CARE HOME ADULTS 18-65
Croft House Redlands Lane Fareham Hampshire PO14 1EX Lead Inspector
Nick Morrison Unannounced 13 September 2005
th 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 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 Stationary 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. Croft House H54 S33288 Croft House V248167 130905.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Croft House Address Redlands Lane, Fareham, Hampshire PO14 1EX Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01329 280600 Hampshire County Council Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Croft House H54 S33288 Croft House V248167 130905.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: 1 Wheelchair users may only be accommodated on the ground floor, in rooms 2, 4 and 5. Date of last inspection 10/05/05 Brief Description of the Service: Croft House is a Hampshire County Council Home for adults with learning disabilities aged 18-65. The home is divided into four separate units. There are two main units for five service users and two units for more independent living or more intensive support. These can each accommodate one service user. The home is a short distance from Fareham town centre with nearby access to public transport. The primary reason for care is learning disability but some service users may have additional needs. Emergency admissions may occur, which can lead to the home reducing its respite service at times. The home may also become involved in longer-term care whilst waiting for alternative accommodation to be provided. Care plans are prepared with service users and relatives. The home has a sensory room, computer equipment, and a garden. Croft House H54 S33288 Croft House V248167 130905.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection, lasting four hours, during which the Inspector toured the premises and spoke with service users, staff and the Manager. A sample of four service user files were seen. All other records referred to in the report were seen by the Inspector on the day. This inspection concentrated on the core standards not assessed at the previous inspection and this report should be read in conjunction with the report of 10th May 2005. 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.
Croft House H54 S33288 Croft House V248167 130905.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Croft House H54 S33288 Croft House V248167 130905.doc Version 1.40 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 standard(s) None of these standards were assessed on this occasion EVIDENCE: Croft House H54 S33288 Croft House V248167 130905.doc Version 1.40 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 standard(s) None of these standards were assessed on this occasion EVIDENCE: Croft House H54 S33288 Croft House V248167 130905.doc Version 1.40 Page 9 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 standard(s) 12, 13 and 16 Service users benefit from being supported to make use of the community and having their rights respected while they are staying at the home. EVIDENCE: As the home is a respite service, they do not actively support service users into employment opportunities. Service users are supported to continue with their own activities while they are staying at the home and this includes supporting people to continue using day services. The home does liaise with other services and will become involved in supporting service users with developing specific skills where appropriate. Service users and staff spoken with and observations from this and previous visits have shown that staff do support service users to make use of the local community and other places of interest during their stay at the home. The Manager acknowledged that there was a lack of records to show this and to demonstrate that activities related to the interests and wishes of service users. It is recommended that records of activities are kept. Staff time is arranged around which service users are using the service and which activities are
Croft House H54 S33288 Croft House V248167 130905.doc Version 1.40 Page 10 planned. During the inspection the Inspector observed the Manager and Deputy Manager organising staff time around these issues. The rules of the home are covered within the Terms and Conditions of residence and are not unnecessarily restrictive for people who use the service. Daily routines are based around activities and mealtimes but are flexible enough to accommodate the particular needs and wishes of individual service users. Staff were observed to knock on service users’ doors before entering their rooms and service users had a key to their room and to the lockable drawer within it. No service users had a key to the front door and agreements were made with service users who went out for the evening on their own that they would be back at a particular time. The Inspector observed staff addressing service users according to their stated preferences as recorded on the Care Plan. Croft House H54 S33288 Croft House V248167 130905.doc Version 1.40 Page 11 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 standard(s) 19 Policies and practices in the home ensure that the healthcare needs of service users are met. EVIDENCE: The healthcare needs of service users are assessed on first admission and then again each year. Information relating to healthcare needs is checked out and updated prior to each stay for each service user. Wherever possible, service users are encouraged to take control of their own healthcare needs if they choose to. Service users’ files demonstrate that healthcare needs are continually monitored and responded to appropriately. Croft House H54 S33288 Croft House V248167 130905.doc Version 1.40 Page 12 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 standard(s) None of these standards were assessed on this occasion EVIDENCE: Croft House H54 S33288 Croft House V248167 130905.doc Version 1.40 Page 13 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 standard(s) None of these standards were assessed on this occasion EVIDENCE: Croft House H54 S33288 Croft House V248167 130905.doc Version 1.40 Page 14 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were assessed on this occasion EVIDENCE: Croft House H54 S33288 Croft House V248167 130905.doc Version 1.40 Page 15 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 Service users would benefit from the opportunity to give their own views about the quality of the service they receive. EVIDENCE: The home has a number of quality assurance measures in place that the new Manager is planning to coordinate so that they will contribute towards the production of an annual plan for the service. The plan is due to be updated by January 2006 and the Manager has set aside time in October to include staff in the process. There are service user meetings and carers meetings in place to enable both groups to contribute. Various processes are in place to ensure that the service has up-to-date information on the needs and wishes of service users, including end of stay assessments, pre-admission discussions and annual home visits. The Manager acknowledged that these are useful to the home in gaining the information they need but that an additional opportunity for service users to pass qualitative comments on the service they receive Croft House H54 S33288 Croft House V248167 130905.doc Version 1.40 Page 16 would be useful. This may include organising satisfaction surveys that can be included in the annual planning process. Croft House H54 S33288 Croft House V248167 130905.doc Version 1.40 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 x x x x Standard No 22 23
ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score x x x x x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 x N/A 2 x x 3 x Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Croft House Score x 3 x x Standard No 37 38 39 40 41 42 43 Score x x 2 x x x x H54 S33288 Croft House V248167 130905.doc Version 1.40 Page 18 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 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. 1. 2. Refer to Standard 13 39 Good Practice Recommendations The home should keep records of activities provided for service users The home should enable service users to comment directly on the quality of the service they receive Croft House H54 S33288 Croft House V248167 130905.doc Version 1.40 Page 19 Commission for Social Care Inspection Hampshire Area 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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