Inspection on 20/09/06 for Deja Vu.

This inspection was carried out on 20th September 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Deja Vu. 04/11/05

Deja Vu. 07/07/05

Deja Vu. 22/11/04

Deja Vu. 08/06/04

Deja Vu. 11/02/04

Deja Vu. 08/10/03

Deja Vu. 10/03/03

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

CARE HOME ADULTS 18-65 Deja Vu 14 - 16 Liphook Road Lindford Hampshire GU35 0PX Lead Inspector Mr Roy Bega Unannounced Inspection 20th September 2006 10:00 Deja Vu DS0000011567.V306956.R02.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Deja Vu DS0000011567.V306956.R02.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Deja Vu DS0000011567.V306956.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Deja Vu Address 14 - 16 Liphook Road Lindford Hampshire GU35 0PX 01420 477863 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) Robinia Care Limited Ms A Snell Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Deja Vu DS0000011567.V306956.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users not to be admitted under the age of 18 years Date of last inspection 4th November 2005 Brief Description of the Service: Déjà vu is a care home for seven younger adults with learning disabilities. The home is situated in a residential area of Lindford, Hampshire, within easy reach of the local shops. All residents are accommodated in single bedrooms. One bedroom has en-suite facilities and the remainder are provided with hand basins. The home has a large, enclosed rear garden and patio area. The home is owned and operated by Robinia Care Limited, an organisation that has been a care provider since 1995. Current fees are from £965 to £1,442 per week with additional charges for hairdresser, newspapers chiropody, toiletries and annual holidays over £500. Deja Vu DS0000011567.V306956.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is an assessment of how the National Minimum Key Standards for Care Homes for adults 18-65 were being met at the time of the inspection This visit took place on 20 September 2006 between the hours of 10 a.m. and 4 p.m., a total of six hours. Opportunity was taken to look around the home view records, observe the working environment and speak with management, and staff. Due to residents low ability of verbal, signing or pictorial communication they were not able to converse with the inspector. There were not any relatives/friends present during the visit. Subsequent to the previous inspection a new manager has been appointed and registered by the Commission in August 2006. There were not any requirements raised from the previous and this inspection. What the service does well: What has improved since the last inspection? Management and staff continue to maintain a relaxed positive environment where residents are supported to make decisions about what they want out of their lives. Deja Vu DS0000011567.V306956.R02.S.doc Version 5.2 Page 6 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. Deja Vu DS0000011567.V306956.R02.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Deja Vu DS0000011567.V306956.R02.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this area is good. This judgement has been made using available evidence including a visit to the service. Prospective residents benefit from a stringent pre admissions assessment procedure. EVIDENCE: There have not been any new admissions to the service since 15 June 2004. The organisations admissions policy and procedure were seen with which the manager portrayed good knowledge and understanding. Recent full reviews detailing residents required level of personal support in meeting their daily living needs and wishes were seen. Areas covered included, communication, social skills and wishes, management of risk, physical and mental health care. Due to residents low level of verbal, signing or pictorial communication ability they were not able to converse with the inspector. (See also section Individual needs and Choices of this report). Deja Vu DS0000011567.V306956.R02.S.doc Version 5.2 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 and 9. Quality in this area is good. This judgement has been made using available evidence including a visit to the service. Residents benefit from having clear and effective care plans. Residents are able to make decisions about their lives. Activities are supported by regularly reviewed risk assessments. EVIDENCE: The home promotes the person centred approach to care planning (PCP) where the resident is at the centre of making decisions about what they want out of their life. A random sample of three up to date care plans were seen and case tracked as part of the visit. Plans reflect what is important to each resident, their abilities and support they need including methods of communication. They also reflect what is possible and not just what is available. For example, being assisted to obtain part time employment, using public transport and personal interest such as gardening. Records and discussions indicated that residents’ relatives/advocate had participated in agreeing the plans. Up to date risks assessments and reviews have been completed that coincide with residents’ chosen and agreed activities and lifestyle. Staff spoken with informed the inspector that they find this way of planning resident care very positive in that the resident is put first. Deja Vu DS0000011567.V306956.R02.S.doc Version 5.2 Page 10 Discussions with staff and records seen indicated residents are actively involved in the process of deciding which member of staff is to be their key worker in supporting them achieving the objectives set out in the PCP. Whilst communication with residents was difficult, it was evident that good relationships exist between them and staff. It was seen that residents were able to make decisions with support from staff. One resident went into the kitchen and indicated she would like a drink and a staff member showed the resident tea and coffee to help her make a decision about which drink they would like. Residents were able to choose which activities they wished to