Inspection on 09/05/07 for Cameron House

This inspection was carried out on 9th May 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 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

Cameron House 03/03/09

Cameron House 30/01/06

Cameron House 27/06/05

Cameron House 30/11/04

Cameron House 20/04/04

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Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Cameron House Cameron Road Chesham Bucks HP5 3BP Lead Inspector Catherine Kane Unannounced Inspection 9th May 2007 1:00 Cameron House DS0000022955.V331547.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 Cameron House DS0000022955.V331547.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. Cameron House DS0000022955.V331547.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cameron House Address Cameron Road Chesham Bucks HP5 3BP 01494 793290 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) Manager.ladyelizabeth@fremantletrust.org The Fremantle Trust vacant Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Cameron House DS0000022955.V331547.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th January 2006 Brief Description of the Service: Cameron House is a two-storey home, owned by The Fremantle Trust, and is home to ten adults with learning disabilities. The home provides all single room accommodation And all service users rooms have been decorated and personalised for each individual. Cameron House is situated in a residential area approx two miles from Chesham town centre. The home is close to local amenities which include shops, pubs, restaurants, library and cinema. The service users in the home also have access to the local leisure centres and swimming pool. The home supports service users to access local transport such as taxis and buses. The fees for this service are £570.97 per week. Cameron House DS0000022955.V331547.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 1.00pm on Wednesday, 9 May 2007. The inspector was in the service for nearly four hours. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s owner or manager, and any information that CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the service and other people seen during the inspection or who responded to questionnaires that the Commission had sent out. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. The new manager was present at time of the inspection visit. Three members of staff were on duty for the afternoon shift. The inspector met five residents. The inpsector was in the home when one resident was having lunch and was in the home when some residents returned from an afternoon activity. She saw how residents and staff prepared for their evening meal and saw how staff help residents look after and take their medicines. She also looked at residents care plans and other records kept in the home and made a tour of the part of premesis. At the time of the inspectors visit the organisation’s senior finance manager was also visiting the home as part of the new managers induction programme. The inspector also spoke with the area manager responsible for this service by telephone. The inspector would like to thank the manager and her staff team for their assistance with the inspection. She also thanks residents, their relatives and all others who shared their experience of this home. What the service does well: The home continued to have a friendly, relaxed atmosphere with positive relationships between residents and staff. Staff had a good understanding of residents’ support needs. Meals provided are good. Personal care and healthcare support provided in this home is good. The home would be able to meet the needs of individuals of various religious, racial or cultural backgrounds. Cameron House DS0000022955.V331547.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Cameron House DS0000022955.V331547.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 Cameron House DS0000022955.V331547.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): Standard 2. Quality in this outcome area is good. The admission procedure is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the time of this inspection the home had one vacancy. There has been one new admission to this home since the last inspection. The inspector viewed the homes pre-admission assessment; this was a comprehensive document and indicated that the home could meet the individual’s needs at the time of admission and a review process was in place. Generally, admissions would not made to the home until a full needs assessment has been undertaken. The home would then be able to confirm that they can meet the needs of the individual through the service they deliver. Cameron House DS0000022955.V331547.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): Standards 6, 7 and 9. Quality in this outcome area is good. The care planning system in place to provide staff with the information they need and for assessing risk is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the inspection the inspector viewed three residents’ care plans. These were easy to understand, written in plain language, considered all areas of the individual’s life including health, personal and social care needs. The manager informed the inspector that reviews of residents care plans was being undertaken and some work to evidence this was seen. Regular house meetings take place and residents are involved in making choices and taking decisions their life and how the home is run. During the visit the inspector saw how two residents were helped by staff to look after their own money and medicines. The inspector commends how some residents are involved to the best of their ability to manage their money with as much independence as possible. The inspector encourages the home to develop this Cameron House DS0000022955.V331547.R01.S.doc Version 5.2 Page 10 and other real ways for residents to be involved in developing their independent life skills further. The risk assessment system used by the home to support residents to take responsible risks and promote independent lifestyle is generally good. While risk assessments seen in residents care plans were just out of date this will be addressed through the planned review of care plans currently in progress. Cameron House DS0000022955.V331547.