Inspection on 26/06/06 for 59 Bury Road

This inspection was carried out on 26th June 2006.

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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

59 Bury Road 13/08/08

59 Bury Road 08/08/07

59 Bury Road 08/11/05

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 59 Bury Road Gosport Hampshire PO12 3UE Lead Inspector Roy Bega Unannounced Inspection 26th June 2006 10:00 59 Bury Road DS0000064247.V295127.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 59 Bury Road DS0000064247.V295127.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. 59 Bury Road DS0000064247.V295127.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 59 Bury Road Address Gosport Hampshire PO12 3UE 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) 020 8544 8900 www.caremanagementgroup.com Care Management Group Limited To Be Confirmed Care Home 6 Category(ies) of Learning disability (6) registration, with number of places 59 Bury Road DS0000064247.V295127.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th November 2005 Brief Description of the Service: This service was registered in May 2005 and owned by the Care Management Group. The provider has two houses next door to each other in Bury Road and they are registered separately. The house has been refurbished to a good standard and provides a home for up to six people who have a learning disability and/or autism and challenging behaviours. At the time of inspection there were six residents living in the home. Current fees range from £1,634.62 to £2422.31 per week with additional charges for hairdresser, chiropody and toiletries. 59 Bury Road DS0000064247.V295127.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is an assessment of how the National Minimum Key Standards for Care Homes for adults 18-65 were being met at the time of the inspection This visit took place on 26 June 2006 between the hours of 9-30 a.m. and 4-30 p.m., a total of seven hours. Opportunity was taken to look around the home view records, observe the working environment and speak with management, staff and residents. There were not any relatives/friends present during the visit. Three of the four requirements raised resulting from the previous inspection have been assessed as being met. A further requirement has been raised resulting from this inspection visit. What the service does well: What has improved since the last inspection? What they could do better: The service would benefit from having more staff achieving a National Vocational Qualification level 2 in care. The service would benefit from the service having and effective quality assurance and quality monitoring system in place based on seeking the views of residents. 59 Bury Road DS0000064247.V295127.R01.S.doc Version 5.2 Page 6 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. 59 Bury Road DS0000064247.V295127.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 59 Bury Road DS0000064247.V295127.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this area is good. This judgement has been made using available evidence including a visit to the service. Prospective residents benefit from a stringent pre admissions assessment procedure. EVIDENCE: All six residents moved into the service after it opened in May 2005. There has been one new admission to the service since the last inspection of 8 November 2005. Records showed that full assessments had been completed by competent staff prior to admission in consultation with families, residents where possible and relevant professionals. Recent full reviews detailing residents required level of personal support in meeting their daily living needs and wishes were seen. Areas covered included education/training/occupation, social skills and wishes, management of risk, physical and mental health care. Residents spoken with told the inspector that they liked being involved in their review. (See also section Individual needs and Choices of this report). 59 Bury Road DS0000064247.V295127.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this area is good. This judgement has been made using available evidence including a visit to the service. Residents’ benefit from the care planning process ability to make decisions and support to take risks. EVIDENCE: Information provided and discussions have substantiated that management accountability has not been consistent within the service since the last inspection. Discussions with staff, residents and observations indicated that this has not however had an adverse effect upon residents. Staff informed the inspector that over the few weeks prior to this visit, the organisation and direction within the service has improved in that more is being achieved in the interest of residents’ needs and wishes. Current acting management informed the inspector that record keeping in respect of residents care plans have not been maintained appropriately and are in the process of being reorganised in order to make them more usable documents. For example having a daily working file that includes, activities linked to risk assessments and daily records. The inspector was also informed that personal centred plans are being introduced as part of the revised system. Evidence of this was seen. (See also section “ Conduct and Management of the Home”.) 59 Bury Road DS0000064247.V295127.R01.S.doc Version 5.2 Page 10 However, the sample of three care plans seen included the relevant information. Records and discussions indicated that where appropriate residents had participated in agreeing their plans. Residents readily talked with the inspector stating that they liked spending time with staff in making choices about what they want to do and where they want to go. For example, going to college, ice hockey, music workshop, playing drums, shopping and local pub. (See also section on Lifestyle of this report). It was seen that up to date risks assessments and reviews have been completed that coincide with residents’ chosen and agreed activities and lifestyle. Residents eagerly showed the inspector their bedrooms stating that they had chosen the colour scheme furniture and soft furnishings. Observations and discussions with residents indicated that they like helping to do jobs around the house with staff. Current management informed the inspector that enabling residents towards independent living is an area to be developed further. Information in the returned pre inspection questionnaire and Regulation 37s pre-empted discussion with regards to the management of and recording of residents’ extreme behaviour. Acting management agreed to ascertain from senior management within the company as to whether current methods used have been accredited by the appropriate organisation. 