CARE HOME ADULTS 18-65
Halcyon House Halcyon Road North Prospect Plymouth PL2 2PJ Lead Inspector
Brendan Hannon Announced 24-05-05 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. Halcyon House D52-D04 S3530 Halcyon House V214882 240505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Halcyon House Address Halcyon Road, North Prospect, Plymouth, Devon, PL2 2PJ 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) 01752 605541 Royal Mencap Society Mrs Linda Jean Lewin-Smith Care Home 9 Category(ies) of Learning disability (9), Physical disability (9) registration, with number of places Halcyon House D52-D04 S3530 Halcyon House V214882 240505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 02/11/04 Brief Description of the Service: The home is located in a single storey purpose built detached building within a row of ordinary semi detached houses in the North Prospect area of central Plymouth. A full range of amenities and facilities are within walking distance though, the home has its own vehicles and the central shopping area of Plymouth is accessible by public transport. The home can accomodate up to nine residents. The home is fully accessible to residents and visitors who use wheelchairs. The home has one main entrance from which all parts of the home may be accessed. The communal areas of the home are in one half of the building and the residents bedroom accomodation is in the other half. There are two communal bathrooms and two communal showers. There is one double bedroom. There are two communal areas in the home. A lounge and dining area and another lounge accessed from the lounge/ diner. There is a medium sized area of garden and patio to the rear of the building and this is fully accessible to the residents. This area can be accessed either round the side of or from the rear of the building. The service offered by the home is for men and women with a learning disability between the ages of 18 and 65. Some of the residents have substantial mobility needs. The present group of residents are of a mixed range of ages and abilities but are in the main very active within the home and in the community. Halcyon House D52-D04 S3530 Halcyon House V214882 240505 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was announced. Preparation for the inspection included analysis of the pre inspection questionnaire, the previous inspection report and resident and relative comment cards, and correspondence with the home over the last 12 months. An inspection plan was developed from this information. The inspector was in the home from 9.45am to 3.00pm. The inspector spent time with or spoke to seven of the nine service users, with particular attention being given to two residents whose care was looked at closely. The whole of the building was inspected. The registered manager and the deputy manager were spoken to at length during the inspection. Care planning files, care delivery records, medication records, general records, and health and safety records, were inspected. What the service does well:
The home has a stable staff team. The management and staff aim to provide a homely and comfortable place for the residents to live. The home provides good information about the service to potential new residents, and their representatives, so that they can make an informed choice about whether to use the service. The service states clearly the needs that it can meet. The planning and delivery of resident’s care is good. There is an individually planned scheme of appropriate activity for each resident that ensures that all the residents enjoy a good quality of life both through leisure and valued life activity, such as education courses. Residents receive enough, varied, good food and their tastes and preferences are respected. Residents’ personal care needs are well met by a well trained and effective staff team. The home is advocating strongly on behalf of some of the residents to obtain the best service possible from the NHS. The system of medication administration in the home is managed effectively. The home has had no complaints during the last 12 months. If complaints were made the complaints procedure and policy for the home would protect the welfare of the residents. The home was commended on the new accessible complaints procedure that has been implemented by the home and the organisation. The residents benefit from a homely, comfortable, clean and well maintained building that has been appropriately designed and adapted to meet their needs. Resident’s needs are well met by enough competent, qualified, vetted and trained staff. Thorough personnel checks help to protect the vulnerable adults who live in the home.
