Inspection on 30/08/05 for 52 Winchester Road

This inspection was carried out on 30th August 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 Winchester Road 23/05/07

52 Winchester Road 22/08/06

52 Winchester Road 16/01/06

52 Winchester Road 08/11/04

52 Winchester Road 22/06/04

52 Winchester Road 10/07/03

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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 Winchester Road Four Marks Alton Hants GU34 5HR Lead Inspector Pat Hibberd Unannounced 30/08/05 9.00am 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 Winchester Road H54 s11642 52 Winchester Road v237505 300805.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 52 Winchester Road Address Four Marks, Alton, Hants, GU34 5HR 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) 01420 564028 ILIACE Limited To be confirmed CRH 4 Category(ies) of Ld registration, with number of places 52 Winchester Road H54 s11642 52 Winchester Road v237505 300805.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 08/11/04 Brief Description of the Service: 52 winchester Rd provides care and support to four service users between the ages of 18 and 65 years and who fall within the learning disability service user group. The Home is owned by a private organisation Iliace ltd. Since the last inspection the manager has resigned and a new manager has been appointed. The home is a four bedded detached property situated in the rural village of Four Marks a ten minute drive from the town of Alton which has a range of leisure, educational and employment facilities. Alton is also the location of the organisations head office. All service users have their own bedroom, communal space and a large garden which accommodates an indoor heated swimming pool. There have been no changes to the service user group living at 52 Winchester Rd for a number of years. 52 Winchester Road H54 s11642 52 Winchester Road v237505 300805.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over 4 1/2 hours and was the first of the 2005/2006 inspection programme. Sixteen of the forty-three standards relating to younger adults were assessed. There were two areas of improvement identified on this occasion, details of which can be found in the main body of the report. Of the five requirements identified at the last inspection four have been met. Since the last inspection two managers have resigned. On the day of the inspection the new manager had only been in post for one day. To offer support to the new manager the Responsible Individual Richard Roynane attended the inspection. The inspection included a tour of the home and garden. Discussions were held with two service users, two staff members on duty , Mr Roynane and the new manager. Prior to the inspection the Home was sent a self-assessment questionnaire relating to care provision, staffing, the environment and health and safety in the home. This was completed by the previous manager and returned to the Commission prior to the inspection and contributed to the findings as detailed in this report. Four comment cards were received from relatives. Praise was given to the service in terms of the general communication with the staff team and the overall care provided. A further two comment cards were received from service users. Service users indicated that they liked living in the home, felt well cared for and that staff listened to them and treated them well. Both had a care plan and felt they had plenty of things to do and received the support they needed. One service user file was viewed which further contributed to the findings of the inspection. 52 Winchester Road H54 s11642 52 Winchester Road v237505 300805.doc Version 1.40 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. 52 Winchester Road H54 s11642 52 Winchester Road v237505 300805.doc Version 1.40 Page 7 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 52 Winchester Road H54 s11642 52 Winchester Road v237505 300805.doc Version 1.40 Page 8 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 Winchester Road H54 s11642 52 Winchester Road v237505 300805.doc Version 1.40 Page 9 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) 2 There is a comprehensive assessment process ensuring service user’s needs are identified by the home prior to admission. EVIDENCE: There have been no new admissions to the Home since the last inspection. The home has an extremely comprehensive process of assessment, which includes four areas of need. The first is a personal profile of the individual, the second skills maintenance, the third work placements and finally behavioural guidelines. The Responsible Individual Richard Roynane confirmed that there are systems in place to ensure any prospective service users’ needs are assessed by a suitably experienced and competent person. Mr Roynane indicated that information and guidance with regards to the admission process will form a part of the new manager’s induction. 52 Winchester Road H54 s11642 52 Winchester Road v237505 300805.doc Version 1.40 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 The arrangements for care planning are consistent for all service users, ensuring their care needs are met. Risk assessments must be undertaken to ensure service users are adequately supported to make decisions as to their chosen lifestyle. EVIDENCE: One service user file was viewed, and the care was discussed with staff and the individual service user. Observations were also made about how the care was delivered. The care plan had a range of information relating to the individual and the support required to ensure their needs are being met. A number of risk assessments had been completed which are constantly monitored and reviewed on a two monthly basis or sooner if required. However, following a discussion with one staff member and a service user who regularly accesses the community it was evident that a risk assessment 52 Winchester Road H54 s11642 52 Winchester Road v237505 300805.doc Version 1.40 Page 11 should be in place . This could not be found . A requirement was made for the risk assessment to be undertaken with the service user . The new manager indicated that he will be reading all care plans and risk assessments of the four service user’s accommodated which will be updated if required. This will be followed up at the next inspection. Service user views as to care provided had been captured through a continuous process of monitoring /observation by the staff team. Details were recorded in reviews held in files and daily records completed by staff. Time was spent with one service user who indicated that their needs were being met and that they were very happy with the care provided. From discussions held with staff it was evident that they were aware of service user’s needs, and care plans and risk assessments would be implemented as appropriate. They indicated that they are fully involved in compiling care plans and reviews held. Social Services and Community Health Teams are involved with individuals as necessary. A Health Action Plan had been completed and was held in one file viewed. Daily records are completed for all service users with shift “handovers” taking place with a view to ensuring continuity of care. 52 Winchester Road H54 s11642 52 Winchester Road v237505 300805.doc Version 1.40 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) 12,13,15,16 and 17. Links with the local community are good with service users having opportunities for appropriate activities based on their interests. Menus are well-balanced, creative and offering choice ensuring the dietary needs of service users are met. EVIDENCE: The Organisation has an ‘activities ‘ team and together with the home staff they endeavour to ensure service users have a community presence by devising programmes of activities for each service user. These include work placements, swimming, cooking, bike rides, shopping, horticulture, music and movement. Three service user’s have employment in the community. One service user was able to describe the tasks they undertake and how much they enjoy their job. 52 Winchester Road H54 s11642 52 Winchester Road v237505 300805.doc Version 1.40 Page 13 They felt supported by staff and were observed being encouraged to prepare for their “shift” on the day of inspection. One file viewed confirmed that the service users interests are being pursued through planned programmes. One service user was able to indicate activities they enjoy and pursue and who supported them. Service users weekly programmes were viewed which indicated that they were actively involved in a range of activities including weekends. The home has one unmarked vehicle available for service users. One staff member was able to confirm that there is generally always a member of staff on duty who can drive enabling service users to have days out and/or attend prearranged activities. All service users who would understand the concept of voting would be supported to do so. Menus were well balanced, following consultation with a dietician to ensure their nutritional value. Menus are in a pictorial format with service users actively involved in the planning/shopping and preparation. An alternative meal choice is always available. One service user indicated that they are supported to choose what they would like to eat through pictures and discussion with staff. Service users are able to make their own drinks and snacks with support as required. 52 Winchester Road H54 s11642 52 Winchester Road v237505 300805.doc Version 1.40 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) 18,19 and 20 The health needs of service users are well met with evidence of good multidisciplinary working taking place on a regular basis. Personal support is offered in such a way as to promote and protect service users’ privacy and dignity. EVIDENCE: All service users are registered with a GP with one care plan viewed confirming that the individual has access to health professionals as required including the local community learning disability health team. Details of preferred personal support needs for the service user were available in the file viewed. The information was detailed and had been regularly reviewed by the manager and staff team to ensure they had read and understood the guidance documented. A Health action plan had also been completed and shared with staff. Staff were observed supporting service Users with their personal care in a dignified and respectful manner and were able to demonstrate that they had read and understood the individual’s care plan regarding their needs. At the last inspection a requirement was made in relation to a risk assessment being completed for one service user who self medicates and, that training 52 Winchester Road H54 s11642 52 Winchester Road v237505 300805.doc Version 1.40 Page 15 devised for the individual is undertaken six monthly as detailed in their care plan. This requirement has been met. A further requirement related to the need for the provider to ensure service users’ medical administration sheets produced by the Pharmacist include all “as required” (PRN) medication prescribed by their GP . This requirement has also been met. The pre inspection questionnaire received indicated that there are five staff responsible for the administration of medication in the Home. However, staff training in this area could not be confirmed due to training records being unavailable in the Home. This will be followed up at the next inspection. 52 Winchester Road H54 s11642 52 Winchester Road v237505 300805.doc Version 1.40 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 The complaints policy and procedure is available to all service users and relatives, ensuring their concerns are addressed. EVIDENCE: The home has a complaints policy and procedure in a pictorial format which was displayed in the office and is also contained within all service users individual guides. The manager confirmed that parents and representatives are also provided with a copy, as not all service users would have an understanding or concept of how to make a formal complaint. Two staff members spoken to indicated that they felt confident that service users would express dissatisfaction with service provision using their individual means of communication or, through a change in behaviour. One service user was able to explain who they would speak to if they were unhappy and was further able to confirm that they would talk to management at the Head office if necessary . Advocacy is and would be arranged for individuals as required. There have been no complaints since the last inspection. 