Inspection on 15/06/05 for 79 Silvester Road

This inspection was carried out on 15th June 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

79 Silvester Road 06/03/07

79 Silvester Road 13/12/05

79 Silvester Road 28/02/05

79 Silvester Road 29/09/04

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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 79 Silvester Road Cowplain Hampshire PO8 8TR Lead Inspector Drew Gurney Unannounced 15/06/05 9.30am 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 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 Stationary 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 H54 s12361 79 Silvester Road v229092 140605.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 79 Silvester Road Address Cowplain, Hampshire, PO8 8TR Telephone number Fax number Email 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 CRH 6 Category(ies) of LD registration, with number of places 79 Silvester Road H54 s12361 79 Silvester Road v229092 140605.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users may only be admitted between the ages of 22 and 55 years. Date of last inspection 28/02/05 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 residents throughout weekdays and as chosen by residents. There is close contact maintained with the local community care team. The home is situated in a quiet residential area of Cowplain near Waterlooville, and blends in with all surrounding residential 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 residents 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. There is sufficient and suitable communal space. The home is comfortably and well furnished. 79 Silvester Road H54 s12361 79 Silvester Road v229092 140605.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over a period of 5.5 hours during the course of two days. The inspector met with the registered manager and deputy on the first day spent in the office, viewing paperwork and discussing administration and care issues, and then returned on the second day to meet with the residents of the home, on their return from day activities. The inspector was able to speak with all residents, staff on duty and the registered manager of the home during the course of the inspection. What the service does well: What has improved since the last inspection? The recommendations suggested at the previous inspection had been put into practice. Specimen signatures of staff administering medication are available and the medication procedures have been improved. All members of staff are now undertaking NVQ level 2 training; the registered manager and her senior member of staff are undertaking a distance learning medication administration course; the senior member of staff has recently successfully completed NVQ 79 Silvester Road H54 s12361 79 Silvester Road v229092 140605.doc Version 1.30 Page 6 level 3 training and has been accepted to commence NVQ level 4 and the Registered Manager’s Award in September of this year. 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 H54 s12361 79 Silvester Road v229092 140605.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection 79 Silvester Road H54 s12361 79 Silvester Road v229092 140605.doc Version 1.30 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 standard(s) 2 and 5. The home’s assessment information was found to be limited and to rely mainly on care management information. Contracts were found to be satisfactory. EVIDENCE: Those residents’ files viewed, contained a copy of care management assessment documentation, which had been obtained at the point of preadmission or initial enquiries. The manager states that she conducts assessments for prospective residents, in the presence of a care manager and a resident’s personal representative. The current recorded assessment information is limited in content and requires further development to ensure that there is sufficient information gained to identify whether a prospective resident is suitable for admission to the home and on an ongoing basis. The assessment information must be adequate to guide staff on the actions to be taken to ensure that new residents’ needs are properly assessed and planned. There was no recorded initial assessment evidence of any potential restrictions with prospective residents on choice, freedom, services or facilities or risk involved. No agreement had been reached about any identified risks and how to address such risk. An improved assessment format, combined with care management assessments would therefore assist in the development of care plans and risk assessment procedures. A sample of the contract and statement of terms and conditions between the home and prospective resident was viewed and found to contain the necessary 79 Silvester Road H54 s12361 79 Silvester Road v229092 140605.doc Version 1.30 Page 9 information. Normal practice for prospective residents is that they are supported by a representative when drawing up contracts, the information is explained and a copy provided to all residents. 79 Silvester Road H54 s12361 79 Silvester Road v229092 140605.doc Version 1.30 Page 10 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 standard(s) 6, 7, 8. 9. Appropriate care plans were included within personal files. Residents are very involved and participate in reaching decisions within the home. Risk assessments must be developed for all residents for all activities. EVIDENCE: A selection of files viewed by the inspector contained care plans which were found to be appropriate and to contain sufficient information for staff to carry out their duties. Care plans had been reviewed at six monthly intervals or as changes indicated it to be necessary. This was evident from signatures and dates on the documentation. The manager explained that she sends out invitations for reviews to all representatives, having discussed the invitations with the residents. It was also explained by the manager at the time of the inspection, that all residents had an allocated care manager contact. The manager informed that a residents’ meeting is held in the home every Tuesday, when residents are able to participate and be involved in making decisions within the