Inspection on 05/01/07 for 61 New Road

This inspection was carried out on 5th January 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 no outstanding requirements from the previous inspection report, but made 6 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 26/10/07

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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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 61 New Road Netley Abbey Southampton Hampshire SO31 5AD Lead Inspector Nick Morrison Unannounced Inspection 5th January 2007 10:00 61 New Road DS0000012358.V328148.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.V328148.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.V328148.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 Limited Care Home 6 Category(ies) of Learning disability (6), Physical disability (2) registration, with number of places 61 New Road DS0000012358.V328148.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th January 2006 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 are responsible for maintenance. Each service user 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. 61 New Road DS0000012358.V328148.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report represents a review of all the evidence and information gathered about the service since the previous inspection. This included a site visit that occurred on 5th January 2007 and lasted six hours. During this time the Inspector toured the premises, looked all service users’ files and met all five service users. All records and relevant documentation referred to in the report was seen on the day of inspection. The Inspector spoke with the Area Manager and three members of staff. The manager of the home was not available on the day of the inspection visit. Current charges in the home were not available at the time of the inspection. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. 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.V328148.R01.S.doc Version 5.2 Page 6 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.V328148.R01.S.doc Version 5.2 Page 7 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): 2 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users benefit from having their needs assessed prior to admission to the home. EVIDENCE: Service user files showed that each service user had an assessment of need prior to moving into the home. The assessments had been completed with input from service users, where possible, and input from families. Assessments were written clearly and covered the range of different need areas. 61 New Road DS0000012358.V328148.R01.S.doc Version 5.2 Page 8 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): 6, 7 and 9 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Service users benefit from having clear individual plans in place and from support to take decisions and risks appropriate to their development. Service users would benefit further from having their care plans and risk assessments kept under regular review. EVIDENCE: Service users and their families had been involved in the care planning process and the care plans related to the needs identified in the initial assessment. There were different care plans for each different area of need. The plans detailed exactly what support each person required and how the support needed to be delivered. Staff spoken with were not clear about the care plans for each service user and could not remember what things were ion the care plans. Care plans had not been updated in response to changes in service 61 New Road DS0000012358.V328148.R01.S.doc Version 5.2 Page 9 users’ needs and had not been reviewed on a monthly basis since August 2006. The care planning process emphasised the rights of service users and the importance of them being involved in decisions about their own care and their own lives. The home was in the process of introducing Person Centred Plans for each service user. Risk assessments were contained within the care plans and were well written. They contained clear information about the identified risks and had appropriate control measures put in place to ensure that all risks were minimised as far as possible. Risk assessments, like care plans, had not been reviewed regularly and had not been updated to reflect changes in the needs of service users. There had been a recent incident where one service user had repeatedly punched another service user, but the care plans and risk assessments for each of these service users had not been reviewed and updated in light of this incident. Staff spoken with about this issue acknowledged that there was not a clear and agreed way of supporting the two service users around this issue and that different members of staff had different approaches to supporting them. 61 New Road DS0000012358.V328148.R01.S.doc Version 5.2 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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. Service users benefit from being part of the community and involved in varied activities. They also benefit from regular contact with their families and a healthy diet. EVIDENCE: Each service user had an activity plan in place and staffing was organised to ensure support was available when service users needed support with activities. Transport was available in the home for service users to get to different activities. Some service users had activities arranged through local colleges as well as by staff in the home. Activities were based around the individual interests of service users and suited to their individual needs and preferences. All service users spoken with said they felt they had enough 61 New Road DS0000012358.V328148.R01.S.doc Version 5.2 Page 11 activities throughout the week and that they were able to do things they enjoyed. Service users were supported and encouraged to maintain contact