Inspection on 15/01/07 for Haldon View

This inspection was carried out on 15th January 2007.

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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Haldon View 18/11/05

Haldon View 31/08/04

Haldon View 02/04/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Haldon View 1 Beech Avenue Pennsylvania Exeter Devon EX4 6HE Lead Inspector Sue Dewis Unannounced Inspection 15th January 2007 12:00 Haldon View DS0000039152.V316246.R01.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 Haldon View DS0000039152.V316246.R01.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. Haldon View DS0000039152.V316246.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Haldon View Address 1 Beech Avenue Pennsylvania Exeter Devon EX4 6HE 01392 411229 01392 421317 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) http/www.devon.gov.uk Devon County Council Mr Nigel Frank Seal Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Haldon View DS0000039152.V316246.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Age Group - 18 - 65 years Date of last inspection 18th November 2005 Brief Description of the Service: Haldon View is a large detached house set in its own grounds in a residential area of Exeter. It is on the bus route into the city and from the outside has nothing to distinguish it as a residential home. The home is owned by Devon County Council and offers evenings and weekend respite care for younger adults with learning disabilities between the age of 18 to 65 yrs. Service users are individually assessed in order to determine their fees, but fees average £12 per night generally. The CSCI reports for the home are on display in the entrance hall. Haldon View DS0000039152.V316246.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over approximately four hours one afternoon in mid January 2007. The home had been notified that an inspection would take place within three months and had returned a pre-inspection questionnaire, information from which was used to write this report. As part of this process the inspector sent out questionnaires to 17 service users, 2 care professionals, 17 relatives and 11 staff. At the time of writing the report, replies had been received from one service user and the relatives of two service users. Haldon View provides evening and weekend respite care only. Therefore, some of the standards are not entirely applicable to the home, as the service users spend only short periods of time there. Towards the end of the inspection three service users came in from day services, two others would also be spending the night at the home. During the inspection 3 service users were case tracked. This involves the inspector looking at the service users’ individual plans of care, and speaking with the service user (if possible) and staff who care for them. This enables the Commission to better understand the experience of residents living at the home. Some service users at the home have limited verbal communication skills, and as the inspector was not skilled in their other methods of communication it was difficult for the inspector to have any meaningful communication with these service users. However, the interaction between these service users and the staff who are able to communicate with the service users was closely observed. The inspector met with 1 service user individually, 2 staff and the manager. A tour of the building was also made and a sample of records were inspected, including medications, the fire log book and staff records. What the service does well: The service provides a flexible and responsive short break service to carers of service users. There are good assessments and a god care planning system in place that provides staff with the information they need to meet the service users’ needs. Haldon View DS0000039152.V316246.R01.S.doc Version 5.2 Page 6 Some activities are provided and choice is offered whenever possible. Healthcare, complaints and health and safety matters are well managed. The service provides its users with a safe, comfortable and homely place to stay with staff who are well trained and motivated. 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. The summary of this inspection report can be made available in other formats on request. Haldon View DS0000039152.V316246.R01.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 Haldon View DS0000039152.V316246.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users and their families are assured that their care needs can be met. EVIDENCE: Brief details of prospective service users are initially given to the home by the care management team. The home then invites the service user and their family to visit the home for a look around and to discuss any concerns they may have. One such visit took place on the day of inspection. If they wish to proceed, they are given a blank copy of a care plan for them to complete. This is so that the home has as much information as possible about the prospective service user. If the placement is approved by the care management team, and the home feels they can meet the needs of the service user then a service contract is issued. Service users have at least one ‘Tea-visit’ at the home to meet staff and other service users, before a formal placement is made. Families book placements (usually six months in advance) direct with the home, the number of placements per year having been approved by the care manager. Haldon View DS0000039152.V316246.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a good care planning system in place, that provides the information that staff need in order to satisfactorily meet the needs of the residents. EVIDENCE: Service users visit the home on a regular basis, with the length of stay and frequency varying according to assessed needs. Some visit one night each week, and others for a week every few months. This regular programme has enabled staff to build up information on the residents and to get to know them and their needs very well. Three service users’ care plans were inspected. All three contained good information and detail on residents’ needs and how staff should meet these needs. The plans also give details of emergency contacts, allergies, sleeping pattern, reasons for using the service, likes and dislikes, medications, usual Haldon View DS0000039152.V316246.R01.S.doc Version 5.2 Page 10 discharge/admission procedure and a brief profile of the service user, including their behaviour/disposition and their communication skills. The plans also gave good details of how they like to spend their time at the