Inspection on 21/12/05 for 75 Hightown Road

This inspection was carried out on 21st December 2005.

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

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

Other inspections for this house

75 Hightown Road 06/09/07

75 Hightown Road 19/03/07

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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 75 Hightown Road Ringwood Hampshire BH24 1NH Lead Inspector Mrs Pat Trim Unannounced Inspection 21st December 2005 08:15 75 Hightown Road DS0000064991.V273176.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 75 Hightown Road DS0000064991.V273176.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. 75 Hightown Road DS0000064991.V273176.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 75 Hightown Road Address Ringwood Hampshire BH24 1NH 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) 01425 461269 www.c-i-c.co.uk Community Integrated Care Rebecca Ann Oldfield Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 75 Hightown Road DS0000064991.V273176.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 07/06/2005 Brief Description of the Service: This home is registered to provide care and accommodation for four service users who are young adults and have a learning disability. The responsibility for managing this service has been taken over since the last inspection by Community Integrated Care (CIC). The property is leased from Hampshire Voluntary Housing. Rebecca Oldfield was the registered manager at the time of the inspection, but was leaving the service at the end of the month. Accommodation is provided in a large family home, situated in a quiet residential area. It is close to local amenities, shops and public transport. Service users each have their own room on either ground or first floor. There is a large lounge, dining room, conservatory and kitchen/diner. 75 Hightown Road DS0000064991.V273176.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second statutory inspection carried out for 2005/2006 and the first one since CIC took over the running of the service. The inspection was unannounced and took one inspector 3.5 hours to complete. The focus of the inspection was to assess key standards not covered on the previous inspection. Information was gathered by spending time with the four service users, talking with the registered manager and one member of staff. Information was also obtained from a partial tour of the premises, looking at a selection of documents and from the pre inspection questionnaire. One comment card had been received from one of the service users. The registered manager had notified the commission that she had handed in her notice and time was spent discussing the interim arrangements for the management of the home until a new manager was appointed. What the service does well: What has improved since the last inspection? What they could do better: Staff are not confident they would be able to follow the fire procedure and should be given further training and fire drills. One service user needs more support with personal care needs and an improved assisted bath would enable staff to give this more effectively. 75 Hightown Road DS0000064991.V273176.R01.S.doc Version 5.0 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 75 Hightown Road DS0000064991.V273176.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 75 Hightown Road DS0000064991.V273176.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 The home has a comprehensive admission procedure that ensures a placement will only be offered to service users whose needs can be met. EVIDENCE: The current service users have lived in the home since it was opened, so the registered manager has had no experience of assessing or admitting a new service user. However, she said she felt the most important aspect of anyone new moving in would be that they fitted in with the current service users and that the service could meet their needs. This would be achieved by meeting the person, completing an assessment and by getting as much information as possible about the person’s needs. Time would be needed to make sure the service user wanted to move to the service. This would be achieved through a planned move that included short stays, before a placement was offered. The home had a policy and procedure for the admission of a new service user. These confirmed the process described by the registered manager and stressed the need for a planned admission to be made. 75 Hightown Road DS0000064991.V273176.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): The key standards were assessed on the last inspection. EVIDENCE: 75 Hightown Road DS0000064991.V273176.R01.S.doc Version 5.0 Page 10 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): 15 and 16. Service users have the support they need to enable them to maintain relationships with family and friends. The individual approach to care provision ensures that service users consistently have their rights and responsibilities upheld by staff. EVIDENCE: Service users are enabled to keep in touch with their families and to maintain friendships. Information is given to service users and family and friends that visitors may call at any time. The registered manager said that families usually rang first to make sure the service user was going to be in. Service users had their own telephone line and relatives rang to speak to them on this number. The registered manager said that there is good communication between service users, their families and the service. Service users said there had been a carol service the night before and all their families and friends had been 75 Hightown Road DS0000064991.V273176.R01.S.doc Version 5.0 Page 11 invited. The registered manager said that relatives were invited to attend annual reviews so they could be involved in care planning. Service users attend a wide range of outside activities, where they have the opportunity to develop friendships. These included the W.R.V.S., a local church group, a luncheon club and the local church. One service user has a support worker, employed through another agency, to take him out on a one to one basis and this provides him with the opportunity to have new experiences. Staff use their knowledge of the service users to make sure the access they get to the local community meets their needs, and to find workable solutions to identified problems. For example, one service user needed to see a dentist but required specialist support to be able to have treatment. The registered manager worked hard to get this support. Another service user has his hair cut by staff, as he does not like to go to the hairdressers. Staff were observed knocking on bedroom doors before entering. They address service users by the name they have chosen. The registered manager said that service users do not use door keys, but everyone has their key hung next to their door, so they can if they wish. They can lock their doors when they are inside their rooms, to give them privacy. Service users were seen to be able to move freely round the home. When the inspector arrived at the home, one service user was having breakfast in the dining room, one was still in bed, and two were sitting in the kitchen. The registered manager said that only service users who wished to help with housework or shopping did so. Where a service user liked to help, this was recorded in the care plan so staff were aware of what activities the service user liked to do. For example, one service user liked to help clean her room, do the drying up and help with shopping. Another liked to go to the local shop for fruit and vegetables. 