Inspection on 11/11/05 for 70 and 72 Worting Road

This inspection was carried out on 11th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

70 and 72 Worting Road 17/11/08

70 and 72 Worting Road 07/12/06

70 and 72 Worting Road 12/05/05

70 and 72 Worting Road 23/11/04

70 and 72 Worting Road 12/05/04

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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 70/72 Worting Road Basingstoke Hampshire RG21 8TP Lead Inspector Ms Wendy Thomas Unannounced Inspection 11/11/05 12:00 70/72 Worting Road DS0000012277.V265006.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 70/72 Worting Road DS0000012277.V265006.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 70/72 Worting Road DS0000012277.V265006.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 70/72 Worting Road Address Basingstoke Hampshire RG21 8TP 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) 01256 844 057 Advance Housing and Support Limited Miss Catrina Jean Knapp Care Home 8 Category(ies) of Learning disability (8) registration, with number of places 70/72 Worting Road DS0000012277.V265006.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th May 2005 Brief Description of the Service: Advance Housing and Support Ltd. are the providers of care at 70/72 Worthing Road. The home comprises of two semi-detached properties that have been converted into one home, and is registered to provide care for up to eight people who have learning disabilities. Service users have a single bedroom with en-suite bathroom and have shared communal space within two lounges, two kitchens and a conservatory. There is an enclosed garden and parking facilities to the rear. The home is situated in a residential area, close to the town centre of Basingstoke and is accessible to local amenities. 70/72 Worting Road DS0000012277.V265006.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector visited the home from 12:00 to 16:30 on Friday 11 November 2005. She had in depth discussions with two service users individually, two service users together, a relative of a service user, and the acting deputy manager. The inspector had briefer discussions with two members of staff and two other service users. Three service user plans and other records were examined. When the inspector arrived two service users were in the home, the others were out attending activities and arrived home during the afternoon. One service user was away on holiday. What the service does well: What has improved since the last inspection? There had been a big improvement in the décor of the conservatory. This is the most used communal space in the home. With the new flooring, dining chairs and the curtain now at the right length it is a pleasant place for service users to eat and spend time together. The service user plans had been developed since the last inspection and now give clear information about the service user and what staff need to do to support that person. Goals have been identified that the service users are working towards. This is important in home where service users are looking to acquire skills to enable them to live more independently in the future. Several service users mentioned the desire to become more independent to the inspector. 70/72 Worting Road DS0000012277.V265006.R01.S.doc Version 5.0 Page 6 A risk assessment requested by the inspector during the last inspection had been done. 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@Commission for Social Care Inspection.gsi.gov.uk or by contacting your local Commission for Social Care Inspection office. 70/72 Worting Road DS0000012277.V265006.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 70/72 Worting Road DS0000012277.V265006.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Initial assessment clearly identifies whether the home can meet prospective service users’ needs. EVIDENCE: Two service users had been admitted to the home since the last inspection. One told the inspector they had had a number of visits to the home before moving in. Both were happy with their choice and said they liked living in the home. Their files showed that they had had initial assessments covering a number of topics including housing related support, personal care support, daily living skills, managing money, looking after their physical and mental health. There was also a sheet for assessing areas of potential risk. 70/72 Worting Road DS0000012277.V265006.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 and 9. Assessment, care planning, risk assessment and reviewing ensure that service users’ plans are up to date and that plans are established to support them to achieve their goals. EVIDENCE: The inspector examined the files of three service users. They all contained “summary care plans” which included objectives and goals. Topics covered included, showering/bathing, cleaning teeth, cooking skills, kitchen hygiene, using domestic appliances, keeping a good appearance, finance, medication, getting up routine, travel, and issues outside the home. There were “action plans” which explained in a little more detail what support was needed to achieve these goals. These had been reviewed and updated in October 2005. In house annual reviews had taken place, and on the afternoon of the inspection one service user was having a social services review to which they, their care manager, a relative and the home’s acting deputy manager attended. Because the action plans had been drawn up in October, there was not yet any monitoring in place to track the service users’ progress to achieve their identified goals. 70/72 Worting Road DS0000012277.V265006.R01.S.doc Version 5.0 Page 10 There were a number of risk issues that were assessed for all the service users whose files the inspector examined e.g. safety in the home environment, personal care, financial abuse. They all also had additional risk assessments pertinent to their individual needs. The service users spoken with were aware that records were kept about them but were not aware exactly what. Two of them looked at their service user plans with the inspector and acknowledged that some of it looked familiar and they had discussed some of it with their key workers. Each file had a recent assessment covering activities of daily living. A service user said that this had not been completed in consultation with them and they were unfamiliar with the document. Some service user files contained “personal planning books” which service users had worked through several years ago with their key-workers. These followed a “person centred planning” process and format. This format was no longer being used in the home. 70/72 Worting Road DS0000012277.V265006.