Inspection on 02/06/05 for 64 Farlington Road

This inspection was carried out on 2nd June 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 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 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 18/11/05

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 Address 3 PO2 7HU Lead Inspector Ian Craig Unannounced 2 June 2005 9:00 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 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 Stationary 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 H55-H03 S11686 64 Farlington Road V220239 020605.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 64 Farlington Road Address North End, Portsmouth PO2 7HU Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 023 9243 1941 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 H55-H03 S11686 64 Farlington Road V220239 020605.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Service users in the category LD are only to be admitted between the age of 20 and 45 years Date of last inspection 5/10/04 Brief Description of the Service: 64 Farlington Road provides care and accommodation for up to three adults with a learning disability. Staffing is provided on a 24 hour per day basis in order to meet the needs of the service users. There are times, however, when staff are not present in the home, as service users are attending activities outside the home. The home has close links with local social services care management teams. The home 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 service users accessing a variety of social, leisure and occupational activities. 64 Farlington Road H55-H03 S11686 64 Farlington Road V220239 020605.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced. Assistance was given by the home’s manager, Mrs. Walsh, and by one of the staff members. All three residents were spoken to during the visit and the inspector had the opportunity to meet a relative of one of the resident’s. What the service does well: What has improved since the last inspection? What they could do better: 64 Farlington Road H55-H03 S11686 64 Farlington Road V220239 020605.doc Version 1.30 Page 6 Residents attend a wide range of social and leisure activities, but this varies from person to person. Records did not show that all residents social and leisure needs were being assessed or that there are opportunities to attend leisure and social activities. Whilst each resident has a care plan and needs are reassessed on a regular basis, the home needs to implement a system whereby resident’s take an active part in their assessments and care plans. Additional recording is needed to clearly set out whether or not individual residents can go out alone safely. Staff records need to be securely stored. 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 H55-H03 S11686 64 Farlington Road V220239 020605.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection 64 Farlington Road H55-H03 S11686 64 Farlington Road V220239 020605.doc Version 1.30 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 standard(s) 2 Several of the standards in this section are not relevant as the same residents have lived at the home for more than five years. Whilst assessments of need and care plans had been recorded for each resident, the home could not demonstrate that social and leisure needs were being assessed for one resident. EVIDENCE: The home has not admitted any new residents for several years now. Assessments of need and care plans are recorded for each resident. These address care, and ‘lifestyle’ needs, such as hobbies, activities etc. From examination of assessments of need and care plans, it was clear that one resident’s ‘lifestyle’ needs were not being fully assessed. Daily running records did not show that leisure activities were being provided. 64 Farlington Road H55-H03 S11686 64 Farlington Road V220239 020605.doc Version 1.30 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 standard(s) 6, 7, 8 and 9 The home continues to improve the written assessments and care plans for each resident. However, additional information is needed regarding leisure needs for one person. Residents participate in many of the decision making processes in the home, but the home needs to involve residents in the assessment and care planning process. There is a system for ensuring that residents’ independence is promoted whilst safeguards are maintained, using risk assessments, although additional details are needed. EVIDENCE: Assessments, care plans and daily running records were examined for all three residents. These cover personal and health care needs, domestic tasks, daily routines, money management, procedures for dealing with aggression, etc. The assessment of risk for activities where risk is identified was examined. These were generally of a good standard and included use of public transport, going out, use of kitchen equipment, road safety etc. Written guidelines were recorded for staff to follow. There are two areas of this recording that need to be improved: firstly, several of the ‘ safeguards and risk management’ records had not been signed or dated by the person completing them, and, secondly, where it was known by staff that a resident must not go out unaccompanied, this was not recorded. 64 Farlington Road H55-H03 S11686 64 Farlington Road V220239 020605.doc Version 1.30 Page 10 The home also needs to develop a system whereby resident’s are directly involved in the assessment and care planning process. This has been raised in a previous report. A resident showed the inspector how meals are chosen by the people who reside at the home. This involves recipe and cookbooks, which the residents use to choose the food they would like to eat. Residents also help choose food when they accompany staff to the shops. The home uses a system to obtain feedback from residents by way of a survey. 64 Farlington Road H55-H03 S11686 64 Farlington Road V220239 020605.doc Version 1.30 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 standard(s) 11, 12, 13, 14, 15, 16 and 17 Residents benefit from a range of educational, social, and work related activities. There are opportunities for residents to get involved in domestic routines. For leisure activities there is a wide variance in what is being arranged for the residents, and the home needs to address this in order to show that each resident has opportunities for undertaking leisure pursuits. Residents choose food for the home’s menu plan. EVIDENCE: One resident has a specific ‘outreach’ worker funded by social services in order that leisure activities are arranged, such as, swimming, pub lunches, sightseeing trips to London, shopping etc. All residents attend day service activities. All three residents attend educational and occupational activities, including college courses in computing, cookery, numeracy, and crafts. Certificates of achievement in local history and arts and crafts were available. Residents are able to develop independent living skills in the home, such as cooking and other domestic tasks. One resident has completed a course in independent living skills. Residents described how they help with cooking and were observed making use of the kitchen facilities. Residents make use of local facilities such as the pub, cafes and shops. 