Inspection on 30/01/07 for 97 Old Street

This inspection was carried out on 30th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

97 Old Street 09/12/08

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

CARE HOME ADULTS 18-65 97 Old Street 97 Old Street Stubbington Fareham Hampshire PO14 3HG Lead Inspector Liz Palmer Unannounced Inspection 30 January 2007 10:00 th 97 Old Street DS0000067607.V319664.R01.S.doc Version 5.2 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 97 Old Street DS0000067607.V319664.R01.S.doc Version 5.2 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. 97 Old Street DS0000067607.V319664.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 97 Old Street Address 97 Old Street Stubbington Fareham Hampshire PO14 3HG 020 8544 8900 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) www.caremanagementgroup.com Care Management Group Limited Alison Cook Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 97 Old Street DS0000067607.V319664.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: 97 Old Street is a care home providing accommodation for 5 adults with a learning disability. It is owned by Care Management Group Limited, which also owns other registered premises. The home is located near to the centre of Stubbington with there being easy access to the local shops and public transport services. It is a detached property with a rear garden accessible to service users. All service users have their own bedroom. Communal space in the home consists of a lounge, dining room and conservatory. The home has a car for service users with designated staff drivers. The home has a hydro pool and a sensory room within the building. The fees range from £1800 to £2100 per week. 97 Old Street DS0000067607.V319664.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection since the home was taken over by the Care Management Group (CMG). There have been no changes to the management or staff of the home and apart from one service user leaving the services users have remained the same. Five hours was spent in the home, all the service users were met and time was spent observing staff working with them. Three staff were interviewed and the deputy manager assisted with the inspection. The registered manager was spoken to on the telephone during the inspection and the following day. Four relatives returned comment cards. The comments were mainly positive and are referred to in the report. What the service does well: What has improved since the last inspection? A quality audit has been undertaken and an action plan for improvements drawn up. The staff say the transition to CMG has not had any negative impact on service users. A holiday for one service user proved particularly successful. 97 Old Street DS0000067607.V319664.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 97 Old Street DS0000067607.V319664.R01.S.doc Version 5.2 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 97 Old Street DS0000067607.V319664.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s approach to assessing prospective service users ensures their individual needs and aspirations can be met in the home. EVIDENCE: No new service users have moved into the home since CMG took over. Their procedure assessing prospective service users was seen. This included a full assessment, with care management involvement if appropriate, arrangements for service users to visit the home and a six-week trial period. The deputy manager stated that the home is going through the assessment process at the moment to fill the vacancy. 97 Old Street DS0000067607.V319664.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans and risk assessments are drawn up on an individual basis and are detailed and clear. Service users are supported to make decisions, which affect their life. EVIDENCE: Three service user files were looked at. They included details of how individuals communicate and how staff should interpret some of their actions. There were headings such as ‘How I communicate’ and ‘how I make my choices’. One plan describes how a service user responds negatively to something therefore ensuring staff know when they are refusing or dislike something. This also supports people to make choices in their life and encourages staff to promote this with service users who have limited verbal 97 Old Street DS0000067607.V319664.R01.S.doc Version 5.2 Page 10 communication. Also included were personal preferences on social activities, dietary needs, and the level of staffing required for each activity. The attention to detail, for example in each person’s morning routine, ensured that for those who could not tell staff verbally their wishes, consistency was maintained. The plans were person centred in the sense that they focused on the individual and service users are involved in them. However, they are not yet produced in a format accessible to individuals. The manager stated that they were working towards accessible plans, for example an audio plan for one person. Risk assessments are in place and cover activities such as travelling in the home’s transport, using the hydro pool, financial abuse, sexuality and personal care. There was evidence that these were regularly reviewed and an emphasis towards supporting individuality and independence was clear. 97 Old Street DS0000067607.V319664.