Inspection on 06/10/08 for 91 Redlands Lane

This inspection was carried out on 6th October 2008.

CSCI found this care home to be providing an Good service.

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

91 Redlands Lane 06/10/06

91 Redlands Lane 02/11/05

91 Redlands Lane 23/06/05

91 Redlands Lane 14/12/04

91 Redlands Lane 08/07/04

91 Redlands Lane 06/01/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 91 Redlands Lane 91 Redlands Lane Fareham Hampshire PO14 1HG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Chris Johnson     Date: 0 6 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: 91 Redlands Lane 91 Redlands Lane Fareham Hampshire PO14 1HG 01329829661 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Community Integrated Care care home 2 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 2. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home 91 Redlands Lane is a care home that offers care for two people who have a learning disability. The property is owned by Knightstone Housing Association and is managed by Community Integrated Care who is the registered provider. The home is situated in a residential area near to the to the centre of Fareham. There is easy access to local recreational and health care facilities. 2 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The purpose of this inspection was to assess how well the home is doing in the meeting of all key National Minimum Standards, compliance with regulations and to assess what the outcomes are for people who live at this home. The findings of this report are based on a number of different sources of evidence. These included a visit to the home, which was carried out over one day on 6th October 2008 whereby we looked at all key standards. The visit was announced beforehand as one person living in the home finds it difficult to cope with unannounced inspections. Previously to this, we carried out an annual service review of the home on 28th february 2008 and this did not raise any issues of concern. Care Homes for Adults (18-65 years) Page 5 of 26 All regulatory activity since the last inspection was reviewed and taken into account including any notifications sent to the Commission for Social Care. The manager completed an Annual Quality Assurance Assessment (AQAA) prior to the annual service review and also prior to this inspection and this information was taken into account and forms some of the evidence for this report. During this visit we looked at the physical environment including, peoples bedrooms and all communal areas of the home. Staff and care records were inspected. Some members of staff were spoken with and others were observed during their day to day interactions with those living at the home. We examined records, policies and procedures. We spoke with people who live at the home. Due to communication difficulties and the complex needs of the people living at the home the inspector was not able to hold in depth discussions with them. However the inspector was able to talk to people briefly, interact with them and spend time observing the care being given to them. The manager was present throughout the visit to answer questions and discuss issues. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are assessed prior to admission so that the individual and the home can be sure that the home is right for them and will meet the persons needs. Evidence: There had not been any new admissions to the home since the previous inspection. Both of the current people living at the home have lived there for over ten years. At the last inspection of the home on 6th October 2006 we made the following judgement, Service users benefit from having their needs assessed prior to admission to the home. From discussion with the manager we found that the assessment process was unchanged since the last inspection. This included the opportunity for prospective residents to visit the home prior to moving in. The homes assessment policy and procedure is however kept under regular review. Care Homes for Adults (18-65 years) Page 9 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are kept under regular review and recorded in detailed and personalised plans of care that promote independence. Evidence: The care plans of both people were examined during the visit to the home. These were comprehensive and were integrated with risk assessments and risk management plans. Both peoples care plans had been reviewed at regular intervals or as and when a change in their support needs had occurred. Peoples personal care and daily support needs were clearly identified and care plans provided step by step instructions regarding the level and type of support needed with various care needs. We saw evidence that people had been consulted and involved in formulating their plans. We saw that people are able to take risks as part of their everyday lives and that plans were in place to manage these appropriately. Staff had all signed to confirm that they had read each care plan and risk assessment. Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: Staff spoken with confirmed that they had access to care plans. In discussion they demonstrated that they were aware of peoples support needs and were observed to support people as described within the care plan. Further evidence that care was being provided as per the care plan was seen from the daily evaluation sheets completed at the end of each shift. At the last inspection we found that people were supported to make their own decisions about their lives and were supported in making choices. We saw evidence to support this within the care plans and daily evaluation sheets. Due to the needs of both people we were unable to ask them about this. However staff were observed to offer people choices and also in discussion with staff they were able to provide examples of how they facilitated choice. Care Homes for Adults (18-65 years) Page 11 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at this home can receive visitors as often as they please and keep in touch with their family and friends. People are supported to make their own decisions and choices and they receive a healthy diet. Evidence: Information recorded in the AQAA told us that people living at the home continued to be supported to take part in a variety of individual activities such as accessing the local cafe and shops and pursuing their own interests. We confirmed through information recorded in care plans and other records held at the home that people do engage in a variety of activities of their own choosing. Evidence Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: was seen that each person does different things according to their needs and preferences and in a manner that is suited to their needs. For example one person had a personalised activity plan based around their favourite activities, this was intended to provide structure and to ensure that they did the things they wanted to do in a planned manner. The other person preferred to plan each day, on a daily basis depending on what they felt like on the day. Both people are supported to take part in activities outside of the home. During the inspection both people went out individually with staff support. The manager explained that one person had obtained a bus pass and that this had enabled him to get about locally when the weather was poor and given him the opportunity to visit different places. We saw evidence that people living at the home are offered a balanced and healthy menu. Meals are chosen based on individual likes and healthcare needs. Each person decides on their own menu and these are prepared in their own kitchens. The home has a visitors policy and people can receive visitors at any time. Staff support people to keep in touch with their friends and family. Care Homes for Adults (18-65 years) Page 13 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Medication is managed safely and people have access to healthcare support as necessary. Evidence: Records seen during the visit demonstrated that the home liaises with outside professionals and other agencies as appropriate and that people had access to a range of health care services such as GPs, dentists and opticians. We saw evidence that peoples health care support needs are monitored and that people are supported to attend appointments as necessary. Within the care plans each person had an individual health support plan. Staff spoken with understood the principles of upholding the privacy and dignity of people who use the service when giving personal care and support and this was addressed within care plans. We also saw that people could exercise choice and that their preferences regarding their personal support needs had been taken into consideration and were respected. Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: An example of this being that one person preferred to be supported by a male staff member and arrangements had been made to facilitate this. Due to their communication needs the health care plans detailed how each person expressed different emotions and feelings such as when they were in pain, felt fed up, happy and tired. The medication administration records were checked for both people during the visit. From examination of these records it was evident that staff were following correct administration recording procedures. The home has a written medication policy and clear procedures. Evidence was seen to demonstrate that staff undergo training before being able to administer any medication. It was unclear whether the homes medication storage facilities met with the legal requirements for the storage of controlled drugs. We saw however that this had already been identified by a senior manager within the organisation during one of their monthly inspections of the home. We are therefore not making a requirement about this as we have every confidence that it will be addressed if necessary. The manager is advised to request formal confirmation from the supplier. If it does not meet the requirements the home must replace the cabinet with one that does conform. Care Homes for Adults (18-65 years) Page 15 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Satisfactory systems are in place for people to address any concerns or complaints that they may have. Procedures are in place to offer them protection. Evidence: No complaints regarding the home have been reported to the Commission for Social Care Inspection since the last inspection. Data in the AQAA told us that the home had not received any complaints in the last twelve months and examination of the homes complaint log supported this. People living at the home have the opportunity to raise any concerns that they may have and the complaints procedure had been explained to each of them verbally. They also have the opportunity to raise any concerns that they may have during their monthly meetings with their key-worker. The home has the facility to looks after peoples money. We looked at the procedures for looking after peoples money and checked the records for people living at the home. All transactions had been recorded and receipted as per the homes policy and the storage facilities were safe and secure. The home has adequate policies in place regarding responding to issues of potential or suspected abuse and we saw evidence that staff at the home receive adult protection Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: training. Care Homes for Adults (18-65 years) Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from living in a comfortable, safe and clean home. Evidence: The home is arranged into two flats, one for each person. People do not have to share any facilities except the front door and even have their own personal part of the garden. The flats are based around the individual needs of each person and they are therefore able to have their bedrooms, lounges, kitchens and bathrooms exactly as they want them. We looked at all areas of the home during our visit. The home was found to be clean and tidy and homely. From observation people were relaxed and at home in their environment and were able to pursue their own leisure interests as they chose. Each persons flat was individually decorated and reflected their individual tastes and needs. People had been able to personalise their flats with pictures, belongings, televisions and audio equipment. We saw evidence that the general upkeep of the building is maintained and that furnishings and decor are replaced as necessary. The AQAA identified the Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: improvements that had been made and that were planned for the future. Since our last visit some floor coverings had been replaced in one of the flats to a more suitable material to meet the persons needs. People had been individually risk assessed as to their safety within the home environment and systems had been put into place to minimise these risks. These were observed to be put into practice during our visit. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are employed in sufficient numbers to meet the needs of people living at the home. They are well trained and undergo a thorough recruitment process. Evidence: During the visit to the home staff rotas were examined. These confirmed the rota to be a true reflection of actual staffing levels. Staffing levels remain constant and are maintained at the same level as at previous inspections. Rotas are planned in advance and it was seen that they had been planned for the following four weeks. From the information supplied in the AQAA, examination of staff files and discussion with staff it was evident that the home provides training and development opportunities to staff which is relevant to their work. We saw evidence that new staff had undertaken skills for care linked induction training and a basic induction into the home. In discussion with one staff member they described their induction and told us that they considered it to be thorough and that it had prepared them adequately to support the people living at the home. New staff are supernumerary for the first two weeks of their employment at the home. During this time they have the opportunity to familiarise themselves with the homes written Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: policies and procedures as well as getting to know the people living at the home. The recruitment records of two members of staff who had been employed by the home since the last inspection were examined. These demonstrated that the home follows procedures and carries out all relevant checks on staff prior to recruitment. This was supported by evidence supplied in the AQAA and was consistent with the findings of previous inspections. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed. The manager is accessible and sensitive to the needs of those living at the home. The home is well maintained and equipment is serviced to keep everyone safe. Evidence: When we carried out an Annual Service Review of this service in February 2008 the conclusion was that, The home continues to let us know about things that have happened since our last key inspection and they have shown that they have managed issues well. They work well with us and have shown us that their service continues to provide good outcomes for the people who use it. The manager has been in post for several years and demonstrated that she had a good understanding of the individual needs of those living at the home. Information sent to us in the AQAA that had been completed by the manager proved to be an accurate reflection of the service. Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: Data recorded in the AQAA told us that policies and procedures are kept under regular review and examination of a sample of these confirmed this. The AQAA also gave details and evidence that maintenance checks, tests and servicing of equipment are carried out on a regular basis evidence seen during the visit substantiated this. Examination of the fire logbook demonstrated that regular and thorough testing and servicing of the homes fire detection and fire-fighting equipment was being carried out and other appliances as appropriate. The home has systems in place to monitor the quality of service that it provides. A representative of the organisation regularly undertakes visits to the home and reports of these visits were available for examination. From these we saw that during these visits the views of those living at the home are listened to, records are checked and the safety and upkeep of the environment monitored. Service users were able to contribute to the running of the home in a number of ways, including input into their own care plans and reviews, private meetings with key-workers and they both had regular access to the manager. Care plans were clear and related to issues that had been raised by people living at the home. There were not any concerns with regard to safety within the home environment. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 26 of 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!