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Inspection on 12/09/08 for 7 Newgate Lane

Also see our care home review for 7 Newgate Lane for more information

This inspection was carried out on 12th September 2008.

CSCI found this care home to be providing an Adequate 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 7 Newgate Lane 7 Newgate Lane Fareham Hampshire PO14 1BQ one star adequate service The quality rating for this care home is: 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: Craig Willis Date: 1 2 0 9 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. They reflect the things that people have said are important to them: 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 27 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 27 Information about the care home Name of care home: Address: 7 Newgate Lane 7 Newgate Lane Fareham Hampshire PO14 1BQ 01329 667041 01329 667041 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Community Integrated Care Mrs Lin Cowdrey care home 4 Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 4 4 4 0 learning disability physical disability Additional conditions: Date of last inspection 1 2 0 9 2 0 0 8 Care Homes for Adults (18-65 years) Page 4 of 27 A bit about the care home 7 Newgate Lane is a care home that offers care for up to four people who have a learning disability and sensory disability. The property is owned by Knightstone Housing Association and is managed by Community Integrated Care. The home is situated in a residential area near to the town of Fareham and the village of Stubbington. The home has easy access to local recreational and health care facilities. The placement fee for this service is currently 1080.52 pounds per week. Care Homes for Adults (18-65 years) Page 5 of 27 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: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 27 How we did our inspection: This is what the inspector did when they were at the care home A site visit was made to the home on 12 September 2008. During the visit we spoke with one person who lives in the home. Due to the communication needs of the other people who live in the home we did not have direct conversations with them, but observed their interactions with staff. We also spoke with the deputy manager and staff on duty. We received surveys from three relatives completed on behalf of people who live in the home and six staff. The communal areas of the building were viewed and documents relating to the running of the home were inspected during the visit. What the care home does well Peoples needs are set out in clear care plans. People are involved in making decisions about their lives and the plans help staff provide the support that people need. Care Homes for Adults (18-65 years) Page 7 of 27 People are supported to take part in a range of activities they enjoy and to keep in contact with family and friends. The home is well maintained and provides a clean, comfortable and safe environment for people. Staff are well trained and there are good systems to check staff before they work in the home. This helps to keep people safe and ensure staff can meet their needs. What has got better from the last inspection Care Homes for Adults (18-65 years) Page 8 of 27 The care plans now contain clear information about the support people need if they become aggressive. Staff have received additional medication training and medication is being checked when it is received from the pharmacist. What the care home could do better The manager needs to make sure staff always make a record when they support people to take their medication. Care Homes for Adults (18-65 years) Page 9 of 27 The fire alarm must be tested each week. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Craig Willis The Oast Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 01622724950 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.southeast@csci.gsi.gov.uk or by Care Homes for Adults (18-65 years) Page 10 of 27 telephoning our order line - Care Homes for Adults (18-65 years) Page 11 of 27 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 12 of 27 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 . There are good systems to assess peoples needs before they move into the home. This reassures people that the home will be able to meet their needs. Evidence: The manager reported in the annual quality assurance assessment for us that no one has moved into the home since the last inspection. The records of two people were inspected during the visit and demonstrated that there was a comprehensive assessment of their needs before they moved into the home, which is regularly reviewed to ensure it remains accurate. The home has procedures in place to assess peoples needs before they move into the home and support the person to settle into their new home. There is a guide to the services that are provided in the home that is available in pictorial and audio versions to aid understanding. Care Homes for Adults (18-65 years) Page 13 of 27 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 . There are good care planning and risk assessment systems, which involve people in making decisions about their lives and helps staff to provide the support that people need. Evidence: The records of two people who live in the home were inspected during the visit. People had a care and support plan, which set out how their assessed needs should be met. The plans seen contained detailed information about how staff should provide support to meet peoples needs and aspirations. Plans are regularly reviewed and there was evidence that plans had been amended where peoples needs have changed. A requirement was made following the last inspection that there must be guidelines in place covering the support people need when they are being physically aggressive. Detailed guidelines were seen in one of the plans inspected, setting out how the person should be removed