Inspection on 11/04/05 for 94 Eastern Road

This inspection was carried out on 11th April 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

94 Eastern Road 09/08/06

94 Eastern Road 05/10/05

Similar services:

Flint House

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

The Cotswold Home

Fairways

Treloar College

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

CARE HOME ADULTS 18-65 94 Eastern Road Portsmouth PO3 5EW Lead Inspector Lorraine Parton Unannounced 11 April 2005 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. 94 Eastern Road Version 1.10 Page 3 SERVICE INFORMATION Name of service 94 Eastern Road Address 94 Eastern Road, Portsmouth PO3 5EW 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) Community Integrated Care Mrs Karen Lisa Lee Care Home 2 Category(ies) of Learning Disability (2), Physical Disability (1) registration, with number of places 94 Eastern Road Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection N/A Brief Description of the Service: 94 Eastern Road is a detached house situated in Portsmouth. The home is close to some local shops, but is situated on the corner of a busy main road. The home provides two good sized bedrooms, which have ensuite facilities. The home also has a shared lounge/dining room and kitchen, which are situated on the ground floor. If a service user is unable to manage the stairs one of the bedrooms is downstairs. The home is staffed for 24 hours per day and has purchased a mini bus for the use of service users to access activities of their choice. Currently the home is undergoing some building works to provide another bedroom and is extending the lounge and dining room to ensure that more space is available in the shared areas. The home also has a garden, which surround the home and to the rear of the home there is space for parking. 94 Eastern Road Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 7 hours and was the first inspection of the home since registration. Two service users live in the home and both were involved in the inspection as they wished. Both service users showed the inspector around their bedrooms. Both service users advised the inspector that they had chosen the décor and how they have their rooms. Both bedrooms were found to reflect the personalities and chosen lifestyles of the service users occupying them. The inspector participated in a tour of the home and looked at some of the homes records. One service user assisted the inspector when looking at their care plan. Four members of staff were on duty during the inspection and service users went out as they choose throughout the inspection. The home was found to be homely with a friendly atmosphere. Service users and families advised the inspector of their satisfaction with the home. One service users family advised the inspector that the homes staff had done very well at getting to know and understand their relative in the time the home had been operating, but felt staff needed to encourage their relative to go out on the days that they were visiting. A suggestion was made that alternative venues should be explored for these days. The home agreed to look at alternative venues for the service user to meet the family. What the service does well: The home has only been open for a few months and as such they are establishing the way the home is being managed and ensuring that the service users are settling into their new home. On speaking to staff, service users and the homes manager it is evident that the home is doing very well and are working towards the ethos of the promotion of independent living. During the inspection, several occasions were witnessed by the inspector, which displayed that the homes staff were promoting and supporting service users in independent living skills. This included cleaning their bedrooms, preparation of meals, choices in activities and use of local facilities. The home has built up good relationships with other professionals in order to ensure service users can access a wide range of external support. This has included the learning disability team, physiotherapists and occupational therapists and speech therapists. Service users and their families confirmed that the homes staff were doing very well in getting to know them and their needs. Care plans confirmed the level of awareness of the service users needs. Service users confirmed that with support of the homes staff they access the community and that staff ensure that they participate in activities of their 94 Eastern Road Version 1.10 Page 6 choice and based on their own individual interests and hobbies. The home is currently providing at least three staff per shift and as such this ensures that staff are able to provide a one to one service throughout the day. What has improved since the last inspection? What they could do better: The home is undergoing some building works to permit another service user being admitted. This involves the extension of some of the existing facilities. Service users will benefit from the extension to the home; however, service users choices have been limited by not being involved with the planning for the new décor and furnishing in their home. The homes kitchen is not totally accessible to service users who are wheelchair users and work surfaces appear to be too high. Staff open the door in order for the service user to enter the kitchen and once in the kitchen the service user cannot use all the facilities and is unable to leave until staff open the door. The home is to review the homes kitchen facilities and access. Whilst it is recognised that the staff are getting to know service users very well and that referrals have been made to speech therapists for one service user. The home is in need of finding ways to facilitate communication systems that are appropriate to both service user needs. Staff at the home, feel they can do better in understanding the boundaries between the protection of vulnerable adults and promoting independence. The homes manager is currently looking at ways to develop the staff team. Whilst the home has completed care plans and individual risk assessments with service users, these need further developing and enhancing as the homes staff get to know service users. 