Inspection on 12/01/06 for Chippings

This inspection was carried out on 12th January 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Chippings 11/06/07

Chippings 24/04/06

Chippings 07/07/05

Chippings 23/11/04

Chippings 04/08/04

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 Chippings Chippings 28 Russells Crescent Horley Surrey RH6 7DN Lead Inspector Deavanand Ramdas Announced Inspection 12th January 2006 10:00 Chippings DS0000013601.V270066.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 Chippings DS0000013601.V270066.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. Chippings DS0000013601.V270066.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Chippings Address Chippings 28 Russells Crescent Horley Surrey RH6 7DN 01293 775350 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) Gresham Care To be confirmed Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Chippings DS0000013601.V270066.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age/age range of the persons to be accommodated will be: 18-45 YEARS 7th July 2005 Date of last inspection Brief Description of the Service: The Chippings is a detached property located in a residential area in Horley, Surrey and provides accommodation for six service users with a learning disability. The property is close to public amenities and accommodation is on two floors accessed by stairs. The facilities on offer include six single bedrooms, lounge, a dining area, kitchen, bathrooms, toilets, showers, utility room and a sensory room. The home has a large garden which is private, secure and easily accessible and private parking is available to the front of the property. Chippings DS0000013601.V270066.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection by one inspector carried out over a period of 6 hours. A full tour of the premises took place, staff and service users were spoken to and care records and documents were inspected. Some service users have communication difficulties and judgements were made about them based on observations of their mood and behaviour during the inspection. The inspector would like to thank the manager, staff and service users for their contribution to the inspection and a CSCI business card was left at the home for information. A number of complaints have been received by the CSCI which have been investigated and action required by the home where necessary. A more recent complaint has yet to be resolved following an incident involving a service user at the home. What the service does well: What has improved since the last inspection? The home has appointed a manager and a deputy manager to provide leadership and stability to the staff team. The manager commented she is “concentrating on supporting staff during a period of change” and during discussions a member of staff stated we have “a new manager, new staff and it has been unsettling”. Recruitment at the home has proved successful and the home has a full compliment of staff to support service users. The provider has a development plan for 2006 which has resulted in recent investment in the home to improve the utility room and kitchen. One bathroom has been refurbished and decorated to make it nice, attractive and comfortable for service users. The home has met the previous requirements which have resulted in the property being well maintained, policies and procedures updated and a training Chippings DS0000013601.V270066.R01.S.doc Version 5.0 Page 6 plan developed for staff. During discussions a member of staff stated “the company offered good training opportunities for staff” 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. Chippings DS0000013601.V270066.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 Chippings DS0000013601.V270066.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): 1,2,3&4. The homes statement of purpose and service user guide are good providing service users and prospective service users with the details of services the home provides enabling an informed choice to be made about admission to the home. The systems for the assessment of needs are satisfactory ensuring service users aspirations and needs are assessed and identified. The arrangements for assessing needs are adequate ensuring the needs and aspirations of prospective service users will be met. However, please refer to the requirement set in respect of the review of a service user’s care plan under the next section of this report. The home offered contracts safeguarding the tenancy rights of service users. EVIDENCE: The home had a statement of purpose and service user guides which contained information about the home and was well presented, clearly written and in a widget format to make the information accessible to service users. The home had a procedure for admission and assessment and the manager stated service users were admitted to the home after a full assessment of needs had been undertaken. The inspector noted one service user had a joint assessment of needs and the home had person centred plans and health action plans which described service users aspirations and goals. The manager stated the home is capable of meeting the needs of service users and staff have completed the learning disability award framework (LDAF) and a training course in autism to equip them with the skills to support service users. Chippings DS0000013601.V270066.R01.S.doc Version 5.0 Page 9 Observations confirmed a member of staff using verbal prompts and gestures to communicate with a service user who was happy and smiling as he had been offered a placement to do voluntary work in a local shop. The manager stated the home offered contracts to service users which were sampled and dated and signed by the provider and purchaser. Chippings DS0000013601.V270066.R01.S.doc Version 5.0 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 the following standard(s): 6,7&9 The systems for care planning are satisfactory however a review must be undertaken on a service user to reflect his changing needs and ensure his health and safety. The arrangements for decision making are satisfactory ensuring service users are supported to make decisions about their lives. The systems for participation are adequate ensuring service users participate in all aspects of life in the home. EVIDENCE: The home has person centred plans dated October 2005 which are based on the homes own assessment and covers personal care, social support and health care needs. The plans are drawn up with the involvement of key workers, service users, family members, health care professionals and has individual guidelines for the management of challenging behaviours. The inspector noted one service user was involved in an incident which resulted in a serious injury and a requirement has been made for a care plan review to assess the adequacy of support plans, management guidelines and the suitability of the environment to ensure the safety of the service user. Please Chippings DS0000013601.V270066.R01.S.doc Version 5.0 Page 11 also refer to