from the situation by being escorted to another room. This requirement has been met. People who live in the home are involved in the process of developing and reviewing their plans and they are able to invite other people to planning meetings for support. The plans have been made available in audio format for Care Homes for Adults (18-65 years) Page 14 of 27 people with a visual impairment. Six staff completed a survey for us and all said they received up to date information about peoples needs. Details of how people should be supported to make decisions are set out in the care and support plans. Three relatives who completed a survey on behalf of people who live in the home said people are either able to make some decisions themselves or are supported to make decisions due to the level of their disability. The plans seen contained information about the way people communicate. Risk assessments have been completed for all people living in the home and include clear information about how to minimise the identified hazards. These assessments are regularly reviewed and have been amended where assessed as necessary. Staff spoken with demonstrated a good understanding of peoples needs and the importance of supporting people to make decisions about their lives. Care Homes for Adults (18-65 years) Page 15 of 27 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 . The home provides good support for people to take part in a range of activities, to maintain contact with family and friends and to maintain a healthy diet. Evidence: People are supported to take part in a range of activities including day services, visits to the local library, shopping, using a sensory room and cooking. People have an individual programme of activities, which is based on their needs and wishes. The home has a minibus that is used to support people to travel to their activities. People are supported to maintain contact with their friends and family, with staff providing support for people to visit family where necessary. The home has a menu, which is planned every week and incorporates peoples choices and known likes. The kitchen was well stocked and alternative meals are available if people do not like what is on the menu. Mealtimes are flexible to fit round activities and snacks are available at any time. Care Homes for Adults (18-65 years) Page 16 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Peoples personal and health care is well met by staff who know their needs. There are systems to store and administer peoples medication, however they are not always followed which does not demonstrate that medication is being managed safely. Evidence: Care plans contain details of the personal care support people need and how it should be provided. Three relatives who completed a survey on behalf of people who live in the home said staff always treat people well and two said staff always listen to them and act on what they say. People are supported to attend a range of health services, including GP, nurse, dentist, chiropodist and optician. Details of consultations are recorded, including any advice given by the practitioner. People who live in the home have been supported to complete a health action plan that assesses whether they are receiving the health services they need. Medication is stored in a locked cabinet in the office and most tablets are supplied in blister packs. A record is kept of medication coming into the home and returned to the pharmacist for disposal. A requirement was made following the last inspection that staff must receive updated training on the safe handling of medication and medication must be checked on receipt. Records indicated medication was checked each month when it was delivered and staff confirmed that they have all received additional Care Homes for Adults (18-65 years) Page 17 of 27 training since the last inspection. This requirement has been met. The medication administration record for the current month was inspected. This record had twelve gaps where medication had been prescribed but there was no record that it had been administered. The medication for these twelve incidents had been removed from the blister pack, so it appeared that the medication had been administered, however this could not be demonstrated. The issue of medication not being signed for when administered was raised in a staff meeting on 28/5/08, however this has not resulted in an improvement. Where people have been prescribed medication to be taken as required there are clear guidelines in place stating under what circumstances the medication should be administered. Staff reported that none of the people who live in the home are currently able to manage their own medication. Care Homes for Adults (18-65 years) Page 18 of 27 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 are good systems for dealing with complaints and responding to allegations of abuse, which gives people confidence that any complaints will be taken seriously and responded to. Evidence: The home has a complaints procedure, which is provided to all people living in the home in a pictorial and audio format to make it more accessible. The survey responses completed by relatives on behalf of people who live in the home indicated people are able to communicate if they are unhappy about something and that relatives have been made aware of the complaints procedure. The manager reported that the home has not received any complaints in the last year. We have not received any complaints about the home since the last inspection. Staff have completed training in keeping people safe from abuse. Staff spoken with demonstrated a good understanding of the action they should take if abuse is witnessed, reported or suspected. There is a policy and procedure on safeguarding adults and the prevention of abuse. CIC is the appointee for all four people who live in the home. The financial records of two people were inspected during the visit. There