94 Eastern Road Version 1.10 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 94 Eastern Road Version 1.10 Page 8 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 94 Eastern Road Version 1.10 Page 9 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) 1, 4, 5 Service users have access to information about their home, however, service users would benefit from this information being made available in a more suitable format. Service users have not been provided with a contract of their tenancy. Service users and families confirmed that they had visited the home prior to moving in. The home is to ensure that any future service users admitted into the home are afforded the opportunity to visit the home in accordance with the homes policies. EVIDENCE: Both service users living in the home moved in the home when it opened. From discussions with the homes staff it was evident that service users and their families were involved in their admission to the home. The home has a statement of purpose and service user guide, which is being developed to be easily understood by the service users living at the home. Neither of the service users have a copy of their contracts for tenancy. On discussion with the homes manager the inspector was informed that contracts have not yet been agreed upon. The inspector spoke to CIC representative who advised the inspector that a meeting is being held to discuss the terms 94 Eastern Road Version 1.10 Page 10 and conditions and it is envisaged that contracts will then be agreed upon and copies supplied to service users or their representatives. All service users must be given a contract, which includes terms and conditions of tenancy, rooms to be occupied and fees payable. 94 Eastern Road Version 1.10 Page 11 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 Both service users have a care plan, which are based on professional assessments and information that has been supplied to the home. Care plans are in need of further development. One service user displayed their involvement in their care planning process. Service users participate within the home and are fully involved in the decisions regarding their lifestyles. Risk assessments had been completed for areas of risk identified and incorporated into service user plans. Further risk assessments are required to ensure service users personal needs are met whilst outside the home. EVIDENCE: Two service user plans were seen and one service user discussed their care plan with the inspector. The care plans seen were found to include all relevant information and the home had involved relevant health care professions to assess areas of identified need. This included an occupational therapists regarding moving and handling and the provision of suitable equipment to promote independence. These assessments had been incorporated into the service user plans. 94 Eastern Road Version 1.10 Page 12 The home had assessed service users risks with regard to participation within the home and for community access and these had been documented and incorporated into service user plans. Some development of the risk assessments are required to ensure personal needs of one service user can be met whilst out socialising. Staff were seen to be encouraging service users to participate in their home and to make decisions regarding their lifestyles throughout the inspection. Service users confirmed by both verbal and by body language communication that they choose how they live their life and staff recognise certain signs indicating what service users are requiring. Currently the home is doing this through a process of elimination of choices and by the use of a picture system. One service user has been referred to a speech therapist; however, the home is going to refer both service users to ensure communication needs can be met. 94 Eastern Road Version 1.10 Page 13 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, Service users have established good links and social lives within the community. Activities are based on service user choices and support is given to access these by the homes staff. EVIDENCE: Both service users interests and hobbies were clearly documented in their service user plans. Service users were found to have different interests and staff support individual choices of leisure activities. Service users access a wide range of community facilities and these include pubs, cafes, sports facilities, local walks and shops. Service user rooms were found personalised with items that reflected individual personalities and interests. Currently the home has enough staff to support these individual choices and the home has purchased transport to enable service users to access further a field venues. Both service users were seen dictating their wishes as to the activities they wished to participate in, which included where they wished to go during the 94 Eastern Road Version 1.10 Page 14 inspection and participation with in the home. One service user did not wish to go out as they were expecting their family to visit, which was supported by the homes staff. On speaking to the service users family concerns were raised with regards to the staff encouraging and looking at alternative ways to ensure the service user goes out on days that they visit especially if it is a nice day. The homes staff, service user and the family agreed on future arrangements. One service users family confirmed that their relationship with their relative was supported and that the homes staff had been good at supporting them in the processes of their relative settling into their new home. 94 Eastern Road Version 1.10 Page 15 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) 18,19,20 The health needs of the service users are being met, in consultation with other health care professionals. The medication policies and practices were safe. EVIDENCE: All personal care needs are documented in the service user plans. All staff spoken to were aware of one service users choices of the preferred staff to support them with personal care. Service users and staff advised the inspector that this is always maintained. The home has involved relevant health care professions to ensure needs have been assessed and the provision of correct equipment is provided to ensure service users are able to be as independent as possible when receiving personal care. The home operates a Monitored Dosage System and Mar sheets, which were found to tally. A local pharmacist provides the home with the medication and any support that the home may require. The home only stores a basic stock of prescribed medication and as such this was found to also tally with records being held by the home. All staff that administer medication received training during the induction period of employment. 94 Eastern Road Version 1.10 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 Service users were aware of how to make a complaint and to whom. Staff displayed verbally their awareness of the Adult Protection Procedures implemented in the home. EVIDENCE: The home has a detailed complaints procedure. The home has not received any complaints. Both service users and their families have been given a copy of the homes complaints procedure. One service user advised the inspector that the homes manager had gone through verbally with them the procedure for making a complaint. The inspector had the opportunity to speak to one relative who also confirmed that he had received a copy of the homes complaints procedure and that if they had any concerns they would discuss these with the homes manager in the first instance. The home on a monthly basis also holds a meeting with each service user to discuss and issues they may be experiencing. These meeting are documented. The inspector had the opportunity to speak to four staff members during the inspection. All staff demonstrated their awareness of ‘what is abuse’ and the procedures to follow in the event of incident. The homes manager advised the inspector that they had identified that staff are unsure about the boundaries between adult protection and promoting independence, due to them being a new staff team. The homes manager advised the inspector that they are looking at ways to develop the staff team and that all staff are receiving training, supervision and encouragement in the promotion of independence. 