comments under standards 22-23 ‘Concerns, Complaints and Protection in respect of this matter. The manager stated service users are supported to make decisions about their lives which were recorded in the person centred plans. The company employed a placement officer to provide assistance to service users in finding employment and work placements and observations confirmed a member of staff using pictures to enable a service user to make decisions about his meals. The staff offered opportunities to service users to participate in the day to day running of the home and some policies and procedures are in a widget format to make the information understandable to service users. The home had regular service users meetings to enable service users to take part in discussions and to make decisions. Chippings DS0000013601.V270066.R01.S.doc Version 5.0 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 the following standard(s): 12,13 &16. The home supports service users to take part in valued and fulfilling activities. The arrangements at the home enable service users to be part of the local community. The policies and routines at the home promote the rights of service users. EVIDENCE: The home supported service users to take part in fulfilling activities and a number of service users attended a local college to do life skills, computer skills and environment awareness training. The home provided its own transport to enable service users to access the community and the home reflected the cultural diversity of service users by supporting a service user of Asian ethnicity to attend an Asian awareness course at a local college. Staff supported service users to integrate into the community by taking them to shops, pubs, cinema and other places of interest. The home had a policy on privacy and dignity and observations confirmed staff sitting and interacting with service users in the lounge and the manager knocking on service users bedroom doors before entering. One service user Chippings DS0000013601.V270066.R01.S.doc Version 5.0 Page 13 had a key to his bedroom and other service users had unrestricted access within the home. Chippings DS0000013601.V270066.R01.S.doc Version 5.0 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 the following standard(s): 18,20&21. The arrangements for personal support are satisfactory ensuring service users are supported in the way they prefer and require. The arrangements for the management of medication needs to improve to ensure the health and well being of service users are protected. Care planning for the ageing, illness and death of a service user need to improve to ensure it is handled with respect and as the individual would wish. EVIDENCE: The manager stated staff provided flexible personal support to service users which were recorded in the person centred plans. The inspector noted one service user had a communication plan which described his preferences for personal support and another service user had restrictions on times for going to bed which was agreed and recorded in the care plan. The home had a policy on medications and a service agreement with a local chemist that supplied medications on a monthly basis. The manager stated the home had a nominated staff with responsibility for medications and provided two locked metal cabinets for the storage of medications. The inspector sampled medication record sheets and noted they had a recent photograph of the service user and were dated and signed by staff with no discrepancies. The home had homely remedies which were approved by a doctor and a list of names of staff with specimen signatures for information. Observations confirmed the home had a prescribed medication which was not Chippings DS0000013601.V270066.R01.S.doc Version 5.0 Page 15 recorded on the medication record sheet and evidence confirming staff competence to administer medications was not available for some members of staff. This was discussed with the manager and a requirement has been made in this area to safeguard the health of service users. The home had a bereavement policy and some staff had training in managing emotion in bereavement, change and loss. As part of the company’s policy bereavement packs were sent to relatives to gather information about ageing, illness and death of service users and the manager stated the response was “poor”. Care plans did not reflect the wishes of service users concerning ageing, illness and death and a requirement has been made in respect of this matter. Chippings DS0000013601.V270066.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 The complaint process at the home is satisfactory with complaints information available to staff, service users and relatives. EVIDENCE: The home had a complaint policy which was in a widget format and copies were available in the service users’ guides for information. The manager stated the home kept a record of complaints and staff remarked they were aware of the complaint policy which was kept in the manager’s office. The inspector noted complaints received at the home were recorded and appropriate management action taken. A number of complaints have been received by the CSCI which have been investigated and action required by the home where necessary. A more recent complaint has yet to be resolved following an incident involving a service user at the home. Chippings DS0000013601.V270066.R01.S.doc Version 5.0 Page 17 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): 24,26&27. The home is well maintained ensuring service users live in a homely, comfortable and safe environment. Bedrooms are adequate promoting the independence of service users. Toilets and bathrooms provide sufficient privacy and meet the needs of service users. EVIDENCE: On the day of the inspection the home was clean, airy and free from offensive odours with a good standard of décor throughout and furniture and fittings were adequate. The inspector noted the utility room and kitchen area were being altered to make it more spacious and comfortable for service users as part of a planned maintenance programme. The home had single bedrooms which were well presented and personalised. One service user who liked football had his bedroom decorated in colours which reflected his personal choice and the football team he supported and another service user had his room simply decorated and furnished which reflected his choice and lifestyle. Bedrooms had wardrobes, chest of drawers, sinks, tables, chairs, carpets, lighting, ventilation and heating. The home had adequate toilets and bathrooms and one bathroom had been refurbished making it nice, comfortable and attractive for service users. A Chippings DS0000013601.V270066.R01.S.doc Version 5.0 Page 18 toilet was near to the dining room and lounge which was easily accessible by service users. Chippings DS0000013601.V270066.R01.S.doc Version 5.0 Page 19 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): 32&34 The arrangements for staff training need to improve to ensure the home achieve the target set