Inspection on 17/05/05 for FCH Romsey Winchester

This inspection was carried out on 17th May 2005.

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

The inspector 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

FCH Romsey Winchester 29/06/09

FCH Romsey Winchester 30/06/07

FCH Romsey Winchester 02/12/05

FCH Romsey Winchester 11/11/04

FCH Romsey Winchester 17/06/04

Similar services:

The Lodge Nursing Home

Bracken House

Sunnycroft

Field Farm House

Edgeview Nursing Home

Church Terrace Nursing & Residential Home

The Forbury

The Maples

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

CARE HOME ADULTS 18-65 FCH - Romsey/Winchester 81/83 Winchester Avenue Nuneaton Warwickshire CV10 0DN Lead Inspector Sheila Briddick Unannounced 17 May 2005 09:00 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. FCH - Romsey/Winchester E53 S4487 FCH - Romsey Winchester V229165 170505 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service FCH - Romsey/Winchester Address 81/83 Winchester Avenue Nuneaton Warwickshire CV10 0DN 02476 354175 02476 354175 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) FCH - Housing and Care Ms Lilian Jakovlevs PC 13 Category(ies) of MD 13 registration, with number MD(E) 3 of places FCH - Romsey/Winchester E53 S4487 FCH - Romsey Winchester V229165 170505 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: People admitted to the home will be in the category of mental disorder, excluding learning disability and dementia, in the age range of 18 to 64 years. Date of last inspection 11 November 2004 Brief Description of the Service: The Romsey/ Winchester Care Home is a registered establishment for 13 service users with a mental disorder. FCH Housing & Care provide 24 hours support to the people living in the home. The care home consists of 2 four bedded houses, a 2 bedded bungalow and 3 single bedded flats. All are selfcontained with accessible bathrooms, fitted kitchens, lounge and dining facilities. There is a walk-in shower and a bathroom in the four-bedded houses. Each property, other than the first-floor flats, has it’s own garden; there is also a communal garden with a seating area and greenhouse. The office, sleeping room facility for staff, communal lounge and kitchen are situated in 46 Romsey Avenue. Service users each have a tenancy agreement for the self-contained property they live in. The property is situated in a quiet suburb of the town of Nuneaton in Warwickshire and close to all local services and amenities. FCH - Romsey/Winchester E53 S4487 FCH - Romsey Winchester V229165 170505 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over four hours and was unannounced. A tour of the premises took place and staffing and care records were examined. Two of the three staff on duty and five service users who were at home were spoken with. There views are included in this report. What the service does well: What has improved since the last inspection? Decorations and furnishings have been improved and all areas of the home are looking more welcoming and homely. Equipment that is no longer in use has been stored safely. All staff have accessed training in mental health issues. Staff felt the two-day course had been extremely useful in developing the skills to meet the needs of service users living in this home. All new staff coming to work in the home are now assessed in their competency to take on the responsibility of ‘sleep in’ duty prior to taking on the role. FCH - Romsey/Winchester E53 S4487 FCH - Romsey Winchester V229165 170505 stage 4.doc Version 1.30 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. FCH - Romsey/Winchester E53 S4487 FCH - Romsey Winchester V229165 170505 stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection FCH - Romsey/Winchester E53 S4487 FCH - Romsey Winchester V229165 170505 stage 4.doc Version 1.30 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 standard(s) 1 Information about services and facilities in the home is available to support prospective service users when making a decision about coming to live in the home. Staffing information in the statement of purpose does not reflect the current situation therefore prospective service users will not know whether the service has sufficient numbers of staff, with the knowledge and skills necessary to meet their needs. EVIDENCE: The registered manager has amended the statement of purpose to include terms and conditions for service users, which reflect the care home setting. The statement of purpose is currently at FCH Housing and Care central offices for printing. Although prospective users in the interim period can access some written information about the care home it is important that all information about the service is readily available to ensure that the staff and manager of the home will be able to, and be accountable to deliver the service the prospective service user needs. FCH - Romsey/Winchester E53 S4487 FCH - Romsey Winchester V229165 170505 stage 4.doc Version 1.30 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 standard(s) 6 There is a clear, consistent care planning system in place to adequately provide staff with the information they need to satisfactorily meet service user needs. EVIDENCE: Two care plans were examined at this inspection. The system for reviewing care plans in this home has been developed to a high standard. Service users and their key worker meet on an eight weekly basis to review their health and social care needs. At each review service users and key workers discuss the activities they have accessed, review personal goals and record the outcome of those achieved. The views of the service user are included and recorded. All meetings with healthcare professionals that have taken place in between the review meetings are discussed with the service user. Service users are signing their care plans and review notes. The good practice in care planning at this home ensures that service users know their assessed and changing needs and personal goals are reflected in their individual plan. Staff spoken with said that the key working system, including the review system, is very good and easily managed. The