Inspection on 29/12/05 for 76 Highlands Road

This inspection was carried out on 29th December 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 no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

76 Highlands Road 16/09/08

76 Highlands Road 12/09/06

76 Highlands Road 11/07/05

76 Highlands Road 09/11/04

76 Highlands Road 08/06/04

76 Highlands Road 16/12/03

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 76 Highlands Road Fareham Hampshire PO15 6BZ Lead Inspector Tracey Box Unannounced Inspection 29th December 2005 09:30 76 Highlands Road DS0000012367.V273700.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 76 Highlands Road DS0000012367.V273700.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. 76 Highlands Road DS0000012367.V273700.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 76 Highlands Road Address Fareham Hampshire PO15 6BZ 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) 01329 230121 www.c-i-c.co.uk. Community Integrated Care Mr Michael Wearn Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 76 Highlands Road DS0000012367.V273700.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users are only to be admitted between the ages of 30 and 50 years. 11th July 2005 Date of last inspection Brief Description of the Service: 76 Highlands Road is a registered care home, providing personal support and accommodation for three young adults with learning disabilities. It is a bungalow set back from the main A27 road to Portsmouth in Fareham. Community Integrated Care (CIC) are the registered providers, and the manager, Nicola Keltie is in the process of applying to CSCI for registration to become the registered home manager. Knighstone housing association own the home which comprises of three single bedrooms, a communal lounge, dining room, kitchen and a laundry/staff sleep in room and an enclosed garden. 76 Highlands Road DS0000012367.V273700.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The three people living at 76 Highlands prefer to be referred to as service users, therefore will be referred to as this throughout the report. The inspector saw good interacting between the three service users and staff who were participating in activities that service users seemed to enjoy. This included watching television and spending time with staff sitting close by. The inspector read records which were available,(staff files were not available) and asked staff for their views and opinions of working in the home. The home appeared clean. What the service does well: What has improved since the last inspection? What they could do better: The manager is required to ensure that records are available for inspection at all times. Two members of staff said that if a member of staff was employed to work during the day, this would enable service users to go out with staff, as all three service users require two staff to support when away from the home, thus leaving one member of staff to remain in the home. Staff who can drive the 76 Highlands Road DS0000012367.V273700.R01.S.doc Version 5.0 Page 6 home’s vehicle would be beneficial to service users, as this would increase the amount of opportunities service users have to access the wider community. The provider must reduce the time it takes between the home reporting a fault and the fault being fixed. The manager must ensure her application to become the home’s registered manager is submitted to the Commission for Social Care Inspection (CSCI). The inspector saw one service user communicate with staff using sign language, staff said they would benefit from attending Makaton training (Sign language) to enable them to communicate more effectively with a service user. Decoration of the dining room and bathroom would considerably improve the environment for service users, especially the bathroom which has wall paper peeling from the walls. First impressions of the home would be considerably improved if the outside of the building was decorated the paintwork is very worn and bare wood work is exposed by the front door, staff reported the door to the porch does not close during certain weather as it warps, letting rain enter the building. The manager must ensure the homes Policies and procedures are specific and relevant to the home and that they are reviewed annually. 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. 76 Highlands Road DS0000012367.V273700.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 76 Highlands Road DS0000012367.V273700.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 clear procedure for assessing the needs and aspirations of potential new service users to ensure the service users and the homes needs are met prior to admission. EVIDENCE: The inspector sampled the homes admission policy and procedure which clearly states the process of assessing prior to admission, and that a placement is only agreed once the potential service user has received written confirmation of their placement by the home. This process would lead to pre-placement assessments taking place, however records were not available to confirm this had been completed for three service users who live at the home. One staff member explained as far as she knew the three service users who live at the home have lived here since the home opened in July 2002. 76 Highlands Road DS0000012367.V273700.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): 6,9 (Standard 7 was assessed during the previous inspection.) Service users’ individual plans reflect their assessed and changing needs and personal goals. Practices within the home demonstrate that service users are encouraged to take risks as part of an independent lifestyle. EVIDENCE: The inspector read all three service user’s care plans which included comprehensive risk assessments on all areas from personal care needs, to travelling in a vehicle, going on holiday, attending activities, and behaviour guidelines. One member of staff supported a service user having a bath, as stated in their care plan and risk assessment. One member of staff said the care plans are reviewed almost daily, any changes are discussed with the service user and agreed before any action is taken, signed documentation showed this practice occurred. Staff ensure service users views are listened to by communicating in the style and pace appropriate to the individual. They spend one to one time with service users and to form positive relationships with families, friends and outside agencies who know the service user. 76 Highlands Road DS0000012367.V273700.R01.S.doc Version 5.0 Page 10 Care plans and risk assessments are also reviewed at the service users annual essential life plan (ELP) review, where relatives/representatives, day placement representative( when applicable) and social workers are invited if the service user wishes, the inspector saw three service users files which included names of people who attended. The inspector saw staff communicate with service users in their preferred manner, as stated in their care plan. The staff explained “service users communicate in many different ways, usually a facial expression or body language informs us of whether or not the individual is happy or agrees with the outcome!” 