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): Standard 12, 13, 15, 16 and 17. Quality in this outcome area is good. Opportunities for people who use this service to take part in a variety of interesting activities are good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of the inspection the inspector was in the home during the afternoon. She spoke with four of the nine residents and the staff on duty. She also spoke by telephone with the relative of one resident. Two of the residents who spoke with the inspector had good verbal communication skills, were confident and able to talk about things that are important for them. The two other residents were a little bit shy but with the help of staff who know them well they were still able to let the inspector know that they understood. One resident said, “The staff are nice, they are very helpful”. Another resident said, “I’ve lived here for 25 years, it’s changed a lot”. All nine residents, helped by staff, completed a survey where they Cameron House DS0000022955.V331547.R01.S.doc Version 5.2 Page 12 indicated that staff treat them well and they know who to speak to if they are not happy. Many activities provided in house were based on what residents prefer to do in their leisure time and take into account their age range and need for either stimulating activity or tranquillity; these included watching TV, listening to music or helping around the home with light housework or helping prepare meals. Most residents have a programme of regular activities outside the home that include outings to pubs and meals out, shopping, bowling, social clubs, attending sessions at the local college and work at the garden nursery situated next door. The relatives of all nine residents returned surveys where they all indicated that the home generally provides good care. One relative said “The residents always appear happy and well looked after”. Another said that “I’ve found Cameron House and the staff to be very good in all the ways that count- it’s the nearest ‘home from home’ likely to be found in residential care homes”. In the surveys returned two relatives commented that a way for the home to improve would be more staff; this would possibly ensure more outings for those residents that need or want them. One relative related that their family have made numerous requests for their relative to be accompanied regularly to visit their elderly mother who lives in a local residential care home and that they can go swimming. Prior to moving in the residents relative was assured that this would be possible however, the relative feels these have been “empty promises”. The inspector was informed that the resident has, since the relative completed the survey, been accompanied to visit their mother Three relatives raised concerns about the long-term future of the home as it has been reported that the home shall close. The manager stated that she had no clear information about plans for the long-term future of the home. The inspector strongly recommends that the manager develops an effective communication system and includes residents, their relatives or advocates to keep them fully informed and involved through consultation with them about matters relating to their home and their future. The inspector was in the home when one resident was having a snack lunch and when the evening meal was being prepared. The meal was freshly cooked chicken casserole. One resident prepared their own packed lunch for the next day. Regular drinks and snacks are available. A varied menu is provided and residents special dietary needs are catered for. Residents who spoke with the inspector said that meals in the home are good. Cameron House DS0000022955.V331547.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): Standards 18, 19 and 20. Quality in this outcome area is good. The personal and healthcare needs of residents are well met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Essential information needed by staff to be able to provide personal and health care support was included in residents’ files. Staff help residents to look after their own medication and see they get to see their local GP and other community healthcare services when needed. The inspector saw how the home helped residents to access specialist healthcare support when this was needed. One comment card was returned from residents’ GP. They indicated that they were satisfied with the overall care provided in this home. Each resident has a securely locked medicines cabinet in their bedroom. The home uses a pharmacist produced medication administration record (MAR). Records seen were neat and well maintained. Most residents medicines are supplied in pharmacist produced monitored dose system. Records were kept of staff assessed as competent to administer residents’ medicines. During the Cameron House DS0000022955.V331547.R01.S.doc Version 5.2 Page 14 inspection one member of staff confidently demonstrated how a residents’ medicines are looked and how residents are helped to take their medicines. Cameron House DS0000022955.V331547.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): Standard 22 and 23. Quality in this outcome area is good. The home has a protection from abuse policy and the complaints procedure is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager declared that home has received no complaints in the last year. The Commission has received no information relating to complaints in the last year. From training records kept in the home only one member of staff and the manager have attended specific training on protecting vulnerable people from abuse and about local adult protection procedures. The inspector strongly recommends that all staff complete this training without delay. Staff who spoke with the inspector were clear about their responsibilities and were aware of the homes ‘whistle blowing’ policy. The organisations senior finance manager explained the systems in place to ensure that resident’ finances are well monitored and protected. The inspector is aware that the home appropriately implemented local safeguarding vulnerable adults procedures when it was necessary. The Commission has received no information relating to adult protection issues since the last inspection. Cameron House DS0000022955.V331547.