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 17. Service users benefit from being encouraged to fulfil their responsibilities in the running of the home and from having their opinions sought and acted upon. Service users benefit in being involved in choosing and preparing their meals. EVIDENCE: Service users have monthly “residents meetings” where matters regarding the running of the home are discussed along with individual’s concerns about their plans and support, and any group activities to be planned such as a meal out to celebrate Christmas or a visit to the theatre. Minutes are kept of these meetings. The home’s ethos is that service users respect each other and behave appropriately towards each other and people outside the home. Service users acknowledged that they did have differences of opinion with other service users but that they liked the other members of the household. There is an expectation in the home that service users take responsibility for keeping the home clean and tidy and help to prepare meals. There are rotas in the kitchens showing who is responsible for which tasks each day. Some of the 70/72 Worting Road DS0000012277.V265006.R01.S.doc Version 5.0 Page 12 service users explained to the inspector that they hoped to move on to more independent living in the future. Service users also take a role in the recruitment of staff, with three or four of them deciding with a member of staff the questions they want to ask the candidates, and then interviewing the candidate (with the member of staff as a silent observer) after they have been interviewed by the manager and a colleague. Service users explained that they help to draw up the menu once a week, but it needs to be flexible as there isn’t always what is needed for the meal in the freezer. A service user suggested that it would be nice to have more fresh food in stock for making meals from scratch. The acting deputy manager’s perspective was that many meals were being made from scratch. Food records were being kept. A service user explained that although those living in number 70 and number 72 cook separately, they eat together in the conservatory, with staff eating in the kitchens. 70/72 Worting Road DS0000012277.V265006.R01.S.doc Version 5.0 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 the following standard(s): 18, 19 and 20. Service users’ care plans ensure that personal support is provided to them in a satisfactory way. Service users benefit from the involvement of appropriate healthcare professionals to meet their physical and emotional needs. By not having a clearly described medication procedure there is potential for the safety of storage, administration and disposal of service users’ medication to be compromised. EVIDENCE: The service users whose service user plans the inspector examined are independent in their personal care needs, with at most verbal prompts being given. This was described on their care plans. Service user plans included monitoring sheets for healthcare appointments. There were also more detailed “medical reports” giving details of the visit, the outcome, and any follow up. The previous inspection report made a requirement that a comprehensive medication policy be developed in addition to the single sheet aide memoir attached to the medication cabinet. This had not been done. The inspector 70/72 Worting Road DS0000012277.V265006.R01.S.doc Version 5.0 Page 14 saw a copy of the organisation’s medication policy and procedures, which was very comprehensive, and provided good guidance to homes. However an inhouse procedure detailing how medication is obtained, stored, administered and disposed of in the home is needed. The medication records were seen and all medication was indicated as having been given and signed for. Since the last inspection the home was using a new monitored dosage system and staff told the inspector that they found the new system much better than that used previously. A service user who administered their own medication kept this in their room. They had a lockable box, however not all the medication fitted in this and was therefore not being kept securely. This was discussed with the service user and a member of staff and it was agreed that all medication would be kept securely in future. 70/72 Worting Road DS0000012277.V265006.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Clarifying the complaints procedure and how to use it would enable service users to activate the system successfully and have reasonable expectations of the process. Training for staff about abuse and what to do if abuse is suspected would improve protection offered to theservice users. EVIDENCE: The deputy manager assured the inspector that the issue of making complaints was discussed with service users during service user meetings. The minutes of one of these meetings confirmed this. A service user confirmed that they had their own copy of the complaints procedure. Due to the feedback given by relatives on questionnaires sent out by the Commission for Social Care Inspection prior to the inspection, it was apparent that relatives were not aware of the complaint procedure. The questionnaire had prompted a relative to make enquires, and the deputy manager said that she thought all relatives had now been made aware of the procedure. A service user told the inspector that they and other service users were waiting for a response to a complaint they had recently made. When the inspector asked the manager about this in a follow up telephone call, they were not aware of the complaint. This would indicate that although work has been done with service users about making complaints, some follow up is needed as to what constitutes a complaint and how to channel it appropriately. As the manager was not on duty at the time of the inspection the inspector was not able to view the complaints log to assess whether complaints were being appropriately dealt with within the expected timescales. In the follow up 70/72 Worting Road DS0000012277.V265006.R01.S.doc Version 5.0 Page 16 telephone conversation the manager confirmed that timescales were being met. A copy of the organisation’s complaints procedure was seen. It uses plain language and clearly outlines the process of dealing with complaints. There was a copy of the Advance Housing and Support policy on “Vulnerable adults and abuse”. This was a comprehensive twenty-six-page document. There was also a copy of the Hampshire procedure relating to the protection of vulnerable adults (2002). A member of staff asked about what training they had had on the protection of vulnerable adults from abuse could not recall any. However they thought that with common sense and instinct they would know exactly what to do. It is recommended that staff have training about abuse and the action to take if abuse is suspected. 70/72 Worting Road DS0000012277.V265006.