch and a cooked meal is provided at teatime. It was observed that drinks and snacks are offered during the day, although the manager said that because of the health needs of one service user in particular this has to be closely monitored. There is a record kept of food eaten each day. Examples of this were seen on daily record sheets. Meals are served in the dining area and staff on duty demonstrated that they had a good understanding of the likes and dislikes of both service users. Staff said that assistance at mealtimes is given where needed, for example if food needs to be cut up. 52 Abshot Road DS0000012369.V261988.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 18 and 20 Personal support is provided in a sensitive and flexible way. There are appropriate policies and procedures in place for the management of medication, although some guidelines need to be reviewed to ensure that they remain up to date. EVIDENCE: Staff confirmed that personal support is provided in private and said that service users choose which member of staff they wish to assist them on a dayto-day basis. Personal hygiene is carried out in the least intrusive way as possible, for example staff withdraw from the bathroom when not needed and would only return when requested or when required. Current service users do not require any support with moving and there are no technical aids or equipment needed in the house. Records and discussions showed that service users receive additional specialist support where a need has been identified. Service users have key workers whom they have helped to choose. Preferred routines are considered and documented as a part of a person centred planning system, which has been started at the home. There are policies and procedures in place for the safe management of medicines. The manager said that neither service user administers their own medication. Medicines are stored safely in a locked cabinet and are mainly 52 Abshot Road DS0000012369.V261988.R01.S.doc Version 5.0 Page 13 supplied in a monitored dosage system. Records checked on the day of inspection accurately reflected medicine stocks. Guidelines have been drawn up for staff to provide advice on when required (PRN) medicines. The manager agreed to ensure that all guidelines for PRN medication are up to date and that they had been agreed with health professionals. Records and discussion with staff on duty reflected that all staff receive training in medication issues every three to four months. 52 Abshot Road DS0000012369.V261988.R01.S.doc Version 5.0 Page 14 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 the following standard(s): No standards were assessed on this occasion. EVIDENCE: Although no standard was assessed it was noted that the complaints procedure has been amended to include all appropriate information. 52 Abshot Road DS0000012369.V261988.R01.S.doc Version 5.0 Page 15 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 the following standard(s): 24 A number of improvements need to be made to ensure that the property is homely, comfortable and safe. EVIDENCE: The premises were toured and it was apparent that there have been some improvements to the environment since the last inspection, for example new carpets have been fitted in communal areas and the laundry area has been upgraded. 1. One set of windows do not close properly and there is condensation inside the downstairs dining room window. 2. There is a musty smell in the upstairs bathroom, the bath is stained and paint is peeling. Towel holders have been pulled off the walls and not replaced. Tiling needs to be replaced around the toilet area. 3. The kitchen area flooring has not been sealed. One cupboard door has fallen off completely and others are badly fitting. They therefore need to be replaced. 52 Abshot Road DS0000012369.V261988.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 and 34 The staff team have a good understanding of current service users needs. A thorough recruitment procedure is in place, which helps to protect service users. EVIDENCE: Staff were observed to be approachable and comfortable with service users and demonstrated through discussion that they were committed to providing a good quality of service. Staff said that morale had been affected because of changes in the staff team. The manager said that every effort is made to ensure that agency staff employed at the home have worked with the service users before and have an understanding of their abilities and disabilities. Staff are offered training by Community Integrated Care to help them to develop their skills and knowledge. Training includes crisis prevention and intervention, protection of vulnerable adults and principles of care. Sarah Bugg, the registered manager, is currently undertaking a registered managers qualification. One staff member has obtained an NVQ level 3 and two others are studying for this award at present. One staff file was checked with regard to the homes recruitment policies and practices. Records included an application form, two references, evidence of identity and evidence that a satisfactory check had been made with the Criminal Records Bureau. 52 Abshot Road DS0000012369.V261988.R01.S.doc Version 5.0 Page 17 The manager said that interviews for new staff take place at the home and that service users meet all prospective employees. Resident’s reactions are considered as part of the selection process. Staff on duty confirmed that they had been issued with a statement of terms and conditions. The manager said that all staff appointments are subject to a three monthly probationary period. 52 Abshot Road DS0000012369.V261988.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 The registered manager demonstrated a good understanding of her role and responsibilities. Feedback is actively sought from service users regarding the quality of the service provided and this may further improve as the person centred planning approach is developed. Health and safety issues have been addressed to ensure so far as is reasonably practicable, the welfare of service users. EVIDENCE: The registered manager is Ms Sarah Bugg. She has had experience of management since 2001. She is currently studying for her Registered Managers award and records show that she has undertaken periodic training to ensure that her knowledge and skills are up to date. Staff said that because there are only two service users, their views about life in the home and the service provided are known on a daily basis. Friends and family are also consulted regularly and are invited to care planning meetings. 52 Abshot Road DS0000012369.V261988.R01.S.doc Version 5.0 Page 19 A senior manager visits every month and prepares a report on the conduct of the care home. Copies of reports were seen at the home and Ms Bugg agreed to ensure that a copy of future reports would be supplied to CSCI in accordance with Regulation 26 of the Care Homes Regulations. On a national level, CIC produce a survey, which relates to quality assurance and which is published annually. Records show that all staff are trained in moving and handling, fire safety, first aid, and food hygiene. The manager said that staff also have training in infection control. Hazardous substances were observed to be stored safely and COSHH sheets were available to staff. Records reflected that electrical equipment has been maintained and that water temperatures are regulated. The boiler was serviced in October 2005. Since the last inspection two new fire extinguishers have been installed. Staff said that smoke detectors are checked on a weekly basis. A record is kept of any accident that occurs and completed copies of a sample of reports were seen. 52 Abshot Road DS0000012369.V261988.R01.S.doc Version 5.0 Page 20 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 3 X X X 2 Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 52 Abshot Road Score 3 X 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 3 X DS0000012369.V261988.R01.S.doc Version 5.0 Page 21 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 2 3 Standard YA24 YA24 YA24 Regulation 23 23 23 Requirement Windows in the property must open and close properly. Kitchen cupboard doors must be replaced. Action must be taken to eliminate the smell in the upstairs bathroom, to replace tiling and to repaint walls. This is an outstanding requirement. Flooring in the kitchen must be sealed. This is an outstanding requirement Timescale for action 01/04/06 01/04/06 31/12/05 4 YA24 23 01/04/06 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 52 Abshot Road DS0000012369.V261988.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Hampshire 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 52 Abshot Road DS0000012369.V261988.R01.S.doc Version 5.0 Page 23 - 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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