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from the arrangements for educational, social and community activities. Healthy and varied meals are provided with the involvement of service users. EVIDENCE: Service users are supported to access a range of leisure and educational activities. For example, swimming, yoga, trampolining, shopping and using the home’s sensory room and hydro pool. These are arranged individually and personal preferences are recorded. Service users are supported to use local shops, library, pubs, cafes and community centre. Important relationships are recorded and there was evidence of service users being supported to maintain links with relatives and friends. Arrangements for 97 Old Street DS0000067607.V319664.R01.S.doc Version 5.2 Page 12 visiting them are in place and for informing relatives of events affecting their son/daughter. Rights were observed being respected, for example, people were observed getting up when they chose to. Service users are encouraged to eat a healthy and balanced diet. Menu samples for main meals were seen and showed meals to be varied and healthy. A choice is offered at breakfast and lunchtime. Personal preferences are recorded and staff were able to give examples of how individuals made their choices. Picture menus are currently being developed to support some service users with their choices. Specific dietary needs are recorded in care plans. Any supported needed is also recorded in care plans. Service users were observed being supported with their lunch. Staff offered support on a one to one basis. The mealtime was unhurried and staff were observed offering support in a patient and respectful manner. Meal times are flexible and service users can choose where to eat their meals, for example, in the dining room, kitchen or their own bedroom. 97 Old Street DS0000067607.V319664.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported to maintain their health and receive personal care in a way that meets their individual needs and preferences. Support for one service user who needs physical support must be reviewed to ensure consistency. Service users are protected by the home’s policies and procedures for storing, recording and administering medication. EVIDENCE: Service users’ individual needs and preferences regarding their personal care are recorded in their care plans. Emotional needs are also recorded and specific support recorded where needed. Each service user is supported to maintain their health and well being by having their own General Practitioner (GP). Support is given to attend GP’s appointments as well as dental and 97 Old Street DS0000067607.V319664.R01.S.doc Version 5.2 Page 14 podiatry appointments. Specialist healthcare professionals are involved when necessary, for example, for one person with epilepsy. Information on specific health conditions of service users was seen. This ensures staff understand conditions and can support people appropriately. Three members of staff expressed concern about the support they were giving to a service user to transfer from their wheelchair. The guidelines for transferring state ‘use touch as a prompt’ and ‘using hand to guide’. One member of staff said they sometimes ‘take their weight’ when transferring from the sofa to their chair. Another staff member said that was not the case but that transferring to the home’s vehicle was an issue. One member of staff said they had not been trained, however another said all staff had been trained but some were lacking confidence. The manager stated that staff had received specific training from an occupational therapist (OT) and the OT had agreed the guidelines drawn up. The manager also stated that the OT had said the guidelines for transferring the service user to the home’s vehicle was ‘not ideal’ but was the best they could do given the limitations of the vehicle. The manager must ensure that care given is consistent and reflects the guidelines agreed by the OT. This must include all transferring inside and outside of the home. The commission has been informed since the inspection that an OT’s assessment has been carried and that CMG are looking into replacing the current vehicle. Three of the four relatives’ comment cards said they were satisfied with the overall care provided in the home. One said they felt it had improved. Procedures for storing and administering medication were sampled and found to be secure and suitable. Preferred ways of administering to service users were recorded. Protocols for administering ‘as required’ medication were seen. All staff had received training in administering medication. 97 Old Street DS0000067607.V319664.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported to make their views known. Procedures are in place to protect service users from abuse. EVIDENCE: Service users are provided with a pictorial complaints procedure. Informing them of whom they can complain to and how. Staff were asked how service users in the home would be able to make their complaints known. Staff were able to give examples, which matched what was written in care plans. All four of the relatives’ comment cards said they knew how to make a complaint. One said they had made a complaint to the home. Staff are trained in adult protection as part of their induction and said they were confident about their responsibilities within the home’s policy. Service users are all supported with their finances. Monies held on behalf of three service users were sampled. Cash balances matched the recorded amounts and were stored securely and individually. There is a clear audit trail and receipts are kept. 97 Old Street DS0000067607.V319664.