Inspection on 19/08/08 for 64 Farlington Road

This inspection was carried out on 19th August 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

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 18/11/05

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 08/11/2008.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 64 Farlington Road 64 Farlington Road North End Portsmouth Hampshire PO2 7HU     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: Mick Gough     Date: 1 9 0 8 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: 64 Farlington Road 64 Farlington Road North End Portsmouth Hampshire PO2 7HU 023 9243 1941 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): Type of registration: Number of places registered: Independent Care (Portsmouth) Ltd Mrs Linda Janice Rosa Walsh care home 3 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 3. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). 0 Over 65 0 Date of last inspection Brief description of the care home 64 Farlington Road is a residential home providing care, support and accommodation for up to three younger adults with learning disabilities. The home is one of a terrace of ordinary family style houses, situated in a residential area of Portsmouth. There is a public house and some local shops close to the home, and a shopping centre, which includes a cinema, approximately a mile away. The three single bedrooms for residents, each with a lockable door, are sited on the first floor. Bedrooms do not have wash hand basins. However, a communal shower room with WC and wash hand basin Care Homes for Adults (18-65 years) Page 4 of 28 is close by. The home is centrally heated and windows are double-glazed. Communal areas comprise a thru-lounge and separate kitchen/dining area. There is a small garden to the rear of the property to which the residents have access. The home is owned by Independent care (Portsmouth) Limited and managed by registered manager Mrs Linda Walsh. The home?s fees from April 2008 are #750.00 per week. 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 peterchart Concerns, complaints and protection Environment Staffing Conduct and management of the home Poor Adequate Good Excellent How we did our inspection: This report details the evaluation of the quality of the service at 64 Farlington Road and takes into account the accumulated evidence of the activity at the home since the last inspection, which was carried out in February 2008. The inspection took into account the homes Annual Quality Assurance Assessment (AQAA) that was forwarded to us prior to a site visit to the premises and this provided us with good information about the home. Included in the inspection was an unannounced site visit to the home, which took place on the 19 August 2008. Evidence for this report was obtained from reviewing the homes completed AQAA, reading and inspecting records, touring the home and from observing the interaction Care Homes for Adults (18-65 years) Page 6 of 28 between staff and users of the service. It was also possible to gain the views of the people living at the home and we had the opportunity to speak with two residents, two members of staff and the homes manager who assisted us throughout the visit. The home is registered to provide support for 3 residents who have a learning and at the time of the inspection the home was full. What the care home does well: What has improved since the last inspection? What they could do better: No requirements or recommendations have been made as a result of this visit. However, there were 3 areas identified that could improve the service for residents and these were: The recording of monthly reviews in care plans could be improved to reduce duplication and this was discussed with the homes manager who told us that she will be reviewing how monthly reviews are recorded. The homes medication cabinet was checked and this was suitable for its current purpose. present. The home does not currently hold any controlled drugs, however the law concerning the storage of controlled drugs has recently changed and the home was reminded that should there be a need for any controlled drugs to be held at the home in the future, they must be stored in a proper Controlled Drugs Cupboard. A proper Controlled Drugs cupboard is one, which meets the standard set in the Misuse of Drugs (Safe Custody) Regulations 1973. Suppliers of CD cabinets can confirm that a cupboard meets the legal requirements. At the previous site visit to the home in February it was found that the homes electrical wiring certificate had indicated that there were some defects and this resulted in the wiring being assessed as unsatisfactory. To date the defects have not been rectified despite the manager reporting this to the landlord. We have been informed since the Care Homes for Adults (18-65 years) Page 8 of 28 site visit that the landlord will be booking a contractor to investigate what work is required to bring the electrical wiring up to a satisfactory standard and we have discussed this issue with the homes manager and we will continue to monitor this situation and if necessary revisit the home to ensure that the electrical wiring is safe. 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. 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 10 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. Prospective service users aspirations and needs are assessed before they move into the home. Evidence: The homes completed AQAA told us that the home has a policy and procedure in place with regard to admissions to the home and this was seen at the last site visit. Social Service assessments are undertaken as well as the homes in house assessments. There have been no new residents to the home for over 8 years and the manager told us that any new residents would have the opportunity to visit the home, have a meal and have a weekend stay before they moved into the home to see if it would meet their 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. Residents assessed needs and personal goals are reflected in an individual plan of care and they are supported to make decision about their lives with assistance given by staff. Residents are supported to take responsible risks and this allows them to live an independent lifestyle as much as possible Evidence: Care and support plans were seen for 2 residents and these were clear and easy to follow and gave clear information for staff on what support was needed and how and when this support should be given: Both residents care plans were