Inspection on 10/05/05 for Care at Stennings

This inspection was carried out on 10th May 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Care at Stennings 04/12/07

Care at Stennings 07/09/06

Care at Stennings 25/10/05

Care at Stennings 06/10/04

Care at Stennings 10/05/04

Care at Stennings 19/01/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Care at Stennings Stennings Brookview Copthorne West Sussex, RH10 3RZ Lead Inspector Ms E Southall Unannounced Tuesday, 10 May 2005 V223649 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. Care at Stennings H60-H11 S47546 Care at Stenning V223649 100505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Care at Stennings Address Stennings, Brookview, Copthorne, West Sussex, RH10 3RZ 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) 01342 719388 SusanMSnelling@aol.com Ms Susan Margaret Snelling Ms Joy Day Mrs Donna Wellman Care Home 8 Category(ies) of Learning Disability - 8 Both registration, with number of places Care at Stennings H60-H11 S47546 Care at Stenning V223649 100505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: N/A Date of last inspection 6/10/04 Brief Description of the Service: Stennings is a home for up to eight younger adults with learning disabilities, situated in the village of Copthorne, on the outskirts of Crawley, West Sussex. The premises are two large detached houses situated at the end of a residential close. The houses are connected by a conservatory, and form one residential unit which offers comfortable and well-equipped accommodation. There are attractive gardens surrounding the property. There is good access to transport, leisure and shopping facilities. Care at Stennings H60-H11 S47546 Care at Stenning V223649 100505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and began at 12.45 pm. It took place over four and a half hours, giving the Inspector opportunity to spend time with four of the six residents currently living at Stennings. She also spent time with the home’s manager and four members of staff. Records were examined, a shift handover observed, and one of the residents enjoyed showing the Inspector round all areas of the home. What the service does well: What has improved since the last inspection? Service User contracts are now in place for each resident. Learning Disability Award Framework accredited training is to be provided for staff. A computer has been provided for the use of the residents, following a request made at a residents’ meeting. Care at Stennings H60-H11 S47546 Care at Stenning V223649 100505 Stage 4.doc Version 1.30 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. Care at Stennings H60-H11 S47546 Care at Stenning V223649 100505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Care at Stennings H60-H11 S47546 Care at Stenning V223649 100505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,3,4 &5 Prospective residents have detailed assessments of need carried out before they are admitted to the home. They are fully involved in the admission process and can stay over at the home before deciding to move in. Staff in the home are provided with training that addresses the specific needs of the residents. EVIDENCE: One resident told the Inspector about the visits he made to Stennings before he decided to move in last year. Arrangements were being made during the Inspection for a prospective resident to visit the home, and the Inspector noted good practice by staff in informing the placing social worker of their concerns that the resident’s medical needs could not be met during the planned visit. All written assessments contain very detailed information about each resident’s specific needs, strengths and hopes for their own lives. Records of staff training show that courses have been provided in epilepsy, communication, managing challenging behaviour and medication handling. Each case file contains the resident’s own written contract, which they have signed. Care at Stennings H60-H11 S47546 Care at Stenning V223649 100505 Stage 4.doc Version 1.30 Page 9 Care at Stennings H60-H11 S47546 Care at Stenning V223649 100505 Stage 4.doc Version 1.30 Page 10 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. Care planning in the home is of a particularly high standard. Staff support the residents’ right to make decisions about their lives, with any agreed limitations clearly recorded and risk assessed. Residents are consulted about, and involved in, all aspects of life in the home. EVIDENCE: The residents’ care plans include assessments of every area of their lives. Imaginative and detailed plans are in place to address individual needs and promote independence. One resident, who likes to spend time alone, has been provided with a shed in the garden, where he enjoys pottering around. When being shown around the home by a resident, the Inspector was told how each person living in the home has responsibility for their own laundry and for keeping their own rooms and bathrooms clean and tidy. Any specific support and encouragement needed for individual residents is written into their care plan. One resident assured the Inspector that she is always involved when any new resident arrives at Stennings. Detailed risk assessments are in each case file. They should be dated and regularly reviewed. Care at Stennings H60-H11 S47546 Care at Stenning V223649 100505 Stage 4.doc Version 1.30 Page 11 Care at Stennings H60-H11 S47546 Care at Stenning V223649 100505 Stage 4.doc Version 1.30 Page 12 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 & 17. The people who live at Stennings