Halcyon House D52-D04 S3530 Halcyon House V214882 240505 Stage 4.doc Version 1.30 Page 6 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. Halcyon House D52-D04 S3530 Halcyon House V214882 240505 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 Halcyon House D52-D04 S3530 Halcyon House V214882 240505 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) 1,2,3,5 The home provides adequate information about the service to allow a new resident, and their representatives, to make an informed decision whether to use the service. EVIDENCE: Both the service users guide and the homes statement of purpose were available. The information in these documents would enable potential new residents and their supporters to understand the service provided by the home and to make an informed decision as to whether to use the service. Residents and care staff were observed and spoken to throughout the inspection. Through this observation, inspection of care plans, and through records there was good evidence to show that residents needs are being met. No residents have moved out of or into the home for some time. However the manager has a pre admission assessment form and procedure to use before a new resident is admitted to the home should the need arise in the future. This process would ensure that no new service user is admitted whose needs could not be met by the service. Appropriate contracts or terms and conditions documents between the home and the residents are in place for both local authority funded and privately funded residents. This ensures that all parties are clear about what will be provided by the service. Halcyon House D52-D04 S3530 Halcyon House V214882 240505 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) 6,7,8,9,10 Good care planning and risk assessment of residents needs is being maintained by the home. EVIDENCE: Resident’s care plans were sampled and they were of good quality enabling the delivery of consistent and considered support to the residents. All the residents’ had a care plan and risk assessments in place. These were being reviewed at least every six months. The registered manager was advised to bring the care plan and risk assessment elements together to make all the information more easily accessible. The personal planning file has a list of the regular activities participated in by the resident. The home has piloted a new photographic care plan for one resident to make their care plan information more accessible to them. Some residents have moving and handling risk assessments. The registered manager was advised to put in place a moving and handling risk assessment for every resident to demonstrate that the moving and handling needs of all the residents have been considered. Person Centred Planning is being introduced at the home for all the residents. This will enable residents to express more fully their wishes in both major life decisions and day-to-day choices. Halcyon House D52-D04 S3530 Halcyon House V214882 240505 Stage 4.doc Version 1.30 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 standard(s) 12,13,15,16,17 Residents have enough appropriate activity to ensure a good quality of life while living at the home. Residents receive enough, varied, good food. EVIDENCE: The manager described at length the activities that were enjoyed by the residents. This information was supported by the daily activity sheet record and care plan information. Daily records for each resident cover all the positive and negative elements of the resident’s day and provided clear evidence of the quality of life enjoyed by the residents. Each resident has a completely individualised activity plan both for activities within the home and in the community, enabling the planning of a full lifestyle for each resident. Some activities participated in by residents outside the home include horse riding, music workshops, adult education and swimming. Within the home karaoke, bingo, and individualised arts and crafts, are enabled by the staff. It could be seen from the menu plans, the food provided record and from the stocks of food and drink in the home, that residents are supplied with enough, good quality food. The staff group actively responded to the residents when they demonstrated a wish for something different from the main meal option available. Residents communicated their appreciation of this.
Halcyon House D52-D04 S3530 Halcyon House V214882 240505 Stage 4.doc Version 1.30 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) 18,19,20 The welfare of the residents is maintained by supporting full access to treatment from the NHS and by thoroughly meeting the residents’ personal care needs. EVIDENCE: All the residents present in the home at the time of the inspection were seen. There was good observable evidence that complex personal care needs are being well met. A staff member was seen carrying out a transfer in a communal area with skill, care and compassion involving the use of a sling hoist. Efforts had been made throughout the home to minimise any potential institutional atmosphere by making the building homely wherever possible. Care planning and the observed delivery of personal care showed that the service is caring, professional and thoughtful in the way in which personal care support is provided to the residents. The residents’ files sampled showed that health service input was actively being sought, advocated for, and then supported by the home. Some difficulties encountered in obtaining the medical support needed by residents were being overcome through the strong advocacy of the management and staff in support of the residents. The home uses a monitored dosage system of medication administration. The record and storage of this system was well maintained. The health of the residents is supported by the effective administration of their medication. Halcyon House D52-D04 S3530 Halcyon House V214882 240505 Stage 4.doc Version 1.30 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) 22,23 Complaints are properly managed by the home, which protects the welfare of the residents. EVIDENCE: There is a good accessible complaints procedure and this is clearly displayed in the home. This complaints procedure is new and is much more accessible. The new procedure uses pre paid and addressed postcards. These postcards