Inspection on 18/11/05 for 64 Farlington Road

This inspection was carried out on 18th November 2005.

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

Other inspections for this house

64 Farlington Road 19/08/08

64 Farlington Road 27/02/08

64 Farlington Road 05/09/07

64 Farlington Road 15/02/07

64 Farlington Road 16/10/06

64 Farlington Road 02/06/05

64 Farlington Road 05/10/04

64 Farlington Road 21/05/04

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

CARE HOME ADULTS 18-65 64 Farlington Road North End Portsmouth Hampshire PO2 7HU Lead Inspector Ian Craig Unannounced Inspection 18th November 2005 15:20 64 Farlington Road DS0000011686.V254106.R01.S.doc Version 5.0 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 64 Farlington Road DS0000011686.V254106.R01.S.doc Version 5.0 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. 64 Farlington Road DS0000011686.V254106.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 64 Farlington Road Address North End Portsmouth Hampshire PO2 7HU 023 9243 1941 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) Independent Care (Portsmouth) Limited Mrs Linda Janice Rosa Walsh Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 64 Farlington Road DS0000011686.V254106.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users in the category LD are only to be admitted between the age of 20 and 45 years 2nd June 2005 Date of last inspection Brief Description of the Service: 64 Farlington Road provides care and accommodation for up to 3 adults with a learning disability. Staffing is provided on a 24 hour basis in order to meet the needs of the residents. There are times, however, when staff are not present in the home, as residents are attending activities outside the home. The home has close links with local social services care management teams. It is a terraced property situated in a residential area of Portsmouth. A local shopping centre, including facilities such as a cinema, is located approximately one mile from the home. There is a small rear garden. Communal areas consist of a lounge and separate kitchen/dining area. The home facilitates residents accessing a variety of social, leisure and occupational activities. 64 Farlington Road DS0000011686.V254106.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and assistance was given by a senior member of the care staff team and the registered manager. Each of the residents was spoken to during the visit. This report needs to be read in conjunction with the previous inspection report. What the service does well: What has improved since the last inspection? What they could do better: There are two requirements outstanding from the previous inspection report. The home’s physical environment is showing signs of wear and tear and the bathroom is in particular need of attention. In addition to this it was clear that 64 Farlington Road DS0000011686.V254106.R01.S.doc Version 5.0 Page 6 the bathroom had not be cleaned; both the shower tray and wash hand basin were dirty. Staffing hours have been considerably reduced since the last inspection. 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. 64 Farlington Road DS0000011686.V254106.R01.S.doc Version 5.0 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 64 Farlington Road DS0000011686.V254106.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the standards in this section were assessed at this inspection. EVIDENCE: 64 Farlington Road DS0000011686.V254106.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 and 9 Individual care plans are generally satisfactory with the exception that the home needs to actively engage residents in the process of assessment and completing the care plan. Fuller assessments of the leisure needs for one resident are needed. EVIDENCE: These standards were assessed in greater depth at the previous inspection. Progress on competing the 3 requirements made in the previous report was checked. One of these had been completed: regarding the risk assessments detailing the degree of support needed when going out alone in the community. Assessments of need and care plans, still, do not involve the residents. There is clearly scope to involve residents directly in this. The home’s manger has, at previous visits (and this one), maintained that residents do not have the ability to comprehend the care plans but are always consulted about care and activities. The inspector asked a resident if he/she would be willing to sit down and read his/her care plan and to discuss its contents. The resident replied that he/she would like to do this. 64 Farlington Road DS0000011686.V254106.R01.S.doc Version 5.0 Page 10 There is a variation in the extent of activities attended by residents, especially those related to the use of leisure time. There is an outstanding requirement for the home to assess and record a resident’s leisure needs. 64 Farlington Road DS0000011686.V254106.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 The home needs to demonstrate that each resident’s leisure needs have been fully assessed. EVIDENCE: There is an outstanding requirement for the home to assess and record the leisure needs of each resident. There is a marked variation in the leisure activities pursued by the individual residents. 64 Farlington Road DS0000011686.V254106.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 20 Records show that individual’s health needs are met. An improved system for the handling and administration of medication has been introduced. EVIDENCE: The home maintains a system of recording, which shows that each resident’s health needs are met. This includes appointments with opticians, dentists and general practitioners as well as monitoring and recording each resident’s weight at regular intervals. The procedure of predispensing medication has been replaced by a more appropriate monitored dosage system. Examination of the records and blister packs of medication showed that this was being operated satisfactorily. A revised policy and procedure needs to be recorded to reflect the new system. 64 Farlington Road DS0000011686.V254106.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 Whilst the home has a complaints procedure, residents need to be aware of how they can make a complaint. EVIDENCE: The home’s complaints procedure is displayed in the office and whilst residents were seen to walk in and out of the office the availability of the procedure to residents needs to be improved. One resident was asked if he/s he knew how to make a complaint and replied that he/she did not know. 64 Farlington Road DS0000011686.V254106.