76 Highlands Road DS0000012367.V273700.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): 16,17 (Standards 12, 13 & 15 were assessed during the previous inspection.) Practices within the home demonstrate that individual rights and responsibilities are respected and recognised. Service users individual dietary needs are well catered for. A balanced and varied selection of food is available. EVIDENCE: Staff explained that Service users are encouraged, in line with their care plan and risk assessments, to participate in social activities, both within the home and the community. Records of activities are recorded in the individuals care plan and daily records, these include visits to the pub, local cafe and shopping. Staff also confirmed these are appropriate to the service users preferences. Each service user is involved with a review of their social care plan on a monthly basis, staff record on a daily basis what each service user has participated in and whether or not the service user enjoyed or benefited from it, this monthly review contains information which is used at the annual review. One service user used to attend a local day centre on a regularly basis, until one day he decided he didn’t want to go, staff from the home spoke with staff from the day centre to find out if the service user was experiencing any problems or difficulties whilst at the day centre, no problems were identified 76 Highlands Road DS0000012367.V273700.R01.S.doc Version 5.0 Page 12 and the service user did not explain why he didn’t want to attend anymore. Staff said they tried to persuade him to go but it was obvious he didn’t want to, therefore his wishes were respected and he did not go, he has chosen not to return. The inspector saw that the home’s menus displayed a variety of nutritious meals. Individuals care plans state food which the individual likes and dislikes, staff use this information along with a record of individual’s food intake, to help staff ensure service users are receiving a balanced, varied diet that service users enjoy. Staff said an alternative meal is always available, store areas and fridges were well stocked with fresh and tinned produce. The inspector witnessed staff alter the breakfast menu to provide a more substantial hot breakfast, all three service users appeared to enjoy their breakfast. Staff confirmed they may alter the menu slightly if the weather is different than anticipated, this is recorded in the daily records. 76 Highlands Road DS0000012367.V273700.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): These standards were assessed during the previous inspection. EVIDENCE: These standards were assessed during the previous inspection. 76 Highlands Road DS0000012367.V273700.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): 23 (Standard 22 was assessed during the previous inspection.) Policies and procedures and staff records were not available for the inspector to fully assess this standard. EVIDENCE: The home’s abuse and adult protection policy and procedures were not available. One member of staff said she had received training on abuse which she found useful, and was able to confirm this by showing her certificate, which had not been placed in her personal file. Staff were able to explain their opinion of good practice, and what they would do if they witnessed poor practice. Staff follow comprehensive care plans and risk assessments for a service users who may harm others, the inspector found the records to be eligible and complete. Staff confirmed the details in the care plan and risk assessments enable them to carry our their role effectively. The inspector read risk assessments regarding physical, sexual, verbal and financial abuse. 76 Highlands Road DS0000012367.V273700.R01.S.doc Version 5.0 Page 15 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): 24,30 The home presents as homely, comfortable and clean, however some areas require attention to ensure the environment is safe for service users to live in. EVIDENCE: The provider must improve the time it takes between the home reporting a fault to Knighstone Housing Association and them fixing the fault. The inspector saw records showing that a fault with the hand-wash basin in the kitchen which had not been plumbed into the water supply, and an en-suite shower is not working, staff confirmed both faults have been reported on a weekly basis for at least two months consecutively, as a result staff have been washing their hands in the main kitchen sink and a service user is bathing in the communal bathroom rather than using her en-suite shower. The inspector saw that the un-even path in the garden, which has been reported, is causing a potential trip hazard to anyone accessing the home’s back garden, or the home’s vehicle which is parked on the drive at the rear of the home. The heating in the lounge and dining area was not adequate, especially during cold periods. when service users want to spend time in the home, mainly in the lounge area. It was not possible to check the temperature, but the staff said they have felt cold for some time. This has also been reported. 