participate in with some residents involved in drawing and colouring, while another sat quietly in the lounge. Observations and discussions indicated residents participate in all aspects of life in the home. Pictures and photographs are used to assist residents to make decisions about food items to be purchased each week and some residents go with staff to do the shopping. The inspector was informed that it is planned that prospective new staff members will be asked to spend a day at the home prior to be offered a position so that residents can meet the person and give their opinion about employing them. (See also the section “Life Style” of this report). Deja Vu DS0000011567.V306956.R02.S.doc Version 5.2 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 and 17. Quality in this area is good. This judgement has been made using available evidence including a visit to the service. Residents are supported to participate in a wide range of leisure activities, both in the home and community. EVIDENCE: Four of the residents attend sessions at education or resource day centres. Sessions attended are varied and include cookery, art and crafts and communication. One resident does a small job at the resource centre for a few hours a week. Daily programmes are in place in the home for each resident based on the needs of the individual. It was seen that residents receive support from staff to develop independent living skills and encouragement to participate in household activities such as helping to lay the table, loading the dishwasher and tidying their room. On arrival the inspector noted one resident was busily using a vacuum cleaner. One resident indicated they wanted a drink by putting the kettle on. In the afternoon another led the inspector to sit in the music room with him to listen to the disk that was playing. Another resident engaged a member of staff to play “one on one” basket ball. Deja Vu DS0000011567.V306956.R02.S.doc Version 5.2 Page 12 On the day of the inspection one resident was attending sessions at the resource centre in the morning and another in the afternoon. Residents remaining at home were involved in a number of activities, with some colouring, placing photographs of a recent week-end trip in an album one tidying her room and another sitting quietly in the lounge. Records seen indicated that residents attended events in other local homes such as birthday parties and barbeques. Every three months staff had take residents to a nightclub in London that specialises in providing entertainment for people with learning disabilities. Staff have also arranged for residents to go to a concert. Deja Vu DS0000011567.V306956.R02.S.doc Version 5.2 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 and 20. Quality in this area is good. This judgement has been made using available evidence including a visit to the service. Residents receive support to ensure their physical and emotional needs are met and are protected by the home’s good procedures in the management of medicines. EVIDENCE: Observation and discussions indicated staff provide sensitive and flexible personal support to maximise residents privacy, dignity, independence and control over their lives. Staff were observed to manage instances of unacceptable behaviour with sensitivity and in a calm manner therefore, decreasing the level of stress for all those present. Care plans seen and discussions showed that residents’ health care needs have been assessed, and appropriate procedures put in place to ensure they are carried out. Records and discussions indicated that residents visit their doctor and other health related services as required. A member of the Community Behaviour Support Service visited the home during the inspection to make an assessment of need for a resident. Discussions and records seen indicated that all residents have been assessed as not being able to manage their own medication. Records of medication administered were well maintained and up to date. Deja Vu DS0000011567.V306956.R02.S.doc Version 5.2 Page 14 Evidence was seen that staff have received management of medication training from a recognised organisation. Records of medication retuned to the pharmacist were seen and well documented. Deja Vu DS0000011567.V306956.R02.S.doc Version 5.2 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 and 23. Quality in this area is good. This judgement has been made using available evidence including a visit to the service. Residents are safeguarded by the home’s policy, procedures, dissemination of knowledge and training with regards to adult protection. EVIDENCE: The home has a complaints procedure in place that includes the necessary information. Each resident has a copy in a pictorial format. The manager informed the inspector the document is in the process of being updated. Records seen and discussions indicated that there are close links with the resident’s families and advocates. Since the last inspection there have not been any concerns raised. Residents’ views, ideas and concerns are also discussed in monthly house meetings. Two residents also represent the home as part of the organisation’s “Client Forum” which is held at the main office bimonthly. The Commission for Social Care Inspection has not received any concerns in respect of the service within the preceding year. The home has an adult protection policy and procedure in place of which staff spoken with had a good understanding. Evidence was seen that all staff have received adult protection training by an accredited trainer within the organisation. Records showed that staff have discussed this subject with residents as part of the monthly house meetings. Records for the management of residents’ finances were seen and assessed to be well maintained. Deja Vu DS0000011567.V306956.R02.S.doc Version 5.2 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 and 30. Quality in this area is good. This judgement has been made using available evidence including a visit to the service. Residents’ benefit from a wellmaintained and clean homely environment. EVIDENCE: The premises