Inspection on 24/04/06 for Chippings

This inspection was carried out on 24th April 2006.

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 no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Chippings 11/06/07

Chippings 12/01/06

Chippings 07/07/05

Chippings 23/11/04

Chippings 04/08/04

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Insight - Eastchurch

Southfields

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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 Unannounced Inspection 24th April 2006 10:00a Chippings DS0000013601.V290989.R01.S.doc Version 5.1 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.V290989.R01.S.doc Version 5.1 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.V290989.R01.S.doc Version 5.1 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.V290989.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age/age range of the persons to be accommodated will be: 18-45 YEARS 12th January 2006 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.V290989.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out by one inspector over a period of 5 hours. A partial tour of the premises took place, staff and service users were spoken to, and care records and documents were inspected. Some service users living at the home have communication difficulties and judgements were made about them based on their mood, behaviour and information given by staff. On the day of the inspection the manager and deputy manager was off duty and the inspection was facilitated by care staff who have a knowledge and understanding of how the home operated. The inspector would like to thank the staff on duty and service users for their contributions to the inspection. What the service does well: What has improved since the last inspection? The home has erected a chain link wire fence to the right hand side boundary of the property to prevent a service user damaging the boundary hedge. A summer house has been erected in the back garden offering a private area to one service user for relaxation and enjoyment. Staff training in medications has been addressed and the provider has a service level agreement with a local chemist to provide accredited medication training for staff working in the home. The home has met the requirements made in the last inspection resulting in improvements in care planning, health and safety and records kept at the home. The provider has made significant investment in the home to improve facilities for staff and service users and the home has new carpets, a new laundry room and equipment for the benefit of staff and service users. During discussions a care staff stated ‘‘the laundry facilities have been a big improvement’’. The home has appointed a manager to provide management stability, leadership and direction to the staff team and an experienced deputy manager Chippings DS0000013601.V290989.R01.S.doc Version 5.1 Page 6 is also in post. During discussions staff stated ‘‘things have improved and the home is more stable’’. Service users living at the home are engaged in a recycling project run by the local council collecting cardboard, cans and tins to improve the environment in which they live. 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.V290989.R01.S.doc Version 5.1 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.V290989.R01.S.doc Version 5.1 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 The homes statement of purpose and service user guide are good providing service users and prospective service users with the details of the services the home provides enabling an informed choice to be made about admission to the home. The arrangements for assessing needs are adequate ensuring service users need are assessed and identified prior to admission to the home. EVIDENCE: The home has a statement of purpose and service user guide which was dated January 2006. The information contained in the statement of purpose was clearly written and nicely presented in a widget format to make the information accessible and understandable to service users. The inspector noted one section was in need of updating to reflect the appointment of a manager to the home and action has been required in respect of this matter. The home has a policy on assessment of needs and service users admitted to the home have a full assessment prior to admission which covers health, personal care and social care needs. One service user admitted to the home had a joint needs assessment and a care plan which reflected how needs and aspirations would be met by the home. During discussions a service user remarked he was happy at the home and with the other service users who live at the home. Chippings DS0000013601.V290989.R01.S.doc Version 5.1 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): 6,7&9 The arrangements for care planning at the home are adequate ensuring service users assessed needs are reflected in their care plans. The systems for decision making at the home is satisfactory ensuring service users are supported to make decisions about their lives. Risk taking policies are adequate however the home needs to ensure risk assessments and risk taking plans are dated and signed by staff. EVIDENCE: The home has care plans drawn up with the involvement of service users together with relatives, care staff and other professionals. The home has a key worker system which is regularly reviewed and one care plan was updated on the 26/01/06. The inspector noted a service user who displayed behaviours that challenge the service had a specialist behavioural assessment dated 06/04/06 to enable staff to support the service user in question consistently and safely. The home involves service users in decision making which is reflected in the care plans. Observations confirmed staff provided service users with information to make decisions about their own lives and one service user was Chippings DS0000013601.V290989.R01.S.doc Version 5.1 Page 10 observed to make a decision about accessing his bedroom and listening to music which was reflected in his management guidelines. The home has a policy of risk taking and risk taking plans are in place for service users. The inspector noted some risk taking plans were not signed and dated by care staff and action has been required in respect of this matter to ensure risk assessments meet the needs of service users. Chippings DS0000013601.V290989.