CARE HOME ADULTS 18-65
Churchill House 23 Winifred Road Waterlooville Hampshire PO7 7TD Lead Inspector
Nick Morrison Unannounced Inspection 12th December 2005 10:00 Churchill House DS0000011742.V271388.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 Churchill House DS0000011742.V271388.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. Churchill House DS0000011742.V271388.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Churchill House Address 23 Winifred Road Waterlooville Hampshire PO7 7TD 023 9224 1483 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) www.caremanagementgroup.com Care Management Group Limited Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Churchill House DS0000011742.V271388.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Service users in the category LD are only to be admitted between the ages of 30 and 55 years 26th July 2005 Date of last inspection Brief Description of the Service: Churchill House is a semi-detached house within walking distance of the main shops in Waterlooville. The house has parking at the front and a large, wellkept garden to the rear. There are two bedrooms for service users on the first floor, along with a sleep-in room for staff and a bathroom. The other service users bedroom is on the ground floor at the front of the house. Also on the ground floor are the lounge, the conservatory/dining room and the kitchen. The home is owned by the Care Management Group (CMG). At the time of inspection there was no Registered Manager. The Responsible Individual is Mr Michael Buckingham. Churchill House DS0000011742.V271388.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the second unannounced inspection of the home in this financial year and concentrated on those standards not assessed at the previous inspection as well as the standards that were not met at the previous inspection. This report should be read in conjunction with the report from the inspection on 26/7/05. The inspection lasted for three hours and included a tour of the home, discussion with the Team Leader and staff and discussion with one of the three service users. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Churchill House DS0000011742.V271388.R01.S.doc Version 5.0 Page 6 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 Churchill House DS0000011742.V271388.R01.S.doc Version 5.0 Page 7 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): 2 Service users benefited from having their needs and aspirations assessed on a regular basis. EVIDENCE: Evidence from service users’ files showed that they had all had care management assessments prior to moving into the home. In addition, the home undertook further assessments of service users’ needs on a regular basis. These had recently been updated. Assessments were comprehensive and addressed a full range of need areas. Records showed that service users had been involved in the assessments as far as possible and this was confirmed in discussion with a service user. Individual Care Plans on file clearly related to the issues identified through the assessment process. Churchill House DS0000011742.V271388.R01.S.doc Version 5.0 Page 8 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): 7 and 9 Service users benefit from assistance to make decisions about their own lives, but are not fully protected by the home’s risk assessment practices. EVIDENCE: The service user spoken with was clear that he was able to make his own decisions about his life and lifestyle and that these were supported by staff. Staff spoken with were able to demonstrate an understanding of the need to support service users to make their own decisions. Records examined confirmed the service user’s account of how he had been supported to undertake activities as a result of needs he had identified with staff and how he had changed his mind after trying them and decided he no longer wished to continue with them. There were further examples in service users’ records of how the support they received changed in response to the changing wishes of service users. Risk assessments were on file for each service user to cover areas where potential risk had been identified. The files contained many risk assessments, some of which had been written more than two years ago. More current risk assessments were also available, but were not kept under regular review. There was no indication on the assessments as to how often they needed to be reviewed and no review dates had been set. There was no evidence that the risk assessments were taken account of in supporting service users.
Churchill House DS0000011742.V271388.R01.S.doc Version 5.0 Page 9 The risk assessments seen were clearly written and easy to follow. Churchill House DS0000011742.V271388.R01.S.doc Version 5.0 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 17 Service users’ rights are protected and they enjoy a healthy and nutritious diet. EVIDENCE: The service user spoken with said that his rights were protected and was not able to think of any areas where this was compromised. Service users had keys to their rooms and were able to lock them when they went out. The Statement of Purpose and Service User Guide were clear about the rules in the home and each service user had a copy. These also contained information on who service users could talk to if they were unhappy about any aspect of the home. Both documents were produced in an easily accessible format for service users who had some difficulty reading. The Inspector saw menus for the previous and coming weeks. Service users were involved in writing the menus and were supported to consider the need for balanced and healthy meals. The menus showed that the food offered was healthy and a variety of meals were available. There were not different choices available at each mealtime, but the menus were based around the known and expressed preferences of each of the three service users. An alternative was available if any of the service users decided on the day that they did not want
Churchill House DS0000011742.V271388.R01.S.doc Version 5.0 Page 11 what was on the menu. The individual dietary requirements of each service user were recorded on the assessments referred to under standard 2. Churchill House DS0000011742.V271388.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Service users benefit from having personal support in the way they prefer. EVIDENCE: The service user spoken with was able to confirm that he had been consulted bout how he preferred to receive personal care and this had been recorded on his care plan. The care plan was clearly written and specific enough to explain to each member of staff the exact support they needed to give and how it needed to be given. Staff spoken with were clear about each person’s care plan and individual preferences. Churchill House DS0000011742.V271388.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Neither of these standards was assessed on this occasion. EVIDENCE: Churchill House DS0000011742.V271388.R01.S.doc Version 5.0 Page 14 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were assessed on this occasion. EVIDENCE: Churchill House DS0000011742.V271388.R01.S.doc Version 5.0 Page 15 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34 and 36 Service users benefit from being protected by the home’s recruitment practices. Service users would benefit further from being supported by staff who are well supported and supervised. EVIDENCE: The home has a suitable recruitment and selection procedure in place and records demonstrated that this was followed appropriately. All staff had had necessary checks prior to beginning work in the home. One member of staff had only received two support and supervision sessions in the last twelve months and another had received three. Staff spoken with confirmed that this was due to managers not having enough time to undertake support and supervision sessions. Requirements about regular support and supervision for all staff had been made at the previous three inspections. The Commission for Social Care Inspection is now addressing this matter in correspondence with the service provider. Churchill House DS0000011742.V271388.R01.S.doc Version 5.0 Page 16 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 and 39 Service users would benefit from the home being managed more effectively and from having their views represented in the home’s annual development plan. EVIDENCE: The home is one of three in the local area owned by the Care Management Group. At the time of inspection there was one manager in post to cover the three homes. The Deputy Manager post had been vacant for over four months. The lack of staff supervision, out of date risk assessments and lack of adequate quality assurance systems showed that there was insufficient management time going into this particular home. Staff spoken with were aware of the limited time the manager had to cover all three homes and acknowledged that this caused problems for this home. A requirement has been made in respect of this and the Commission for Social Care Inspection is following up the issue in correspondence with the provider. Churchill House DS0000011742.V271388.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 X 2 X Standard No 24 25 26 27 28 29 30
STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11
12 13 14 15 16 17 X X X X X 3 3 Standard No 31 32 33 34 35 36 Score X X X 3 X 1 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Churchill House Score 3 X X x Standard No 37 38 39 40 41 42 43 Score 1 X 2 X X X X DS0000011742.V271388.R01.S.doc Version 5.0 Page 18 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard YA9 YA36 Regulation 13 18 (2) Requirement All risk assessments must be kept under regular review. Regular Support and Supervision must be in place for all staff. This requirement was made at the three previous inspections on 17/10/04, 15/12/04 and 26/7/05. The Management arrangements for the home must be reviewed and sufficient management time should be put into the home. The home must implement a quality assurance process based on seeking the views of service users. Timescale for action 28/01/06 28/01/06 3. YA37 8, 18 28/01/06 4. YA39 24 28/01/06 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 Churchill House DS0000011742.V271388.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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