75 Hightown Road DS0000064991.V273176.R01.S.doc Version 5.0 Page 12 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): 20 The systems in place for the management of medication and the training of staff ensure that service users are protected. EVIDENCE: No service users were responsible for managing their own medication. Staff were required to complete a training course and to have six monthly refresher courses in the management of medication. The policy for the home stated that only staff assessed as competent by the registered manager could administer medication. The pre inspection questionnaire recorded that all current staff had completed this process. The home has an arrangement with the local pharmacist for medication to be supplied in a monitored dosage system. This was stored, together with creams and lotions in a locked cupboard. The registered manager said this was a new cupboard, provided so that medication currently in use could be stored together. The medication administration record had been completed for the morning’s medication. Records were also kept of any non-prescribed medication. It was noted that one service user had her blood sugar levels regularly monitored at different times of the day. The registered manager was not sure why this was 75 Hightown Road DS0000064991.V273176.R01.S.doc Version 5.0 Page 13 done at different times and was advised to contact the district nurse to review this practice and to establish why it was necessary. 75 Hightown Road DS0000064991.V273176.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. The complaints procedure gives clear guidance on how to make a complaint and to whom it should be made, but could not be used by the service users living in the home. The policies and procedures used in the home, and the training staff have received, are sufficient to protect service users from the risk of abuse. EVIDENCE: CIC have a generic policy and procedure for dealing with complaints and the registered manager was able to show how a recent complaint from a relative had been handled, using these guidelines to respond to the issues raised within the timescales required by CIC. A copy of the complaints procedure was displayed on the notice board and in the statement of purpose. The registered manager said that current service users would not be able to use any written format and that she had begun work to develop a more appropriate pictorial complaints procedure. However, as she was leaving the service, it was not known at the time of the inspection who would be taking over this task. The registered manager had also obtained information about a local advocacy service and hoped the home would make contact to see if they could provide support to service users. The commission had received a complaint after the last inspection, relating to staff working a daytime shift after covering a working night. A visit was made to the home to investigate this complaint and it was established that this 75 Hightown Road DS0000064991.V273176.R01.S.doc Version 5.0 Page 15 incident had occurred. The registered manager took appropriate action to ensure it did not happen again and the complainant was informed of the outcome of the investigation completed by the commission and the action taken by the registered manager. CIC had a generic policy and procedure relating to the protection of vulnerable adults. This required staff to refer to the local area procedure and the home had a copy of Hampshire’s adult protection procedure. The registered manager said that staff had attended a training day about adult protection, prior the service being taken over by CIC. Staff who achieved their National Vocational Training (NVQ) 2 qualification had completed training on adult protection and one member of staff was able to demonstrate her understanding of her responsibility to report abuse, citing the home’s policy and procedure, including whistle blowing. She was aware of social service’s role in adult protection. 75 Hightown Road DS0000064991.V273176.R01.S.doc Version 5.0 Page 16 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 and 30. The home provides a warm, safe, comfortable place for service users to live in that meets their needs. The systems in place for dealing with clinical waste ensure that service users are protected from the risk of infection. EVIDENCE: The furnishings provide a homely environment with a range of chairs and settees that are suitable for the service users. For example, a dining room chair has been adapted to meet the needs of one service user. The registered manager said that this service user required increasing support with her personal care and a referral had been made to the organisation’s occupational therapist to try and find an assisted bath that would meet her needs. A visit to the home had been arranged for January 2006. Staff are responsible for cleaning the home, which on the day of the inspection, was clean with no unpleasant odours. The home was warm and well ventilated. 75 Hightown Road DS0000064991.V273176.R01.S.doc Version 5.0 Page 17 The home had a maintenance book to record any problems and action taken to solve them. The registered manager said that she was required to contact CIC head office in respect of any maintenance issues, who arranged for the work to be carried out or new equipment ordered. For example, a new tumble drier was being provided to replace one that had just broken. The home had not had a visit from Hampshire fire and rescue service or from the environmental health officer since the last inspection. The home had copies of the organisation’s generic policies and procedures for infection control and staff were able to demonstrate that they knew the procedure for dealing with soiled linen and clinical waste. Each service user’s laundry was washed separately. There was a contract with Hampshire county council for the removal of clinical waste. 