are made freely available and if used would go directly to the MENCAP organisation outside the home. This method would help support a resident to feel free to raise a concern and to ensure that any complaint would be investigated objectively from outside the home. There have been no complaints made regarding the home over the last twelve months. The home and organisation are commended in this report for their support for residents to raise any problems they may experience and then to have these resolved by the organisation and the home. All care staff recieve anti abuse training as a standard training element early in their career at the home. The home has all the appropriate anti abuse policies and procedures in place. Halcyon House D52-D04 S3530 Halcyon House V214882 240505 Stage 4.doc Version 1.30 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) 24,25,26,27,28,29,30 The residents benefit from a homely, comfortable, clean and well maintained building that has been appropriately designed to meet their needs. EVIDENCE: The home was looked at closely and only some limited damage to doors and skirting boards, due to wheelchair use, was noted. The home is well maintained. There is a good quality of living environment and a good level of decoration in the home. The home was clean and hygienic. The residents benefit from a personalised, clean and well maintained building to live in. The home was originally designed to meet the needs of people with significant mobility needs. Each bedroom has been decorated and personalised to meet the taste of the resident using it. There are accessible toilets available throughout the home. All toilets and bathroom doors have been fitted with locks that can be overridden from the outside in the event of an emergency. This facility protects both the privacy and the safety of the residents. All hot water outlets have been fitted with water temperature control valves. Most radiators available to residents have been covered or a risk assessment is
Halcyon House D52-D04 S3530 Halcyon House V214882 240505 Stage 4.doc Version 1.30 Page 14 in place to demonstrate that a cover is not necessary at this time. These measures protect residents from the danger of scalds and burns. All the residents have been offered the use of an individual lock on their bedroom door. The availability of locks supports residents independence and privacy. Some of the residents have chosen to use a key to their bedroom. Others have chosen not to use a key or risk assessment has clearly shown that holding a key would create an unreasonable risk. Halcyon House D52-D04 S3530 Halcyon House V214882 240505 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,34,35,36 Resident’s needs are met by enough competent, qualified, properly vetted and trained staff. EVIDENCE: The manager stated that there is always an adequate number of staff on duty to meet the needs of the residents. The home has a minimum of three care staff on each morning and evening. Approximately two thirds of the staff team are NVQ2, or equivalent, qualified. A thorough training programme is run by the organisation to ensure that the level of qualification of the staff in the home is maintained and that residents’ needs are therefore fully met by skilled staff. The organisation is also training new staff in the Learning Disability Award Framework as part of their induction. This qualification gives staff specific skills to work with people with a learning disability. This induction training then forms part of an NVQ2 and enables staff to meet resident’s needs soon after beginning work at the home. The Registered Manager stated that all the staff have Criminal Records Bureau clearances in place. Personnel records were available in the home to verify the recruitment procedure carried out for each member of staff. A programme of six individual staff supervision sessions is carried out per year. This monitoring will help to ensure that the quality of staff practice delivered to the residents is maintained at a good standard. Halcyon House D52-D04 S3530 Halcyon House V214882 240505 Stage 4.doc Version 1.30 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 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) 37,38,39,41,42 The management of the home is effective which ensures that good quality care is consistently delivered to meet the residents’ needs. EVIDENCE: The Registered Manager, Linda Lewin-Smith, became manager at the home in 1992. She has obtained qualifications equivalent to NVQ4 in care and the Registered Managers Award. The manager and staff were seen to be working well together. Good working relationships amongst the staff will promote better quality support for the residents. The organisation has developed a quality assurance system that is focussed on residents concerns. The system is based on questionnaires and therefore some residents will need help to fill these out. However such difficulties should not stop the residents engaging in this process, which is designed to improve the quality of their service. Health and Safety is well managed in the home. The record of fire protection checks is well maintained. Staff are receiving both external and internal training on the fire protection system six monthly. Comprehensive safety checks have been carried out during the last year, as noted in the pre
Halcyon House D52-D04 S3530 Halcyon House V214882 240505 Stage 4.doc Version 1.30 Page 17 inspection questionnaire, including gas appliances, Legionella and electrical equipment. Good management of health and safety protects the welfare of the residents. Halcyon House D52-D04 S3530 Halcyon House V214882 240505 Stage 4.doc Version 1.30 Page 18 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 3 3 3 x 3 Standard No 22 23
ENVIRONMENT Score 4 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 3 3 3
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Halcyon House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x 3 3 x D52-D04 S3530 Halcyon House V214882 240505 Stage 4.doc Version 1.30 Page 19 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. Refer to Standard Good Practice Recommendations Halcyon House D52-D04 S3530 Halcyon House V214882 240505 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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