64 Farlington Road H55-H03 S11686 64 Farlington Road V220239 020605.doc Version 1.30 Page 12 A number of leisure pursuits are undertaken including live concerts, social clubs and holidays. Residents described how they enjoy watching the music channel on cable television as well as listening to music on hi fi equipment in their respective bedroom or on a CD ‘walkman.’ It was evident that one resident undertakes considerably fewer activities and that his/her leisure needs had not been fully assessed. There was little to no evidence in the daily running records of activities apart from those provided by the person’s family. Residents maintain links with family members. At the time of the inspection a resident’s family were paying a visit. A resident described how meals are chosen. The home has a menu plan. Fresh fruit was available in a bowl on the dining room table. 64 Farlington Road H55-H03 S11686 64 Farlington Road V220239 020605.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 and 20 Residents’ personal and health care needs are met. The home has made progress in taking steps to introduce a more effective system of handling medication. EVIDENCE: The home maintains a system of recording which shows that each resident receives appropriate annual health checks, specialist health appointments, as well as eyesight and dental examinations/treatment. Personal support needs are also recorded. A resident was able to confirm that he/she is able to choose activities and routines according to personal preference. Medication procedures were examined. At the time of the inspection this involved a system of predispensing from the pharmacist’s container into dossett boxes. Appropriate records of this are maintained as well as each time medication is dispensed to the resident. Arrangements have been made for the supply of medication by the pharmacist in cassettes, so that the home will not need to predispense medication. 64 Farlington Road H55-H03 S11686 64 Farlington Road V220239 020605.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 The home places residents’ safety as a priority. Progress has been made to ensure that the records for resident’s monies are accurately maintained. EVIDENCE: The home has copies of the local authority adult protection procedure. Staff have not completed training in adult protection, but the home intends to arrange this soon. Key staff members have attended training courses in restraint; this needs to be extended to all staff. There are clear guidelines for staff to follow in dealing with challenging behaviour. Procedures for handling resident’s monies were examined. Accurate records were maintained and these tallied with the amounts held. 64 Farlington Road H55-H03 S11686 64 Farlington Road V220239 020605.doc Version 1.30 Page 15 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 standard(s) None of the standards in this section were assessed. These will be included in the next inspection. EVIDENCE: 64 Farlington Road H55-H03 S11686 64 Farlington Road V220239 020605.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34, 35 and 36 Progress has been made to increase the staffing levels. Recruitment procedures for newly appointed staff were found to be thorough. Staff have access to training courses including national vocational qualifications. A system of formal staff supervision has been introduced. EVIDENCE: The staff rota was examined. This showed the provision of 153.5 care staff hours for the week commencing 5th. June 2005. During periods when residents are absent from the home, such as when attending day centres, the home may not have staff on duty. There is a minimum of at least one staff member on duty and two staff at other times. The staff group is relatively small, comprising of five staff and the manager. This allows residents and staff a degree of contact not possible in a larger home. Staff were observed to treat residents with warmth. Residents stated how much they like the staff. Recruitment procedures were examined for a newly appointed staff member. These were satisfactory and included all the required identity checks, criminal record bureau check, references etc. Training opportunities exist for staff. These were examined for one staff member. This person is completing NVQ level 2 and has completed first aid as well as induction training in the last year. Two staff have also attended a 64 Farlington Road H55-H03 S11686 64 Farlington Road V220239 020605.doc Version 1.30 Page 17 training course on future government policies for people with learning difficulties. Staff training will be examined in greater detail at the next inspection. A system of staff supervision has been implemented. Records for this were not available as they were held at Norlin House; a nearby home also run by Independent Care (Portsmouth) Ltd. and managed by Mrs. Walsh. A staff member confirmed that formal supervision now takes place and that record is made of each supervision session. Evidence of supervision records will be examined again at the next inspection. 64 Farlington Road H55-H03 S11686 64 Farlington Road V220239 020605.doc Version 1.30 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 41 There was a lack of security in the storage of records that contravened policies of confidentiality and data protection. EVIDENCE: Confidential staff records were stored collectively in a locked cupboard that all staff had access to. These records need to be stored securely and in manner that is confidential to the individual staff member. 64 Farlington Road H55-H03 S11686 64 Farlington Road V220239 020605.doc Version 1.30 Page 19 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 2 x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 3 3 3 2 3 3 3 Standard No 31 32 33 34 35 36 Score x x 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 64 Farlington Road Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x 2 x x H55-H03 S11686 64 Farlington Road V220239 020605.doc Version 1.30 Page 20 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. Standard 6 Regulation 15 (2) Requirement Residents must be consulted during the assessment and care plan process. The home must be able to demonstrate that this has taken place. The staff member completing the risk assessment guidelines must sign and date these records. Risk assessments must clearly state whether or not residents can go out alone safely. Individual residents leisure 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. Staff records must be securely stored, and in accordance with data protection guidelines. Timescale for action 2nd. September 2005 2nd. August 2005 2. 9 and 6 13 (4) (a) (b) (c) 3. 6 and 14 12 (1) 14 and 15 2nd. September 2005 4. 41 17 (1) (b) 2nd. July 2005 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 Good Practice Recommendations H55-H03 S11686 64 Farlington Road V220239 020605.doc Version 1.30 Page 21 64 Farlington Road Standard 1. 64 Farlington Road H55-H03 S11686 64 Farlington Road V220239 020605.doc Version 1.30 Page 22 Commission for Social Care Inspection 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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