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Inspection on 13/12/05 for 79 Silvester Road

Also see our care home review for 79 Silvester Road for more information

This inspection was carried out on 13th 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home continues to provide a comfortable, family environment for service users and is well equipped. The group remains stable, with some service users living there since the home was initially registered. The home presents a warm, family atmosphere. Service user involvement is encouraged with regular weekly meetings being held with group involvement in decisionmaking. Service users are also consulted when a new member of staff is considered for appointment. An extensive programme of activities both educational and social is provided for weekdays and weekends for service users. The home also maintains good contact with the community health team, based locally at Waterlooville. The community team are consulted regarding service users` needs and training issues for staff. The home has built up good relationships with the local community. Recording systems are well maintained. Service users individual emotional and social requirements are very much focused on by staff. There is an excellent quality assurance questionnaire and this is regularly provided for service users to express their views.

What has improved since the last inspection?

The requirements placed at the previous inspection had been put into practice and it was evident that further development had taken place on records in general. A structured maintenance plan was available and had been adhered to including both internal and external features.

What the care home could do better:

Risk assessments must be further developed to ensure appropriate actions for service users are carried out. The home should have a risk assessment strategy to reduce or eliminate risk s where possible and the staff must be trained to enable this to happen. An individual moving and handling risk assessment is also required for each service user. References for the most recently appointed member of staff must be available for viewing.

