Inspection on 17/01/07 for Hammonds

This inspection was carried out on 17th 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 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

Hammonds 30/01/06

Hammonds 12/07/05

Hammonds 08/12/04

Hammonds 09/07/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Hammonds 210 Hawthorn Road Bognor Regis West Sussex PO21 2UP Lead Inspector Mrs V Gay Unannounced Inspection 17th January 2007 11; Hammonds DS0000037437.V322558.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 Hammonds DS0000037437.V322558.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. Hammonds DS0000037437.V322558.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hammonds Address 210 Hawthorn Road Bognor Regis West Sussex PO21 2UP 01243 841005 01243 869179 pat.holmes@westsussex.gov.uk www.westsussex.gov.uk West Sussex County Council 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) Miss Pat Holmes Care Home 16 Category(ies) of Learning disability (16), Learning disability over registration, with number 65 years of age (16), Physical disability (8) of places Hammonds DS0000037437.V322558.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Up to 16 male and/or female service users in the category of learning disability aged between 18 and 65 years may be admitted/accommodated. Up to 16 male and/or female service users in the category of learning disability over 65 years of age may be accommodated. No service users over the age of 65 years may be admitted. No more than a total of 16 service users may be accommodated. Up to 8 persons with physical disability and learning disability may be accommodated on the condition that all rooms providing services for people With a physical disability are fitted with overhead tracking lifting equipment. Date of last inspection Brief Description of the Service: West Sussex County Council owns Hammonds. The responsible individual on behalf of the local authority is Mr. J Dixon and Miss Pat Holmes is the registered manager in charge of the day-to-day running of the home. Hammonds is registered to accommodate up to sixteen adults between the ages of 18 and 65 years with a learning disability. Two of the current service users have been resident in the home for many years and are now over the age of 65. Four of the service users also have a physical disability. Hammonds is situated in Bognor Regis close to local facilities. The establishment is arranged in three buildings, an administration centre,The Willows and The Dolphins. One bed is used to provide short stay respite care. Hammonds DS0000037437.V322558.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an Unannounced Key Inspection using “Inspecting For Better Lives methodology” (IBL) which took place on 17 January 2007 between 11-45am and 5pm. Prior to the Inspection, the previous inspection report and pre-inspection questionnaire was reviewed, along with any correspondence received since the last inspection. There were no requirements or issues outstanding from the previous inspection. During the course of the inspection the inspector toured the home and reviewed records. A majority of the residents were seen at the inspection. Due to the very complex needs of the majority of the residents communication was difficult, and the inspector relied on the staff to interpret many of the responses. Residents able to engage in meaningful conversation said that they like living in Hammonds. The inspector also took the opportunity to observe residents at their leisure activities and observe their interaction with staff. Residents and staff appeared relaxed and confident in each other’s company. Eleven support workers were spoken with, and three staff were interviewed in order to gain a sense of the support received to assist them to carry out their duties. Comments will be included in the main body of the report. A phone call was made to a resident’s relative during the inspection, and she gave a very favourable account of the service provided and said her daughter was happy in the home. The weekly scale of charges range from £388.10 to full cost depending on a financial assessment What the service does well: The service endeavours to provide residents the opportunity to develop and maintain as independent as possible a lifestyle, taking into account their varying needs. The person centred reviews enable residents to actively take part in the identification of personal goals and aspirations. Staff do there utmost to ensure the resident’s rights are protected and that they have the opportunity to enjoy a range of holidays of their choosing. Hammonds DS0000037437.V322558.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Hammonds DS0000037437.V322558.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 Hammonds DS0000037437.V322558.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. New service users are admitted only on the basis of a full assessment of need being undertaken by people competent to do so. EVIDENCE: Prior to moving into the home each residents needs are assessed by a person qualified to carry out the task. The resident is then invited to visit over a period of time, to meet staff and other residents, before a contract of residency is agreed the resident usually has a trial short stay. The inspector, as part of the case tracking process examined the records of four residents, three of whom were in the centre at the time of the inspection to make a judgement about whether their needs are being met in Hammonds. Assessments were thorough, using “person centred” planning which involves residents, staff and other appropriate key persons. The majority of residents have lived at Hammonds for several years, and the only change in the group since 2002, is the regular use of the one respite bed available in the home. Hammonds DS0000037437.V322558.