are in keeping with the local community and have a style and ambiance that reflects its stated purpose. The inspector had the opportunity to walk around the communal areas and two residents bedrooms that were well maintained. All residents are accommodated in single rooms that are meeting their needs. Bedrooms seen are bright, cheerful and contain many personal items including posters, photographs, soft toys and ornaments. Furniture and fittings are of good quality, domestic in design, unobtrusive and compatible with fulfilling their purpose. The inspector was shown an order for new lounge furniture and carpet. Discussions indicated that residents were involved in the process of choosing these items. It was noted that one resident had recently purchased their own reclining chair with assistance from their key worker. Deja Vu DS0000011567.V306956.R02.S.doc Version 5.2 Page 17 Management complete a weekly health and safety and maintenance record. Any defects are then passed onto the organisation’s maintenance department. Discussion and records seen indicated faults are dealt with promptly. The home was clean, hygienic and free from offensive odours. Laundry facilities are of a domestic type and meet requirements. Records seen discussions and observations indicated residents are encouraged to participate in domestic duties as part of their daily living skills. Systems are in place to control the spread of infection. Evidence was seen that staff have received training with regards to infection control. Deja Vu DS0000011567.V306956.R02.S.doc Version 5.2 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 and 35. Quality in this area is good. This judgement has been made using available evidence including a visit to the service. Residents’ benefit from good recruitment procedures. Staff benefit form training provided by the organisation. EVIDENCE: Records seen and staff spoken with demonstrated that the recruitment procedures followed in the home protect residents. All necessary checks were in place prior to staff commencing work. Records for two of the most recently recruited staff were seen which included a comprehensive induction-training programme. However neither staff were on duty to discuss their viewpoint. Staff on duty did express to the inspector that they receive regular supervision where they are able to discuss their concerns, personal developmental and training needs. Records seen and discussions indicated staff have received the following accredited training – • • Three care staff have completed the National Vocational Qualification (NVQ) level 3 in caring for adults who have a learning disability. One care staff is commencing the NVQ level 2 in caring for adults who have a learning disability, October 2006. DS0000011567.V306956.R02.S.doc Version 5.2 Page 19 Deja Vu • Two care staff are commencing the NVQ level 2 in caring for adults who have a learning disability January 2007. Robina Care has a designated training officer who co ordinates training opportunities and refresher courses. Records seen showed that all staff are provided with training in health and safety, communication, autism, deescalation of unacceptable behaviour, epilepsy, medication assessments, moving and handling, first aid, and food hygiene. Staff spoken with informed the inspector that they feel well supported in receiving appropriate training. Deja Vu DS0000011567.V306956.R02.S.doc Version 5.2 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 and 42. Quality in this area is good. This judgement has been made using available evidence including a visit to the service. Residents and staff benefit from the registered manager’s open door approach to management. Residents health, safety and welfare are protected by the home’s safe working practices. EVIDENCE: The current manager was registered August 2006. Evidence was seen that she is enrolled to commence the National Vocational Qualification level 4 in care and the Registered Managers Award October 2006. During the visit, the inspector had the opportunity to speak with staff who commented positively on the support they receive and the “Open Door” approach adopted to manage the home. It was evident during the visit that there are positive relationships between the registered manager, staff and residents. Deja Vu DS0000011567.V306956.R02.S.doc Version 5.2 Page 21 The atmosphere was relaxed indicating an environment where resident’s abilities and aspirations are being promoted. A quality assurance system based on seeking the views of residents, relatives, service purchasers and professionals is in place. Resident meetings are held monthly in the home which are recorded. Minutes of the meetings are provided in symbol format suitable for the residents. Some residents also belong to a forum and join residents of other local care homes operated by Robinia Care Limited to discuss possible improvements. Staff have received appropriate training with regards to Care of Substances Hazardous to Health. Hazardous substances are kept in a locked cupboard to promote the welfare and safety of residents. The home has up to date maintenance certificates for the boiler, fire equipment etc. Fire drills and required fire safety precautions are carried out and recorded promoting the health and safety of residents. The most recent inspection report from Hampshire Fire and Rescue Service dated 10 April 2006 was seen which indicated there were not any concerns. Staff have received appropriate training with regards to Care of Substances Hazardous to Health. Hazardous substances are kept in a locked cupboard to promote the welfare and safety of residents. The home has up to date maintenance certificates for the boiler, fire equipment etc. Deja Vu DS0000011567.V306956.R02.S.doc Version 5.2 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Deja Vu DS0000011567.V306956.R02.S.doc Version 5.2 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Deja Vu DS0000011567.V306956.R02.S.doc Version 5.2 Page 24 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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