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24. Service users benefit from a homely and comfortable environment. EVIDENCE: The inspector was shown around the communal areas of the home and one service user’s flat. Following a requirement in the previous inspection report the environment in the conservatory had been greatly improved with new vinyl flooring, new dining tables, and the curtains had been shortened so they no longer dragged on the floor. The conservatory is the most used communal space where service users eat and spend time together. The two lounges were comfortable and the kitchen well decorated and provided all necessary equipment. The carpet in the hallway leading from the kitchen in number 70 was, however, in need of cleaning. The service user whose flat the inspector visited was very happy with it and had put up posters to personalise it. It was suitably furnished and equipped. A risk assessment had been carried out on the carpet in another service user’s flat following concerns raised by the inspector at the last inspection. It had been decided that the carpet did not need replacing. The inspector was also informed that another service user had had a new carpet in their room. 70/72 Worting Road DS0000012277.V265006.R01.S.doc Version 5.0 Page 18 70/72 Worting Road DS0000012277.V265006.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 and 35. Training for staff about issues and conditions pertinent to the service users enhances staff’s understanding and the care they give to service users. EVIDENCE: When asked about the staff a service user informed the inspector that they were “OK”. They commented that they were short of staff and used staff from an agency. They said that this was, “OK”. The acting deputy manager explained that two staff had left since the last inspection. The inspector was informed that Advance Housing and Support Ltd. had imposed a freeze on staff recruitment, but that the home was trying to provide continuity by using a few regular staff from the agency and staff from the home’s bank. Although staff felt that having to do training sometimes got in the way of caring for the service users, they acknowledged that most of the training they had was relevant to their role in the home. The inspector examined the staff training records and since the last inspection there had been updates on manual handling, first aid and food hygiene for those staff for whom these fell due. There had also been training about epilepsy and ongoing sessions on Makaton. Previous training that staff had had relevant to the service users in the home included, elderly clients, and Downs Syndrome. They commented that they had found this very helpful and valuable. Staff suggested that training about diabetes and mental health issues would be useful to them. 70/72 Worting Road DS0000012277.V265006.R01.S.doc Version 5.0 Page 20 Four of the five staff are qualified to a minimum of NVQ level 2. The inspector was informed that the fifth member of staff is likely to be achieving this shortly. As the home’s manager was not on duty at the time of the inspection it was not possible for the inspector to see the staff records and assess the home’s recruitment procedures. In a follow up telephone conversation the manager described a satisfactory recruitment process and confirmed that all required documentation is held in the home. It was suggested that a record was made of the date staff members’ Criminal Records Bureau checks came through. 70/72 Worting Road DS0000012277.V265006.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Service users benefit from a well run home. Ongoing training means that staff are appropriately trained and qualified to meet their needs. EVIDENCE: The administrative systems in place, the filing and arrangement of the office meant that information required by the inspector, or any staff seeking policies or clarification was readily at hand and easy to locate. The inspector noted that all service users had received a letter from Advance Housing and Support Ltd. on the morning of the inspection. One service user showed theirs to the inspector. It was an invitation to an “Inclusion Campaign Conference – involving tenants and service users in decisions about Advance’s future.” The acting deputy manager explained that service users “often” received questionnaires from Advance Housing and Support Ltd. She said that service users also received the organisation’s bimonthly magazine for service users keeping them up to date with what’s happening or changing in the 70/72 Worting Road DS0000012277.V265006.R01.S.doc Version 5.0 Page 22 organisation. Clearly the organisation is proactive in seeking the views of service users. The acting deputy manager did comment that sometimes this was pitched at a level that was not appropriate for the service users at 70/72 Worting Road. The acting deputy manager was not aware of any in-house quality assurance programme, although matters concerned with the running of the home and opportunities to air views about the home were provided at service user meetings. Since discussion with the inspector during the last inspection, the home had amended the procedure of transporting laundry through the kitchens and conservatory (a dining area) to the utility rooms. However a written policy had not been produced describing this. It is recommended that this be done. A service user explained that cleaning chemicals were kept locked in the utility rooms. At the time of the inspection, however a cupboard of cleaning chemicals was unlocked. A member of staff acknowledged that risk issues necessitated the cupboard being locked and remedied this. 70/72 Worting Road DS0000012277.V265006.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score 2 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X X 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 70/72 Worting Road Score 3 3 2 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 2 X DS0000012277.V265006.R01.S.doc Version 5.0 Page 24 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 06/01/05 1 YA20 13(2) A comprehensive medication procedure must be produced. This is a repeat requirement of 12 May 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. 1 2 3 Refer to Standard 22 23 42 Good Practice Recommendations The complaints procedure should be clarified to service users so that they can use the system successfully. It is recommended that staff have training about abuse and the action to take if abuse is suspected. A policy detailing how laundry is to be transported hygienically through food preparation and eating areas should be produced. 70/72 Worting Road DS0000012277.V265006.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 70/72 Worting Road DS0000012277.V265006.R01.S.doc Version 5.0 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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