Inspection on 16/03/06 for 89 Pavenhill

This inspection was carried out on 16th March 2006.

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

89 Pavenhill 21/03/07

89 Pavenhill 04/10/05

89 Pavenhill 22/03/05

89 Pavenhill 24/11/04

89 Pavenhill 19/03/04

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

CARE HOME ADULTS 18-65 Pavenhill (89) 89 Pavenhill Purton Wiltshire SN5 9DA Lead Inspector Pauline Lintern Unannounced Inspection 16th March 2006 10:00 Pavenhill (89) DS0000028555.V274881.R01.S.doc Version 5.1 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 Pavenhill (89) DS0000028555.V274881.R01.S.doc Version 5.1 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. Pavenhill (89) DS0000028555.V274881.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Pavenhill (89) Address 89 Pavenhill Purton Wiltshire SN5 9DA 01793 771373 01793 771373 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) White Horse Care Trust Mrs Karen Brogan Care Home 3 Category(ies) of Learning disability (1), Learning disability over registration, with number 65 years of age (3) of places Pavenhill (89) DS0000028555.V274881.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users who may be accommodated in the home at any one time is 3 Only the named, female service user with a learning disability referred to in the application dated 10 February 2004 may be under the age of 65 years 4th October 2005 Date of last inspection Brief Description of the Service: 89, Pavenhill is one of 14 care homes that are run by The White Horse Care Trust. The home offers accommodation and personal care to two people with learning disabilities. The building is a detached bungalow in Purton. There are two bedrooms, a lounge with dining area and a garden to the front and rear of the property. There is a shower room with toilet and another toilet is available close to the kitchen area. The service users receive personal care and support throughout the day from a permanent staff team. There is at least one member of staff on duty throughout the day, one in the evening and one sleeping in. The philosophy of care emphasises the importance of an ordinary, domestic type home environment and the involvement of people with a learning disability within the wider community. Each service user is offered a range of daytime and leisure activities and is well known in the local community. Pavenhill (89) DS0000028555.V274881.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over five and a half hours. The inspector was able to spend time with service users, two staff and the registered home manager, Mrs Brogan. Various documents were sampled including health and safety files, care plans, risk assessments and quality assurance audits. One service user was able to explain to the inspector what it is like to live at 89 Pavenhill. What the service does well: What has improved since the last inspection? What they could do better: Pavenhill (89) DS0000028555.V274881.R01.S.doc Version 5.1 Page 6 Continue to offer opportunities for service users and maintain the high standard already achieved. Commendably there are no requirements or recommendations arising from this report 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. Pavenhill (89) DS0000028555.V274881.R01.S.doc Version 5.1 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 Pavenhill (89) DS0000028555.V274881.R01.S.doc Version 5.1 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): EVIDENCE: These standards were not inspected in this cycle. Pavenhill (89) DS0000028555.V274881.R01.S.doc Version 5.1 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, 8 and 9 Service users are involved in developing their individual plan. Service users are given assistance to make decisions if unable to do so on their own. Service users are involved and participate fully in the running of the home. Risk assessments are in place to enable service users to lead as independent a lifestyle as is safe. EVIDENCE: Care plans sampled indicated that they are reviewed on a regular basis with full involvement from the service user where possible. Staff report that at one service user’s last review, they lead their meeting and the agenda was their own. Care plans clearly demonstrate the wishes of the service user and a section shows when this was actioned and by whom. Discussion with the service user confirmed that these wishes had been achieved or were in the process of being planned. Photographs shown to the inspector also confirmed that their wishes had been fulfilled. Minutes from the meeting showed that a close friend had also attended and the service user confirmed that this was the case. The day care co-ordinator was also in attendance. Discussion took place with the manager, staff member and the inspector regarding circle of supports. Due to limited family of service users we discussed the possibility of involving friends in questionnaires sent out by CSCI Pavenhill (89) DS0000028555.V274881.R01.S.doc Version 5.1 Page 10 (with service users’ permission). It was agreed that as lots of the friends have known service users for many years, their opinions on the service would be valuable. Staff aim to discuss this further with the service users. During the inspection service users were observed making decisions. One service user has limited verbal communication, however she was observed indicating that she did not wish to put on her coat by shaking her head. Service users make choices in relation to what they want to eat, clothes to wear and what time they retire to bed and get up in the morning. One service user reported to the inspector that they’ spend their money on what they wish and always choose what clothes they wish to buy’. Individual care plans inform the reader on how the service user prefers to be woken in the morning, what time and whether or not they wish to have a hot drink before rising. Staff reported that one service user was able to attend courses on ‘how to choose staff’ and ‘how to complain’. Certificates on the wall confirmed their attendance. One service user had the opportunity to meet John O’Brien (John O’Brien’s Five Principles) at the Corn Exchange in Devizes recently. Photographs of the meeting were shown to the inspector. The service users at Pavenhill clearly participate in all aspects of the running of the home. Service users always answer the door to visitors and take responsibility for ensuring the house is locked up at night and electrical equipment, such as kettles are unplugged from the wall before retiring. White Horse Care Trust has a number of homes within