Inspection on 26/10/07 for 61 New Road

This inspection was carried out on 26th October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

61 New Road 23/10/08

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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REACH Upton Court Road

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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 61 New Road Netley Abbey Southampton Hampshire SO31 5AD Lead Inspector Craig Willis Unannounced Inspection 26th October 2007 10:00 61 New Road DS0000012358.V347317.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 61 New Road DS0000012358.V347317.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. 61 New Road DS0000012358.V347317.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 61 New Road Address Netley Abbey Southampton Hampshire SO31 5AD 023 8045 3347 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) www.new-support.org.uk New Support Options Ltd Care Home 6 Category(ies) of Learning disability (6), Physical disability (2) registration, with number of places 61 New Road DS0000012358.V347317.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th January 2007 Brief Description of the Service: 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 £937.88 per week. 61 New Road DS0000012358.V347317.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The evidence used to write this report was gained from a review of the information the provider sent to us since the last visit and the previous inspection report. This information included incident reports and an annual quality assurance assessment. A site visit to the home was made on 26 October 2007. During the visit we spoke with four people who live in the home and observed their interactions with staff. We also spoke with the manager and staff on duty. The communal areas of the building were viewed and documents relating to the running of the home were inspected during the visit. Two of the requirements made at the last inspection have not been complied with and are repeated in this report. We will consider enforcement action if these requirements are not met. What the service does well: There are good systems to assess people’s needs before they move into the home. This helps to assure people that the home will be able to meet their needs. People receive good support to make decisions about their lives. People take part in a wide range of activities they enjoy. Support is provided for people to keep in contact with their friends and family and maintain a healthy diet. People are supported to attend the health services they need. People know how to complain and are confident that if they do complain it will be taken seriously and responded to. The home is well maintained and provides a clean, comfortable and safe environment for people. Staff are well trained, which gives them the skills they need to provide care and support to people. 61 New Road DS0000012358.V347317.R01.S.doc Version 5.2 Page 6 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. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 61 New Road DS0000012358.V347317.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 61 New Road DS0000012358.V347317.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good systems to assess people’s needs before they move into the home. This reassures people that the home will be able to meet their needs. EVIDENCE: The manager reported in the annual quality assurance assessment that there are systems in place to ensure people have a full needs assessment before they move into the home. There are currently five people living in the home, who moved to the home in 1996. The assessments for these people have been inspected on previous visits and so were not looked at in detail during this visit. The manager reported that she was currently in the process of assessing a person who may be interested in moving into the home. 61 New Road DS0000012358.V347317.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good care planning and risk assessment systems, which supports people to make decisions about their lives and helps staff to provide the support that people need. EVIDENCE: The records of three people who live in the home were inspected during the visit. People had a care plan, which set out how their assessed needs should be met. The care plans seen reflected the information that was included in the initial assessment. A requirement was made at the last inspection that care plans must be regularly reviewed. There is now a programme for reviewing the care plans and it was clearly recorded where people’s needs had changed. Details of how people should be supported to make decisions are set out in the care plans. People spoken with said they were able to make decisions about their lives and felt well supported by staff. 61 New Road DS0000012358.V347317.R01.S.doc Version 5.2 Page 10 Risk assessments have been completed for all people living in the home and include actions that should be taken to minimise the identified hazards. A requirement was made at the last inspection that risk assessments must be regularly reviewed. There is now a programme for reviewing the assessments and those seen had been amended where necessary. The manager reported that she is currently working with staff to support all people who live in the home to develop a person centred plan. These documents were seen and set out people’s wishes and aspirations, including the support needed to achieve them. 61 New Road DS0000012358.V347317.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides good support for people to take part in a range of activities, to maintain contact with family and friends and to maintain a healthy diet. EVIDENCE: People are supported to take part in a wide range of activities, including college courses, visits to the local pub and shops and walking in the local area. People have an individual programme of activities, which is based on their needs and wishes. Support is provided for people to practise their religion. People are supported to maintain contact with their friends and family, with staff providing support for service users to visit family where necessary. People spoken with said their friends and relatives were made to feel welcome by staff. 61 New Road DS0000012358.V347317.R01.S.doc Version 5.2 Page 12 People are supported to plan a weekly menu, with help from staff to provide a balanced diet. Mealtimes are flexible to fit round activities and snacks are available at any time. People spoken with said they liked the food. 61 New Road DS0000012358.V347317.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People’s personal care is well met by staff who know what their needs are and people attend the health services they need. Errors in the medication system, however, do not demonstrate safe practice. EVIDENCE: Care plans contain details of the personal care support people need and how it should be provided. People spoken with said staff treat them well and provide the support they need. People are supported to attend a range of health services, including GP, nurse, dentist, psychiatrist and specialist hospital appointments. Details of consultations are recorded, including any advice given by the practitioner. A requirement was made at the last inspection that all medication administered in the home must be properly recorded. Following this requirement, the manager has amended the procedures for administering medication to prevent further errors. Medication is securely stored in a locked cupboard and most tablets are supplied in a monitored dosage system. A record is kept of 61 New Road DS0000012358.V347317.R01.S.doc Version 5.2 Page 14 medication coming into the home and returned to the pharmacist for disposal. The medication administration record for the current month was inspected and there were two occasions where the medication administration record had not been signed. Other records indicated that the medication had been administered to the person and the medication was missing from the blister packs. There was an incident in September 2007 when staff administered the wrong medication to a person who lives in the home. Staff consulted with the person’s GP and sought their advice, which was followed. All staff administering medication have received training. Due to these medication errors the home has not demonstrated that the requirement from the last inspection has been complied with and it is repeated in this report. 