broken down into sections and had information on: behaviour, personal hygiene, physical health, day to day living, environment, information for going out into the community and leisure, Independence and general information. All plans were person centered and had good Care Homes for Adults (18-65 years) Page 12 of 28 information about the person. One care plan had good information about sexuality and provided good information for staff so that they could provide the support required. Another car plan had information about how to support a resident who could potentially become aggressive and this plan would benefit from updating to give clear guidance for staff on how any aggressive behaviour could be managed. Both care plans were reviewed monthly and the recording procedures were discussed with the manager who told us that she intended to review the monthly recording to reduce duplication and to involve residents in the review process. Staff are made aware of any changes through regular meetings and also via the communication book in use at the home. Daily recording takes place and there is good clear documentation to evidence care delivery. Residents are supported to make decisions about their day to day lives and staff were observed interacting with residents and taking their views into account, there was evidence in care plans of residents preferences and there was information in care notes, which showed that residents had been offered choices and also detailed the choices made. We were informed that residents views are listened to and taken into account, those residents spoke with stated that they were able to make their own decisions and that staff respected this. One comment from a service users stated the staff are very good and look after me Both residents who were case tracked had risk assessments in place and these gave details of the assumed risk and the support required and also the action staff should take to minimise the risk. 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. Residents are encouraged and supported to be part of the local community and to be involved in appropriate activities. They benefit from support to maintain social contacts and daily routines at the home respect their rights and responsibilities. Meals at the home are flexible and residents benefit from a healthy diet. Evidence: Care plans that we viewed had records of weekly routines and also records of activities undertaken on a day to day basis. Each resident attends day services, one residents is enrolled in college for 2 days a week and she told us that she is looking forward to going back to college after the summer break. Care Homes for Adults (18-65 years) Page 14 of 28 Residents have opportunities for developing personal relationships at organised social events such as Gateway Club and the home supports people with this. Residents are supported to maintain contact with family and visitors are welcome at the home at any time and there is a clear visitors policy. 2 residents have regular contact with their families and are able to visit their families at weekends. The homes menu plan is displayed in the kitchen and staff are aware of peoples likes and dislikes. Menus are made up weekly by residents with input from staff to ensure there is a balanced diet and residents told us that they decide what is included on the menu and that they can help with the shopping and cooking if they wish. The care plan for one person had good information for staff so that they could help the resident to make appropriate decisions about food and their individual health needs. residents told us that they are able to make drinks and snacks whenever they want and staff support them with this. 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. Residents receive personal support in the way they prefer and service users physical, emotional and health needs are met. The homes policies and procedures with regard to medication provide protection for service users. Evidence: Personal support is given flexibly and residents plans gave clear information to staff on how they would like their personal support to be given, All residents are able to attend to their own personal care needs with minimal support and this support is normally verbal prompts but staff will give extra support if needed. There is a mix of both male and female staff and each resident is given personal support in private and the preferences of residents on who they prefer to give them the support they need is respected. Residents at the home are registered with 2 GP surgeries and residents visit a community dentist and optician and records of all health care visits are recorded. Care Homes for Adults (18-65 years) Page 16 of 28 Residents are able to access other health care professionals such community nurses, occupational therapists and CPNs through GP referrals. The local learning disability team also provide support for residents and staff as required. The home has a medication policy and all staff have received training in the administration of medication. The home uses a monitored dose system for medication and records were inspected and found to be accurate and up to date. The homes medication cabinet was checked and this was suitable for its current purpose and the home does not currently hold any controlled drugs. The law concerning the storage of controlled drugs has recently changed and the home was reminded that should there be a need for any controlled drugs to be held at the home, they must be stored in a proper Controlled Drugs Cupboard. A proper Controlled Drugs cupboard is one, which meets the standard set in the Misuse of Drugs (Safe Custody) Regulations 1973. Suppliers of CD cabinets can confirm that a cupboard meets the legal requirements. 