CARE HOME ADULTS 18-65
CARE (Walberton) Freeman Close, Eastergate Lane Walberton Nr.Arundel West Sussex BN18 0AE Lead Inspector
Mrs H Church Unannounced Inspection 28th November 2005 10:00 CARE (Walberton) DS0000014424.V267383.R01.S.doc Version 5.0 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 CARE (Walberton) DS0000014424.V267383.R01.S.doc Version 5.0 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. CARE (Walberton) DS0000014424.V267383.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service CARE (Walberton) Address Freeman Close, Eastergate Lane Walberton Nr.Arundel West Sussex BN18 0AE 01243 542714 01243 544796 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.care-ltd.co.uk CARE (Cottage and Rural Enterprises Ltd) Mrs Sarah Shallis Care Home 32 Category(ies) of Learning disability (32), Learning disability over registration, with number 65 years of age (32) of places CARE (Walberton) DS0000014424.V267383.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Only persons in the category LD (Learning disability) under 65 years may be admitted. 13th July 2005 Date of last inspection Brief Description of the Service: CARE Walberton is a care home registered to accommodate up to thirty-two service users in the category of adults with learning disabilities. The service is made up of two residential cottages, a separate day service and administration block located on the outskirts of Walberton West Sussex. Accommodation is provided in twenty-nine single rooms and three flat-lets. Facilities in each cottage include, a large lounge/dining room, kitchen, and a number of sitting rooms. There is a small covered swimming pool to the rear of one of the cottages. Orchards and gardens form the rest of the estate. The service is voluntary owned by Cottage and Rural Enterprises Limited (CARE) and the registered manager is Mrs Sarah Shallis. The Responsible Individual is Mr Michael Keighley. CARE (Walberton) DS0000014424.V267383.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. To prepare for this inspection, previous reports and letters were reviewed. The inspector noted that the Statement of Purpose and Service Users Guide had been updated in July 2004 to include relevant information on how the home is run and how residents can make any changes they wished to improve their lives there. The manager was present and assisted the inspector with the inspection. A number of residents were in the main workshop block before lunch and following this were able to speak to me about their lives. It was clear from the manner and demeanour of the residents as we toured the building and two residential cottages that they felt part of a large family; doing the work they enjoyed, fulfilling their lives and socialising both inside and outside the home. All of the residents were happy and relaxed in whatever activity they were undertaking. One resident, who had spoken with the inspector before, repeated her enthusiastic account of her independent living in a flat, furnished and decorated to her own style. During the inspection, three residents were seen in the cottages and three others seen following lunch in the main dining room. Others gave short comments when met in the grounds when accompanying the Manager. The inspector examined four resident’s records to obtain a clear account of some of the care provided. Some of the residents spoken to were able to give a clear account of their lives at CARE (Walberton) but even when unclear, without exception all body language and comments were enthusiastic. It was clear that residents are encouraged to say what they like or don’t like about the home. There were no requirements or recommendations made at this inspection. What the service does well:
CARE (Walberton) excels in valuing residents individual and collective needs in a warm, homely and friendly environment. Residents are encouraged to own it as their own home and live their lives in it to the fullest extent. Every aspect of their care needs is identified and staff are recruited and trained to support residents to seek out new opportunities and develop their independence. The home is being continually updated and from resident’s comments and observing staff at work, it was clear that the outcomes for residents are good with staff committed to individuality and treat their residents with respect and dignity. CARE (Walberton) DS0000014424.V267383.R01.S.doc Version 5.0 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. CARE (Walberton) DS0000014424.V267383.R01.S.doc Version 5.0 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 CARE (Walberton) DS0000014424.V267383.R01.S.doc Version 5.0 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 the following standard(s): 1-4 Trial visits are provided according to the individual and collective needs of the residents. Care plans are well documented and residents are provided with full information of care and services. Contracts are provided. EVIDENCE: The enthusiastic comments from residents on all aspects of their lives showed that the home is being run according to the residents needs and wishes. The records reflected the care being provided, the risk levels supported and the future aspirations to be achieved. Four care plans, tow form each cottage, according to the assessed needs identified. Trial visits were not examined on this occasion but are held in the main office and form the basis of care provided. Visits of varying lengths are provided according to the needs of the residents. The manager is involved in initial assessments and the home manager of each cottage included when appropriate. CARE (Walberton) DS0000014424.V267383.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6-10 All residents were clearly enthusiastic about the way CARE (Walberton) operates as both a care home and work placement. Independent living is available and residents have full choice about their work, home and social activities. EVIDENCE: Four individual care plans were examined and they all contained extensive information on the care required and provided. There was evidence to show that residents and their representatives have contributed and agreed to the care plans and risk assessments. Residents are encouraged to take identified risks and the staff commitment exceeds this standard. The inspector did note that a radiator that provided a risk for a resident was not covered to minimise this. The manager agreed to cover any radiators where residents were at risk from burns and scalds. Resident’s rooms reflected their varied interests and it was clear from specialist equipment provided that residents are encouraged to take identified risks both inside and outside the home.