home. This was confirmed when the inspector held a discussion with residents and they all agreed that these meetings were enjoyed and gave them the opportunity to say what they wanted. The minutes of these meetings were shown to the inspector. Residents also agreed that 79 Silvester Road H54 s12361 79 Silvester Road v229092 140605.doc Version 1.30 Page 11 they had a say in choosing new staff employed within the home and were happy about this involvement. On those files viewed by the inspector, few risk assessments were found to be available. It is essential that an individual risk assessment is undertaken for every resident and must incorporate a separate moving and handling risk assessment. Risk assessments must include every activity undertaken by an individual and where it is identified that there is any form of risk or hazard involved, clear guidelines are stated. Each topic must include measures required to minimise risk and be clear and concise for staff to follow. It is recommended that formal risk assessment training is undertaken by a member of the home’s staff and this will then ensure competency in reaching decisions. 79 Silvester Road H54 s12361 79 Silvester Road v229092 140605.doc Version 1.30 Page 12 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 standard(s) 12,13,14,15,16,17 Residents participate in educational, leisure activities and undertake voluntary employment. The home integrates with the local community and residents are able to receive visitors in private and have regular contact with relatives and friends. Residents’ rights and responsibilities are recognised. Residents are provided with a nutritious diet. EVIDENCE: In files viewed by the inspector, it was evident that activities are organised with the involvement of residents and include choice and specific interests. Day care activities are detailed in each resident’s file and include sewing, fabric art, women’s self care, self advocacy, daily living skills and community sports. The activity programme is arranged at the local day centre or local college for weekday involvement. During a conversation with residents, they confirmed that they enjoyed educational activities at Southdown College and Staunton Park School and that some enjoy employment on a voluntary basis at Malmesbury Lawn Day Centre and Leigh Park Gardens. 79 Silvester Road H54 s12361 79 Silvester Road v229092 140605.doc Version 1.30 Page 13 Weekend social activities are well organised with local clubs and some residents spoken to left the group to get ready to enjoy a swimming session at Havant Swimming Pool. The group also confirmed that they enjoy table tennis and disco activities on Saturdays at the Anders Activity Centre and had enjoyed participating in Olympic sports. The manager confirmed that the home has a visiting policy and that should a resident not wish to see particular visitors, she would comply with their request. Residents agreed that they are able to greet any visitors either in the dining conservatory area, or in bedrooms. A clear policy for sexuality/sexual relations was available for the inspector to view. From conversations, it was clear that all residents are visited by friends and family, or they return their visits. During conversation with residents, they agreed that they all have a key to the front door of the home. Three of the residents choose to lock their bedroom doors, but a master key is available for staff access. Currently, no resident requires special equipment. It was very evident during time spent with residents, that they and staff have a very warm relationship, with lots of laughter, jollity and a relaxed atmosphere. Residents showed the inspector the household chore rota where it is recorded what their responsibilities are for the week and is reviewed by the residents at their weekly meeting. The residents were about to start their evening meal when the inspector arrived and the food looked well-presented and tasty. The meal was well received by everyone and the inspector was able to have a chat for a lengthy period when residents had finished eating. Those in charge of washing-up duties were delighted that their chore had been undertaken on their behalf by staff, whilst they were free to hold a conversation with the inspector. 79 Silvester Road H54 s12361 79 Silvester Road v229092 140605.doc Version 1.30 Page 14 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 standard(s) 18, 20, 21 Residents receive personal support in the way they prefer and require. Medication administration is appropriate. EVIDENCE: All residents at 79 Silvester Road are self-caring, apart from assistance provided for hair washing. One male member of staff is available to support male residents should this be required, but no specific member of staff provides care for named residents. There is a well-established link with the local community health team for specific advice or support. Residents informed the inspector that they enjoy being able to get up at weekends when they wish, loved going to the shops to choose their own clothes, were assisted by staff with makeup and enjoyed trips to the hairdresser. All residents looked well cared for. A medication policy statement was available for viewing. Currently no resident self-administers medication but the manager is aware that risk assessments would have to be undertaken, should this eventuality arise. Medication records were viewed by the inspector and found to be appropriate. The manager and her deputy have commenced medication administration training and hold a copy of the Royal Pharmaceutical guidelines. A weekly check is made of all drugs. 79 Silvester Road H54 s12361 79 Silvester Road v229092 140605.doc Version 1.30 Page 15 The home has a policy on ageing and death and personal arrangements were recorded on care plans. 