Inspection on 23/09/08 for 74 Central Road

This inspection was carried out on 23rd September 2008.

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

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

Other inspections for this house

74 Central Road 19/09/06

Extracts from inspection reports are licensed from CQC, this page was updated on 22/11/2008.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 74 Central Road 74 Central Road Drayton Portsmouth Hampshire PO6 1QX     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Richard Slimm     Date: 2 3 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. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: 74 Central Road 74 Central Road Drayton Portsmouth Hampshire PO6 1QX 02392376470 F/P02392614526 noemail Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Hampshire Partnership NHS Trust Type of registration: Number of places registered: care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 3. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home The home is a detached house in the residential suburb of Portsmouth called Drayton. Care is provided for up to 3 service users who have a learning disability. The home benefitted from a full refurbishment in the summer of 2008 in order to update and improve facilities for the service users. Accommodation for service users is organised on the ground floof there are three single bedrooms, one with an en suite. There is also a shared kithen / diner, lounge, WC, and communal bath/shower also with WC. There are staff facilities on the first floor including an office area and a staff sleep in Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 3 Brief description of the care home room with ensuite WC and shower. To the front of the property is a small garden with off street parking for up to 2 vehicles. To the rear is a large private garden with a patio. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: In order to make a judgment on the quality of this service – information was gathered from a number of sources, including an unannounced site visit to the home. During the visit we spoke to the manager and two members of staff on duty, and observed some of the practice in the home. We looked at some of the home’s records, including case tracking of 2 of the people living at the home. We toured the premises. The manager was on duty and she and the care staff were helpful in providing information and assisting with the unannounced visit. Additional information for this report was also provided by the manager in the form of data requested from the service prior to the visit. This information is known as the annual quality assurance assessment (AQAA) for the home. Care Homes for Adults (18-65 years) Page 6 of 28 We spent some time with two of the people who live at the home, and they were involved in the process by showing us around their home and their own personal rooms. Comment cards and surveys were returned form a number of sources, all saying the quality of the service was good. Service users were not able to complete comment cards. We spoke to a visiting professional who also confirmed that there were good outcomes at the service, and confirmed the home work well with the local community health team. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Care Homes for Adults (18-65 years) Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service ensures that any prospective service users individual aspirations and needs are fully assessed. Evidence: We case tracked 2 of the 3 people living at the home. All people are fully assessed by competent staff prior to admission. Assessment systems are in sufficient detail to ensure peoples needs can be met at the home. Assessments ensure people are not admitted to the home inappropriately, protecting the people admitted and ensuring the provider complies fully with any legal requirements. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know their individual needs, goals and aspirations are recorded in their personal plans. People are encouraged and supported to make decisions about their lives with support where needed. People are support to take risks as part of leading as independent lifestyle as possible. Evidence: There was evidence from the case tracking exercise that the home develops person centred plans of support and care with people. These plans are based on thorough systems of assessment of need and wishes / preferences. The plans identify how needs and aspirations are to be met within the service, how staff are to support this and how positive outcomes are to be promoted and recorded. The homes AQAA tells Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: us that the home has the following in place - Service User Surveys - Staff Meetings Tenants Meetings - Service Users Annual Assessments - Statement of purpose Homes terms and conditions / contract. Annual re-assessments are completed for all Service Users. These are reviewed and updated regularly. All aspects of the persons life are considered, care plans and risk assessments are derived from this assessment. Information is presented in a format that is easily understood and/or explained to the people living a the home. Service Users are encouraged to take part in the day to day running of the home, cooking, cleaning, shopping, etc. All service users have a comprehensive risk assessment completed for them. If through individual meetings other risks are identified then assessments will take place and depending on the outcome appropriate staff support will be provided. Staff are all aware and receive training in confidentiality and data protection. People take risks as part of an informed process and risk taking framework, supported by a staff team who promote peoples rights to make choices and take risks as part of an independent lifestyle. As far as possible people are supported, encouraged and enabled to take as much day to day control over their own lives as possible. Peoples rights to be involved in decisions about their lives are respected by a staff team that know their service users well and have developed positive relationships with them. There is also and emphasis on identifying responsibilities and where needed additional support is available to people whenever they need this. Person centred planning has enabled the service to constantly monitor outcomes for people, and to have systems that consult and take full account of each individuals particular preferences. People are supported to be actively involved in the daily running of their home, by means of innovative methods to promote good communication between staff and residents. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported and encouraged to take part in age, peer and culturally appropriate activities. People are part of their local community. People are supported to maintain existing friends and social networks, to keep in touch with family and loved ones and to develop new friends and social contacts. Peoples rights are respected and their responsibilities recognised in their daily lives. People are treated as adults. People are supported to have a healthy diet that they enjoy. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: There was clear evidence that people are enabled to lead the lifestyle suited to them as individuals. Person centred plans identified who liked what and then packages of support are put into place to enable the Person to pursue their goals. There were many different opportunities on offer for people both inside and externally to the home. Other opportunities included annual holidays that people are supported to choose and go on with staff support. These arrangements are monitored closely by the use of individualised activity sheets that not only identify what people are doing but also how often. People are encouraged and supported to maintain relationships and to develop new relationships. There are clear visiting arrangements that are geared around the needs and wishes of the people living at the home. Person centred plans ensure that people are supported in a way that they want. There are no needless restrictions as risk assessment informs activities in an adult manner. Staff are clear about their roles and were found to be very clear about promoting the core values for people in such areas as privacy, dignity, respect, choice, independence and rights. People are supported to shop regularly, with each person getting individual support each week to shop for things they want to have on their menu. Consequently people choose not only when they but what they eat. Once more person centred plans clearly identify such areas as diet and food preferences / likes and dislikes. Some people eat out quite often as they enjoy doing this. There is one evening each week when a take away is organised at the home. Food tends to be eaten when people are hungry, and the arrangements in place where flexible, and reflected ordinary living. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive personal care and support in the way they prefer and require. Peoples physical, emotional and health care needs are met. People maintain as much control over their medications as they can. Where support is offered this is done safely. Evidence: Each persons specific needs and wishes were identified in the area of personal care and support. The staff work as a team, with the manager acting as the fulcrum or link/contact point. This is possible due to the relatively low number of service users accommodated. Person centred plans recorded all areas of care and support as well as lifestyle issues. Staff were found to be sensitive to the needs and the wishes of the people they supported, and were acutely aware of the need to ensure peoples dignity, privacy and choices were respected. Plans outlined any specialist areas of need in respect of health and/or psychological Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: needs, including communication needs. There were records of regular appointments and repeat appointments such as dental checks or well women checks were taken care of and monitored via annual reviews and re-assessments of need. People use mainstream health care services, but also have access to more specialist services when needed, as was evident on the day of the visit, when a nurse practitioner visit the home to offer guidance in respect of one of the service users. Due to the needs of the current resident group, all of the people need support to manage their medication. While this is held centrally for safety reasons, medication is given out individually within each persons own private room. The arrangements at the home for the safe storage, administration and recording of medicines, were a monitored dosage system, with full recording systems. Medications were stored safely, an staff had been trained in the use of the system, in line with best practice. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People feel their views are listened to and acted on. People are protected from abuse, neglect or self harm. People feel safe. Evidence: The organisation has a clear complaints procedure. Action has been taken to make complaints procedures more accessible to people with learning disabilities and communication deficits. The home regularly survey people about the quality of the service, and have a number of other arrangements in place to promote service user and stakeholder involvement, as identified above. Staff members interviewed were found to have a good understanding of the needs and preferences of the people they worked with and supported. People were observed to be happy, calm and contented in their home. There had been no complaints since the service re-opened recently, or since the last inspection. The home has clear guidance and policies in place in respect of safeguarding adults. This is linked to the local arrangements as required in the national guidance No Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: Secrets. Staff received regular training in safeguarding vulnerable people, and staff recruitment also takes account of the need to carry out all checks needed to promote good safeguarding practice. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a homely, safe and comfortable environment. The home is clean and hygienic. Evidence: The home has recently just benefited form a full refurbishment. The home now offers 3 single bedrooms, one with an en suite WC. All bedrooms are on the ground floor, as well as a communal WC, a communal bath / shower and WC, a lounge with door and ramped access to the rear garden and patio, and the communal kitchen diner. The upper floor has an office and a staff sleep in room with en suite shower and WC. The whole house has been redecorated and people have been involved in colour scheme choices, and each resident has chosen how their own rooms are decorated and furnished. There is a large private rear garden, and a small front garden, some of which is given over to off road parking for 2 cars. The home is similar to other premises in the street and does not stand out in any way. The home was found to be well presented, offering a valuing environment to residents throughout, and was very clean and tidy. People are supported and encouraged to Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: keep their home clean and are actively involved in household tasks in line with ordinary living. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by competent and qualified staff. People are supported and protected by the homes recruitment policy and practice. Peoples individual and group needs are met by appropriately trained staff. Evidence: The staff team is made up of 2 full-time and 5 part time support workers. The services AQAA tells us that in the week before the AQAA was completed 221 care hours were provided in the home for the 3 people accommodated. There has been low turnover of staff with only one full time person leaving the employment of the service in the past year. The home manager advised us that she covers extra hours by bringing in regular support staff from the organisations domiciliary care agency, and this helps with consistency and continuity, as she can employ the same staff members who know the service users well. Out of the seven staff members above 4 have achieved NVQ level 3, and have linked the training with the national learning disability award framework (LDAF). The home does not adopt a strict key or link worker system. As there are only three residents, Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: the manager is able to act as the central contact for each resident, allocating tasks as needed. There was clear evidence of the organisations commitment to staff training, development and retention. In addition to the high standard of NVQ training, staff all have mandatory training that is regularly topped up, and other courses in more specialist areas as needed. The staff team offer an excellent mix of skills and experience, and it was clear that the people living in the home had good relations with the staff and manager. Staff interviewed were able to demonstrate a thorough knowledge of the needs of each resident and how they promoted choice and control for the people they supported. Staff members confirmed they were well supported by the manager and the organisation. The homes AQAA tells us there is a - Thorough recruitment and selection process.Good induction and subsequent training for staff. The registered manager is in post in accordance with CSCI regulations. All staff have clear job descriptions. There are sufficient staff numbers. Staff receive supervision at least 6 weekly. This is recorded and filed. Staff selection and recruitment pays close attention to processes that safeguard people living at the home. Each staff member has regular checks to Criminal Records and new staff have a protection of vulnerable adults check before starting work supervised in the home. Other checks are carried including taking up references with at least one from the most recent employer. The organisation provides a human resource department to support managers and staff as well. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a well run home. People are confident their views underpin all self-monitoring, review and development by the home. Peoples rights and best interests are safeguarded by the homes record keeping, policies and procedures. Evidence: The manager is registered with the CSCI, has achieved a National Vocational Qualification (NVQ) level 4 and is completing her registered managers award. There was evidence of good management practices that promote good outcomes for people living at the home, and supports the staff team. The manager is supported by the organisation, and there were clear operational guides in place to support and promote best practice. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: The home has developed a sound system of quality assurance that focuses on input from and consultation with the resident group at every opportunity. This continues to link increasingly to the person centred planning information in each persons personal plan. Staff adopt flexible, consistent and innovative methods to ensure people using the service are involved, empowered and listened to. Peoples best interests are served and promoted by a committed staff group. The financial interests of people are safeguarded and promoted by transparent systems provided by the organisation. There is also periodical auditing of individual services. There is a clear guide for staff in connection with managing service users money, valuables and/or financial affairs. The home has certification for electrical wiring dated June 2008; portable electrical equipment dated March 2008; fire detection and equipment dated June 2008; emergency call equipment dated July 2008; central heating system and gas appliances dated June 2008. COSHH assessments are in place, as is an infection control policy. All 7 staff have been trained in infection control. The home has a health and safety policy, and the manager risk assesses all relevant areas to promote a safe environment at the home. Staff received training in food hygiene, fire safety and first aid. We toured the premises and they appeared well maintained and safe. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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 28 of 28 - 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. 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