Inspection on 01/09/06 for 78 Stubbington Lane

This inspection was carried out on 1st September 2006.

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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

78 Stubbington Lane 12/11/08

78 Stubbington Lane 08/05/07

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Pinta

Kestrel House, St Anne`s Opportunity Centre,

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

CARE HOME ADULTS 18-65 78 Stubbington Lane Stubbington Hampshire PO14 2PE Lead Inspector Craig Willis Unannounced Inspection 1st September 2006 09:30 78 Stubbington Lane DS0000067609.V307509.R02.S.doc Version 5.2 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 78 Stubbington Lane DS0000067609.V307509.R02.S.doc Version 5.2 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. 78 Stubbington Lane DS0000067609.V307509.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 78 Stubbington Lane Address Stubbington Hampshire PO14 2PE 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) 020 8544 8900 www.caremanagementgroup.com Care Management Group Limited To be confirmed Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 78 Stubbington Lane DS0000067609.V307509.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection This is the first inspection since Care Management Group Limited has provided the service. Brief Description of the Service: 78 Stubbington Lane is registered to provide care and accommodation to five people between the ages of 18 and 65 who have learning disabilities. Each service user has a single bedroom, and shares the use of two bathrooms. Service users share the use of a lounge, dining room and kitchen. There is an enclosed garden to the rear of the home that service users are able to access. The manager provided information to the CSCI on 26/6/06 that the range of fees at the home was from £1750 to £2200 per week, depending on the assessed needs of service users. 78 Stubbington Lane DS0000067609.V307509.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The evidence used to write this report was gained from a review of the information the provider sent to the Commission for Social Care Inspection (CSCI) and a site visit to the home on 1st September 2006. During the site visit the inspector spoke with three of the service users, care staff on duty and the manager. CSCI surveys were returned from five service users and three relatives. A tour of the building was made and the inspector observed the way staff were supporting service users. Documents relating to the running of the home were inspected during the visit. What the service does well: What has improved since the last inspection? Not applicable. This is the first inspection since Care Management Group has provided the service. 78 Stubbington Lane DS0000067609.V307509.R02.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 78 Stubbington Lane DS0000067609.V307509.R02.S.doc Version 5.2 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 78 Stubbington Lane DS0000067609.V307509.R02.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good systems to assess the needs of service users before they move into the home. EVIDENCE: One service user has moved into the home since the last inspection. The records for this service user contained a comprehensive needs assessment that was completed prior to them moving into the home. The home had also obtained a copy of the care management assessment that was completed for this person. Monthly meetings have been held with this service user since they moved in to review the assessment and ensure that the home is able to meet their needs. 78 Stubbington Lane DS0000067609.V307509.R02.S.doc Version 5.2 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, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good care planning and risk assessment systems, which support service users to make decisions about their lives and take managed risks. The manager is taking action to ensure the changing needs of service users will continue to be met. EVIDENCE: The personal files of three service users were inspected during the visit. Each service user had a care plan that was developed from their initial needs assessment. These plans are reviewed monthly with the service user and have been changed where the needs of the service user have changed. Service users spoken with said they were aware of what was in their care plans and confirmed that they were involved in their review. Care plans contain details of how service users should be supported to make decisions. Staff were observed supporting service users to make decisions about the activities they wanted to take part in. Risk assessments were in place for all three service users whose files were inspected. These documents set out the assessed hazards to service users and 78 Stubbington Lane DS0000067609.V307509.R02.S.doc Version 5.2 Page 10 action to minimise the risk of harm. The risk assessments had been reviewed every three months, or more frequently if necessary. Specific risk assessments were in place to cover aggression between service users and the support that staff should provide to prevent assaults. The manager said she feels the needs of two current service users are not compatible and it is difficult for them to live in the same home. The manager has made referrals to Adult Services under the adult protection procedures, details of which are included in the Concerns, Complaints and Protection section of this report. It was reported that work has started with the service users, their families and care managers to assess what options are available to ensure that their needs can be fully met. The manager reported that the care plans and risk assessments are in the process of being re-written to comply with the procedures used by Care Management Group. 