79 Silvester Road H54 s12361 79 Silvester Road v229092 140605.doc Version 1.30 Page 16 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 standard(s) 22, 23 There is an appropriate complaint procedure. Adult protection procedures are addressed within the home. EVIDENCE: The inspector reviewed the complaint procedure and found it to be adequate. No complaints have been received by the home since the previous inspection, nor any by the Commission for Social Care Inspection (CSCI). Whilst talking to residents, they discussed what action they would take if they had any concerns. The manager also stated that staff reinforce complaint rights during residents’ meetings. The staff are aware of their responsibilities with regard to adult protection procedures. The deputy manager has undertaken a POVA training course and using a video, discusses POVA guidelines with staff. Certificates viewed confirmed that staff have done a TOPPS Challenging Behaviour course. The inspector checked one resident’s financial records and found the balance to be accurate. Appropriate records were viewed for financial transactions. 79 Silvester Road H54 s12361 79 Silvester Road v229092 140605.doc Version 1.30 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 standard(s) 25, 26, 30 Bedrooms suit residents’ needs and lifestyles and reflect their choice. The home is clean and hygienic. EVIDENCE: The inspector was shown round the home on the first day of the inspection and again, was shown a bedroom by one of the residents on the second day of the inspection. The home is very well presented and fitted in a comfortable, homely fashion suitable for all the residents’ needs. The curtains, carpets and fittings are of good quality and the décor is tasteful and fresh. The home is very clean and well maintained. All bedrooms are appropriate in size and reflect their owners’ hobbies and interests. They have all the furnishing and equipment to enjoy a comfortable environment for sleeping and pursuing personal activities including computers, television and listening to music. The resident who showed the inspector her bedroom, explained that she was so happy in the home and had known the manager for many years and had specially requested to live there. The resident chatted for a long while and it was evident that she and others spoken 79 Silvester Road H54 s12361 79 Silvester Road v229092 140605.doc Version 1.30 Page 18 to by the inspector, are extremely happy with their lifestyle, their home and the staff. 79 Silvester Road H54 s12361 79 Silvester Road v229092 140605.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34, 35,36 There are sufficient staff employed. Satisfactory employment practices are pursued. Training topics requires review. Supervision of staff is undertaken. EVIDENCE: Staff are on duty from 3 p.m. until 9 a.m. on a weekday daily basis, with an on-call person available at all other times. Weekend rotas cover a 24-hour period. On Mondays through to Fridays, the residents all lead a very busy, active life pursuing educational activities, which they all enjoy. The inspector is satisfied that staff cover is adequate. From 3 p.m. until 7 p.m. two members of staff are present and night handover procedures occur at 7 p.m. The inspector viewed staff files and all necessary information was available. The registered manager conducts initial interviews, and a follow up interview takes place for residents to meet applicants and participate by providing their feedback. One of the residents told the inspector that she enjoyed this participation. The manager values the second interview as it gives her an opportunity to watch interaction between candidates and the residents. All staff have undertaken a one day first aid course and the deputy has completed the four day course. Staff have undertaken fire safety training, and infection control training has been cascaded to all. Staff have undertaken food hygiene training. All staff have commenced NVQ level 2 training. One 79 Silvester Road H54 s12361 79 Silvester Road v229092 140605.doc Version 1.30 Page 20 member of staff has a B-tech qualification in Health and Social Care. The deputy has achieved her NVQ level 3 training and is about to commence the Registered Manager’s Award and NVQ 4. The manager has a certificate for Professional Studies in Counselling and supervision. The inspector viewed certificates supporting this information. The inspector recommended that training be sought for epilepsy for some members of staff to provide further knowledge for staff to provide support for residents in the group who have epilepsy. Adequate, recorded supervision is provided for staff at required times. 79 Silvester Road H54 s12361 79 Silvester Road v229092 140605.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 EVIDENCE: The accident book was viewed and records found to be appropriate. Fire records were viewed and were in order. Temperature records were also viewed for refrigerator and freezer and found to be in order. Servicing information will be viewed at the next inspection. 79 Silvester Road H54 s12361 79 Silvester Road v229092 140605.doc Version 1.30 Page 22 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 1 x x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 1 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x 3 3 x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 79 Silvester Road Score 3 x 3 3 Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x H54 s12361 79 Silvester Road v229092 140605.doc Version 1.30 Page 23 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 2 Regulation 14 {2} Requirement That assessment information is developed further to ensure that a decision can be reached on the homes ability to provide required care and support. Risks assessments must be undertaken to identify and eliminate wherever possible, any risks to the health and safety of residents. Timescale for action 15.09.05 2. 9 13 {4} {c} 15.09.05 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. 2. Refer to Standard 9 35 Good Practice Recommendations That risk assessment training is undertaken by a member of staff to improve competency That epilepsy training is provided to extend knowledge. 79 Silvester Road H54 s12361 79 Silvester Road v229092 140605.doc Version 1.30 Page 24 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton Hampshire, 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 H54 s12361 79 Silvester Road v229092 140605.doc Version 1.30 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. 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