Inspection on 20/03/07 for Caroline House

This inspection was carried out on 20th March 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

Caroline House 16/10/08

Caroline House 07/03/06

Similar services:

Flint House

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

The Cotswold Home

Fairways

Treloar College

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

CARE HOME ADULTS 18-65 Caroline House 191 London Road Horndean Waterlooville Hampshire PO8 0HJ Lead Inspector Ms Sue Kinch Unannounced Inspection 20th March 2007 09:50 Caroline House DS0000064919.V326823.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 Caroline House DS0000064919.V326823.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. Caroline House DS0000064919.V326823.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Caroline House Address 191 London Road Horndean Waterlooville Hampshire PO8 0HJ 02392 592502 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) Dolphin Homes Limited Ann Mary Phillips Care Home 6 Category(ies) of Learning disability (6), Physical disability (6) registration, with number of places Caroline House DS0000064919.V326823.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To accommodate a named child DOB 24/02/1991 through to adulthood. Date of last inspection 7th March 2006 Brief Description of the Service: Caroline House is a detached property situated set back from the London Road in Horndean among other residential properties. The home is owned and run by Dolphin Homes Limited and provides accommodation for up to six adults with a learning disability and who may also have physical disabilities. The home has been adapted provide suitable equipment for people with physical disabilities. This includes a passenger lift, ramps, easy access showers, hoists and ramps. Services are provided on two floors. The ground floor shared area has been extended and now includes a large conservatory with rear exit to the garden. The garden is large and contains leisure equipment such as seats, table and a large trampoline. The current service focuses on meeting the needs of service users experiencing the transition to adulthood. Current fees range from £1000-£1600 per week. Caroline House DS0000064919.V326823.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection and all key standards were assessed. The site visit followed a review of the file, and consideration of a pre inspection questionnaire completed and supplied, by the manager, before to the visit. The visit was completed in 6.5 hours. Conversations were held with two service users, three of the staff and the responsible individual who assisted in the manager’s absence. Some of these conversations were private and others were in group situations. Care practices were observed. Service users assisted in a tour of some private and shared areas of the home and explained routines. A sample of records, policies and procedures were viewed. What the service does well: What has improved since the last inspection? What they could do better: No requirements have been made at the end of this report. It is recommended however that encouraging age appropriate surroundings and recreational activities is continued to enhance the adult status of the service users. Caroline House DS0000064919.V326823.R01.S.doc Version 5.2 Page 6 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. Caroline House DS0000064919.V326823.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 Caroline House DS0000064919.V326823.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 has an admissions procedure, which ensures that needs are assessed before admissions, and that service users needs can be met. EVIDENCE: The home has a referral and admission procedure and this was assessed for one of the three service users admitted since the last inspection. There is sufficient written information available to demonstrate that needs were assessed prior to the admission. A range of records is available and this also demonstrates that the service user’s needs have remained under review. Since the last inspection the registration conditions of the home have been varied and the home is now able to accommodate one named service user under 18. There are policies and procedures in the home that relate to this and additional procedures for review have been implemented. Being admitted to the home was discussed with one service user who had visited the home beforehand and had overnight stay. This service user had been involved in the decision-making about coming to the home and likes the home. Caroline House DS0000064919.V326823.R01.S.doc Version 5.2 Page 9 The homes last quality audit confirmed that the statement of purpose and service user guide had been reviewed. This was available in the home and in an easy read format. Caroline House DS0000064919.V326823.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 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 detailed and regularly reviewed giving attention to individual needs and wishes. EVIDENCE: Evidence of the care planning system was obtained in a number of ways. One file was looked at and discussed with a service user who was familiar with some sections of the file. Another care plan was viewed with a with a member of staff who was fully aware of its lay out and the contents. Other files were sampled in the office and discussed with the responsible individual. Conversations about care plans were also held with other staff and another service user. The service users spoken with agreed that they receive help that they need from staff with the examples discussed such as cooking, personal care and mobility. While talking about the help comments about the staff were ‘ they help me make choices’, ’nice’, ’smile’, ’work hard’ and ‘enjoy it’. Caroline House DS0000064919.V326823.R01.S.doc Version 5.2 Page 11 Staff said that they read and use the care plans. They explained how they plan their work and update each other at handovers. One member of staff said that the goals are worked on and that the activity timetables are worked to. They also gave examples of guidance kept in the kitchen regarding communication and this was viewed. Files are well organised and full of relevant information about the service users needs, covering a wide range of issues and how to support them. There are goals and evidence of reviewing information. Much day-to-day recording takes place for monitoring purposes. Each file also contains risk assessments with guidance for staff and evidence of reviews although these do need dating. Staff are required to read and sign these risk assessments as they are changed and they said that they do try and keep up to date. Evidence of signing to say they had read them was seen. Caroline House DS0000064919.V326823.