78 Stubbington Lane DS0000067609.V307509.R02.S.doc Version 5.2 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): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides good support for service users to take part in suitable activities, to maintain relationships with family and friends and provides good food. EVIDENCE: Service users are supported to take part in a range of educational and leisure activities. Service users spoken with said they like to go to local pubs, the cinema and take part in arts and crafts in a new room that has been developed in the home. During the visit service users were supported to go out to local shops and some had a game of badminton in the garden. Service users’ files contained details of activities they had taken part in, including computer courses at a local college, cooking and bowling. One relative who completed a comment card stated that more structure was needed with activities. The manager stated that there is a structure of activities in place for all service users, although service users sometimes choose not to take part. When this happens, the manager said that alternative activities within the home are offered. 78 Stubbington Lane DS0000067609.V307509.R02.S.doc Version 5.2 Page 12 Service users are supported to keep in touch with family and friends, with one service user’s saying they visited and phoned their relatives. One service user wrote that “I have friends and I like the staff” on a comment card. Service users spoken with said that staff maintain their privacy and treat them well. Locks are fitted to all bedroom doors, although some service users do not choose to lock their door. The manager reported that all service users had been provided with a key to their bedroom. Details of the support service users need to complete household jobs, such as cleaning and cooking, are detailed in their care plans. Service users spoken with confirmed that they are supported to complete these tasks. The home has a planned menu that takes into account the likes and dislikes of service users and provides a varied and balanced diet. Service users spoken with said the food was good and they could always have something different if they wanted to. Mealtimes are flexible to fit in with service users’ activities. 78 Stubbington Lane DS0000067609.V307509.R02.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides good support to meet the personal care and health needs of service users. The medication systems in the home are good, although action is needed to ensure that medication administration records are fully completed. EVIDENCE: Details of the personal care support service users need are set out in their care plans. Service users spoken with said that staff provided support in the way they wanted it and treat them well. Comments from service users included “the staff are very helpful and they treat me really well”, Records are maintained of service users’ visits to health services, including GP, dentist, optician, psychiatrist and neurologist. The records kept included details of any advice given by the practitioner. Service users spoken said they were supported to see their doctor when they needed to. The manager reported that the home has good links with a local GP surgery. Medication was stored in a locked cabinet and records were kept of medication coming into the home and administered to service users. The administration records contained a gap on two consecutive days for one service user’s medication. The manager was not aware of the reason for these gaps and said she would investigate why the records had not been fully completed. All staff 78 Stubbington Lane DS0000067609.V307509.R02.S.doc Version 5.2 Page 14 administering medication have undertaken training and the manager has obtained a copy of the guidance from the Royal Pharmaceutical Society for the administration of medicines in care homes since the last inspection. None of the service users were assessed as being able to administer their own medication. 78 Stubbington Lane DS0000067609.V307509.R02.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are confident their complaints will be taken seriously and acted upon, however, the home does not have a clear recording system for complaints so it is not possible to say whether complaints have been resolved. The home has good adult protection procedures, although action is needed to ensure that all service users feel safe. EVIDENCE: The home has a complaints procedure available and since the last inspection it has been provided to service users in a more accessible, pictorial format. The procedure sets out who will deal with a complaint and how long the provider will take to respond to a complaint. Service users spoken with said they know what to do if they want to make a complaint and were confident that it would be taken seriously. All three of the relatives completing a comment card said they were not aware of the home’s complaints procedure. The home has a complaints log, however, it did not contain any details of how they were responding to complaints. This meant it was not possible to determine whether a complaint had been resolved and whether the complainant was happy with the outcome. The home has an adult protection policy and a copy of the local authority adult protection procedures. Staff have received adult protection training and those spoken with demonstrated a good understanding of abuse and action to take if abuse was reported or suspected. Records are available of a recent adult protection strategy meeting that was held as a result of aggression between service users. One service user said that they did not feel safe in the home as a result of aggression from another service user. The manager reported that guidelines had been put in place for action staff should take to keep the service 78 Stubbington Lane DS0000067609.V307509.R02.S.doc Version 5.2 Page 16 user safe and action was being taken to look at an alternative placement for one of the service users. 78 Stubbington Lane DS0000067609.V307509.R02.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is generally well maintained and comfortable, although action is needed to ensure that light fittings are repaired to ensure they are safe. EVIDENCE: A tour of the communal areas of the home was made during the visit. The home is generally well maintained, however, the cover of the light fittings in the first floor bathroom and the laundry room have been removed by a service user. This has resulted in light fittings with exposed bulbs and fittings in areas where water and steam are present. The manager said that she has reported this problem and made follow up calls to check progress, although has been waiting for a long time for it to be repaired. Furnishings were domestic and of good quality. The manager reported that a new television cabinet was being delivered in the following week as the current one had been broken by one of the service users. Since the last inspection an arts and crafts room has been created in an outbuilding. Service users spoken with said that the home is always clean and that they have sufficient space. The home has an enclosed rear garden, which service users are able to access. 