59 Bury Road DS0000064247.V295127.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this area is good. This judgement has been made using available evidence including a visit to the service. Residents’ benefit from having their rights respected and being supported to maintain contact with families and friends. Some residents would benefit from having access to a wider range of activities in the area of enabling them to become more independent EVIDENCE: See also the previous section, Individual needs and Choices, Standards 6 –10. Samples of three residents’ daily activity programmes were seen. Activities include college courses, sporting interests, musical interests and community access. During the visit staff were observed to support residents in communicating and carrying out activities. Planned activities were relevant and suitable for the people living at the home and based on known interests and preferences. Residents readily informed the inspector of what they choose and like to do and how staff are very helpful in helping them. Discussions indicated that residents are involved in deciding what they eat and are assisted with shopping and cooking. At the time of the visit one resident was being assisted to complete a food-shopping list. Acting management informed the inspector that it is planned to increase activities in the area of 59 Bury Road DS0000064247.V295127.R01.S.doc Version 5.2 Page 12 enabling more residents to become more independent. For example, domestic duties such as keeping rooms clean and tidy, laundry and cooking. Records seen and discussions indicated that residents are encouraged and supported to maintain contact with their families and friends. Staff observed and spoken with on the day of visit demonstrated an understanding of resident’s rights with the ability to ensure they are upheld. This was supported by the organisation’s clear policies and information for staff on the rights of residents. 59 Bury Road DS0000064247.V295127.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this area is good. This judgement has been made using available evidence including a visit to the service. Residents’ benefit from being supported by staff in maintaining their physical and emotional health needs. Residents benefit from there being appropriate procedures in place and trained staff in the administration of medication. EVIDENCE: Observation and discussions indicated staff provide sensitive and flexible personal support to maximise residents privacy, dignity, independence and control over their lives. Residents made comments to the inspector that included – “They help me here”, “I can have time in my room”, “I am helped to keep my room clean” and “When I am not well I do not have to do anything”. Care plans seen and discussions showed that residents’ health care needs have been assessed, and appropriate procedures put in place to ensure they are carried out. Residents told the inspector that staff take them to see the doctor and dentist when they are not feeling well or need their teeth seen to. In accordance with the organisation’s policy and procedures all residents have been assessed as not being able to manage their own medication. Records of medication administered were well maintained and up to date. 59 Bury Road DS0000064247.V295127.R01.S.doc Version 5.2 Page 14 Evidence was seen that staff that administer medication have received appropriate training by a recognised organisation. Staff spoken with indicated that they feel more confident in handling medication. Records of medication retuned the pharmacist were seen and assessed to be well documented. 59 Bury Road DS0000064247.V295127.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this area is good. This judgement has been made using available evidence including a visit to the service. Residents’ benefit from having their views listened to and acted upon and robust adult protection procedures. EVIDENCE: A clear and effective complaints procedure, which is also available in picture format so that residents can more easily understand it was seen. Records are kept of the nature and outcome of each complaint along with details of what action was taken in response. Residents meet weekly with their key workers to discuss any areas of concern and informed the inspector that they know how and to whom to report any problems. The Commission has not received any complaints in relation to the service since the last inspection. Behavioural management plans are in place aimed at protecting residents from self harm or other people living in the home. Records kept of all incidents that have occurred where physical intervention has been necessary were seen and assessed as being well maintained. The home has an adult protection policy and procedure in place of which staff spoken with had a good understanding. Since the last inspection staff have received adult protection training by an accredited trainer within the organisation. Since the last inspection there have been two incidents that have been reported under the protection of vulnerable adults procedures. One was not proven and the second was subject to investigation at the time of this visit. On both occasions management had acted in accordance with the organisation’s policy and procedures. 59 Bury Road DS0000064247.V295127.R01.S.doc Version 5.2 Page 16 With their permission resident’s personal financial accounts were seen. It was assessed that appropriate records were being maintained. During the visit residents were assisted by staff in going to their bank to withdraw cash. 59 Bury Road DS0000064247.V295127.R01.S.doc Version 5.2 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 the following standard(s): 24 and 30. Quality in this area is good. This judgement has been made using available evidence including a visit to the service. Residents live in a clean, hygienic homely environment. EVIDENCE: The premises are in keeping with the local community and have a style and ambiance that reflects its stated purpose. The inspector had the opportunity to walk around the communal areas and two bedrooms that were well maintained. Furniture and fittings are of good quality, domestic in design, unobtrusive and compatible with fulfilling their purpose. Residents spoken with informed he inspector that they had chosen their bedroom furniture. The home was clean, hygienic and free from offensive odours. One resident was keen to show the inspector how well they keep their room. Laundry facilities are of a domestic type and meet requirements. Systems are in place to control the spread of infection. Evidence was seen that staff have received training with regards to infection control by the organisation’s accredited trainer. 