CARE HOME ADULTS 18-65 79 Silvester Road Cowplain Hampshire PO8 8TR Lead Inspector Drew Gurney Unannounced Inspection 13th December 2005 03:30 79 Silvester Road DS0000012361.V272826.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 79 Silvester Road DS0000012361.V272826.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. 79 Silvester Road DS0000012361.V272826.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 79 Silvester Road Address Cowplain Hampshire PO8 8TR 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) 023 9226 8922 Mr Dawson Smith Mrs Julie Smith Mrs Julie Smith Care Home 6 Category(ies) of Learning disability (6) registration, with number of places 79 Silvester Road DS0000012361.V272826.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users may only be admitted between the ages of 22 and 55 years 15th June 2005 Date of last inspection Brief Description of the Service: 79 Silvester Road is a care home accommodating six adult service users who have a learning disability. There is an active educational and activity plan arranged for service users throughout weekdays and as chosen by them. There is close contact maintained with the local community care team. The home is situated in a quiet service userial area of Cowplain near Waterlooville, and blends in with all surrounding service userial properties. The home is close to local shops and public transport is available within walking distance from the home. The accommodation comprises of an open plan kitchen, sitting room and conservatory, where service users are able to sit as a group for dining purposes. There are six single bedrooms, four of which are on ground floor level and a bathroom on both floors, fitted with shower facilities. 79 Silvester Road DS0000012361.V272826.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over a period of 2.5 hours. The inspector met with the registered manager and deputy manager viewing paperwork and discussing administration and care issues, but spent the major part of the inspection with service users on their return from day activities. The inspector was able to speak with all but one service user staying at the home. Following the previous inspection, the registered manager has improved the initial assessment information and risk assessments. There were two requirements as a result of the current inspection. What the service does well: What has improved since the last inspection? The requirements placed at the previous inspection had been put into practice and it was evident that further development had taken place on records in 79 Silvester Road DS0000012361.V272826.R01.S.doc Version 5.0 Page 6 general. A structured maintenance plan was available and had been adhered to including both internal and external features. 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. 79 Silvester Road DS0000012361.V272826.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 79 Silvester Road DS0000012361.V272826.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’s assessment information has been further developed enabling a decision to be reached on the provision of care and support. EVIDENCE: Further work has been done on the initial assessment paperwork required to admit prospective service users to the home and this information, combined with care management assessments will provide staff and assist in the development of care plans and risk assessment procedures. There has been no new admission to the home since the previous inspection but the revised information is more informative and directive towards reaching an admission decision. 79 Silvester Road DS0000012361.V272826.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): 9 Risk assessments are now available for each service user but further development is required. EVIDENCE: All current service user files contain individual risk assessments. These however, require further development, as those viewed were not found to contain sufficient information to ensure the safety of service users. One example regarding bathing procedures did not identify fully what the risk entailed, nor that it was essential that the service user should not be left unattended. A training video is shown to staff as part of the risk assessment training procedures. The registered manager must ensure that risk assessments are carried out for all safe working practice topics and that significant findings of the risk assessment are recorded. These findings should then be fully recorded and reviewed from time to time to encompass significant changes. Training must be provided for one member of the team to improve recording skills and knowledge. It is also recommended that all staff dealing with risk 79 Silvester Road DS0000012361.V272826.R01.S.doc Version 5.0 Page 10 assessments undertake further training to improve their competency in this area. The home must have an overall risk assessment strategy in order to clearly identify risks or an individual basis, as well as ensure that staff have the competency to remove or reduce the risks. A separate moving and handling risk assessment must also be provided for each service user as required. 79 Silvester Road DS0000012361.V272826.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): 14 Service users are encouraged to participate in leisure activities including holidays. EVIDENCE: The inspector spent a considerable part of the inspection with service users and enjoyed listening to their experiences of their annual summer holidays and discussions on their hobbies and interests. All service users had been on a group holiday to Hastings, accompanied by the registered manager and deputy manager and others had enjoyed a wonderful time in Spain. Holiday photographs were on display and it was clearly evident that these events were so enjoyed. Service users also were so pleased to show the inspector the home’s decorations for the Christmas festivities and talked about their participation in dressing the Christmas tree. They also shared their holiday plans during the festive seasons, which included visits home to families for the majority. Other activities include knitting, colouring and cooking. The inspector observed the group participating in clearing the dining table and sharing the washing up and general tidying up that follows meal times. The atmosphere was happy and all were undertaking their allotted tasks in good humour. 79 Silvester Road DS0000012361.V272826.R01.S.doc Version 5.0 Page 12 79 Silvester Road DS0000012361.V272826.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): 19 The home provided information indicating that they meet the physical and emotional health needs of service users. EVIDENCE: The inspector viewed two service users files. These files contained full information with regard to health needs having been addressed by staff. The system is supported by specific forms, that are designed to indicate visits for general health purposes. Records clearly identified the specific reasons for staff to be aware of areas that could cause emotional concern for service users and measures were clearly laid out to counteract any issues. Daily records supported that these measures had actually been followed through in general practice by staff and had proved to be well designed and sensitive to the needs of specific service users. To counteract a highly sensitive situation, tactics had been introduced to divert emotional concerns towards brighter topics. 79 Silvester Road DS0000012361.V272826.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 Complaint procedures are appropriate EVIDENCE: The inspector reviewed the complaint procedure at the previous inspection and found this to be adequate. No complaints have been received by the home since the previous inspection, nor any received by the Commission for Social Care Inspection (CSCI). 79 Silvester Road DS0000012361.V272826.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 The home has an annual maintenance plan and this has been complied with. The property is well maintained throughout both internally and externally. EVIDENCE: The inspector viewed the annual maintenance plan and is pleased to note that this has been followed throughout. Since the previous inspection, new chairs and a sofa have been provided for the service users’ lounge; a new unit has been purchased for the dining area for storage purposes; new garden furniture has been installed; a new bed has also been provided for staff for sleep-in purposes. Structural work undertaken includes a new beam being fitted across the conservatory roof and UPVC installation in this area; wooden facia to the side of the house have been replaced with UPVC and wall lighting in the lounge has been renewed. The home throughout is in good maintenance order. The manager discussed forthcoming improvements, including the decoration of the bathroom and also the fact that the kitchen will be refurbished and updated when service users are on annual holiday next year. 79 Silvester Road DS0000012361.V272826.R01.S.doc Version 5.0 Page 16 79 Silvester Road DS0000012361.V272826.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): 34 Staff employment references for the most recent appointment were not available for viewing and must be available at all times within the home. EVIDENCE: The inspector viewed the records of a recently appointed member of staff. Available information included an application form, CRB verification, health and mental fitness and induction procedures having been followed positively. However, two references were not available. The registered manager assured the inspector that these had been acquired but had been misfiled. 79 Silvester Road DS0000012361.V272826.R01.S.doc Version 5.0 Page 18 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 and 42 Effective procedures are in place to obtain service user views regarding the review and development of the home. Accident procedures are maintained according to requirements. EVIDENCE: During conversation with service users, the inspector identified that they enjoy participating in weekly house meetings and being able to express their views about various issues, including menu planning, chore and task involvement and social issues. The inspector was shown minutes of these meetings and these had been well recorded, signed and dated by a member of staff. The inspector also observed quality assurance questionnaires. These have been designed in a service user-friendly format. Information included service user views on treatment by staff and people in general; menu planning and choice of food; activity involvement and arrangements; whether service users felt they were listened to/understood; whether sufficient assistance was provided; views on the home’s routines; decision making; complaints procedure; general running of the home; whether friends were made welcome; 79 Silvester Road DS0000012361.V272826.R01.S.doc Version 5.0 Page 19 house facilities and general description of accommodation; improvement suggestions; budgeting; shopping and general enjoyment in living at 79 Silvester Road. The forms had either been completed personally, or with verbal support from staff but there was clear indication that service users had personally identified their thoughts and views. The inspector viewed the accident book during the course of the inspection and any incidents had been recorded. This information was cross-checked in daily service user records and found to be accurate. 79 Silvester Road DS0000012361.V272826.R01.S.doc Version 5.0 Page 20 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 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X X 2 X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 79 Silvester Road Score X 3 X X Standard No 37 38 39 40 41 42 43 Score X X 3 X X 3 x DS0000012361.V272826.R01.S.doc Version 5.0 Page 21 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. Standard YA99 Regulation 13{4}{c} Requirement Timescale for action 13/02/06 2. YA3434 The home must have a risk assessment strategy so that risk assessments must be further developed to fully identify and eliminate wherever possible, any risks to the health and safety of service users. Also individual moving and handling risk assessments must be completed. 19d{1}{I} All documentation including two written references relating to employed persons must be available for inspection in the home. 07/01/06 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 YA9 Good Practice Recommendations That risk assessment training is provided for staff to improve competency in line with the home’s risk assessment strategy. 79 Silvester Road DS0000012361.V272826.R01.S.doc Version 5.0 Page 22 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 79 Silvester Road DS0000012361.V272826.R01.S.doc Version 5.0 Page 23 - 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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