staff spoken with said that managers of the home monitor the review program and are fully aware of the changing needs of the service users and how these are being met. Service users spoken with were familiar with FCH - Romsey/Winchester E53 S4487 FCH - Romsey Winchester V229165 170505 stage 4.doc Version 1.30 Page 10 their care plan, and that key workers meet with me every month and they have reviews to discuss my needs Key workers work closely with healthcare specialists in identifying guidelines and procedures to follow to meet specific needs of service users. This includes Community Psychiatric Nurses, Psychologists, Occupational Therapists, Dieticians and Speech and Language Therapists. Written guidelines for staff to follow were included in the care plan file. Service users spoken with said that they could visit their doctor, dentist and optician whenever I need to and that they meet with the dietician every 12 months. Service users spoken with were fully informed of when their next appointments were with specialist consultants. FCH - Romsey/Winchester E53 S4487 FCH - Romsey Winchester V229165 170505 stage 4.doc Version 1.30 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 standard(s) 15 The people living in this home are supported to maintain and develop family links and friendships during their stay in the home in such a way as to promote their privacy and independence. EVIDENCE: Service users spoken with said that family and friends were able to visit at any time. Staff spoken with were fully aware of the support needs of service users in maintaining relationships with family and friends. This support is recorded on their care plan. Service users are able to meet with family and friends in the privacy of there own environment or can use the communal lounge if they wish. FCH - Romsey/Winchester E53 S4487 FCH - Romsey Winchester V229165 170505 stage 4.doc Version 1.30 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 standard(s) 20 Personal support in this home is offered in such a way as to promote service user privacy, dignity and independence. The home was eager to improve their current system for medicine management. Current systems for checking all the medicine received into the home have the potential to lead to discrepancies in administration records. EVIDENCE: The care planning system ensures that the personal support needs of service users and how these are to be met has been discussed and agreed with them. Promoting independence is a key service aim for this home and this is reflected in the care plan programmes. Service users are living in their own independent living units and as such times for getting up/going to bed, bathing, meals and other activities are flexible to the individual needs. Service users spoken with said that people always knock before coming into my house. Service users spoke of the support they have from staff when shopping for clothes and going to the hairdressers. Service users have the aids and equipment they need to promote independence and care plans show that professionals have assessed this equipment, which includes occupational therapists and speech and language therapists. Staff were seen to be supporting service users in a manner that respected the dignity and independence of the individual. FCH - Romsey/Winchester E53 S4487 FCH - Romsey Winchester V229165 170505 stage 4.doc Version 1.30 Page 13 The changing needs of service users are reviewed as and when necessary and this includes amending care plans to meet temporary needs as a result of accidental injury when personal support needs may be higher than usual. Staff spoken with had a good understanding of the medication needs of the service users. All changes to service users medication are recorded on their care plan. Systems have been installed to check medication received into the home but balances of medicines are not carried over from previous cycles. In some instances the full prescription had not been written on the medication chart, (MAR) by the pharmacy. The original prescription for service users medication is not held in the home, this is being held by the pharmacy. Without a copy of the original prescription staff cannot be sure that they are administering the medicine as prescribed. FCH - Romsey/Winchester E53 S4487 FCH - Romsey Winchester V229165 170505 stage 4.doc Version 1.30 Page 14 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) 23 Staffs knowledge and understanding of adult protection issues and the effective policies and procedures in place for the protection of vulnerable adults provides a safe environment for the people living in this home. EVIDENCE: FCH Housing and Care have established policies and procedures in place to ensure that service users are protected from harm. Staff spoken with had attended training in the vulnerable adults procedure last year, the training included physical intervention strategies and ‘calming techniques’. Staff demonstrated a good understanding of physical intervention strategies that maintained the safety of the individual. Staff described instances they felt service users could be most vulnerable and explained some of the risk assessments in place to ensure service user and staff safety. This included risk assessments around service user anxiety, being in the community alone and when staff work alone supporting service users. Service users spoken with said they felt safe living in the home and were aware of health and safety procedures in place to protect them from harm, this included fire safety and use of equipment. FCH - Romsey/Winchester E53 S4487 FCH - Romsey Winchester V229165 170505 stage 4.doc Version 1.30 Page 15 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) 24 and 30 Recent investment has significantly improved the appearance of this home creating a comfortable and homely environment for those living there and visiting. Heating systems do not have sufficient guards in place to protect service users from harm. EVIDENCE: A redecorating programme was taking place at the time of the inspection and was nearing completion. Service users spoke to the inspector about being fully involved in choosing