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 27, 28 and 30 The home is showing signs of wear and tear as well as the need for repairs and additional attention to routine cleaning. Hall carpets and the lounge furniture are in need of replacement. The first floor bathroom was in a particularly poor state. Residents have personalised their bedrooms. EVIDENCE: A leak from the first floor bathroom shower has caused damage to the ceiling below. The leak has been repaired and the home’s manager stated that the ceiling will be redecorated in the near future. The entrance hall was clean and tidy although the carpet is worn and will be in need of replacement in the near future. There is a lounge with a television, armchairs and sofa. This area is comfortable but the armchairs and sofa are worn and should be replaced in the near future. Bedrooms do not have wash hand basins, as this was not a minimum standard when the home registered under previous legislation. Two bedrooms were seen and these were clean and tidy, containing numerous items of personal possessions. One resident described how he/she likes his/her bedroom. 64 Farlington Road DS0000011686.V254106.R01.S.doc Version 5.0 Page 15 The first floor bathroom was in a poor state. The shower tray and wash hand basin were both very dirty. The need for the wash hand basin in the bathroom to be kept clean is underlined by the fact that the residents do not have a basin in their bedrooms. The flooring in the bathroom is also in need of replacement. The bath/shower mat was also very dirty. The ceiling of the bathroom was covered with mildew from condensation and ceiling paint was beginning to peel. The home also has a ground floor toilet. Apart from the bathroom, the rest of the home was found to be clean. At the time of the inspection the central heating system was not working properly and this was thought to be a matter of ‘bleeding ‘the radiators, which the home would be addressing. 64 Farlington Road DS0000011686.V254106.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 34 and 36 Staffing levels have been considerably reduced compared to that found at the previous inspection. The recruitment of staff is thorough. Staff are not adequately supervised. EVIDENCE: The staff rota was examined for the week commencing 13/11/05 and showed the provision of 75 care staff hours compared to a total of 153.5 at the previous inspection. The home needs to increase staff hours per week to at least a minimum of 35 hours per resident. Staff recruitment procedures were found to be thorough and documentation showed that all the checks as required by the Regulations were being carried out. Staff supervision records were not available and one of the senior carers responsible for supervision of staff stated that this takes place every 3 months when the minimum requirement is for 6 times a year. A newly appointed staff member had not received formal supervision according to the manager but had completed an induction. 64 Farlington Road DS0000011686.V254106.R01.S.doc Version 5.0 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 and 42 The home seeks the views of residents but needs to take further steps to develop an annual development plan after completing an audit of the home. Health and safety checks are carried out so ensuring that the home is safe for residents and staff. EVIDENCE: The home needs to build on the surveys of residents’ views about the home in order to meet the quality assurance standards. A system of audit and an annual development plan should be devised. Health and safety procedures were found to be satisfactory with the exception that it was unclear when the electrical wiring was last tested. Smoke detectors are tested each week and a record made. Fire extinguishers, gas heating and portable electrical appliances are all tested and serviced by qualified engineers. Staff have received training in first aid, food hygiene, infection control and moving and handling. 64 Farlington Road DS0000011686.V254106.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score 2 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X 3 1 X X 2 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 2 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X 2 3 X 2 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 64 Farlington Road Score X 3 2 X Standard No 37 38 39 40 41 42 43 Score X X 2 X X 3 X DS0000011686.V254106.R01.S.doc Version 5.0 Page 19 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA6 Regulation 15(2) Requirement Timescale for action 18/12/05 2 YA6YA14 12(1), 14 and 15 3 YA20 13(4) 4 YA24 23(2)(b) Residents must be consulted during the assessment and care plan process. The home must be able to demonstrate that this has taken place. This is outstanding from the previous inspection report. Individual residents leisure 18/12/05 needs must be assessed and recorded. Arrangements for leisure activities must be recorded and the home must be able to demonstrate that the resident has had the opportunity to take part in leisure pursuits. This is outstanding from the previous inspection report. The home must devise a written 18/01/06 procedure for the receipt, handling, recording, safekeeping, administration and disposal of medication. Written confirmation must be 30/12/05 sent to the Commission detailing dates of when repairs will be made to the following: • Ceiling area damaged by a leak from the shower • Plans to replace the bathroom floor DS0000011686.V254106.R01.S.doc Version 5.0 64 Farlington Road Page 20 5 6 7 8 YA30 YA33 YA36 YA39 23(2)(d) 18(1) (a) 18(1)© 24 Peeling and poor state of bathroom ceiling The bathroom must be kept clean, including the shower tray, wash hand basin and bath mat. Staffing level must be increased to at least a minimum of 35 hours per resident per week. Staff must receive supervision at least 6 times per year. The home must develop a quality assurance system, including a system of audit and an annual development plan. • 18/12/05 18/12/05 18/01/06 18/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 64 Farlington Road DS0000011686.V254106.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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