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 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 personal relationships with families and the rights of service users. Meals at the home are good offering both variety and choice however the menu plans needs to be reviewed by a dietician to ensure it meets the nutritional needs of service users. EVIDENCE: Service users at the home have opportunities for education and occupation and some service users attend a local college. The home has its own transport to enable service users to access community facilities and the inspector noted service users were supported by staff to use public transport to access shops, pubs, cinema and other places of interest. The home has a policy on sexuality and relationships dated August 2005 and signed and dated by care staff. The home support service users to maintain family links and friendships and the inspector noted relatives visited service users at the home regularly. Observations confirmed service users had Chippings DS0000013601.V290989.R01.S.doc Version 5.1 Page 12 unrestricted access in the home and staff supported service users in maintaining their independence. A care staff supported a service user to walk using verbal and physical prompts to enable the service user to maintain his mobility in the home. The home has a written weekly menu plan and a record of meals eaten by service users. Service users are involved in planning the menu and in the preparation of meals and one service user with religious requirements have his special dietary needs catered for by the home. The inspector noted the menu offered variety and choice and meals were nicely presented however the menu needs to be checked by a dietician to ensure it meets the nutritional needs of service users. Chippings DS0000013601.V290989.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19&20 The arrangements for personal support are satisfactory ensuring service users are supported in the way they prefer. The arrangements for meeting the health care needs of service users living at the home are adequate. Medication management at the home is good and promotes the health of service users. EVIDENCE: Service users are supported in a way that promotes their privacy and dignity and the inspector noted a care staff knocking on doors before entering service users bedrooms. Service users preferences about personal support are recorded in care plans and observations confirmed staff supported service users to maintain their independence in choosing clothing, meals and activities. The home has health action plans and service users have access to a GP, dentist, optician and chiropodist to maintain good health. The home has a policy on medications dated August 2005 and staff are in the process of receiving accredited training in medications. Medication recording sheets were sampled, dated and signed by staff and had a recent photograph of the service user. The home has a service level agreement with a local chemist and medications are supplied to the home on a monthly basis. The home kept a record of medications returned to the pharmacy which was signed and dated by care staff and the pharmacist. Medications are stored in a locked Chippings DS0000013601.V290989.R01.S.doc Version 5.1 Page 14 metal cabinet secured to the wall in the staff office which are appropriately labelled for information and the home had a list of homely remedies approved by a doctor. Chippings DS0000013601.V290989.R01.S.doc Version 5.1 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 the following standard(s): 22&23 The complaints process at the home is satisfactory with complaints information available to staff, service users and relatives. The arrangements for protection are satisfactory ensuring service users are safeguarded from abuse, neglect and harm. EVIDENCE: The home has a complaint policy dated August 2005 and complaints information is in a widget format to make the information accessible to service users. The home kept a record of complaints which was sampled and the inspector noted appropriate management action had been taken. A recent complaint following an incident at the home has been investigated by the CSCI (Commission for Social Care Inspection) and management action has been required by the provider to promote the safety of service users. The home has a policy on abuse and a whistle blowing policy dated August 2005 and staff had training in protection of vulnerable adults. A care staff stated that any allegations of abuse would be taken seriously, recorded and be handled by the manager. The inspector noted the company offered training to enable staff to deal with verbal and physical aggression and had introduced a de-briefing policy to support staff involved in serious incidents. The home did not have a copy of the local authority (Surrey County Council) procedure on safeguarding vulnerable adults and action has been required in respect of this matter. Chippings DS0000013601.V290989.R01.S.doc Version 5.1 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 the following standard(s): 24,25&30 The systems for managing the premises are adequate ensuring service users live in a homely and comfortable environment however the downstairs corridor and hallway needs painting and decorating to make it nice for service users. Bedrooms are adequate promoting the independence of service users. The arrangement for hygiene and control of infection is adequate ensuring the home is clean and hygienic. EVIDENCE: On the day of the inspection the home was clean, well presented and free from mal odour. The standard of décor was generally good throughout the home however the downstairs corridor and hallway was in need of painting and decorating and action has been required in respect of this matter. The gardens were well maintained and the inspector noted contract gardeners working in the front garden to clear the hedge and improve the driveway. One service user had a summer house installed in the back garden for his enjoyment. Bedrooms were nicely decorated, well presented, personalised and one service user with difficult behaviours had the flooring in his bedroom replaced to meet his needs. Furnishings and fittings were of good quality and the home had new carpets in the hallway and stairs. Facilities for staff and service users have improved as a result of recent investment and the home has a laundry room with two washing machines and a dryer. Staff had training in infection control Chippings DS0000013601.V290989.R01.S.doc Version 5.1 Page 17 and observations confirmed staff practised infection control measures by washing their hands regularly and using disposable gloves. The home kept a record of repairs and maintenance to the home with appropriate management action taken and a care staff commented ‘‘the new laundry facilities have been a big improvement’’. Chippings DS0000013601.V290989.R01.S.doc Version 5.1 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 