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 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 being provided with opportunities for educational and social activities, community access and support from staff with relationships. Healthy and varied meals are offered with involvement from service users. EVIDENCE: In the week before the inspection all of the service users had been away for a weekend and had then enjoyed a week of being offered a range of outdoor activities. Most service users had participated fully but choices not to join in had been supported. The activities had included celebration of one of the service user’s birthdays. During the inspection both staff and service users spoke of their enjoyment and pleasure from the experiences. Staff are also regularly involved in offering service users a range of support with social and recreational needs. Caroline House DS0000064919.V326823.R01.S.doc Version 5.2 Page 13 Staff said they are able to keep to the activities timetable which as been devised for each service user. These are posted on the wall in the kitchen and are in pictorial form. Staff said that they do the things on the timetable and additional activities. Service users spoken to about this agreed. One listed some of the activities enjoyed: cinema, eating out, church, swimming, holidays, birthday celebrations and college. Staff said that there is always a driver on shift, staffing levels also allow for spontaneous trips out. Adults do not normally engage some of the activities provided. This includes watching children’s, TV- listening to children’s music and using toys. This was discussed with the responsible individual who said that at the home they are working on promoting adult status among service users. Staff members help service users to keep in touch with family and friends. Examples spoken about by staff and service users were phoning and arranging to visit relatives and sending e-mails. Two service users spoke of inviting a friend for tea regularly. The new lift enables service users with wheelchairs to go to the first floor and this means that they are more able to visit each other. Staff spoke of working and supporting with social and emotional skills. One resident talked of being able to do things with the friends particularly liked in the house. Staff and service users provided information to indicate that rights and responsibilities are promoted in the home. Some examples spoken of included service users being encouraged to be involved in domestic activities, making food choices and making decisions about when to get up and go to bed. The home assists with financial management and although this is regularly audited within the organisation, some minor errors had been made. The responsible individual agreed to address this and talked of plans to promote service users rights further in this area. Comments about food are positive .One service user spoke of liking the food, that it is good, there is enough food and some choice and staff help to get it ready and clear it up. Another service users said that the food was good A menu is provided but staff members encourage service users to make their own decisions and staff gave examples of how they do this with service users who use non verbal communication such as gestures. They said that they record what each person has eaten in relevant files. This was noted when looking at files. Caroline House DS0000064919.V326823.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users are positively supported with personal care and emotional and physical health. Service users benefit from trained staff members who deal with medication competently. EVIDENCE: How service users wish to be supported in personal and health care is documented in their care plans and records show that this is regularly monitored. The manager does monitoring on a monthly basis collating information to form an overview of health needs and support given. There was sufficient verbal and written evidence that service users are given support with health needs. One service user discussed some of the detail of support with the inspector and confirmed that help was given. Another said that staff looked after them well when ill. The responsible person said that physiotherapy is regularly received. One service user confirmed that staff helped with exercises. Moving and handling assessments are in place. In discussion about one service Caroline House DS0000064919.V326823.R01.S.doc Version 5.2 Page 15 user a member of staff mentioned that the support that staff had given had reduced the service users signs of stress. Medication is held securely and only trained and assessed staff are responsible for administration. Evidence of training was seen in the training records and in the file sampled there was evidence of an assessment of skill. Elements of the medication system were assessed. In the sample of administration sheets seen administration has been recorded and signed for .A list of staff names and signatures are recorded at the front of the medication file. Controlled drugs are held and stored in an inner lockable box. Some associated records were viewed and checked against a sample of stocks. These corresponded. There was some confusion over what had happened to some of the drugs but this was resolved by checking the separate record of drugs coming in and out of the home. The responsible individual agreed that some clearer recording could help. Caroline House DS0000064919.V326823.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Systems are in place for service users to express their views in the home Staff also consider service users non-verbal communication and take this into account on a day-to-day basis. Systems are in place to offer child and adult protection. EVIDENCE: CSCI has not received any complaints about the service since the last inspection. Service users said that they are able to talk to the staff if they have problems or need help. Staff confirmed that service users do talk to them about problems. They also gave examples of how they watched for responses from those relying more on non-verbal communication and take their actions into account. There is a complaints procedure in the home and this is available in a pictorial format. One formal complaint had been made since the last inspection and had been addressed by the home. Local child protection and adult protection procedures are held in the home. Staff can access these and are aware of them. During the site visit there was sufficient verbal evidence from staff and from records to demonstrate that the home provides staff training in child and adult protection. A member of staff spoken to about reporting was confident that support is always available for emergencies. In respect of child protection there was evidence of links with education and social services with regular reviews. The responsible individual gave example of current action being taken to ensure safeguards are in place, Caroline House DS0000064919.V326823.R01.S.doc Version 5.2 Page 17 of involving appropriate agencies and of raising issues with care managers in relation to this home. Caroline House DS0000064919.V326823.R01.S.doc Version 5.2 Page 18 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): 24,30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users have a comfortable, well-decorated, clean and regularly