carpeting and paint colours for their homes. Service users have opportunity to talk about furniture and other issues affecting their homes at house meetings which they said, occurred monthly. All houses were visited during the inspection and were found to be comfortable, bright and cheerful. The radiators at number 81 were found to have extremely hot surfaces in access of 43°C, this had the potential to cause injury to service users. Care record notes identified that one service user had received a small burn when falling against one of these radiators. As a result of this accident radiator covers had been purchased to minimise the risk to service users in this house. The radiator covers were not in place at the time of the inspection due to the redecoration that was taking place. FCH - Romsey/Winchester E53 S4487 FCH - Romsey Winchester V229165 170505 stage 4.doc Version 1.30 Page 16 Laundry facilities in each house are domestic in style and situated in kitchens. Service users are generally responsible for laundering their own belongings. There are policies and procedures in place however for the control of infection, which includes the washing of soiled linen and clothing. Staff spoken with had accessed a distance learning training programme in infection control and were understanding of the homes infection control policy. There are arrangements in place for the disposal of clinical waste including use of a SHARPS box. FCH - Romsey/Winchester E53 S4487 FCH - Romsey Winchester V229165 170505 stage 4.doc Version 1.30 Page 17 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) 34 and 35 Staff morale is high resulting in an enthusiastic staff team that works positively with service users to improve their quality of life. EVIDENCE: There are effective recruitment and selection policies and procedures in place to protect service users from harm. This includes ensuring that all preemployment checks, including Criminal Record Bureau and POVA checks are completed prior to the person starting work in the home. Recruitment records seen showed that all the necessary information had been received for the most recently employed staff prior to their working in the home. All records relating to recruitment and selection were found to be in good order and well documented. Service users can be involved in the recruitment of staff if they wish and generally prefer to do this in an informal way by meeting prospective staff when they come to visit the home. The manager seeks feedback at house meetings with service users on the suitability of new staff. The manager has recently reviewed the induction programme for new staff to ensure that competencies in their role and responsibility can be properly assessed before they take on individual roles and this includes sleep in responsibility and the administration of medicines. A newly appointed staff member confirmed that their supervisor gave weekly supervision and reviewed their needs during their FCH - Romsey/Winchester E53 S4487 FCH - Romsey Winchester V229165 170505 stage 4.doc Version 1.30 Page 18 induction period. A comprehensive record of induction is maintained and this includes an agreed timetable of the induction period. Staff spoken with felt that the training in this home is ‘very good and supported well by the manager’. Staff also said that here is opportunity for feedback following training and that they learn from each others experiences. All staff spoken with felt that the recent mental health awareness training had been excellent. Other training that is available to enable staff to meet service user needs includes behavioural family therapy, death and bereavement, healthy eating, listening and counselling skills, challenging behaviour, which included violence and aggression and calming down strategies. There is an active NVQ programme in place. Staff confirmed that training needs are audited on a monthly basis and that if they are not able to attend a training session this is picked up by management and alternative arrangements are made. FCH - Romsey/Winchester E53 S4487 FCH - Romsey Winchester V229165 170505 stage 4.doc Version 1.30 Page 19 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) These standards were not looked at on this occasion. EVIDENCE: FCH - Romsey/Winchester E53 S4487 FCH - Romsey Winchester V229165 170505 stage 4.doc Version 1.30 Page 20 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 2 x x x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 x x x x 3 x x Standard No 31 32 33 34 35 36 Score x x x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 FCH - Romsey/Winchester Score x x 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x x x E53 S4487 FCH - Romsey Winchester V229165 170505 stage 4.doc Version 1.30 Page 21 es 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 1 Regulation 4 Requirement A copy of the statement of purpose for the home must be forwarded to the Commission. (Previous timescale of February 15, 2005 not met) Excess medication must either be returned to the pharmacy for destruction or the balance recorded on the new Medicine Administration Record (M. A R) chart. Full directions and dosages must be recorded on the MAR chart in all instances. A copy of the current GP prescription for each service user must be held in the home. All radiators at 81 Winchester Avenue must have protective covers installed over the radiators to minimise the risk of injury from the hot surfaces. Timescale for action September 30, 2005 2. 20 13 June 16, 2005 3. 4. 5. 20 20 24 13 13 13 June 16, 2005 June 16, 2005 June 16, 2005 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 Good Practice Recommendations E53 S4487 FCH - Romsey Winchester V229165 170505 stage 4.doc Version 1.30 Page 22 FCH - Romsey/Winchester Standard 1. FCH - Romsey/Winchester E53 S4487 FCH - Romsey Winchester V229165 170505 stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Imperial Court Holly Walk Leamington Spa CV32 4YB 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 FCH - Romsey/Winchester E53 S4487 FCH - Romsey Winchester V229165 170505 stage 4.doc Version 1.30 Page 24 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!