the area and they hold regular resident consultation meetings. Staff confirmed that one service user attends to represent the home. Minutes from the last meeting indicated that service users had fully participated in the proceedings. Risk assessments were examined and all showed that they were regularly reviewed. The trust has risk assessment representatives for each service. Records show that the staff members have attended training to provide them with the skills to carry out the assessments competently. Care plans inform whether the service user is aware of environmental hazards or not. There is a risk assessment on safe systems at work and generic environmental risk assessments. Each service user has their own individual risk assessments in place to protect them from harm where possible. Pavenhill (89) DS0000028555.V274881.R01.S.doc Version 5.1 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): 13, 14, 15 and 17 Service users are very much part of the local community. Staff strive to find new and appropriate leisure activities for the service users. Friendships and family involvement is paramount at Pavenhill. Menus are varied and nutritious. EVIDENCE: It is reported by staff that service users are well known and liked within the local community. Over the years many good friendships appear to have developed. One service user told the inspector about the many visits they receive from friends, who just pop in for a ‘cuppa and a chat’. The home enjoys the opportunity to throw a party, which is open to all. The manager said that they have been known to have a Christmas dinner anytime in the year, if there are no special occasions at that time. Every year the home participates in the local carnival, when they enjoy decorating the front of the house and front windows. One service user reported to the inspector that ‘we win every year’ for the best decorated house. Again the inspector was shown photographs of service users wrapped up against the elements and enjoying a front row seat (in the garden) of the carnival procession going by. Service users attend various social activities including a day centre, visits to the zoo, circus, cinema, garden centre, and afternoon teas. In house activities Pavenhill (89) DS0000028555.V274881.R01.S.doc Version 5.1 Page 12 include watching television, board games and cooking. One service user showed the inspector a rug that they were making. The manager and another member of staff run the ‘crafty club’, where service users have the opportunity to meet people from other Trust homes and where they can develop their craft skills. This club takes place monthly in various locations. A vicar who visits the home and delivers communion needs meets spiritual needs. Occasionally service users will attend church for special services and if the weather is warm. At the time of the inspection one service user was going out to have their hair and nails done in the afternoon. They had also attended a ‘music alive’ session in the morning with staff support. One service user informed the inspector that at their review meeting they stated that they wished to have their ears pierced and they reminded the staff member to make an appointment when they were at the hairdressers that day. Staff reported that one service user does not like crowds and this is recorded in their care plan. Body language and facial expression indicated that service users who have communication difficulties have good relationships with the staff and peers. One care plan stated that a service user wanted to watch dancing and it was arranged to take them to see the Christmas pantomime. The service user commented that they ‘really enjoyed watching dancing on ice’ on the television. The staff informed the inspector that they were making plans for a service users birthday party in April. The service user confirmed that they are ‘really looking forward to it’ and that they would be having a ‘big cake’. Staff reported that one service user had attended a promotional event for Housing Associations in Trowbridge. The service user took an active part in talking to people about where they live and what it means to them. The service user informed the inspector that ‘ they do not want to ever leave Pavenhill and aim to stay there until they are 100’. A holiday has been planned for the service users to return to a working farm in Dorset during June, as it has been so successful in the past. One service users told the inspector all about their holiday last year and the things which they particularly enjoyed. The inspector was invited to join the service users and staff for lunch. One service user commented that they always prepare the vegetables and that there would be plenty. The menu had been changed for the day as staff reported that one service user had decided they did not wish to have what was on the menu and had chosen an alternative. The meal consisted of various vegetables and meat and was well balanced and tasty. There was plenty of food to go around and a couple of people managed second helpings. Consideration had been given to the diabetic needs of one service user and sugar free products had been used. This person’s care plan included a section where recommended foods have been identified along with foods to avoid. The meal was unrushed and there was a relaxed atmosphere. One service user informed the inspector that they liked to clear away the table and do the washing up themselves. Staff confirmed that this was the service users choice and they enjoyed doing it. The manager reported that the service user used to Pavenhill (89) DS0000028555.V274881.R01.S.doc Version 5.1 Page 13 also load the dishwasher but often banged their legs on the door of the machine, causing minor bruising. After discussion with the service user it was agreed that staff would now load the dishwasher and then the service user could turn it on their selves to maintain their independence. Pavenhill (89) DS0000028555.V274881.R01.S.doc Version 5.1 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 the following standard(s): 18, 19 and 21 Personal support is given in a way, which service users prefer. The home aims to ensure service users’ healthcare needs are met. Death and ageing is dealt with in a sensitive way. EVIDENCE: Care plans explain how each service user wishes to be supported with their personal care needs. One service user prefers to have their hair washed daily, whilst another will inform staff when they want it to be washed. Support is needed with drying hair. There are clear procedures for morning and night routines. One