maintained and improved environment to live in. EVIDENCE: The service users and staff keep the home clean. It is pleasantly decorated and staff said that service users had been involved in decisions about the colours of their rooms. Two service users who talked about their rooms liked them. These rooms were equipped with adaptations to meet individual needs and had been given personal touches. The new conservatory has increased the amount of open plan shared space available and the level of light in the home. Blinds are planned to protect service users from the heat in the summer though their effectiveness will need to be monitored. Ramps are provided to the front and rear of the home and bathrooms are accessible to service users in wheelchairs. There were some signs of wear and tear: a toilet seat was broken; a shower side was on the floor and one of the doorframes was badly damaged from a wheelchair. However, staff said that there was a system for maintenance and Caroline House DS0000064919.V326823.R01.S.doc Version 5.2 Page 19 the company’s maintenance person was available regularly. They said that things were fixed promptly. Policies and procedures are in place concerning infection control and guidance is readily available about hand washing. Staff spoken to had either had infection control training or advice with training to come. One person asked spoke of action to take to maintain infection control and confirmed that protective aprons and gloves were available. These were seen in the bathroom. Caroline House DS0000064919.V326823.R01.S.doc Version 5.2 Page 20 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): 32,34,35 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 a thorough staff recruitment policy and procedure. Sufficient numbers of appropriately and increasingly trained staff members with good awareness of their roles and responsibilities, support service users. EVIDENCE: During the day shifts three staff are provided to meet the needs of the six service users. They are supportive and helpful towards the service users and care for them in a friendly and pleasant manner. They feel that they are able to meet the range of needs of the service users and have time for assistance with recreational and social support. They were noted to be providing service users with social stimulation during the visit to the home. One member of staff commented that staff in the home were clear about their roles. Records of recruitment were considered and all of the samples requested to be viewed were available showing that there is a system in place to carry out the required checks of staff backgrounds before commencement of employment at the home. Caroline House DS0000064919.V326823.R01.S.doc Version 5.2 Page 21 There was much evidence of support for staff training in the home. Samples of records showed that new staff have had a comprehensive induction training programme. The home uses a programme of induction from a training company. Staff members complete an individual workbook that is then sent for external marking and a certificate is then sent to them. Staff members are then encouraged to undertake various pieces of training including some to assist in meeting more specific health needs. The manager has a training log for each staff member. Records sampled indicated that staff, in programme of training, receive core training in fire safety, health and safety, administration of medicines, manual handling, infection control, food hygiene, risk assessment and diet and nutrition, over a period of time. All staff members have all had training in child protection and further training is planned. They are also provided with adult protection training. The attainment of National Vocational Qualification is promoted and all staff either have achieved level 2 or above or are working towards it. Regular house meetings, daily handovers and regular supervision also support staff. Caroline House DS0000064919.V326823.R01.S.doc Version 5.2 Page 22 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): 37,39,42 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 management use of effective quality auditing and use of a quality monitoring system based on seeking views of service users, staff, family members and other professionals. Service users live in a unit that is well run with an open management approach that promotes their protection, safety and welfare. EVIDENCE: The registered manager was appointed to her post prior to the registration of the home in August 2005 with relevant experience and training. Since the last inspection she has successfully completed the Registered Managers Award and has continued to update herself with regular training. Verbal feedback through Caroline House DS0000064919.V326823.R01.S.doc Version 5.2 Page 23 the inspection process confirmed that she is approachable and supportive to staff and service users. There are several elements to the quality assurance system in the home. The views of service users, staff, relatives and others are sought and recent evidence of this was viewed. Most comments are positive and where an issue about laundry had been raised the responsible individual gave details of action taken by the company to rectify the matter. The responsible individual audits aspects of the service in the home every six months and the manager is provided with written feedback and an action plan. Progress is monitored at subsequent audits. In addition monthly regulation 26 visits are made and recorded. Within the home are a number of regular checks such as the weekly health and safety checks. Health and safety is addressed and promoted in the home. Sample of records of regular checks needed in the home were examined and all have been completed within the timescales required. A report from an environmental health officer following a visit in February 2007 confirmed that the home had been given a food standard award for cleanliness and food hygiene. There is evidence that staff have health and safety training and support. Fire training was discussed and there is evidence that this is regularly organised. Recent training by an external provider was reported by staff to have taken place although this needed to be recorded. However a sample of staff training records showed that other key areas of training, such as food and hygiene, moving and handling, and first aid have been provided and refreshers are planned. Training involves a mixture of distance learning and practical sessions. Caroline House DS0000064919.V326823.R01.S.doc Version 5.2 Page 24 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 3 33 x 34 3 35 3 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 Caroline House DS0000064919.V326823.R01.S.doc Version 5.2 Page 25 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 Caroline House DS0000064919.V326823.R01.S.doc Version 5.2 Page 26 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 Caroline House DS0000064919.V326823.R01.S.doc Version 5.2 Page 27 - 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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