59 Bury Road DS0000064247.V295127.R01.S.doc Version 5.2 Page 18 The home has been made safe in response to potential difficult behaviours from residents. For example kitchen appliances have been secured to the work surface. 59 Bury Road DS0000064247.V295127.R01.S.doc Version 5.2 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 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, 34 and 35. Quality in this area is adequate. This judgement has been made using available evidence including a visit to the service. Residents’ benefit from good recruitment procedures. Internal training is good but there is a need to increase the number of care staff who have acquired accredited National Vocational Qualification training. EVIDENCE: Records seen and staff spoken with demonstrated that the recruitment procedures followed in the home protect residents. All necessary checks were in place prior to staff commencing work. A sample of two staff comprehensive induction training records we seen. Staff spoken with informed the inspector that they were fully supported in their induction period and have been subsequently. They receive regular supervision where they are able to discuss their concerns, personal developmental and training needs. Records seen and discussions indicated staff have received the following accredited training – • One member of care staff has obtained the National Vocational Qualification (NVQ) level 3 in caring for adults who have a learning disability. DS0000064247.V295127.R01.S.doc Version 5.2 Page 20 59 Bury Road • Three care staff are currently studying for the NVQ level 2 in caring for adults who have a learning disability. This will provide the service with four care staff holding an accredited NVQ qualification. The service has a total of 18 care staff therefore there is a shortfall in the required 50 to be NVQ 2 accredited. Since the last inspection evidence was seen that the following training has been provided for all full time and all bank staff – Fire safety. First aid. Moving and handling. Food hygiene. Infection control. Communication training in “Makaton” and “Signalling” has been arranged for July and August 2006. 59 Bury Road DS0000064247.V295127.R01.S.doc Version 5.2 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 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. Quality in this area is adequate. This judgement has been made using available evidence including a visit to the service. Whilst management of the home has not been consistent since the last inspection this has not had an adverse effect upon residents. Although a quality assurance system based on obtaining residents, family and professional views on how the service is meeting its aims is not in place, residents voice is heard through weekly discussions with key workers and monthly house meetings. The health and safety of residents is promoted. EVIDENCE: Information provided and discussions have substantiated that management accountability has not been consistent within the service since the last inspection. The inspector was informed that interviews for the manager’s position are being held on 6 July 2006. The acting manager is currently studying for the Registered Managers Award. Discussions with staff and residents and observations indicated that the disruptions have not however had an adverse effect upon residents. 59 Bury Road DS0000064247.V295127.R01.S.doc Version 5.2 Page 22 During the visit, the inspector had the opportunity to speak with staff and residents. It was evidenced through these discussions and observations that good working relationships exist between the staff group and residents. Staff informed the inspector that over the few weeks prior to this visit, the organisation and direction within the service has improved in that more is being achieved in the interest of residents’ needs and wishes. Observations and discussions with staff and residents also indicated that the management approach of the home has created an open, positive and inclusive environment. The atmosphere was relaxed indicating an environment where resident’s abilities and aspirations are being promoted. Residents engaged in friendly banter with staff and management. The inspector was informed that due to the inconsistent management of the home since the last inspection a quality assurance system based on seeking the views of residents, relatives, service purchasers and professionals has not been put in place. (This was a requirement raised resulting from the last inspection.) However, the inspector was shown minutes of weekly house meetings between staff and residents where suggestions and concerns are discussed. Staff have received appropriate training with regards to Care of Substances Hazardous to Health. Hazardous substances are kept in a locked cupboard to promote the welfare and safety of service users. The home has up to date maintenance certificates for the boiler, fire equipment etc. Fire drills and required fire safety precautions are carried out and recorded promoting the health and safety of service users. 59 Bury Road DS0000064247.V295127.R01.S.doc Version 5.2 Page 23 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 2 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 3 3 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 3 X 3 X 2 X X 3 X 59 Bury Road DS0000064247.V295127.R01.S.doc Version 5.2 Page 24 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA32 Regulation 18 (1b) Requirement The registered person shall ensure that at all times suitably qualified, competent and experienced persons are working in the care home ----. You are required to provide your plans to ensure that at least 50 of care staff acquire NVQ level 2 by the stipulated dated The Manager must ensure that a quality assurance system is in place in the home. You are to provide your plans in meeting this requirement by the stipulated date. This requirement is outstanding from the last inspection. Timescale for action 03/08/06 2 YA39 24 03/08/06 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 59 Bury Road DS0000064247.V295127.R01.S.doc Version 5.2 Page 25 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 59 Bury Road DS0000064247.V295127.R01.S.doc Version 5.2 Page 26 - 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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