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): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Registered Manager develops a care plan with each resident based upon the initial assessment of need. Staff provide residents with information and assistance with communication to enable them to make decisions about their own lives. Residents are supported to take risks as part of an independent lifestyle and risk assessments are being routinely carried out and are up to date. EVIDENCE: Care plans are in place based on “person centred” planning. These plans are comprehensive and are based on the information assessed by the home, care management and the residents preferences on how care should be delivered. Care plans case tracked for four residents were informative and gave a clear picture of the resident’s choice and how they required assistance. Hammonds DS0000037437.V322558.R01.S.doc Version 5.2 Page 10 Care plans showed clear evidence that discussions with the staff are carried out, and symbols to aid communication are used. Individual key workers do their best to ensure residents understand what is happening. Staff on duty were able to demonstrate a clear understanding of the residents’ preferences and how to meet their needs. Two residents were able to name their key worker (a designated person who provides personal care) and said, “ that they liked having a special person to go out with”. Staff told the inspector that as a key worker you are focused and able to act as their advocate to ensure their potential is maximised. Some residents with more complex needs have one to one care, and during these sessions staff can work closely with them and develop communication skills. Risk are part of everyday living and staff make sure any potential risk is assessed and minimised to ensure restrictions do not impinge on the residents fulfilment of living. Residents said “ I like it here, the staff are nice and the food is good”. “ I can go home to visit my family”. “ I have my own door key to lock my bedroom”. “ I prefer to stay home and not attend day centres” It was evident from comments made from staff and residents and the inspector’s own observations that residents are consulted on and participate in all aspects of life as far as is possible. Hammonds DS0000037437.V322558.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): 12,13,15,16,17, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home seeks ways to reflect the cultural diversity of residents as appropriate. Residents have the opportunity to attend college and develop social skills. Residents are encouraged to pursue their own interests and hobbies in and out of the home and maintain personal relationships. Residents make use of all local resources and integrate within the community. They are offered a healthy diet and enjoy their meals. Resident’s rights are respected. EVIDENCE: The majority of residents attend day centres during the day. Records of activities undertaken show that they are age appropriate and meet the needs Hammonds DS0000037437.V322558.R01.S.doc Version 5.2 Page 12 of the individual. Residents are also encouraged to make use of community resources and maintain friendships outside of the home. Several residents were very excited on the day of inspection as they were helping the deputy manager arrange chosen activities for a planned holiday to Centre Parcs. Another resident said she was going to a farm on the Isle of Wight, which she really enjoyed last year. The Statement of Purpose and Service Users Guide informs relatives and friends of the visiting arrangements. Residents can go home to visit their families, and relatives are invited, if the resident chooses, to their reviews. From observation during the course of the inspection and from reviewing residents care plans it is evident that the rights of residents are respected. Examples of this were observed during the inspection, for example staff were seen to knock on residents’ doors prior to entering and to speak with residents in a respectful manner. The record of food was available. The home employs a cook to prepare and cook the daily meal for the residents. The duty cook was from the relief scheme arranged through social caring services. She told the inspector that she has worked at the home for several years, and is therefore experienced in catering for this client group. The meal being prepared was shepherds pie with a selection of vegetables followed by apple crumble and custard. Residents usually take a packed lunch with them during the week. The main meal is served in the evenings. The inspector discussed the menu with the residents and asked if they enjoyed their meals. Residents who could communicate said the food was good. They were with the help of their key worker invited to assist with planning the menus in order that their favourite dishes are incorporated into the weekly plan. The dish prepared during the inspection was appetising and, generous in quantity. Hammonds DS0000037437.V322558.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): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents choose their own clothes and their appearance reflects their personality. The health care needs of residents are met by them visiting community resources. The arrangements for the safe guarding, recording, storage and disposal of prescribed medication was found to be satisfactory. EVIDENCE: Residents receive the necessary support and encouragement to meet their varying needs. All residents are registered with a GP, and visit the surgery as needs dictate. Residents care plans showed that they have access to all health related services such as, chiropodist, opticians, and dentist. The Community team for people with learning disabilities is also available as required, to support the residents with any particular areas that may need more resources than the home can provide. Hammonds DS0000037437.V322558.R01.S.doc Version 5.2 Page 14 Staff interviewed said that residents can spend their evenings as they wish, the majority due to the busy day they have spent at the relevant centres like to relax. When residents returned from the day centre they were made welcome by the staff. They enjoy a cup of tea and removed their shoes. Generally they were made comfortable to relax and spend time with the staff. Residents able to walk unaided moved between the two houses and to the main office block. No restrictions appeared to be placed upon them. Due to the specific needs of the residents no one is deemed competent to manage their own medication. This is managed by staff, that have received training in the safe handling and recording of prescribed medication. All medication was safely stored on the day of the inspection. Hammonds DS0000037437.V322558.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): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents able to engage in meaningful conversation said that staff help them to make choices. Systems are in place to protect residents. EVIDENCE: The Pre inspection questionnaire states that no complaints have been received since the previous inspection, and no adult protection issues are pending. Policies and procedures are in place for the staff to follow informing them what action to take if they should suspect the abuse of a resident. Records showed that all staff have attended training in the protection of vulnerable adults (POVA). Staff interviewed during the inspection were able to demonstrate a sound understanding of the procedures in place and what action they would take if allegations of bad practice were made. Records examined showed that adult protection issues are discussed fortnightly during the staff meetings. Also the majority of permanent staff have undertaken National Vocational Training and LADF training which includes modules regarding the protection of vulnerable adults. One resident told the inspector that she knew who to speak to if she wanted to complain. Residents also have a good working relationship with their appointed key workers and residents able to communicate were able to identify them by name. Hammonds DS0000037437.V322558.