enjoy a full and varied life. Every opportunity is provided for them to take part in activities which promote their independence, development, and participation in the local community. EVIDENCE: Activity programmes are in place for every resident, which include life skills training within the home, and many varied activities outside. These include educational courses, shopping and leisure activities and work with local voluntary organisations. On the day of the inspection, it had been decided that the planned Tuesday evening visit to the pub was to be changed to a visit to the cinema. One resident currently travels to and from his college independently on local transport. Enough staff are available to support each resident’s chosen activities. Records seen and conversations with residents showed that visits to their families are a key part of their lives. Care at Stennings H60-H11 S47546 Care at Stenning V223649 100505 Stage 4.doc Version 1.30 Page 13 The home is dealing sensitively with the issues of sexuality affecting the service users. Care plans show that ongoing risk assessments, clear boundaries, and appropriate management are in place, with the rights and needs of other residents also being taken into account. The residents choose their menus each week, and one prepares and cooks the evening meal in the kitchen of each house each day, with staff support. The Inspector saw tuna and vegetables and a stir-fry being prepared during her guided tour of the home. Care at Stennings H60-H11 S47546 Care at Stenning V223649 100505 Stage 4.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 & 20 The residents at Stennings are largely self-caring. Staff provide any specific support or encouragement needed by individuals. Health and emotional needs are closely monitored and well managed. EVIDENCE: Care plans are very detailed and give clear direction for staff about each resident’s preferences about any support or guidance that they need. Two residents told the inspector that they are able to decide for themselves about their day-to-day routines, one of them saying that she likes to have personal space in the home, not necessarily choosing to spend her free time with the other residents. A pharmacy contract is in place with a local chemist, and records of staff training in medicine administration are in their personnel files. One resident looks after his own medication and detailed risk assessments and procedures are in his case file. Another resident is in hospital in London at the moment and staff at the home are in close communication with the medical staff responsible for his care, to keep track of his needs. Care at Stennings H60-H11 S47546 Care at Stenning V223649 100505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 Arrangements for residents of the home to make their opinions and any concerns known are satisfactory. Good records are kept of any incident when residents may be at risk of harm. Adult Protection training is not routinely provided for staff. Staff are not aware of a Whistleblowing procedure. EVIDENCE: One resident told the Inspector that she is able to speak to the manager and staff at Stennings when she has concerns or worries. She was clear that she would contact her social worker if she needed to speak to someone else outside the home. Another resident was very confident that he is always listened to by staff. A log of any serious complaints is kept in addition to records in case files. Incident and keywork reports are well written and show that staff actions protect the welfare of the residents. However training records in personnel files do not include Adult Protection training. None of the four care staff who spoke with the Inspector had received specific training in Adult Protection, and they were not clear about the presence of a Whistleblowing procedure in the home, or why it is necessary. Care at Stennings H60-H11 S47546 Care at Stenning V223649 100505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28 & 30 Stennings provides very high quality accommodation for the people who live there. EVIDENCE: The home at Stennings is based around two large detached houses which have been joined together by a conservatory. This means that residents have free access to two lounge areas, dining rooms, kitchens and laundry rooms; although for meals they use the kitchen and dining rooms in the house where their bedroom is. Everyone eats a roast lunch together in the conservatory on Sundays. All areas of the home are comfortably furnished, freshly decorated and maintained to a very high standard. The resident who showed the Inspector round the home told her that she had recently changed her room, as she preferred the bathroom in her new room. All of the residents have ensuite bathrooms, or a private bathroom close to their bedroom. The rooms seen by the Inspector were all large, airy and bright, with plenty of space for the resident’s own things. They are able to have a key to their own room if they wish. Care at Stennings H60-H11 S47546 Care at Stenning V223649 100505 Stage 4.doc Version 1.30 Page 17 Downstairs, the residents said that they can choose to sit in either of the two lounges, or their own rooms, to watch television in the evenings if they disagree about which programme they want to watch. There are attractive gardens surrounding the home. One of the residents has his own shed in the back garden, where he enjoys spending some of his free time. Care at Stennings H60-H11 S47546 Care at Stenning V223649 100505 Stage 4.doc Version 1.30 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 