with their families and friends. One service user was supported to compile a family tree. Service users spoken with said that staff were always supportive in helping them to keep in contact with families and friends and this was confirmed by support in this area being recorded on service users’ care plans. The staff in the home had supported one service user to reunite with members of her family and this proved a positive experience for her. The rights of service users were emphasised throughout the home. Care plans placed emphasis on this, as did the home’s policies. Staff observed during the visit were clearly aware of service users’ rights and of their own role in ensuring that rights were respected. All service users spoken with said they thought the food in the home was very good. There were set menus in the home and service users were able to contribute ideas for the menus. Menus were pinned up in the kitchen so that everyone knew what meals they were having on each day. Staff also contributed to menu planning to encourage service users to try new and different foods. Records were kept of what food was consumed and these demonstrated that meals in the home were varied and nutritious. 61 New Road DS0000012358.V328148.R01.S.doc Version 5.2 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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. Service users benefit from having their health and support needs met appropriately. Service users were not protected by the home’s medication practices. EVIDENCE: Service users spoken with were happy about the personal care they received. Staff spoken with said they were clear about what support each person required. Care plans and records demonstrated that service users’ healthcare needs were regularly monitored and that they were supported to access relevant healthcare services as necessary. Records were kept of all medical appointments along with actions required as a result. The home had a comprehensive medication policy in place which staff were aware of. All staff involved in administering medication had received relevant training and said they understood their responsibilities within the process of 61 New Road DS0000012358.V328148.R01.S.doc Version 5.2 Page 13 administering medication. All medication was appropriately stored in a medication cabinet. Records of medication administered to service users were not accurate. There were gaps in the records of two service users, showing a total of five occasions on the current records where medication had, apparently, been administered but had not been signed for. 61 New Road DS0000012358.V328148.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users benefit from a clear complaints policy and were protected by the home’s abuse policies and practices. The financial interests of service users were not fully protected. EVIDENCE: Staff spoken with were very clear that their role was to support service users in a way that respected their right to make their own decisions. The care planning process placed a lot of emphasis on ensuring that service users were involved throughout the planning of their care and that their own views and decisions were to be respected. The home has an abuse policy in place to ensure that service users are protected from any kind of abuse. Staff had received training on identifying and responding to instances of suspected abuse and those spoken with were clear about the relevant issues and their responsibilities in this area. The staff in the home manage the spending money of each service user. Their money is kept locked in separate cash-tins in the office. Staff keep handwritten records of all financial transactions for service users. There were some discrepancies between those written records and the bank statements service users received and occasions where the withdrawal dates from the bank did not match with the bank statements. Some of the written records were recorded out of sequence and there were also a lot instances where records 61 New Road DS0000012358.V328148.R01.S.doc Version 5.2 Page 15 had been overwritten, scribbled out or tippexed out. There was a lack of information about how service users’ money was spent. The manager checked the written records periodically and signed to say they were accurate. On some of these occasions they had been checked and signed but were not accurate (according to the bank statements). These issues were discussed with the Area Manager during the inspection visit and she undertook to review all the financial records for each service user and to devise a more straightforward procedure together with a procedure for staff so that it is clear how and when transactions should be recorded. The home has a Complaints Policy in place that is written in a format designed to be accessible to people who use the service. Each service user has their own copy of the policy and a copy was also pinned to the notice board in the kitchen. An adequate system was in place for recording and responding to complaints, although none had been received. Service users spoken with were aware they could complain about the service but had different ideas about how they would go about it. Some said they would talk directly to a particular member of staff while others said they talk to their relatives and get their help. 61 New Road DS0000012358.V328148.R01.S.doc Version 5.2 Page 16 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): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from living in a comfortable, safe and clean home. EVIDENCE: The home was clean and tidy throughout, without detracting from the homeliness and comfort of the house. Staff were responsible for maintaining the cleanliness of the home, but some service users liked to join in with cleaning and laundry tasks from time to time and they were supported to do so. The home was regularly maintained and records were kept. Service users spoken with said they thought the home was a nice place to live and were keen to show the Inspector around their home. The garden area was well maintained and had a fishpond that was popular with service users. The gardens area of the home were accessible to service users and were nicely kept. 61 New Road DS0000012358.V328148.R01.S.doc Version 5.2 Page 17 There are six bedrooms in the home for service users. None of these have ensuite facilities but there are three bathrooms around the home, each shared by two service users. The home had adequate infection control procedures in place and staff were aware of these. 