61 New Road DS0000012358.V347317.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good systems for dealing with complaints and responding to allegations of abuse. This gives people confidence that any complaints will be taken seriously and responded to. EVIDENCE: The home has a complaints procedure, which is provided to all people living at the home in a pictorial format to make it more accessible. People spoken with during the visit said they would speak to staff if they wanted to complain and were confident that any complaint would be taken seriously. The manager reported in the annual quality assurance assessment that the home has not received any complaints in the last year. We have not received any complaints about the home since the last inspection. Staff have completed training in safeguarding adults. Staff spoken with demonstrated a good understanding of the action they should take if abuse is witnessed, reported or suspected. There is a policy and procedure on safeguarding adults and the prevention of abuse. Requirements were made at the last inspection that accurate records must be kept for people’s finances and the financial records must be reviewed and new procedures put in place. The finance records of three people were inspected during the visit. Records matched the cash held for all three and also matched the bank statements. Since the last inspection the manager has devised new 61 New Road DS0000012358.V347317.R01.S.doc Version 5.2 Page 16 procedures to ensure that records are always kept up-to-date and regularly checked. These two requirements have been complied with. 61 New Road DS0000012358.V347317.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained and provides a clean, comfortable and safe environment for people. EVIDENCE: All of the home’s communal areas were viewed during the visit. The home is maintained to a high standard, with good quality, domestic furniture and fittings. People living in the home have access to a lounge, kitchen / dining room, and conservatory. There is a planned maintenance and renewal programme and staff reported that the maintenance team responds quickly to requests. There are two bathrooms on the first floor of the home. The two rooms on the ground floor share the use of a connecting bathroom, which has access from each of the rooms and a ceiling hoist. The manager reported that it is planned to change the bath in this bathroom, as it is difficult for one of the people who lives there to use it. There is a large garden to the rear of the home. 61 New Road DS0000012358.V347317.R01.S.doc Version 5.2 Page 18 The home has a domestic laundry that is situated in a utility room. The home is clean throughout. Hand washing facilities are suitably situated in the kitchen, laundry, toilets and bathrooms. 61 New Road DS0000012358.V347317.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are well trained and there are good systems to check staff before they work in the home. EVIDENCE: The manager reported in the annual quality assurance assessment that three of the twelve staff have achieved the National Vocational Qualification (NVQ) at level 2 or above and one is currently completing the award. It was reported that there is currently a problem with the NVQ programme due to a lack of assessors. People who live in the home who were spoken with said they felt there were enough staff to provide the support they need. Staff spoken with said they felt there were sufficient staff on each shift to provide the support that people need. The manager reported in the annual quality assurance assessment that all staff who have worked in the home over the last twelve months have had satisfactory pre-employment checks. The files of two members of staff who have been employed since the last inspection were inspected. Both had references on file but no confirmation that a Criminal Records Bureau (CRB) 61 New Road DS0000012358.V347317.R01.S.doc Version 5.2 Page 20 disclosure had been obtained. The manager reported that both of these staff had transferred from other New Support Options services and she was confident all of the checks had been completed. Following the inspection the manager reported that details of the CRB checks had been obtained from their head office and were now being held in the home. The home has an on-going training programme and staff reported that they receive good training, which helps them meet people’s needs. Staff training records indicated people had completed an induction and courses in medication administration, first aid, safeguarding adults, food hygiene, challenging behaviour, moving and handling, mental health and fire safety. The manager has identified where there are gaps in people’s training and planned courses throughout the year. 61 New Road DS0000012358.V347317.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Improvements have been made to the management of the home and the support for staff, however, the quality assurance systems do not ensure that identified shortfalls in the service are resolved and requirements from previous inspection reports complied with. EVIDENCE: The manager has completed the NVQ level 4 in care and the registered manager’s award. Staff expressed some concerns at the last inspection that they did not feel well supported. Staff spoken with during this visit said things were now a lot better and they receive good support from the manager. A requirement was made at the last inspection that an application to register a manager must be submitted to us. The manager reported that she had still 61 New Road DS0000012358.V347317.R01.S.doc Version 5.2 Page 22 not submitted an application because of delays in getting some of the information required. The manager was informed that this must be submitted as a matter of urgency. An area manager visits the home every month to assess the quality of the service that is being provided. Reports of these visits are made and sent to the manager, including any actions that are required. Despite these quality assurance systems, two of the requirements made at the last inspection have not been complied with. A person who uses a different support service has recently completed an audit of the home. The manager said she would receive a report from this visit and use it to develop an action plan to improve the service. The manager reported in the annual quality assurance assessment that the electrical system, portable electrical equipment, hoists, fire detection and fighting equipment and gas system are regularly serviced and maintained. These records were sampled during the visit and confirmed the manager’s report. 61 New Road DS0000012358.V347317.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 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 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 2 X 2 X 2 X X 3 X 61 New Road DS0000012358.V347317.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 YA20 Regulation 13 Requirement All medication administered in the home must be properly recorded. This requirement was made at the last inspection but the time-scale of 5/1/07 was not complied with. An application to register a manager must be submitted to the Commission. This requirement was made at the last inspection but the time-scale of 15/3/07 was not complied with. Timescale for action 30/11/07 2. YA37 Care Standards Act Sections 11 & 12 30/11/07 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 61 New Road DS0000012358.V347317.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: 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 © 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 61 New Road DS0000012358.V347317.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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