76 Highlands Road DS0000012367.V273700.R01.S.doc Version 5.0 Page 16 The main lights in the lounge were not sufficient, as three out of the six bulbs were not working, staff said they are not supposed to change light bulbs for health and safety reasons. The inspector witnessed the lack of hand washing facilities in the communal bathroom and laundry, staff rectified this immediately by providing hand soap and paper towels. The inspector requested staff remove a sharps box that was kept in the bathroom to put used disposable razors into. The box was full and the lid was not secure. Staff locked the box away and assured the inspector arrangements would be made for the safe removal of the box from the home and that any replacement would be stored appropriately in future. The inspector looked at all communal areas and two bedrooms, all area appeared clean, bedrooms were warm and brightly decorated to meet the preferences of the service users, however the dining area and bathroom appeared shabby due to paper falling off the wall and marks on the walls. The walls displayed pictures of service users participating in activities, with family/friends and on an individual basis, which appeared to give a ‘homely’ feel to the home. Staff explained service users are encouraged to furnish their room to their taste with personal belongings, furniture and pictures to make it feel like home. The staff confirmed they clean the home as part of their daily responsibilities. Risk assessments are in place to minimise identified risks regarding the building and garden. 76 Highlands Road DS0000012367.V273700.R01.S.doc Version 5.0 Page 17 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): 32,34,35 Staff records were not available for the inspector to fully assess these standards, however staff appear experienced and competent. EVIDENCE: Staff files were not available for the inspector to sample, therefore the manager is requires to ensure at all times records are available for inspection. The inspector sampled the homes staff rota which showed adequate cover during the day and night, one member of staff confirmed she was senior person on duty, and was confident of her ability as she has worked at the home for many years and has therefore gained experience. Staff confirmed they feel that whilst service users want to remain in the home, there are adequate staff are on duty to meet the service users needs, however one staff said more drivers would enable service users to go out more. One staff member said and two other staff were about to take their driving tests. This would mean the home had five drivers to support three service users to go out more. One staff member said “ I feel I have adequate training and experience in order for me to carry out my job, I can just ask if I want training, I don’t have to wait until a meeting or my supervision.” One staff confirmed they had received all mandatory training. 76 Highlands Road DS0000012367.V273700.R01.S.doc Version 5.0 Page 18 Staff explained “we work well together as a team, during staff meetings we talk openly and share ideas and support one another, this helps us meet the needs of all service users.” Staff confirmed they felt the recruitment process was robust, and that they were not confirmed in post until the necessary checks had been completed. Staff also confirmed they felt the induction of new staff was robust and includes all mandatory and specialist training in order to support staff into their role. One member of staff said the home operates a ‘buddy’ system, where an existing experienced member of staff supports any new member of staff for the first few weeks of their position. Staff confirmed they receive monthly supervisions. 76 Highlands Road DS0000012367.V273700.R01.S.doc Version 5.0 Page 19 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): 39,42 The systems for service users consultation are good, however there is limited evidence that indicates service users views underpin all self monitoring, review and development by the home. The health, safety and welfare of service users are not fully protected. EVIDENCE: The home operates a keyworker system, which means each service user has a named member of staff who has specific responsibilities for the service user. A member of staff said “ I often spend one to one time with the service user I am keyworker to, we may spend time doing an activity, this promotes a relaxed atmosphere so that the service user feels able to communicate their wishes and we get to know one another.” The inspector receives monthly reports from the homes responsible individual when they visit the home, in which service users are consulted on their views of the home, to meet regulation 26 of the Care Standards Act (CSA). 76 Highlands Road DS0000012367.V273700.R01.S.doc Version 5.0 Page 20 The member of staff was not sure if a service user survey had been distributed recently. Staff confirmed quality issues are discussed on a one to one basis at their supervision and within staff meetings. Staff said they receive adequate training on health and safety issues, including moving and handling training, first aid, food hygiene and Control Of Substances Hazardous to Health, however, certificates for staff attending the training were not available. Records of staff attending fire training and drill practice were not available. The home has risk assessments in place for the building and safe working practices for staff. Certificates showing the maintenance of services within the home were not available. The inspector saw the homes maintenance file which is used by staff to report any faults they find, staff confirmed a weekly check is completed on all areas within the home to check for faults or potential hazards, the inspector saw records of this. 76 Highlands Road DS0000012367.V273700.R01.S.doc Version 5.0 Page 21 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 X 3 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 2 X X X X X 2 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 2 X 2 2 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 76 Highlands Road Score X X X X Standard No 37 38 39 40 41 42 43 Score X X 2 X X 2 X DS0000012367.V273700.R01.S.doc Version 5.0 Page 22 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. 1. 2 Standard YA24 YA30 Regulation Requirement Timescale for action 29/01/06 29/01/06 3 YA34YA32 4 YA35 YA42 YA39 5 23.2.(b,d,o,p) The home must be in a good state of repair internally and externally. 23.2.(j) The provider must ensure the wash hand basin is connected to the hot and cold water supply. 17(3)(b)(2) The provider must ensure Sch.4,14 staff records are available for CSCI inspection in the manager’s absence. 17(3)(b)(2) The provider must ensure Sch.4,14 staff records are available for CSCI inspection in the manager’s absence. 24.(1,2,3) The provider must develop and implement a quality assurance and monitoring system. 29/01/06 29/01/06 29/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 76 Highlands Road DS0000012367.V273700.R01.S.doc Version 5.0 Page 23 76 Highlands Road DS0000012367.V273700.R01.S.doc Version 5.0 Page 24 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 76 Highlands Road DS0000012367.V273700.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!