Inspection on 23/10/08 for 61 New Road

This inspection was carried out on 23rd October 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

61 New Road 26/10/07

61 New Road 05/01/07

61 New Road 25/01/06

61 New Road 25/08/05

61 New Road 14/12/04

61 New Road 02/08/04

61 New Road 16/03/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 61 New Road 61 New Road Netley Abbey Southampton Hampshire SO31 5AD     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Michelle Presdee     Date: 2 3 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: 61 New Road 61 New Road Netley Abbey Southampton Hampshire SO31 5AD 02380453347 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Diane McCarthy Type of registration: Number of places registered: Dimension (NSO) Ltd care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 6. The registered person may provide the following categories of service : Care Home only - (PC) to service users of the following gender : Either Whose promary category needs on admission to the home are within the following categories : Learning Disability (LD) Date of last inspection Brief description of the care home 61 New Road is registered to provide care and accommodation for 6 people with learning disabilities. The service is provided by New Support Options and the building is owned by Downland Housing Association, who is responsible for maintenance. Each person has their own single bedroom and has access to communal bathrooms, lounge, dining room, conservatory, kitchen and garden. The home is located within 50 metres of local shops and pubs in the village of Netley Abbey. The current fee for a place in the home is 133.40 per week. Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 6 Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The evidence used to write this report has been gained from a range of sources. The home sent us their Annual Quality Assurance Assessment (AQAA) back on time, which had detailed information. The home has also sent us incident reports. A visit to the home was undertaken and during this time we were able to speak to people who live in the home and observe their interactions with care staff. We were able to speak to care staff on duty and the manager. At this time we looked at all communal areas of the home and each persons bedroom was viewed. Paperwork including assessments, service user plans, menus, staffing records and health and safety checks were seen. Surveys were received from all people who live in the home. All this information has helped form the judgments included in this report. Care Homes for Adults (18-65 years) Page 6 of 28 Care Homes for Adults (18-65 years) Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are confident the home can meet their needs. There is an accurate assessment of their needs that they and others have been involved in. Evidence: In the AQAA we were advised the home would offer information visits and written information to any new potential resident. We were advised an up to date statement of purpose is available for any new resident. One new resident had recently joined the home. Staff explained how the process had worked and stated it had taken nearly a year for the person to move in. All spoken to felt the process had worked well. The person concerned had a very gradual process before moving in on a permanent basis and still spends week-ends at home. The person had been to look at the home and then spent days meeting the other people living in the home increasing to overnights and a gradual longer period. The other people living in the home had been consulted on how they thought the person would fit into the home. Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: When asking a member of staff for the homes brochure or service user guide they stated they did not know where these were stored. They were not seen in peoples own rooms or in the communal areas of the home. It was noted in the AQAA the home has stated they are going to introduce a new brochure in a pictorial format. When talking to the last person to move into the home she stated she felt happy in the home. She did state she was missing her parents but felt it had been a good way to come to live at the home. The assessment of the last person to come to the home was viewed. It was noted this contained a lot of information, which had been sought from a lot of different professionals already known to the person and included details from the person themself and their family. It was clear the home had adequate information to ensure they could meet the persons needs. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a plan of care for each person showing there needs can be met. People are supported to make decisions and take risks with support if they need it. Evidence: In the AQAA we were advised some people receive direct payments and an advocacy scheme has been introduced. Risk enabling strategies have been put into person centered plans. People take part in a wide range of activities and attend college courses. People can follow their religion preferences. People are involved in weekly menu choices and meal times are flexible. People are taking annual holidays. The records of three people living in the home were viewed. Care plans had been completed which were extensive and gave clear information on how a persons needs should be met. When looking at the care plans, held in the kitchen two of the peoples whose records were looked at where in the home. Both were happy for me to look at the records and had an input into their care plans. Plans were being changed and were Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: being put in a person centered way starting with, I would like. It was clear from records seen they had been reviewed on a regular basis and the person whose review it was had been involved and signed the review. It was clear from discussions on the day people made and make decisions about their life. On arrival one person who uses the direct payment scheme was deciding what to do with the person who is funded through this scheme. The person decided she would like to go into town and have a coffee. This was agreed and the person was able to access her money so she could do what she wanted. Another resident was asked if she wanted to go to the local shop and decided she would, another person stayed at home. People living in the home were encouraged to take part in daily activities in the home including bed making, vacuming and cleaning up after lunch. Photographs were dispalyed around the home of people on holiday, one person had been on a cruise, another had been to France and one person had been to the Isle of wight. Risk assessments which were individual to each person had been completed. These detailed how the risk could be minimized and gave clear instructions on how staff should behave at these times. Evidence was seen that risk assessments had been reviewed on a regular basis. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home supports people to have choices to take part in activities and to maintain contact with friends and family. Evidence: From evidence seen and from discussions with people living in the home it was clear each person was able to take part in activities they wished to join in. Three of the residents are over 60 and we were advised no longer want to take part in as many community activities. None of the people living in the home currently go to college but we were advised this is down to each persons choice. In surveys received from all people living in the home all indicated they could do what they wanted during the day, evening and weekend. Staff spoken to indicated some times they were restricted on what they could do if there was not a driver of the homes mini bus on duty. Staff also stated they felt now the home was full this put extra pressure on them to ensure Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: everyones social needs were met. People spoke of their enjoyment of having visitors to the home and going out to the local pub, swimming and into town. One person attends Church on a weekly basis and one person goes when they feel like it. People spoken to on the day confirmed they plan the menu on a weekly basis. All people get together and decide what they would like for the following week . The weeks menu was displayed on the fridge. All people spoken to confirmed they enjoyed their meals and stated they looked forward to a takeaway at the week end. All confirmed meal times were flexible and they could always have something to eat if they were hungry. At lunch time it was noted each person was asked what they would like for lunch. The meal time was relaxed with all involved having a chat and a laugh. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have clear records of their personal and health care needs, which are met by staff when and how they want. Medication is managed in a safe manner. Evidence: In the AQAA we were advised people can choose their own G. Individual support is given. Staff are trained in medication and health care emergencies. Visits are made to GP, nurse, dentist and psychiatrist. In each persons file a document has been produced by the person and with the assistance of their key worker entitled A day in the life of. This gives details of a typical day for each person and highlights areas where the person may need assistance, support or encouragement. Staff explained this is a very useful document and can be given to agency workers who would then have an understanding of how to support each person. People spoken to were happy with the staff and felt they always had assistance when and how they wanted it. When looking at each persons records it was clear all have access to a wide range of Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: professionals to meet their physical and health needs. Details of all visits are recorded and the outcome of the visit was is detailed. On the day of the visit one person was getting ready to attend a hospital appointment. The person stated they were very worried but was glad two staff members were going with her to offer support and reassurance. In the last report a repeated requirement regarding the the administration and recording of medication had been made. It was found this had been complied with. The home uses a monitored dosage system which is delivered to the home on a monthly basis. Clear records were maintained of all medication when it enters and leaves the home. All medication is kept in a locked secure area on the first floor and at times of administration medication is taken to a private area on the ground floor. No person currently manages their own medication but we were advised this is their choice. A photograph of each person is attached to their medication. Details are recoded on what the medication is, why the person is taking the medication and what effect it has on the person. Records were checked and it was found all records had been signed correctly and medication held matched the records. All medication administered is signed for by two people. A clear policy and guidelines were held on all medication described as take as necessary. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are clear about the complaints procedure and confident any complaints will be taken seriously. A clear policy regarding safeguarding is in place, people need to be aware of the wider procedure to ensure people are safe at all times. Evidence: The AQAA states procedures have been put in place in pictorial form to ensure all people have an understanding of the complaints procedure. In each persons file, which is kept in the kitchen, a pictorial copy of the complaints procedure is kept in there. A copy was also available on the noticeboard in the hallway. All surveys received from people living in the home stated they would know who to speak to and know how to make a complaint. Staff stated they were not aware of any complaints being made in the last year. The home has a policy and procedure on safeguarding adults and the prevention of abuse. Staff reported they had received training in this area and the AQAA stated staff had received training. In discussion with staff it was clear they were aware of the in house procedures for reporting suspected abuse. However none of the staff spoken to were clear about the procedures outside of the home and it was agreed this would be discussed at the next staff meeting. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: Staff have received training in safe guarding adults procedure. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People stay in a safe well-maintained home that is homely, clean, comfortable, pleasant and hygienic. Evidence: In the AQAA we were advised we support residents to maintain a hygienic and clean home. The home is decorated regularly with residents choosing decor. A new specialist bath has been purchased tor the downstairs bathroom. On the day all areas of the home were seen including the lounge, kitchen/dining room and conservatory. Some people enjoyed showing us their own rooms, which people confirmed they had chosen the decor and the style of their room. Two ground room floors have a connecting bathroom, with a new specilaiast bath, which each have access to a ceiling hoist. Details of how staff should assist people with the hoist were included in the care plans. Staff spoken to stated they had all received training in the use of the hoist. All areas of the home were clean and decorated to a good standard. The home has recently decorated the hallway, landing and stairs. It was noted in two bathrooms the ceilings were covered in cobwebs and it was agreed theses would be cleaned. It was agreed both upstairs bathrooms were looking old and in need of replacing. In one bathroom it was noted the flooring did not fit around the toilet as the Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: toilet at some time had been replaced. The toilet seat had no lid. The tiles around the bath did not match. In the second bathroom the base of the bath was cracked and coming away from the bath. The flooring was stained and the bathroom furniture looked old. The manager did state they had provisionally been told they could replace both bathrooms. The home has access to a large garden, where a raised flower bed has been created. Two areas have been made into vegetable patches, which we were advised people in the home take an interest in. The home has its own laundry, situated in the utility room, which staff on all shifts are responsible for maintaining. The home has suitable hand washing facilities throughout the home. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are kept safe and their needs met by correct recruitment procedures being followed and staff being trained and supported by their manager. Evidence: In the AQAA we were advised the home recruits staff with knowledge and skills to promote independence and choice. It ensures the rota meets the needs and desires of people we support. All staff are trained to a high standard and have a good induction process. Staff spoken to on the day of the inspection stated they felt there was usually enough staff on duty to meet the care needs of the people living there. Discussions were held on the fact now a new resident has come to live at the home this has put extra pressure on staff and at times they can not meet all the social needs of people living in the home. Staff and the manager stated the home is currently trying to recruit two more staff members and at times has to use agency staff. Staff spoken to stated they would prefer agency staff not to work as they do not know the people living in the home. In the last week agency staff had worked three shifts. A duty rota was available, three people ususlly work a morning shift and two people work an afternoon shift. Two extra people were on duty on the day of the visit so a person could have Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: assistance whilst going to the hospital. People spoken to on the day of the inspection were positive about the staff and felt they did meet their needs. In surveys received from all people living in the home all had stated staff always treat them well. The home currently employs eleven members of care staff. Of these four have achieved a National Vocational Qualification (N.V.Q) Level 2. One members of staff is currently working toward this and three members of staff are working towards a N.V.Q. Level 3. The manager stated she was very aware of the need to ensure all checks are completed before a member of staff is employed. The recruitment records of the last three members of staff to join the home were viewed. It was noted all had completed an application form, two written references were available and checks had been made with the relevant agencies. It was noted for two people no photograph identification was available and for another person all evidence was in the persons married name but only a copy of her birth certificate was available and not the marriage certificate. Staff spoken stated they had received a good induction procedure. Staff also confirmed they felt training was available that met their needs. Good records were maintained on each persons file, which indicated when they had completed their induction period and what training they had undertaken. When looking at training records it was clear the majority of staff were out of date in training in such areas as manual handling and first aid. We were advised most staff had been booked on these courses again. However this was highlighted during the last inspection and in some cases more than six months had elapsed when the training was due for renewal. Records were available demonstrating staff had received regular supervision sessions. Staff spoken to felt there was adequate support to meet their needs. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and the views of those who live there help develop future practice. The environment is safe for people because health and safety practices are carried out. Evidence: At the last inspection a repeated requirement was made that the home must have a registered manager. Since the last inspection the manager has now been registered with the Commission. The manager stated she felt things had improved in the home and the staff group had changed their focus and were now far more led by the needs of the people living in the home. Staff spoken to stated they felt they worked well as a team and were supportive of each other. The manager has not started a Registered Managers Award but stated she is hoping to register for this soon. The manager also stated she now works four days a week to ensure she can meet everyones needs. People spoken to felt their views were listened to. Regular meetings are held for those who live in the home and evidence was seen of regular individual reviews where their Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: views are sought and recorded. Surveys are sent on an annual basis to those living in the home, staff members, family members, advocates and professionals who visit the home, to try and seek the views of how they rate the home. A recent audit had also been undertaken by a person who has a learning difficulty to seek their views. No feedback has yet been given to the home. In the AQAA the manager reported the electrical system, portable electrical equipment, hoists, fire detection, fire fighting equipment and gas system are regularly serviced. Some of these records were sampled and found to support the managers claims. Hampshire Fire and Rescue Service are currently working with the home to ensure all fire safety deficiencies identified by them are being addressed. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 35 18 All staff must receive training in key areas which is kept in date and renewed as necessary. It is vital staff are kept up to date with training in the key areas for the protection of people living in the home and staff themselves. 09/01/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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