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a clean, homely and safe environment. EVIDENCE: A partial tour of the home was undertaken. The home was found to be comfortable, clean and safe. Adequate communal space was provided including a lounge, dining room, sensory room and a hydro pool. Photographs and personal items displayed made it homely. One service users bedroom was seen this was decorated and furnished to reflect the individuals’ needs and preferences. Notices in the home promoted health and safety and staff receive suitable training, for example, Health and Safety, Food Hygiene and Fire Safety. 97 Old Street DS0000067607.V319664.R01.S.doc Version 5.2 Page 17 97 Old Street DS0000067607.V319664.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are protected by the recruitment procedures. The manager must ensure that there are enough trained and competent staff to provide the care needed by service users at all times. EVIDENCE: Staff have a range of qualifications, skills and experience. They said they enjoyed their work and showed an in depth knowledge of the individual needs of service users. They spoke about service users in a sensitive and positive manner and were seen interacting in this way. CMG provide a comprehensive training programme, which includes an in depth induction programme and all the mandatory training, such as, Health and Safety, Fire and First Aid. Seven of the 14 care staff have completed National Vocational Qualification (NVQ) level 2. Two have completed level 3 and 2 are booked to start level 2. Staff spoke highly of the training and said they could request training specific to the service users they support. There was evidence of this specific training 97 Old Street DS0000067607.V319664.R01.S.doc Version 5.2 Page 19 being undertaken. Other than the issue of supporting one service user to transfer from their wheelchair mentioned under ‘Personal and Healthcare Support’ staff spoken to were confident and expressed competence in how they support people. The rotas were seen and they reflected the staff on duty. At some busy points in the day, for example, the morning there were only two staff on duty. Care plans stated that one service user may occasionally need 2:1 support with their personal care and all the others would need at least 1:1 support at this time. One staff member said they thought there wasn’t always enough staff on duty to meet the needs of service users at all times. One relative’s comment card stated that in their opinion there were not always sufficient numbers of staff on duty. The deputy manager stated that as service users get up at different times it was always possible to give individuals the support they needed. The manager stated that where there were ‘gaps’ on the rota these would be filled with bank staff. She said there is a ‘recruitment action plan’ in place and her plans to address this are to promote a part time member of staff to a senior full time position and to recruit another part time member of staff. This recruitment is already underway and references are being sought for the prospective candidate. The company has a robust recruitment procedure and the deputy and manager have experience in recruiting staff in a way that protects service users. 97 Old Street DS0000067607.V319664.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run and service users are supported to give their views. However, improvements must be made to ensure the safety of staff and service users. EVIDENCE: The staff say the transition to CMG policies and procedures has been smooth and has had little impact on the service users. Staff say the home is well run and they have confidence in the manager. They say they feel well supported 97 Old Street DS0000067607.V319664.R01.S.doc Version 5.2 Page 21 and can talk to the manager. They receive regular supervision as well as attending team meetings. Service users are consulted via a survey, which is also sent to next of kin. CMG collate and analyse the surveys and inform service users of the results. An action plan is drawn up where deficits in service occur. Each service has an annual improvement plan. The home has, in general, policies, procedures and risk assessments in place to promote the health and safety of clients and staff. There needs to be an improvement in the way one service user is ‘transferred’ from his wheelchair. Staff must all receive training and feel confident and be competent in this task to ensure the safety of themselves and the service user. 97 Old Street DS0000067607.V319664.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 x 3 X 3 X X 2 X 97 Old Street DS0000067607.V319664.R01.S.doc Version 5.2 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. Standard YA19 Regulation 12 Requirement Timescale for action 14/03/07 2. YA42 13 The registered person must ensure that an assessment of one service user is carried out to ensure they are safely supported at all times. This includes inside and outside the home and the use of the home’s vehicle. The registered person must 14/03/07 ensure that staff are suitably trained and competent to maintain the health and safety of service users and staff at all times. In particular this applies to one service user with regard to their moving and handling and with regard to the use and choice of equipment. 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 97 Old Street DS0000067607.V319664.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 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 © 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 97 Old Street DS0000067607.V319664.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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