75 Hightown Road DS0000064991.V273176.R01.S.doc Version 5.0 Page 18 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 34. Staff are able to undertake training and to gain qualifications that enable them to develop the skills they need to work with service users. The home has a robust employment procedure that ensures service users are protected. EVIDENCE: The registered manager said that staff are expected to undertake any training that enables them to meet the needs of service users. This includes completing a National Vocational Qualification (NVQ) in care. The home employs 7 care staff, 5 of whom have completed NVQ level 2. This exceeds the minimum standard. CIC have a recruitment policy and procedure and a recent appointment to the team evidenced that the registered manager followed them to employ a new member of staff. The policy and procedure state that no staff may be employed until they have completed an application form, been interviewed, had two references requested and supplied and had satisfactory response to a criminal records bureau (CRB) check and protection of vulnerable adults check (POVA). The staff file seen contained copies of all this documentation. 75 Hightown Road DS0000064991.V273176.R01.S.doc Version 5.0 Page 19 The pre-inspection questionnaire stated that agencies providing care staff to the home were required to provide copies of their references, CRB and POVA checks. The registered manager confirmed this. There was a policy and procedure for the induction of new staff. This included identifying training needs and arranging appropriate courses, providing weekly supervision, identifying an experienced member of staff for the new staff to work with. The induction process took three months to complete and included a six-week, mid probationary review of progress. 75 Hightown Road DS0000064991.V273176.R01.S.doc Version 5.0 Page 20 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. The registered manager provides a strong leadership that enables clients to live in a well-run service. The development of a quality audit tool that enables clients to express their views will be more effective in demonstrating their views are taken into consideration. Systems are in place that ensure the health, safety and welfare of clients are protected. EVIDENCE: The registered manager has completed the National Vocational Award level 4 and the Registered Manager’s Award. Staff felt she was approachable, supportive and good at her management role. 75 Hightown Road DS0000064991.V273176.R01.S.doc Version 5.0 Page 21 From records seen on this and the previous inspection, it was evident she has developed monitoring systems for all aspects of the day to day running of the home and is providing strong leadership to the staff team. The current systems used to find out what service users think of the service are limited and cannot enable them to freely express their opinions. Annual reviews are held which are attended by relatives and care managers who are able to contribute to the evaluation of care provision. The providers complete a monthly audit of care and provide a written record (Regulation 26 notice) to evidence how the service is performing. The registered manager said the providers had a quality audit tool they used for evaluating the service in all their homes. This had not yet been used for 76 Hightown Road. Because staff have in depth knowledge of service users’ non-verbal communication, they can, on an informal basis, report when a service user appears unhappy with any aspect of their care and the registered manager said that staff meetings always allow time for these issues to be raised. The registered manager was aware that the home did not have an effective method for enabling the current service users to give feedback about the care they received. She had obtained information about a local advocacy scheme and was looking at non-verbal communication tools that could assist service users to give their views. The registered manager ensured that the health and safety of service users was maintained. Staff records showed that staff were able to complete health and safety training such as first aid, moving and handling and food hygiene on a rolling programme. Their individual training needs were identified through monitoring, supervision and appraisal, and the provider had timescales for all health and safety training refresher courses. The pre-inspection questionnaire recorded that appliances and equipment were serviced regularly. A number of records and certificates were checked at the time of the inspection. These confirmed the dates given in the pre-inspection questionnaire. In addition, staff completed their own in-house checks on equipment. For example, staff checked that fire alarms were working on a weekly basis and completed a visual check of fire extinguishers every month. The registered manager said that fire training was given using an approved fire training video. Staff then had to complete a questionnaire. They were also required to read the fire assessment for the home and to sign to evidence they had done this. The registered manager said that staff had expressed their concerns about the actions they were required to take in the event of a fire. The questionnaires had also demonstrated that they were not comfortable with the guidance. It was recommended that current fire safety training methods 75 Hightown Road DS0000064991.V273176.R01.S.doc Version 5.0 Page 22 be reviewed to make sure that the provider was satisfied staff were confident about the actions they would need to take in the event of a fire. 75 Hightown Road DS0000064991.V273176.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 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 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 4 X 3 X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 75 Hightown Road Score X X 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 3 X DS0000064991.V273176.R01.S.doc Version 5.0 Page 24 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA22 Good Practice Recommendations The work to develop a complaints procedure that can be used by the current service users should be continued. Consideration should also be given to involving independent advocates to represent the views of service users. Review current fire safety training and fire drills to ensure it provides staff with the knowledge and skills they need. 2 YA42 75 Hightown Road DS0000064991.V273176.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 75 Hightown Road DS0000064991.V273176.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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