home. As service users do not live permanently at the home staff rely on good communication between themselves and carers to ensure any changes in needs are passed on. There were good detailed and useful recordings on each file looked at. Communication abilities vary substantially across the service users, with some being very able and others much less so. The inspector was unable to communicate with two of the service users. However, staff were observed communicating very well with service users, using verbal and non-verbal communication. Service users were wandering freely around the home, smiling and laughing and they appeared comfortable and relaxed in the presence of the staff. Some service users have a ‘box’ that is kept at the home and contains personal items. This enables staff to be able to put these items into the room the service user will be staying in to make it feel welcoming. There is a laundry drying area within the home that contains very hot pipes, which residents have limited access to, risk assessments have been completed and a gate has been fitted to the doorway to limit access further. (see also Standard 42). Haldon View DS0000039152.V316246.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are generally provided with the lifestyle of their choice. Activities are on offer at any time, though the frequency of outings could be increased, to enable service users enjoy a wider variety of activities. EVIDENCE: Some of these standards are not entirely applicable as staff at the home are not the primary carers for the service users and limited time is spent in the home. The one service user that was spoken with said they enjoyed visiting the home, and thought it was a kind of holiday. They said that they had not liked it at first, but now really liked the home and the staff. Haldon View DS0000039152.V316246.R01.S.doc Version 5.2 Page 12 Service users continue to attend any day services they would normally attend when not at Haldon View. This means that the home has limited staffing available throughout the day in case of an emergency requiring the service user to be back at the home. There is a games room at the home, with a pool table, computer, board games and table-tennis table available for service users to use if they wish. The inspector was told that service users are often quite tired when they get home from day services and often prefer just to watch TV or spend quiet time in their rooms. Concerns were raised by relatives, via comment cards, that there were not suitable activities and outings provided. The manager told the inspector that they tried hard to ensure there were enough staff to enable activities and outings to take place, though this was not always possible, especially if one service user chose not to go out. However, outings are arranged for each Saturday. There is a menu drawn up, with changes made as necessary, depending which service users are at the home. Menus provide prior to the inspection, indicate that varied and nutritious meals are provided. The three service users arrived at the home together and quickly settled in and were responding well to the staff and each other. Service users only attend the home for short periods, and usually this is to allow their relatives a break. Therefore, there are limited visits from families when service users are at the home. Haldon View DS0000039152.V316246.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have a good understanding of the residents’ personal support needs, and residents benefit from the positive relationships they have with staff. Medication at the home is well managed, promoting good health. EVIDENCE: Care plans contain detailed instructions on the type of support needed and how it should be offered to each service user. Staff that were spoken with displayed a good knowledge of the individual personal care needs of the service users. Staff were seen to offer support in a polite and discreet manner. Service users have a diary that goes with them between home, day services and Haldon View, so that everyone is able to communicate with each other. The home is not normally responsible for initiating health care services, unless there is an emergency. However, they do monitor and manage any ongoing health issues, for example incontinence and epilepsy. Detailed records of any Haldon View DS0000039152.V316246.R01.S.doc Version 5.2 Page 14 interventions are kept and staff have received appropriate training in dealing with such issues. The manager told the inspector that they do sometimes have contact with the Liaison Nurse at the Royal Devon and Exeter hospital, who gives advice and support to service users who have a learning difficulty and their supporters. Staff demonstrated a good understanding of service users’ needs and were able to describe good practice in relation to maintaining their privacy and dignity. Service users’ medications are usually obtained by their families and the service user generally either brings in the exact quantity for their stay, or all their medication. However medication is held at the home for some service users. Medication that is brought into the home is counted when it is brought in and taken out of the home. There are good policies and procedures relating to the administration of medicines. There have been some minor mistakes in handling medicines in the past and this has resulted in a further tightening of the procedures, ensuring that risk of further mistakes is minimised. All staff who administer medications have been appropriately trained and records show weekly audits of medications and two staff signatures for all medicines that are administered. Haldon View DS0000039152.V316246.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints system. Residents are protected by staff who are able to recognise abuse and know their duty to report poor practice. EVIDENCE: The home uses the Devon County Council Complaints procedure. Although the one service user that was spoken with was unaware of the procedure, they were able to tell the inspector that they would speak to a member of staff if they were unhappy about anything. No complaints have been received by the Commission since the last inspection. All staff have received training in the Protection of Vulnerable Adults. The two staff that spoke with the inspector were able to give good descriptions of differing types of abuse and of the procedure they would follow should abuse be suspected. Haldon View DS0000039152.V316246.