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): 32,34,35&36 The arrangements for qualifications needs to improve to ensure service users are supported by competent and qualified staff. The recruitment and vetting procedures for staff is satisfactory ensuring service users are protected from harm or abuse. The arrangements for staff training and development are adequate ensuring the needs of service users are met by appropriately trained staff. The systems for staff supervision needs to improve to ensure service users benefit from a well supervised staff team. EVIDENCE: Observations confirmed staff at the home respected service users and were good listeners and communicators using pictorial aids to communicate with service users. Staff have appropriate training and skills in communication and have an understanding of the cultural beliefs and needs of service users. The home is working towards all staff having a (NVQ) National Vocational Qualification and a requirement has been made for the home to do a plan outlining how NVQ targets would be achieved. The home had a training plan for staff dated 2006 and a dedicated budget for staff training. Staff had training in a number of areas which included autism, preventing and responding to challenging behaviour and sign language to equip them with the skills necessary for the job they are expected to do. The home is committed to staff training and development and staff working at the home have completed LDAF (learning disability award framework) training. Chippings DS0000013601.V290989.R01.S.doc Version 5.1 Page 19 Staff had individual training plans and the inspector noted the home had carried out a training needs assessment for the staff team as a whole. The home had a staff recruitment policy and management action has been taken to improve vetting practices for staff. The inspector noted the supervision of staff was inconsistent and was confirmed during discussions with care staff and action has been required in respect of this matter to ensure service users benefit from a well supported staff team. Chippings DS0000013601.V290989.R01.S.doc Version 5.1 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 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 arrangements at the home needs to improve and the manager must submit an application for registration to the CSCI (Commission for Social Care Inspection) to ensure service users benefit from a well run home. The arrangements for quality assurance are satisfactory ensuring service users participate in the development of the home. The systems in place for health and safety are adequate ensuring the health and safety of service users and staff is promoted EVIDENCE: The home has appointed a manager to provide management stability, leadership and direction to the staff team. The manager has experience of supporting people with a learning disability and worked with the company for four years. The inspector noted a deputy manager is also in post to provide additional management support if necessary. A care staff stated ‘‘ things have improved and the home is more stable’’. The home had a policy on quality assurance and used questionnaires to obtain feedback about the home. A care staff stated the home consulted with service users by having regular monthly Chippings DS0000013601.V290989.R01.S.doc Version 5.1 Page 21 meetings and the provider carried out monitoring visits. The inspector noted a Regulation 26 (record of monthly monitoring visits) kept at the home was dated March 2006 and appropriate management action taken. The home has a policy on health and safety dated August 2005 and staff have training in health and safety. As a result of an incident at the home an independent health and safety advisor made a number of requirements and management action has been taken to promote the safety of service users. Staff have mandatory training in fire, food hygiene, moving and handling, and first aid. The kitchen was inspected and found to be clean, food was appropriately stored and fridge and freezer temperatures were within normal limits. The inspector noted a health and safety notice was in the office for information and management action has been taken to produce a gas certificate for the homes boiler and central heating system. Chippings DS0000013601.V290989.R01.S.doc Version 5.1 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 Standard No Score 1 2 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 2 25 3 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 X 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 3 X Chippings DS0000013601.V290989.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? No. STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA1 Regulation 17(3)(a) Requirement The registered person must ensure the statement of purpose is amended to reflect the name and qualifications of the manager appointed to the home. The registered person must ensure risk assessments and risk taking plans are regularly reviewed, dated and signed by staff to promote the independence and safety of service users. The registered person must ensure the homes menu plan is checked by a dietician to assess the nutritional valve of the menu to meet service users need. The registered person must ensure the downstairs corridor and hallway is painted and decorated to make it nice and attractive for service users. The registered person must ensure staff have regular supervision at least six times a year so that service users can benefit from a well supported staff team. The registered person must ensure an application for DS0000013601.V290989.R01.S.doc Timescale for action 01/07/06 2 YA9 12(1) 01/05/06 3 YA17 16(2)(1) 01/07/06 4 YA24 23(2)(d) 01/08/06 5 YA36 18(1)(c) (ii) 01/06/06 6 YA37 9 01/06/06 Chippings Version 5.1 Page 24 7 YA35 18(1)(a) registration as manager is submitted to the CSCI (Commission for Social Care Inspection) without delay so that service users can benefit from a well run home. The registered person must do a 01/07/06 training plan outlining how the home will achieve the target set for NVQ (National Vocational Qualification) for staff and a copy of the plan be sent to the CSCI for information. 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 YA23 Good Practice Recommendations The registered person shall ensure a copy of the local authority (Surrey County Council) procedure on safeguarding vulnerable adults is available at the home for information. Chippings DS0000013601.V290989.R01.S.doc Version 5.1 Page 25 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.V290989.R01.S.doc Version 5.1 Page 26 - 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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