Inspection on 23/11/06 for 7 Eggars Close

This inspection was carried out on 23rd November 2006.

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

7 Eggars Close 17/01/06

7 Eggars Close 29/07/05

7 Eggars Close 24/09/04

7 Eggars Close 20/04/04

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

CARE HOME ADULTS 18-65 7 Eggars Close Alton Hampshire GU34 2UX Lead Inspector Mr Ian Craig Unannounced Inspection 23rd November 2006 12:00 7 Eggars Close DS0000012064.V317497.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 7 Eggars Close DS0000012064.V317497.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. 7 Eggars Close DS0000012064.V317497.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 7 Eggars Close Address Alton Hampshire GU34 2UX 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) 01420 80730 01420 80730 h4moosfielder@mencap.org.uk www.mencap.org.uk Royal Mencap Society Mrs Olwyn Eileen Fielder Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 7 Eggars Close DS0000012064.V317497.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th January 2006 Brief Description of the Service: 7 Eggars Close is a small residential service providing care and support to four younger adults with a learning disability. The care and support is provided by MENCAP and the building is owned by a housing association that is responsible for the maintenance of the property. Staff are provided twenty-four hours a day to support the needs of service users. The home is located in a residential estate and is a short distance from the shops in the town of Alton in a semi-rural part of Hampshire. The home’s weekly fees range from £638.20 to £1007.39. 7 Eggars Close DS0000012064.V317497.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection consisted of a tour of the building, discussions and interviews with the staff on duty, conversation with one of the residents, and examination of records, documents and policies. What the service does well: What has improved since the last inspection? 7 Eggars Close DS0000012064.V317497.R01.S.doc Version 5.2 Page 6 The home continues to update its policies and procedures and to address the training needs of staff. 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. 7 Eggars Close DS0000012064.V317497.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 7 Eggars Close DS0000012064.V317497.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Services users needs are reassessed to ensure that care and lifestyle needs are met. EVIDENCE: The home has not admitted any new service users since the last inspection. Records show that the home has a process for reviewing and updating the current resident’s individual assessments of need and care plans. Residents are involved in reviewing their needs and sign an acknowledgement of this. 7 Eggars Close DS0000012064.V317497.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessments of need and written care plans for each resident are of a very good standard. Service users are able to make decisions about their lives, but could be more involved in participating in the home’s operation. EVIDENCE: For each resident there are comprehensive recorded assessments of need and accompanying care plans. These address personal and health care needs, as well as social and leisure preferences. A key worker system is used whereby each resident has a monthly review with his or her key worker. This is recorded and the resident signs a record to acknowledge his or her agreement to the review. Care plans are particularly good regarding attention to detail, and, the range of needs covered. Specific guidelines for care staff are recorded in a format that is easily understood. These include support for activities such 7 Eggars Close DS0000012064.V317497.R01.S.doc Version 5.2 Page 10 as going out, working in the kitchen (food preparation), bathing, personal care and assistance with finances. Areas of resident’s needs that present an element of ‘risk’ are clearly detailed with corresponding guidance for staff to follow to minimise ‘risk.’ Where there is recognised ‘challenging’ behaviour, care plans set out the intervention and approach that staff should take. Case records also demonstrate that resident’s rights are upheld. For instance, a record is made to show that each person has been offered a key to his or her bedroom door. Residents are able to make decisions about how they spend their time and the activities they wish to pursue. For instance, the residents help devise the menu plan with the support and guidance of staff to ensure a healthy diet. Residents have their own meetings to discuss matters about the home and information is provided to each person in an understandable format e.g. complaints procedure. Each service user’s views about life at the home are obtained and recorded in a survey form, which is presented in a pictorial format so that it is easier to understand. This is an example of good practice. There is scope for the involvement of residents in the home’s operation to be developed further. 7 Eggars Close DS0000012064.V317497.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 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. Residents have opportunities for developing personal living skills as well as taking part in a variety of suitable activities. A healthy diet is provided. EVIDENCE: From conversations with staff and a resident, as well from records, it is clear that each resident has the opportunity to develop their own interests, and to maintain links with family members. A resident described how he/she likes to go to the shops with staff as well as attending a variety of theatre performances at several different theatres in the area. In addition to this, he/she also described participation in voluntary work with a conservation group 7 Eggars Close DS0000012064.V317497.R01.S.doc Version 5.2 Page 12 at weekends. Residents described spending time with relatives and working with staff in the home’s garden. Residents also attend day centre activities, go shopping with staff, and have trips out to the pub and go for walks. Family and community links are maintained. Each resident has the opportunity of a holiday, accompanied by staff, at places such as Butlin’s and a south coast caravan park. Residents were observed using the communal facilities of the home. One resident was completing jigsaw puzzles and word games whilst watching television. The home helps residents to choose meals and snacks whilst also trying to ensure that a healthy, balanced diet is provided. Each resident’s weight is monitored and the input of a dietician is sought when appropriate. Food stocks included fresh fruit. 7 Eggars Close DS0000012064.V317497.