78 Stubbington Lane DS0000067609.V307509.R02.S.doc Version 5.2 Page 18 The home has a separate laundry room, which, apart from the light fitting, is suitably equipped. There are hand-washing facilities in the kitchen, laundry room, bathrooms and toilets. 78 Stubbington Lane DS0000067609.V307509.R02.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good systems to protect service users and meet their needs through the deployment of staff, the training programme and staff recruitment procedures. EVIDENCE: The manager reported that five of the sixteen staff employed have achieved the National Vocational Qualification (NVQ) at level two or above. Three staff are currently working towards the qualification. During the visit, staff were observed interacting with service users in a friendly and respectful manner. Four relatives’ comment cards were received. One said that they felt there were not sufficient staff on duty, three said that there were sufficient staff. The home has a rota which demonstrates there are four staff between 7am and 2.30pm, four staff between 2pm and 9.30pm and two staff between 9.30pm and 7am, one of whom is asleep and on-call. The manager said that additional staffing was provided if necessary to support service users to go out to events in the evenings. The manager did report that they currently have a shortage of drivers on the staff team and are currently trying to recruit staff. Vacancies are currently filled by a team of regular agency staff. The manager reported that four new staff have been employed since the last inspection, although they were all transferred from another service run by Care Management Group. The recruitment records of these four staff were inspected. An enhanced Criminal Records Bureau disclosure and written 78 Stubbington Lane DS0000067609.V307509.R02.S.doc Version 5.2 Page 20 references were available for three of these four staff. The manager reported that the recruitment documents for the other member of staff had been obtained and were being held at their head office. The manager said she would transfer these documents into the home as part of a review of the storage of all documents. Staff spoken with said that they received good training from the organisation which helped them meet the needs of service users. A record is kept of all training that staff have undertaken and a training needs assessment was completed for all staff in February 2006. All staff complete an induction course and additional courses, including first aid, medication administration, food hygiene, moving and handling, fire safety, health and safety, adult protection, autism, epilepsy, challenging behaviour and strategies for crisis intervention and prevention. 78 Stubbington Lane DS0000067609.V307509.R02.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is run by a qualified manager, however, action is needed to ensure outstanding work to keep the home safe is completed. The completion of the home’s quality assurance audit will help to ensure the service improves. EVIDENCE: The manager has completed an NVQ level 4 and the Registered Manager’s Award. The manager is also a qualified NVQ assessor. The manager has submitted an application for registration with CSCI and said she receives good support from her manager. The manager reported that work has started to implement the quality assurance system of Care Management Group. Actions that have taken place include a survey of service users, a survey of relatives, relatives meetings, a monthly surgery for relatives with the Regional Operations Manager and service user meetings. The manager reported that information from these surveys would be analysed and used to develop an action plan for improvement. Senior managers form the providers visit the home each month 78 Stubbington Lane DS0000067609.V307509.R02.S.doc Version 5.2 Page 22 to review the service quality. Reports of these visits contain actions that are required to improve the service, although, as previously reported, actions to repair light fittings and emergency lights have not been completed. The fire authority inspected the home in June 2006 and made a requirement to repair a fault with the emergency lighting. The manager reported that she was still waiting for the maintenance team to complete this work. The manager also reported that the gas system was being serviced in the following week, as it had not been tested since January 2005. Assessments are completed for chemicals used in the home, which are stored in a locked cupboard. The temperatures of the fridge and freezer are taken daily and recorded. Accidents and incidents to service users and staff are recorded and reported where necessary. 78 Stubbington Lane DS0000067609.V307509.R02.S.doc Version 5.2 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X 2 X X 2 X 78 Stubbington Lane DS0000067609.V307509.R02.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? N/A 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 Standard YA20 Regulation 13 (2) Requirement The registered person must ensure that medication administration records are fully completed. The registered person must ensure that complaints and action taken to resolve them are recorded. The registered person must ensure that exposed light fittings in the bathroom and laundry room are repaired or replaced. The registered person must ensure that all emergency lights in the home are working. Timescale for action 30/09/06 2 YA22 17 (2) Schedule 4 13 (4) 30/09/06 3 YA24 30/09/06 4 YA42 23 (4) 30/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA22 Good Practice Recommendations The registered person should provide details of the home’s complaints procedure to all service users’ representatives. 78 Stubbington Lane DS0000067609.V307509.R02.S.doc Version 5.2 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 78 Stubbington Lane DS0000067609.V307509.R02.S.doc Version 5.2 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. 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!