for National Vocational Qualification (NVQ) training. The recruitment and vetting procedures for staff need to improve to protect service users from harm or abuse. EVIDENCE: The home had a training plan for 2006 and staff completed a training course in sign language, autism and preventing and responding to challenging behaviour which equips staff with the skills necessary for the job they are expected to do. The manager stated the home had good professional relationships with the GP and care managers and observations confirmed staff were approachable and comfortable with service users. The inspector noted the manager invited a service user to the office to participate in the inspection and he was clapping his hands which indicated he was happy based on the information given. During discussions a member of staff stated “the home offered good training opportunities to staff”. A review of staff training records confirmed the home had not met the targets set for National Vocational Qualification (NVQ) training and a requirement has been made to ensure service users are supported by competent staff. The home had a recruitment policy and recruitment files were sampled which contained completed application forms, references, CRB disclosure information, statement of terms and conditions and a recent photograph of the employee. The inspector noted the details a verbal reference had not been recorded and Chippings DS0000013601.V270066.R01.S.doc Version 5.0 Page 20 the manager remarked a follow up request would be made for a written reference. Action has been required in respect of this matter to protect service users for harm or abuse. Chippings DS0000013601.V270066.R01.S.doc Version 5.0 Page 21 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): 37,39&42 The management of the home is satisfactory however the manager needs to submit an application for registration to the commission. The arrangements for quality assurance are adequate ensuring service users participate in the development of the home. The systems for health and safety are satisfactory, however the home must ensure the regular servicing of equipment to protect the welfare of staff and service users. EVIDENCE: The home has manager with experience in managing learning disability services who has a National Vocational Qualification (NVQ) Level 4 in management. The manager stated she had overall responsibility for the home which included the implementation of policies and procedures, management of staff and the quality of care. During discussions a member of staff stated “team meetings are regular, care gets done and the lads get supported”. The manager is working a probationary period and on successful completion needs to submit an application for registration as manager of the home. The company has a development plan dated 2006 which details the financial investment and developments in the home to improve the quality of the Chippings DS0000013601.V270066.R01.S.doc Version 5.0 Page 22 accommodation for service users. The manager stated questionnaires were used to obtain feedback about the home and the home consulted with service users by having regular meetings. The inspector sampled questionnaires completed by relatives and it was recorded “just keep doing the good job that you are” and the last service user meeting was dated 23/12/05 to discuss the arrangements for a Christmas party. The home had a policy on health and safety, staff attended a training course in health and safety and a health and safety notice was posted in the office for information. A legionella test was done on 28/8/05, a small appliances test certificate was issued in March 2005, and a fire alarm service certificate was dated 10/11/05. Food storage was appropriate and refrigerator and freezer temperatures were within normal limits. The home did not have a current gas certificate and a requirement has been made for the gas boiler to be serviced to safeguard the health and safety of staff and service users. Chippings DS0000013601.V270066.R01.S.doc Version 5.0 Page 23 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 X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X 3 3 X X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 2 X 2 X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Chippings Score 3 X 2 2 Standard No 37 38 39 40 41 42 43 Score 2 X 3 X X 3 X DS0000013601.V270066.R01.S.doc Version 5.0 Page 24 No. Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard NMS-YA6 Regulation 12(1)(a) Requirement Timescale for action 01/02/06 2 NMS-YA20 13 (c) 3 NMS-YA20 13(c) The registered person must ensure a care plan review is undertaken to assess the changing needs of a service user and the suitability of the home to meet the service users’ needs. The review must involve consultation with all significant persons involved in the service user’s care including relatives; other health and social care professionals; and specialists where necessary. This matter must receive urgent attention in view of the recent serious incident at the home. The registered person must 01/02/06 make arrangements for the recording of medications and ensure prescribed medications are recorded on the medication record sheet. The registered person must 01/03/06 make arrangements for the safe administration of medications by ensuring staff have accredited training in medications with certificates/written confirmation available for inspection to evidence that such training has DS0000013601.V270066.R01.S.doc Version 5.0 Chippings Page 25 taken place. 4 NMS-YA21 12(3) The registered person must ensure care plans have a section to reflect the wishes of service users concerning ageing, illness and death of a service user. The registered person must complete an action plan with timescales outlining how National Vocational Qualification (NVQ) training targets for staff would be met and a copy sent to the commission for information. The registered person must ensure written references are obtained for all staff employed at the service and that the details of verbal references are recorded, dated and signed by the manager for information. The registered person must ensure an application for registration as manager is submitted to the Commission. The registered person must ensure that all gas appliances are regularly serviced and the home has a current gas certificate to evidence this is in order to promote the safety and welfare of staff and service users. 01/04/06 5 NMS-YA32 18(1)(a) 01/03/06 6 NMS-YA34 7,9 01/02/06 7 NMS-YA37 9 01/04/06 8 NMS-YA42 12(1) 20/01/06 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 No recommendations were made following this inspection Chippings DS0000013601.V270066.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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. Extracts may not be used or reproduced without the express permission of CSCI Chippings DS0000013601.V270066.R01.S.doc Version 5.0 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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