61 New Road DS0000012358.V328148.R01.S.doc Version 5.2 Page 18 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): 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. Service users benefit from being supported by competent, trained staff and are protected by the home’s recruitment policies and practices. EVIDENCE: Rotas showed that sufficient staff were on duty at all times in the home. Service users spoken with felt that were sufficient staff and spoke very highly of the staff that supported them. During the inspection visit the Inspector observed staff interacting with service users in a very relaxed and supportive manner. The approach of staff observed on the day was wholly positive. They demonstrated that they understood the needs of service users and were skilled in communicating effectively with service users and supporting their personal development. Staff training records were good and showed that staff are able to access a wide range of training opportunities. Good, clear records were kept of all staff training. Staff spoken with said that the quality of training within the home was 61 New Road DS0000012358.V328148.R01.S.doc Version 5.2 Page 19 very good and that it was quite freely available. They felt that the organisation supported them well in having the skills to do their job. Staff interaction with service users in the home was extremely good and demonstrated that staff receive very good training in communication, dealing with difficult behaviours, supporting service users to be in control of their own lives and encouraging personal development. Staff records showed that all necessary pre-employment checks were carried out on each member of staff prior to them beginning work in the home. 61 New Road DS0000012358.V328148.R01.S.doc Version 5.2 Page 20 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): 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. Service users are protected by the home’s Health and Safety policies and practices. Their views are fully considered within the home’s quality assurance processes. Service users would benefit further from consistent management of the service. EVIDENCE: The manager of the home was on unavailable at the time of the inspection visit. She has been in post for about a year but is not yet registered as the Commission for Social Care Inspection has not yet received an application from her. The Area Manager explained that there had been some delay with the 61 New Road DS0000012358.V328148.R01.S.doc Version 5.2 Page 21 application but that it was now almost ready to be submitted. Throughout the course of the inspection visit there were some concerns about the management of the home over recent months. There was evidence of some deterioration in some areas. The care plans and risk assessments of service users were not being reviewed as regularly as they had been and staff had not been receiving support and supervision. Staff spoken with said that staff morale in the home was currently very low and that they felt unsupported. There had only been three staff meetings in the previous year and the last one was in June 2006. The Area Manager identified a range of quality assurance methods employed in the home including regular monthly visits from senior managers, regular questionnaires for service users, families and other professionals, input from service user meetings as well as individual service user input through the care planning process and through daily activities, behaviour and discussions. The quality assurance system continues to develop and improve and is used to inform the development of the service. All staff had received health and safety training and workplace risk assessments were in place and regularly reviewed. Staff had signed to say that they had read and understood these assessments. Records were kept to show that all equipment was regularly serviced. All accident and incident records were clear and the manager regularly monitored and reviewed these in order to look for patterns and plan to decrease future occurrence of these. 61 New Road DS0000012358.V328148.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME 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 1 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 2 3 X 2 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 1 X 3 X X 3 X 61 New Road DS0000012358.V328148.R01.S.doc Version 5.2 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 3 4 5 5 Standard YA6 YA9 YA20 YA23 Regulation 15 13 13 17 17 Care Standards Act Sections 11 & 12 Requirement Care Plans must be kept under regular review Risk assessments must be kept under regular review All medication administered in the home must be properly recorded Accurate and up-to-date records must be kept for service users’ finances Current financial records must be reviewed and new, adequate procedures put in place. An application to register a manager must be submitted to the Commission. Timescale for action 26/02/07 26/02/07 05/01/07 26/02/07 26/02/07 15/03/07 YA23 YA37 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.V328148.R01.S.doc Version 5.2 Page 24 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.V328148.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!