was clear information about the money held in the home, with records of expenditure, receipts and regular checks of the money. The money is individually stored in a locked cupboard and the balance recorded matched the cash held. Staff reported that the accounts are operated by head office. The manager reported after the inspection that she has statements of all accounts operated on behalf of people, although these are kept locked and staff do not have access to them. These statements were not inspected during the visit. Care Homes for Adults (18-65 years) Page 19 of 27 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 . The home is well maintained and provides a clean, comfortable and safe environment for people. Evidence: All of the homes communal areas were viewed during the visit. The home is well maintained, with good quality domestic furniture and fittings. People living in the home have access to a lounge, dining room, kitchen and garden. There is a planned maintenance and renewal programme. The manager reported that the carpet in the dining room and one bedroom has been replaced with vinyl to enable it to be cleaned more effectively. The home has a separate laundry room that is fitted with machines capable of washing soiled clothing. The home is clean throughout. Hand washing facilities are suitably situated in the kitchen, laundry, toilets and bathroom. The home has infection control procedures and staff have received infection control training. All three relatives who completed a survey on behalf of people who live there said the home is always clean and fresh. Care Homes for Adults (18-65 years) Page 20 of 27 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 . Staff are well trained and there are good systems to check staff before they work in the home. This helps to keep people safe and ensure staff can meet their needs. Evidence: The manager reported that three of the eight staff have achieved the National Vocational Qualification (NVQ) at level 2 or above and two are currently completing the award. Staff members were observed spending time listening to people and responding to requests for support. Staff spoken with said they felt there were enough staff to provide the support people need. The manager reported in the annual quality assurance assessment that all staff who have worked in the home over the last year have had satisfactory pre-employment checks. The files of two members of staff who started working in the home since our last visit were inspected. The files had written references, confirmation that a criminal records bureau (CRB) disclosure had been obtained and that the person was not on the protection of vulnerable adults list as unsuitable to work in a care home. The home has an on-going training programme and staff reported that they receive good training, which helps them meet peoples needs. Staff training records indicated people had completed an induction and courses including medication administration, first aid, safeguarding, food hygiene, crisis prevention and intervention, moving and handling and fire safety. All six staff who completed a survey for us said they received training which is relevant to their role, helps them meet peoples individual needs and keeps them up to date with new ways of working. Care Homes for Adults (18-65 years) Page 21 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home has management systems in place to assess the quality of the service being provided, however, these have not ensured that shortfalls in the service are identified and resolved. Evidence: The manager has been in post for eleven years and has completed the registered managers award. Staff spoken with said they thought the manager was supportive. A service manager from CIC visits the home every month and assesses the quality of the service that is being provided. Reports of these visits are made and sent to the manager and contain a list of any actions that are needed. The most recent report was inspected and did not contain any information about the gaps in the medication records. CIC completes an annual survey of people who use their services, relatives and professionals who have contact with the services. The results of the surveys are collated and presented to people who use the services. The manager reported she was looking into ways of supporting people with communication difficulties to be more involved in the surveys. Records of the servicing and testing of the fire alarm, fire fighting equipment, hoists and gas system were inspected. These were mostly up to date, however, the fire alarm Care Homes for Adults (18-65 years) Page 22 of 27 had not been tested each week on a regular basis. Records showed the fire alarm was tested three times in August 2008, once in July 2008, three times in June 2008, once in May 2008 and twice in April 2008. The lack of tests had not been recorded in the monthly report from the service manager. Care Homes for Adults (18-65 years) Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes  No  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 24 of 27 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 Description 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 Description Timescale for action 1 20 13 The registered person must 31/10/2008 ensure that accurate records are made when medication is administered to people who live in the home This is needed to ensure people receive the medication they have been prescribed safely. 2 42 23 The registered person must ensure that the fire alarm is tested weekly. 31/10/2008 This is needed to ensure that the fire alarm is working effectively. 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 25 of 27 Care Homes for Adults (18-65 years) Page 26 of 27 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. 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. Care Homes for Adults (18-65 years) Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!