94 Eastern Road Version 1.10 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) 24,29,30 The home was clean, homely and decorated to reflect individual needs and interests. Service users are happy living in their new home, but are disrupted due to the building works. The garden is not accessible due to the building works. Service users are able to be independent in their home, but one service user is restricted due to access to the kitchen. EVIDENCE: The house has been re constructed to meet the needs of the current service users living there. One service user is a wheelchair user and their bedroom and en-suite facilities have been specially adapted to meet assessed needs. Currently the home accommodates two service users, however, the home is undergoing building works to increase the lounge and dining room space. Building works have caused some disruption within the home and service users have been unable to access their garden. This disruption appears to be for only a short period of time and on completion it is envisaged that the service users will be able to enjoy their own home. 94 Eastern Road Version 1.10 Page 18 Staff use a third bedroom within the home for office and sleep in facilities. On completion of the building works it is proposed that staff facilities are moved downstairs and the third bedroom is offered for use by a future service user. A variation of registration application has been submitted to the Commission for Social care Inspection. The home was found to be nicely decorated and homely in appearance, however, service users and staff confirmed that service users had not been involved in the choosing of the homes décor and furniture. The home is required to ensure service users are fully involved in the future with all matters affecting their home. The home has undertaken risk assessments regarding the home and have implemented controls for identified risks. The home has fitted thermostatic valves to the hot water system, fitted radiator covers and window restrictors to the first floor. All controls were in place for the use and storage of chemicals and chemicals were noted to be locked up. All certificates were available to the inspector and these were found to be up to date. These included insurances, fire records and gas and electrical safety certificates. It was the opinion of the inspector that the home provides a safe environment for the service users. 94 Eastern Road Version 1.10 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) 31,32,33,34,35,36 Staff have received training and undergone a thorough induction programme based on the identified needs of the service users living at the home. The home had implemented recruitment practices that ensure nobody working at the home poses an obvious risk to service users. EVIDENCE: Staffing rota’s indicate that the home is well covered at all times with a minimum of three staff on duty during the day and one staff during the night. Service users and families stated that they are able to go out when they wish and participate in a range of activities due to the good staffing level being provided by the home. Three staff files were audited by the inspector and were found to contain all the required information. This included confirmation of a POVA and CRB checks, two written references, contracts and job descriptions, and records of interviews. All files also contained the training the staff had undertaken both prior to employment and since employment within the home. Many of the staff employed have completed both the NVQ 2 and 3 and several staff are booked on the NVQ training this year. Community Integrated Care (CIC) are 94 Eastern Road Version 1.10 Page 20 committed to staff training and as such provide a wide range of training courses for staff to attend. All staff were employed prior to the home opening and as such participated in a lengthy two-week induction programme. All staff spoken to confirm that the induction was based on the service users identified needs and the principles and ethos the home is to operate within. The inspector found the staff to be motivated in their work and knowledgeable on service user needs. Service users and visitors described the staff as helpful and approachable. 94 Eastern Road Version 1.10 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) None EVIDENCE: None of the standards were assessed during the inspection; however, the inspector received very positive comments both from the homes staff and visitors to the home regarding the registered manager of the home. 94 Eastern Road Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 x x 3 1 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x 3 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 x Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x x x 94 Eastern Road Version 1.10 Page 23 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. 1. 2. 3. Standard 1 6 6 Regulation 5(c ) 15(2)(b) 14(1) Requirement All service users must be issued with a contract, which includes terms and conditions of tenancy. Develop all service user plans. Obtain a speech therapist assessment for one service user. Develop a suitable communication system that enables the service users to express their opinions and wishes. Develop and enhance service user specific risk assessments. This must include the risks associated with managing personal care whilst out of the home. Review the layout of the kitchen to ensure all service users have independent access. All service users must be afforded the opportunities to be involved in the running of the home. This must include the selection of decor and furnishings. Timescale for action 31/7/05 31/7/05 31/7/05 4. 9 15(1) 31/7/05 5. 6. 24 24 23(2) 12 31/7/05 31/7/05 94 Eastern Road Version 1.10 Page 24 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 4!1)(c ) schedule 1 Good Practice Recommendations The home is to ensure that any future service users admitted to the home are afforded the opportunity to visit the home in accordance with the admission policies. 94 Eastern Road Version 1.10 Page 25 Commission for Social Care Inspection 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. 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