52 Winchester Road H54 s11642 52 Winchester Road v237505 300805.doc Version 1.40 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 Service users live in a clean, hygienic home that meets their needs within a homely and comfortable, safe environment. EVIDENCE: The Home was clean, bright and hygienic on the day of inspection with policies and procedures and systems in place including infection control /Control of hazardous to health substances ( COSHH )/food hygiene . Two staff spoken to indicated that they were aware of their responsibilities in relation to hygiene in the Home and were provided with gloves and aprons as required. Infection control/food hygiene /COSHH /moving and handling procedures are addressed during induction of staff although Mr Roynane advised that a certificated training course would not be undertaken during this period but would form a part of an individuals training programme. However, as detailed in standard 35 staff training could not be assessed as training records were not available in the Home on the day of inspection. Ample hand washing facilities were seen around the Home with laundry facilities accommodated in the the large and recently fitted new kitchen. 52 Winchester Road H54 s11642 52 Winchester Road v237505 300805.doc Version 1.40 Page 18 There are policies and procedures in place to prevent cross infection which were seen to be displayed on the kitchen wall with a staff member indicating there full understanding of the policy . There is a contract in place for the disposal of clinical waste. The Home has a large lounge which was comfortably furnished and had recently been decorated. One service user indicated that they had been asked as to their preferred colour scheme and had chosen pictures that were on the wall. The Organisation have their own maintenance team who discuss the needs of the Home with the manager and organise the work required to be undertaken with the minimum disruption to service users. One service user indicated that they have requested a covered area in the garden so that they can smoke when it is raining without getting wet. This was discussed with the maintenance manager who was at the Home during the inspection. He confirmed that the work will be undertaken but was not a priority at the moment. In the meantime a temporary covered area has been erected in the garden of which the service user indicated they were happy with and were seen to be using. The pre inspection questionnaire indicated that there have been no visits made by the statutory agencies; fire/environmental health since the last inspection. Fire safety/checks are undertaken by the Organisation although due to training records being unavailable confirmation of fire training by all staff could not be determined and will be followed up at the next inspection. The manager further indicated that he will discuss with staff and ensure that they are aware of their role and responsibilities in such an event. Discussions were not held with service users as to what instructions they had been given in the event of a fire due to the anxiety it could potentially have caused. However, fire evacuation risk assessments have been completed for all service users accommodated and are shared with staff. 52 Winchester Road H54 s11642 52 Winchester Road v237505 300805.doc Version 1.40 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) 35 Training could not be determined as being appropriate to meeting the needs of service user’s accommodated. EVIDENCE: Due to training records being unavailable for inspection confirmation as to whether service users needs were being met by appropriately trained staff could not be ascertained on this occasion. The Provider is required to ensure the records are available in the home. This standard will be fully inspected at the next inspection. One staff member indicated that they considered the training provided by the organisation to be good and meeting their needs. They had recently missed the abuse awareness training but were able to demonstrate an understanding of the various abuse that can occur and, what action they would take should they witness an abusive incident or, a disclosure be made to them. They further explained that if they identified a training need they could request training in that area. There is also a job coaching scheme available whereby staff can receive additional support from staff in an area of their choosing or as identified through their supervision/appraisal. Further discussion was held with a member of staff who had worked in the home for three months. They were able to describe their induction which included a period of shadowing and the completion of an induction pack that the Organisation have produced based on the Learning Disability Awareness 52 Winchester Road H54 s11642 52 Winchester Road v237505 300805.doc Version 1.40 Page 20 framework (LDAF). They indicated that they would welcome training in communication and moving and handling. This was discussed with the manager who confirmed that he would be undertaking supervision and support sessions with all staff and discussing training needs as a part of the process. This will also be followed up at the next inspection with the manager and staff. 52 Winchester Road H54 s11642 52 Winchester Road v237505 300805.doc Version 1.40 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) No Standards were assessed on this occasion. EVIDENCE: 52 Winchester Road H54 s11642 52 Winchester Road v237505 300805.doc Version 1.40 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 x 3 x x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 52 Winchester Road Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x x x H54 s11642 52 Winchester Road v237505 300805.doc Version 1.40 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 9 Regulation 13 Requirement The Registered Provider must ensure risk assessments are compiled for service users as identified and are monitored and reviewed. The Registered provider must ensure staff training records are held in the home and available for inspection. (This requirement is outstanding from the last inspection when a timescale of 26/12/2004 was made). Timescale for action 30/10/200 5 2. 35 17 30/9/2005 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 Good Practice Recommendations 52 Winchester Road H54 s11642 52 Winchester Road v237505 300805.doc Version 1.40 Page 24 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton, Hants 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 Winchester Road H54 s11642 52 Winchester Road v237505 300805.doc Version 1.40 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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