CARE (Walberton) DS0000014424.V267383.R01.S.doc Version 5.0 Page 10 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 the following standard(s): 11-17 All residents have opportunities for personal development and to take part in activities in the community. Personal activities and relationships are respected and forming new relationships encouraged accordingly. EVIDENCE: Records showed that resident’s leisure activities and personal family contacts were being maintained and had goals set to develop these. One resident’s mother had been invited to spend Christmas with her daughter and accommodation had been provided locally for this. It was clear that each resident was being provided with extensive opportunities to develop their individual lives through activities, contacts from their peer group and families and the Christmas arrangements confirmed this. This exceeds the standard. One resident was looking forward to being more independent with accommodation off site. Two other residents had enjoyed their first holiday together and were planning another. Another resident had recently returned to site from outside accommodation with a new programme devised to support his needs and promote his confidence.
CARE (Walberton) DS0000014424.V267383.R01.S.doc Version 5.0 Page 11 Social activities included barbeques and events where families, friends and neighbours in the community could be included. The inspector observed a number of notices showing Christmas activities for all residents to attend. In the cottages, residents decide the menu and shop for this. One resident was being encouraged to join in the planning and learn about different foods. Emphasis is placed on healthy eating using reduced fat or sugar items. When residents occupy one of the flats, they choose their own menu and shop and cook the meals being reimbursed for the cost of the food. CARE (Walberton) DS0000014424.V267383.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 18-21 Residents receive personal care and or supervision and are supported to manage their own medication. The system for recording, storing, handling and disposal of drugs met the Medicines Act 1968, guidelines from the Royal Pharmaceutical Society and the requirements of the Misuse of Drugs 1971. EVIDENCE: Four care plans were examined and all of these showed evidence of updated emotional health care needs with strategies to meet residents changing needs. The commission had received appropriate accident/incident reports and statistics of these are well recorded. One resident is self-medicating her own medication with staff monitoring this. All medication was stored in a locked cabinet in a locked mediation room in the cottage and is only accessed through the senior person on duty. The current pharmacy arrangements have not included an inspection or training. The inspector recommended that if this could not be arranged locally, the Commission for Social Care Inspection pharmacy inspector would offer advice on this aspect of care. CARE (Walberton) DS0000014424.V267383.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 22,23 Residents are protected from abuse; self harm or neglect and involved in all discussions on all aspects of their daily lives. A complaints procedure is displayed and available in the Statement of Purpose and Service Users Guide. EVIDENCE: Residents meetings are held regularly and key workers support residents to make their views known at these meetings. It was clear that residents’ views are listened to and acted upon. The West Sussex County Council Adult Protection Procedures was available in the home and staff had received training on this. Staff are alert to all aspects of allegations of abuse and the procedures to ensure complete protection of all residents. Resident’s views are considered when choosing holidays, activities or meals. Each resident had been given a free choice of a holiday or given one to one support for special days out where holidays away are inappropriate. CARE (Walberton) DS0000014424.V267383.R01.S.doc Version 5.0 Page 14 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 the following standard(s): 24,25,26,27,28,29,30. The communal areas and resident’s bedrooms met all parts of these standards with specialist equipment present in areas where staff are required to assist with resident’s physical needs. EVIDENCE: The lounge/dining rooms in both cottages are of a suitable size and decorated, and arranged to allow all residents to participate in activities. All areas were seen to be clean and welcoming with potted plant arrangements in the entrances. Resident’s rooms were of a good size and decorated in individual styles with personal items arranged according to their wishes. It was clear that any additional furniture to display items was encouraged and agreed according to the use of the specialist equipment. Thermostatic valves are in place to restrict water temperatures to safe levels. Some radiators are guarded but where a risk is identified, unguarded radiators need covering. Having identified the risk, this must be minimised where possible. The home was clean and hygienic. CARE (Walberton) DS0000014424.V267383.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36. Staff are recruited according to robust recruitment procedures and receive training and supervision. EVIDENCE: The resident’s care plans showed the support required for maintaining and developing all aspects of daily living. Staff are recruited to meet these needs and provide the support required. At the time of the inspection, two new staff were receiving induction and the inspector was able to see the recruitment and induction programmes in place. It was clear that the recruitment drive planned at the previous inspection had been successful and a high standard of recruitment was implemented. Care had been taken to ensure the new members of staff complement the existing staff group. Training is high on the agenda of the manager and overall, the home continue to achieve 50 of staff with National Vocational Qualification level 2 with some staff doing level 3 and other staff waiting for places. The relaxed atmosphere between the manager, the members of staff and residents was apparent throughout the inspection with residents anxious to be included in all the discussions. CARE (Walberton) DS0000014424.V267383.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,41,42,43. The management style benefits and protects residents whose views are respected whilst acknowledging their rights as citizens. A new business plan was made available. EVIDENCE: The care plans demonstrated all aspects health, safety and welfare needs were being met with periphery records well maintained. The business plan shows an ongoing commitment to providing future care. All residents participate eagerly in the workshop or their cottage activities. This appeared to be the norm when responding to questions about their lives at CARE (Walberton). Throughout the inspection process, it was clear that residents choices were respected in every aspect of their lives from the choice of work, social and community activities their individual style of rooms. The responses to holidays and new developments in their lifestyles and by meeting all other aspects of care, clearly ensures outcomes for residents are very good. CARE (Walberton) DS0000014424.V267383.R01.S.doc Version 5.0 Page 17 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 3 3 3 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 4 3 3 3 Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 4 12 3 13 4 14 3 15 4 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 4 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
CARE (Walberton) Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 X 4 3 X DS0000014424.V267383.R01.S.doc Version 5.0 Page 18 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. 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. Refer to Standard Good Practice Recommendations CARE (Walberton) DS0000014424.V267383.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Worthing LO 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
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