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home generally provides residents with a clean, safe, comfortable and homely place to live EVIDENCE: The home is generally comfortable and well maintained. The furnishings and fittings are of a good standard and a domestic nature. Much effort is made to minimise the short-stay ‘hotel’ feel and to maximise the homeliness so that service users will feel welcome when staying there. The home tries to provide the same room for residents each time they are admitted. A small box of personal items is kept for some service users and these are put into their rooms when they arrive. The rooms contain TVs and are comfortably furnished and decorated. Haldon View DS0000039152.V316246.R01.S.doc Version 5.2 Page 17 There is a comfortable and well maintained lounge/dining area and several other communal areas around the home that residents can use if they wish. There are aids and adaptations around the home such as grab rails, assisted baths, and a walk-in shower. The dishwasher and a freezer are sited in the laundry, which the inspector was concerned could lead to cross infection. However, following the inspection she contacted the Food Safety department of Exeter City Council to discuss the issue with them. The Food Safety inspector felt that as long as clean/dirty tasks were separated by time, and no food was prepared in that area, they would not take any action. Therefore, no recommendations are made regarding this area. The ground floor corridors and bedrooms have recently been redecorated. Haldon View DS0000039152.V316246.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The deployment and numbers of staff available are generally sufficient to meet the needs of the current service users. The procedures for the recruitment of staff are not entirely robust and do not offer full protection to service users. A full training programme ensures that staff are competent to meet the needs of service users. EVIDENCE: Three staff files were inspected. Two contained all the required information, including satisfactory CRB (Criminal Records Bureau) checks, application forms and two references. However, one staff member’s file did not contain a relevant Criminal Records Bureau check, only one from their previous employer. This has the potential to place service users at risk of abuse as they were working unsupervised. A new check is being applied for. Haldon View DS0000039152.V316246.R01.S.doc Version 5.2 Page 19 There are usually two staff on duty while service users are arriving at the home, then three staff from 5pm till 10pm. One relative made comment on their feedback form that they would like to see more staff on duty to ensure the safety of service users and to enable service users to participate in more activities. The inspector discussed the staffing levels with the manager, who feels that staffing levels are adequate for the numbers of service users currently using the home. However, he feels that this will need to be looked at if service user numbers increase. The staff that the inspector spoke with, said that they had worked at the home for several years and had received training in many aspects of care. All staff receive training that helps them meet the service users’ needs effectively and safely. For example, most staff have received training in epilepsy, Protection of Vulnerable Adults, continence, NVQ (National Vocational Qualification - A formal care qualification) and many more, as well as health & safety training, such as fire awareness, food & hygiene and so on. This means residents benefit from a well-trained team of staff that are able to meets their needs effectively. Induction and foundation training is in line with the Learning Disability Award Framework (LDAF). One staff member has NVQ level 3 and five others have NVQ level 2. Staff said that they felt staffing levels were good and enabled them to give the service users ‘time and space to do what they want to do’. Haldon View DS0000039152.V316246.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed resulting in practices that generally promote and safeguard the health, safety and welfare of the residents. EVIDENCE: Nigel Seal has been registered as manager of the home for just over a year. He had worked at the home for some years as assistant manager and has many years experience of working with people with a learning disability. Staff said that they felt well supported by the manager, and were able to talk with him at any time. There are regular quality assurance visits and reports made by the Responsible Individual for the home. Questionnaires have been sent out previously, and Haldon View DS0000039152.V316246.R01.S.doc Version 5.2 Page 21 relatives and service users are regularly consulted. However, no formal review of the quality of care provided by the home has taken place for some time. The pre-inspection questionnaire provided evidence that Haldon View complies with health and safety legislation in relation to maintenance of equipment, storage of hazardous substances, health and safety checks and risk assessments. The fire logbook, record of fire safety training and accident and incident records were found to be accurate and up to date. So that the risk of burning from hot surfaces is minimised, all radiators within the home are covered, and service users’ access to the very hot pipes in the drying area of the laundry has been restricted (see also Standard 9). All windows above ground floor level are fitted with restrictors, in order to minimise the risk of any resident falling from these windows. Haldon View DS0000039152.V316246.R01.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 3 33 X 34 2 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 X 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 Haldon View DS0000039152.V316246.R01.S.doc Version 5.2 Page 23 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 YA34 Regulation 19 Sch 2 8 Requirement You must ensure that a satisfactory Criminal Records Bureau check is obtained for all new members of staff. This is to minimise the risk of abuse to service users Timescale for action 31/03/07 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 YA30 Good Practice Recommendations You should re-site either the laundry or kitchen equipment currently sited in the same room, to prevent the risk of cross infection You should consider providing staffing levels that would enable more service user activities and outings. 2. YA35 Haldon View DS0000039152.V316246.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Haldon View DS0000039152.V316246.R01.S.doc Version 5.2 Page 25 - 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. 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