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 The staff group at Stennings is committed to the welfare of the residents and sensitive to their needs, however there is quite a high level of staff turnover in the home. Training is provided in the specialist areas of need of the residents. The recruitment procedure continues to be unsatisfactory and must be addressed immediately. EVIDENCE: Stennings is a small home and there is a relaxed, respectful atmosphere between staff and residents. Personnel files all contain detailed job descriptions and staff told the Inspector that they have been provided with good opportunities for training that helps their understanding of the specific needs of the residents. Staff meetings take place every month and members of the team told the Inspector that they are well supported by senior staff. The home has been recruiting new staff and the Inspector checked the personnel files. None contain adequate documentation for any staff, longer term or recently recruited. Two references are not routinely obtained, some in the files have no date. Most importantly, the home makes no requirement for a new enhanced CRB and POVA check to be completed before staff begin work in the home. The Registered Persons must review the recruitment procedure Care at Stennings H60-H11 S47546 Care at Stenning V223649 100505 Stage 4.doc Version 1.30 Page 19 immediately. This was a requirement made at the last inspection on 6th October 2004, and no improvement has been made. Care at Stennings H60-H11 S47546 Care at Stenning V223649 100505 Stage 4.doc Version 1.30 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 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) 37, 38, 39, & 42 The management approach at Stennings has created an open, positive and inclusive atmosphere for the residents. The current use of an external consultancy has resulted in some confusion about roles and responsibilities in respect of quality assurance and quality monitoring in the home. EVIDENCE: Residents at Stennings appear secure and confident. Those at home were happy to spend time with the Inspector and were clearly at ease. They made her very welcome, and took pleasure in telling her their views about the care and opportunities provided for them at Stennings. The atmosphere in the home is open and positive. A deputy manager has recently been recruited, which will support the role of the manager, Mrs Wellman. The record keeping in the home is carried out to a high standard and the content of reports and assessments make it clear that the views of the residents are prioritised in decisions made about their care. Care at Stennings H60-H11 S47546 Care at Stenning V223649 100505 Stage 4.doc Version 1.30 Page 21 The registered providers employ an external consultancy to monitor practice in the home, to provide professional advice and information and also to provide professional supervision for the manager. The consultancy can also take a part in the referral and initial assessment of prospective residents. It is evident that the breadth of remit of the external agency has created some difficulties in the lines of communication within the home. A conflict of interests also exists in that if not carried out by the registered providers, the Regulation 26 monitoring visits should be carried out by an employee who is not directly concerned with the conduct of the care home. Additionally, the Regulation 26 reports have not highlighted the unsatisfactory recruitment procedure in the home. A review of the current arrangements for supervision of the registered manager and the quality monitoring system should be carried out by the registered providers in order to improve the lines of accountability and communication in the home. Clearer roles and responsibilities are needed. Care at Stennings H60-H11 S47546 Care at Stenning V223649 100505 Stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 4 4 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 4 4 4 4 4 N/A 3 Standard No 11 12 13 14 15 16 17 4 4 4 4 4 4 4 Standard No 31 32 33 34 35 36 Score 3 3 3 1 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Care at Stennings Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 1 x x 3 x H60-H11 S47546 Care at Stenning V223649 100505 Stage 4.doc Version 1.30 Page 23 YES 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 23 Regulation 13 Requirement Specific training in Adult Protection to be provided in order that staff are clear about the homes procedures for responding to suspicion or evidence of abuse or neglect. The training to include Whistleblowing. (Standard 23.2) The Registered Persons must operate a recruitment procedure that fulfils the requirements detailed in Standard 34 and that complies with Regulation 19. (Previous timescale of November 2004 not met) The Registered Persons must establish effective quality assurance and quality monitoring systems. Timescale for action By 1st August 2005 2. 34 19 Immediate 12th May 2005 3. 39 24 & 26 By 1st August 2005 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 9 Good Practice Recommendations Risk assessments should be dated when completed and routinely reviewed. H60-H11 S47546 Care at Stenning V223649 100505 Stage 4.doc Version 1.30 Page 24 Care at Stennings Care at Stennings H60-H11 S47546 Care at Stenning V223649 100505 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection 2nd Floor, Ridgeworth House Liverpool Gardens Worthing, West Sussex BN11 1RY 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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