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. There is a clear and accessible complaints procedure, which includes timescales for the process and residents can be confident that their views would be listened to and acted upon, any complaints are logged and responded to appropriately. The home has policies and procedures to help protect residents from of abuse. Evidence: The home has a clear and accessible complaints procedure, and this is contained in the Service User Guide and contained all of the required information. The homes completed AQAA told us that there has been no complaints to the home and this was confirmed by the manager. Two staff members spoken to were aware of the complaints procedure and both said they would support residents to make a complaint if they wished to do so. Residents told us that they would make any complaints to a member of staff and they were confident that their concerns would be looked at. The home has a copy of the Hampshire Adult Protection Guidelines and has a whistle blowing policy staff also receive training with regard to adult protection and POVA as part of their induction and refresher training is carried out. Two staff members spoken to confirmed that they had received training and were aware of their responsibilities in this area. Residents spoken to said that they felt safe at the home, Care Homes for Adults (18-65 years) Page 18 of 28 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. Residents live in a homely and comfortable environment and the home is clean and hygienic and free from offensive odours. Evidence: We toured the home and this was laid out over 2 stories and was a normal terraced house. On the ground floor there is a communal lounge with comfortable seating and wide screen television, with cable channels and there is a large kitchen diner. Also on the ground floor there is an office, a utility area and a separate WC. The home has a reasonably sized enclosed rear garden with tables and chairs for residents to relax. On the upper floor there are 3 bedrooms which have been personalised by the residents and a bathroom with shower, washbasin and WC. All areas of the home were clean and furniture and fittings were of good quality and homely in appearance. The service was clean and hygienic and there were no offensive odours. The laundry is situated in the downstairs utility area and this is fitted with a domestic tumble drier and a washing machine that can wash clothing at appropriate temperatures. Residents do their own laundry and staff provide support as required. The home has an infection control policy and all staff at the home have completed Care Homes for Adults (18-65 years) Page 20 of 28 training in infection control 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. Competent, qualified and appropriately trained staff supports service users and meet their needs. The homes recruitment policy and practice protect service users. Evidence: The home employs a total of 5 care staff plus the manager and care staff carry out all domestic duties with the residents helping out if they choose to do so. There are 2 staff on duty between 0700 - 0930 and from 1500 to 2200, From 2300 to 0630 there is one member of staff on duty who sleeps in, with the manager or the deputy manager on call in case of emergency. During the day all of the residents are at day service and we were informed that should anyone not attend day service staff would be provided to support residents. Staff spoken with said that the staffing levels were sufficient and residents told us that there was always someone around to help them if they needed it. Staff at the home are supported to undertake National Vocational Qualifications. Recruitment records were seen for one new member of staff who had recently been employed by the home and all relevant recruitment checks had been carried out. We Care Homes for Adults (18-65 years) Page 22 of 28 also spoke to two members of staff who said that their recruitment was robust and that CRB checks and references were taken up before they started work at the home. The home provides good training for its staff and new staff completed an induction booklet based on skills for care guidelines. There was clear records that showed that training had been completed by staff and this included training in: Confidentiality, infection control, health and safety, 1st aid, food hygiene, fire, POVA, managing aggression, dementia, risk assessment, manual handling, challenging behaviour and medication. The homes completed AQAA and the staff training log provided evidence of staff training and staff members spoken with confirmed that they had received a good induction and said that there was regular training provided by the home. . 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 management arrangements in place at the home are satisfactory and the home is operated in the best interests of residents and effective quality assurance procedures are in place. Staff and residents are protected by the homes policies and procedures and the health, safety and welfare of residents and staff are generally protected by the arrangements in the home, however the unsatisfactory arrangements for the homes electrical wiring potentially puts residents and staff at risk. Evidence: The homes manager has been running the home for over 8 years and has completed her Registered Managers Award and is currently studying to complete the NVQ level 4 in care. She has a good knowledge of the individual and complex needs of the people who live at the home. Care Homes for Adults (18-65 years) Page 24 of 28 The home has contracted with an external company to support the management procedures and to provide effective quality assurance and questionnaires have been developed for residents, staff, relatives and other professionals and there are regular regulation 26 visits, there are also regular resident and staff meetings. The homes fire log book was inspected and all of the required training and testing is carried out and there is a fire risk assessment for the building. Certificates were up to date for the gas appliances in the home and routine maintenance and repairs are carried out by a handyman but any major work is the responsibility of the landlord who owns the building. At the last visit, the most recent electrical certificate was dated 06/12/06 and listed a number of concerns in respect of the wiring at the home with an overall rating of unsatisfactory and it was a requirement that these defects were corrected, however at this visit there was no evidence that any work had been carried out to rectify the defects, which could put residents and staff at risk. The manager has evidence that she has contacted the landlord to get the defects corrected but to date no action has been taken by the landlord. We spoke to the manager the day after the site visit who told us that she had spoken to the landlord who has told her that he is going to book a contractor to investigate what work is required to sort out the problem. We will continue to monitor this situation and arrange a further visit to the home to ensure that this issue has been satisfactorily resolved. 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 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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