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): 24,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Hammonds provides a comfortable safe environment for the residents to live in. Cleanliness and hygiene standards throughout the home were considered to be of a good standard. EVIDENCE: A tour of the premises revealed clean, well maintained accommodation. Each resident has a room that is individually furnished to meet their specific needs. There is a lockable safe for residents to keep their valuables in. Resident’s rooms were attractively presented and personalised. They reflected the interests of the residents. One resident told the inspector that she had a key to her room but she did not choose to lock the door. The staff on duty respect the right of residents to lock their bedroom doors. Hammonds DS0000037437.V322558.R01.S.doc Version 5.2 Page 17 Aids to promote independence and assist staff in providing personal care are in place. Overhead hoists and hospital beds are available where needs dictate. Bathrooms have recently been upgraded to include a hydraulic bath in “Willows unit” and a new shower to improve the facilities for residents. Hygiene/cleanliness throughout the home is of a good standard and procedures are in place for staff to follow in respect of infection control. Resident’s clothes are laundered to a good standard and the home has a contract for the safe storage and removal of clinical waste. Staff are provided with hand washing facilities and protective clothing. Hammonds DS0000037437.V322558.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): 32,34,35, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported by competent staff, who are deployed in adequate numbers to meet the varying needs of the residents. Robust recruitment procedures are followed to ensure vulnerable people are protected. Staff are appropriately trained. EVIDENCE: The pre inspection questionnaire confirmed that 52 of staff have now gained National Vocational Training level 2 or 3 or 4. A training programme was available to the inspector. It showed that all mandatory training is regularly updated as appropriate, and that staff have the opportunity to access external training courses in relevant topics. All staff receive regular supervision. It was agreed that the training record held for individual staff required reviewing to include a record of all the courses they had undertaken. Hammonds DS0000037437.V322558.R01.S.doc Version 5.2 Page 19 There has been only one change in the staff group since the previous inspection in 2006. Therefore the inspector examined and case tracked two staff files. One was a support worker who had been employed for a year, and another support worker made permanent from the county relief scheme. One support worker was on duty and told the inspector that she had received good induction and had done the LADF training and was hoping to complete National Vocational Training level 2. Sound recruitment procedures are in place and staff files examined contained the information required by Schedule 4 Regulation 17 of the Care Regulations. All new staff have (CRB), police checks carried out to ensure they are suitable to work with vulnerable persons. It was agreed that staff files should be reviewed and indexed to make it easier to access information. Duty rotas examined showed that a good skill mix of staff in sufficient number were on duty throughout the day and night to care for the residents. Staff spoken with throughout the inspection were able to describe the needs and personality of the residents. They were knowledgeable about what the residents wanted, and had built up sound systems for aiding communication. Hammonds DS0000037437.V322558.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): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from a well run home. Effective quality assurance and reviewing of systems are in place. Feedback is actively sought from the residents as far as possible with the support of staff or independent advocate. EVIDENCE: Miss Holmes has 19 years experience in caring for people with a learning disability. She has obtained a Diploma in Social Work. Miss Holmes has completed one unit of the Registered Manager’s award to augment the social services management award as suggested by the Skill for Care requirements. Since the previous inspection Miss Holmes has also completed a post-qualifying course (PQ1). Hammonds DS0000037437.V322558.R01.S.doc Version 5.2 Page 21 The home is run for the benefit of the residents. Sound systems are in place, supported by skilled management to ensure staff are supported, in meeting the needs of a very complex group of residents. Staff spoken with told the inspector that they feel supported by the registered manager and felt able to approach her. They confirmed that their views concerning resident’s needs are listened to and acted upon if appropriate. Staff said they worked together as a team. Staff meet regularly to discuss the running of the home and review any matters in respect the residents. Key workers ensure, wherever possible that the views of the residents are included in any decision-making. The management have undertaken a quality monitoring and quality assurance audit and have produced a development plan/report based on the findings. The Responsible Individual arranges for monthly visits by a suitably qualified person to monitor the service as required by Care Home Regulation 26. The Registered Manager confirmed that monthly visits are regular, although the reports in respect of November and December had not yet been received at the home. Questionnaires received by the service from relatives and other interested parties were very positive about the care being provided. Hammonds DS0000037437.V322558.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 4 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 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 4 X 3 X X 3 X Hammonds DS0000037437.V322558.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. 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 Hammonds DS0000037437.V322558.R01.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: 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. 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