people prefer to go to bed by herself, but likes staff to leave the hall light on for them. Each person has a support plan, which was last reviewed on 27/1/06. Care plans include information on the service users health needs, which includes mobility requirements. Service users have an annual OK health check and this is kept in their personal file. There is evidence of appointments made with diabetic and orthopaedic clinics when specialist input is required. Staff reported that it had been identified that one service user would benefit from increasing their exercise. It was suggested that an exercise video be purchased to use at home. This has now been actioned and service users participate in the activity together along with staff members. One service user has an understanding death and dying. They have Pavenhill (89) DS0000028555.V274881.R01.S.doc Version 5.1 Page 15 experienced losing family and friends and will get upset when someone dies, however staff are there to support them through the grieving process. Staff confirmed that one service user has stipulated where they wish to be buried and which hymns they do not want. All details of individual wishes are documented within the care plan. Pavenhill (89) DS0000028555.V274881.R01.S.doc Version 5.1 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 the following standard(s): 22 and 23 Pavenhill has a clear and effective complaints procedure. Service users are protected from abuse where possible. EVIDENCE: There is evidence that one service user has received training on the procedure for making a complaint. Resident’s consultation meetings provide service users with the opportunity to raise any issues. There have been no complaints since the last inspection. Completed post cards are available for service users to post to the Chief Executive if they are unhappy with the service. The complaints procedure is also presented in a pictorial format. The complaints procedure details timescales. Staff confirmed that they have attended abuse training. Pavenhill (89) DS0000028555.V274881.R01.S.doc Version 5.1 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 Pavenhill provides service users with a homely and safe environment. At the time of the inspection the home was clean and hygienic. EVIDENCE: The home is situated with easy access to local shops and amenities and is in keeping with the local community. Furnishings and fittings are of good quality. The home presents itself as homely and comfortable. During the inspection the home appeared clean and hygienic and free from offensive odours. All surfaces and floors were cleaned to a high standard. There is evidence that infection control measures are in place. Infection control checks take place on a monthly basis. Staff who are allocated to this task, complete training in infection control. Pavenhill (89) DS0000028555.V274881.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 and 36 Staff receive regular training to enable them to meet the needs of the service users. Staff are supervised on a regular basis. EVIDENCE: The Trust has a comprehensive training programme for staff members. Topics covered are manual handling, fire, first aid and basic food hygiene. Further training includes sing-along, drug competency, John O’Brien principles, aging process, supervision skills and the key worker role. Documentation shows that all care staff who are new to learning disabilities, or staff returning after a break receives specific training to enable them to work competently and safely. Training organised is within the Learning Disabilities Awareness Framework (LDAF) system, which is designed for this purpose. The LDAF training provides staff with a sound basis before they commence their NVQ awards. The Manager confirmed that some staff become representatives for the home, specialising in specific areas. These include health and safety, COSHH, infection control and risk assessments. Staff training files showed evidence of attendance and regular updates as required. Staff who met with the inspector reported that they felt adequately trained. Staff who met with the inspector confirmed that supervisions took place on a regular basis and that they felt supported by their manager. Minutes from staff meetings were examined and showed that care plans, training and health and safety issues are discussed regularly. Records indicate that meetings take Pavenhill (89) DS0000028555.V274881.R01.S.doc Version 5.1 Page 19 place approximately every six weeks. The manager reported that staff are very conscientious and will come in for a staff meeting in their own time if they need to. Pavenhill (89) DS0000028555.V274881.R01.S.doc Version 5.1 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 and 41 Pavenhill continues to be well run with service user involvement. Polices and procedures protect service users rights and best interests where possible EVIDENCE: Staff at Pavenhill empower service users to make decisions and comments about the service provided where possible. Staff strive to ensure that service users are involved in all day to day running of the home. Quality assurance audits were examined, which showed that questionnaires are sent out to staff, families and the service users themselves. Discussion with the manager highlighted that the service users living at Pavenhill do not have many, if any, relations remaining alive and it was agreed that involving friends into the questionnaires would be beneficial. The manager and staff will discuss this with service users and inform the inspector of their comments. There is a development plan available at the home. Records appear to be clear, concise and accurate. Service users can access their files whenever they wish. Staff sign to confirm that they have read and understood policies and procedures. All files are kept within the homes office. Pavenhill (89) DS0000028555.V274881.R01.S.doc Version 5.1 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 Standard No Score 1 X 2 X 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 3 23 3 ENVIRONMENT Standard No Score 24 4 25 4 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 4 3 X LIFESTYLES Standard No Score 11 X 12 X 13 4 14 4 15 3 16 X 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X 3 X X 3 X 3 X X Pavenhill (89) DS0000028555.V274881.R01.S.doc Version 5.1 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Pavenhill (89) DS0000028555.V274881.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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. 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