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ personal and health care needs are met. EVIDENCE: Care plans record in detail how each person’s personal care needs are to be met. These include the resident being supported to develop and maintain their independence. Health care needs are also assessed with corresponding care plans to show how these needs are being met. A resident described how he/she is assisted when attending hospital appointments. Records also showed that residents are supported when attending medical appointments. Medication procedures were examined and found to be satisfactory. Care plans clearly describe the circumstances when medication “as required” should be administered. Records were signed by staff to show that medication was being 7 Eggars Close DS0000012064.V317497.R01.S.doc Version 5.2 Page 14 dispensed as prescribed. The home has policies and procedures for the safekeeping, handling, recording and administration of medication. Staff confirmed that they attend a one-day training course in medication procedures and this was also supported by training certificates for each staff member. 7 Eggars Close DS0000012064.V317497.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home takes steps to ensure that residents’ views, including, complaints are acted upon, and that service users are protected. EVIDENCE: The complaints procedure is contained in each resident’s case records, and is in pictorial format to aid communication. It is also constructed in such a way that it can be used with the resident to record their views and so that complaints can be recorded and dealt with. There were several examples where the home had used these to record complaints and concerns. An additional record is also maintained of any complaint and how the complaint was handled. Staff receive training in dealing with any challenging behaviour where there may be physical contact. This training is accredited by the British Institute of Learning Disability. Specific strategies for staff to follow for recognised behaviour are recorded in individual resident’s care plans. The home has copies of policies and procedures regarding the prevention of possible abuse. There has been effective liaison by the home with those agencies responsible for dealing with adult protection. 7 Eggars Close DS0000012064.V317497.R01.S.doc Version 5.2 Page 16 There are procedures for dealing with any resident’s finances, which include a system of recording and obtaining receipts. Residents are assisted to deposit and withdraw money from their bank accounts. 7 Eggars Close DS0000012064.V317497.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a clean, homely and well-maintained environment. EVIDENCE: The home was found to be clean, well maintained and comfortable. In certain areas there are signs of wear and tear. There is a maintenance schedule to address any repairs, redecoration and so on. Each resident has his or her own bedroom. These have been personalised by the residents. The home promotes residents having privacy by providing the option of a bedroom door key. One resident chooses to lock his/her bedroom door. 7 Eggars Close DS0000012064.V317497.R01.S.doc Version 5.2 Page 18 Residents were observed using the communal areas to eat in or to watch television. One resident described how much he enjoys working in the home’s garden. Toilets and bathrooms are clean and pleasantly decorated. 7 Eggars Close DS0000012064.V317497.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Services users benefit from a well-trained staff team and are protected by the home’s recruitment and induction procedures. EVIDENCE: At the time of the inspection there were 2 care staff on duty, one of whom was completing an induction course, as he/she is a relatively new employee. The home provides two care staff from 12pm to 9.30pm each day, and one staff member at other times, including a sleep-in staff member at night. Provision of these staffing levels was confirmed by the staff rota, discussions with staff and from observation. Staff have access to a variety of training courses. These include the following: medication, first aid, infection control, moving and handling, epilepsy, adult protection, communication, NVQ, challenging behaviour and Person Centred Planning. Staff confirmed attendance at these courses, and this was supported by training records and certificates. 7 Eggars Close DS0000012064.V317497.R01.S.doc Version 5.2 Page 20 Newly appointed staff undergo a thorough induction before working alone. This was confirmed from discussions with a staff member who was in the process of being inducted. He/she described the induction as structured, with work sheets to complete and an assessment of competency. The process lasts six weeks when the new staff member is supernumerary to the staff on duty. Any shortfalls in staffing can be covered by the use of staff from the organisation’s own relief pool of staff. There is an abbreviated induction procedure for these staff. In order to provide continuity, the home tends to use the same relief staff. These staff also have access to the organisation’s training programme. It was confirmed from discussions with staff, and from staff records, that regular staff supervision sessions take place as well as performance appraisals. Recruitment procedures include appropriate checks on newly appointed staff such as Criminal Record Bureau and Protection of Vulnerable Adults checks, references and a formal interview. This was confirmed from staff records and from discussion with a staff member. Staff described their motivations for working with the service users, which included satisfaction at working to improve the quality of life for the residents. A resident described the staff as “good.” 7 Eggars Close DS0000012064.V317497.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and there are systems to check that it operates in the best interests of the residents. EVIDENCE: There are various systems used to checks differing aspects of the home’s operation. These range from addressing wear and tear on the environment, routine servicing, reviewing care plans and residents’ needs. The views of residents are integral with clear ‘user friendly’ complaints procedures and surveys being used on a regular basis. 7 Eggars Close DS0000012064.V317497.R01.S.doc Version 5.2 Page 22 There are monitoring procedures, servicing routines and staff training to promote health and safety. These include regular checks on the hot bathing water temperature to prevent residents being scalded. All staff receive training in the following: first aid, food hygiene, moving and handling and infection control. Certificates were available to show that equipment is serviced by qualified personnel. The fire logbook and maintenance receipts showed that the fire safety procedures are followed. 7 Eggars Close DS0000012064.V317497.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X 7 Eggars Close DS0000012064.V317497.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action 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 7 Eggars Close DS0000012064.V317497.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 7 Eggars Close DS0000012064.V317497.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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