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): Standard 24 and 30. Quality in this outcome area is good. The home was tidy and clean at the time of the inspection. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The shared areas of the home were comfortable with good quality furniture and fittings. The modern and domestic style provides a home-like environment. At the time of the inspectors visit the maintenance contractor was present in the home undertaking routine repairs. The home has a programme of repair and renewal. Since the last inspection five residents’ bedrooms, bathrooms, hallways and stairs have been redecorated. Cameron House DS0000022955.V331547.R01.S.doc Version 5.2 Page 17 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): Standard 32, 33, 34 and 35. Quality in this outcome area is good. This homes recruitment procedures and training for staff to do their jobs well is generally good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the inspection visit the inspector spoke with two members of staff on duty. The home has a core of well-established staff that understands residents’ needs and they relate well to. Four staff members have left or transferred to other homes and three new members of staff have been recruited or transferred since the last inspection. There has been moderate use of agency staff in recent months. Comments received from relatives were complimentary of the staff team. Staff commented that morale is generally good. However, two residents, a staff member and relatives made comments about staff numbers being an issue. Residents said sometimes there are not enough staff to take them out. At the time of the inspection the new manager had been in post for six weeks. She informed the inspector that the home had started a further recruitment campaign and she was hopeful that a suitable candidate to fill the one remaining full time vacancy would be successful. The inspector strongly recommends that the manager continues to monitor and Cameron House DS0000022955.V331547.R01.S.doc Version 5.2 Page 18 keeps staffing levels under review in order to meet the assessed needs of service users. The recruitment process is thorough. The inspector viewed one staff file. This were well organised and contained the necessary documentation. The home keeps a record of training completed by staff; staff spoken with confirmed details of the training they have undertaken. This was a comprehensive training programme. The manager places high importance on quality training for her staff team. Of nine staff five staff members have completed a relevant National Vocational Qualification (NVQ). Cameron House DS0000022955.V331547.R01.S.doc Version 5.2 Page 19 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): Standard 37, 39 and 42 Quality in this outcome area is good. The registered manager has a good understanding of management areas in which the home needs to improve and has plans in place to address this. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the time of the inspection the new manager has been in post for six weeks. She is experienced and has managed other homes. She informed the inspector of her intention to apply to register as manager with CSCI. She is qualified and competent to run the home and meet its stated aims and objectives. She has sound knowledge and experience in care of people with a learning disability, quality assurance systems, equality and diversity issues, development and implementation of the services policies and procedures, good people skills, strong leadership of staff, responds to need and provides an excellent role model and manages the service efficiently. She has a strong ethos of being open and transparent in all areas of running of the home and is Cameron House DS0000022955.V331547.R01.S.doc Version 5.2 Page 20 aware of current developments both nationally and by CSCI and plans the service accordingly. The area manager provided the inspector with details and outcomes available of the quality assurance survey that is currently being undertaken. The area manager informed the inspector that the views of residents and their family representatives or advocates and all other stakeholders are currently being sought. The organisation routinely carry’s out unannounced monthly visits and produces a report of their findings; these were made available in the home for inspection. The home has sound policies and procedures in line with current thinking and practice. Efficient systems are in place to monitor staff adherence to policies and procedures during their practice. The home works to a clear health and safety policy and checks take place to ensure the home meets relevant health and safety requirements and legislation. Records kept were good and are routinely completed. Where issues have been identified these have been acted upon successfully to ensure residents’ care is not compromised. Fremantle, who run this service, has financial and accounting systems subject to internal and external audits. Cameron House DS0000022955.V331547.R01.S.doc Version 5.2 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 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 2 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 3 3 X 3 X 3 X X 3 X Cameron House DS0000022955.V331547.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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. 1. Refer to Standard YA15 Good Practice Recommendations The inspector strongly recommends that the manager develops an effective communication system and includes residents, their relatives or advocates to keep them fully informed and involved through consultation with them about matters relating to their home and their future. The inspector strongly recommends that all staff complete training on local procedures for safeguarding vulnerable adults without delay. The inspector strongly recommends that the manager continues to monitor and keeps staffing levels under review in order to meet the assessed needs of service users. 2. 3. YA23 YA33 Cameron House DS0000022955.V331547.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 Cameron House DS0000022955.V331547.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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