Inspection on 10/10/07 for Harestock Hostel

This inspection was carried out on 10th October 2007.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Harestock Hostel 30/09/08

Harestock Hostel 18/12/06

Harestock Hostel 01/11/05

Harestock Hostel 27/06/05

Harestock Hostel 14/12/04

Harestock Hostel 09/07/04

Harestock Hostel 19/01/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Harestock Hostel Upton Grey Close Winchester Hampshire SO22 6NE Lead Inspector Nick Morrison Key Unannounced Inspection 10th October 2007 09:00 Harestock Hostel DS0000040578.V347439.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 Harestock Hostel DS0000040578.V347439.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. Harestock Hostel DS0000040578.V347439.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Harestock Hostel Address Upton Grey Close Winchester Hampshire SO22 6NE 01962 886361 01962 889422 bernie.kern@hants.gov.uk 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) Hampshire County Council Post Vacant Care Home 15 Category(ies) of Learning disability (15) registration, with number of places Harestock Hostel DS0000040578.V347439.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th December 2006 Brief Description of the Service: Harestock Hostel is a residential service in Upton Grey Close, Winchester for people with a learning disability managed by the local authority. The home is comprised of three purpose built houses accommodating fifteen service users. Two of the houses provide long-term placements and one is used for respite and assessment. The current fees are £7.22 per night for respite and £48.25 per week for longterm placement. Harestock Hostel DS0000040578.V347439.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report represents a review of all the evidence and information gathered about the service since the previous inspection. This included a site visit that occurred on 10th October 2007 and lasted six hours. During this time we toured the whole of the premises, looked at the files of four service users and observed the service people were receiving. The Inspector also met with five members of staff and observed interaction between staff and service users. All records and relevant documentation referred to in the report was seen on the day of the inspection visit. The Inspector also referred to the service’s own self-assessment of the home and spoke with two parents and eight service users. There was no Manager in post at the time of the inspection visit. A Deputy Manager from another the organisation’s homes was temporarily managing the service. What the service does well: 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. Harestock Hostel DS0000040578.V347439.R01.S.doc Version 5.2 Page 6 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 Harestock Hostel DS0000040578.V347439.R01.S.doc Version 5.2 Page 7 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): 1 and 2 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Service users benefit from having their needs and aspirations assessed prior to moving into the home, but would benefit further from having accurate information about the service before using it. EVIDENCE: There had been a requirement from the previous inspection that the Statement of Purpose and Service User Guide must inform prospective service users and their representatives that emergency admissions sometimes occur, and of any impact this may have. Examination of the Statement of Purpose and the Service User Guide showed that neither of these documents had been reviewed and updated since the previous inspection and that this requirement remains unmet. The home requires a full care management assessment for each person before they move into the home. Records showed that all assessments were in place prior to the person moving in and that, in each case, a decision had been made that the home was able to meet the person’s needs. Harestock Hostel DS0000040578.V347439.R01.S.doc Version 5.2 Page 8 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 adequate This judgement has been made using available evidence including a visit to this service. Service users benefit from being supported to make their own decisions. They would benefit further from having their care plans and risk assessments reviewed on a regular basis. EVIDENCE: There had been a requirement from the previous inspection that care plans and risk assessments must be kept up-to-date and detail how the care and support is given to protect service users and meet their needs. Examination of service user files showed that most care plans and risk assessments had been signed to say they had been reviewed periodically since the previous inspection. Some care plans and risk assessments had been altered in response to changing needs. There was no set schedule or system in place for reviewing care plans and risk assessments. Consequently, there were some care plans and risk assessments that had not been reviewed on a regular basis. Harestock Hostel DS0000040578.V347439.R01.S.doc Version 5.2 Page 9 This requirement remains unmet. Staff spoken with said they felt that care plans and risk assessments were clearly written and easily accessible. They also said that they were involved in contributing to peoples care plans and risk assessments. Service users spoken with understood that they had care plans in place and felt they had been consulted about what their care plans contained. Service users said they were able to make decisions about their own lives and that the staff in the home supported them to do this. This was reflected in care plans and other information from service users’ files that showed that the personal decisions of service users had been recorded and responded to by the service. Harestock Hostel DS0000040578.V347439.R01.S.doc Version 5.2 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. 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 benefit from having their rights respected and from balanced and nutritious meals. They also benefit from having the opportunity to engage in a wide range of activities both inside and outside of the home. EVIDENCE: People living in the home each have a timetable of activities which, from observation throughout the inspection visit, were followed. Staff support was managed so that each person had the necessary support to do the activities they wanted to do. From observation and from discussion with people living in the home it was also clear that people were able to choose whether or not to take part in the activities offered to them. Activities for people living in the home were organised by staff based at the home. Religious preferences were assessed on admission and taken account of in peoples care plans. Harestock Hostel DS0000040578.V347439.R01.S.doc Version 5.2 Page 11 People living in the home had access to a wide range of activities including activities within the community, at day services and within the home. Service users spoken with said they always had enough things to do and did not get bored. Staff in the home regularly sought and planned new activities for people to try. Service users spoken with said they enjoyed the activities in the home and also that the range of activities on offer was broad and met their needs. There was a lot of support for people living in the home to maintain contact with their families. The visiting policy promoted and encouraged visitors. People living in the home were supported to telephone their families whenever they wanted to and were able to do this private. Food in the home was of good quality and people observed during the inspection visit appeared to enjoy their meal. The menu’s showed that the diet was varied and nutritious. Individual preferences were recorded so that people did not have food they didn’t like. There was sufficient staff support throughout the mealtime and staff tried to ensure that mealtimes were an enjoyable time for people living in the home. Food seen on the day of the inspection was homemade and it was clear that good use was made of fresh ingredients, including fresh vegetables. There was also fresh fruit readily available in most parts of the home. Service users spoken with said that the food was varied and interesting and that they were able to choose what they ate. Harestock Hostel DS0000040578.V347439.R01.S.doc Version 5.2 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. 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. Service users benefit from having their healthcare needs met and are protected by the home’s medication policies and practices. EVIDENCE: Care plans contained information on how people preferred to be supported with their personal care. Service users spoken with were happy with the way staff supported them and felt that it respected their own wishes. The files of people living in the home demonstrated that healthcare needs were monitored and that people were supported to use healthcare services as necessary, including GP’s, Speech and Language Therapists and Psychologists. Where people had used healthcare services there were records detailing the date, the reason why they attended and any outcomes as a result of the consultation. Staff in the home liaised closely with healthcare professionals in the interests of people living in the home. Records showed that staff monitored the health of people living in the home and that any concerns were clearly recorded and appropriate action taken. There was evidence of good liaison with healthcare services in the interests of people living in the home. Harestock Hostel DS0000040578.V347439.R01.S.doc Version 5.2 Page 13 The system for administering medication in the home was clear and was stated in the home’s policies. Staff spoken with, who were involved in administering medication, said they had received good training and demonstrated that they had a good understanding of medication issues. Medication records were clear and up-to-date and all medication was stored appropriately and safely. These included clear records of medication coming into and going out of the home. Some people living in the home were being supported to work towards independence in managing their own medication and appropriate risk assessments were in place to support this. Harestock Hostel DS0000040578.V347439.R01.S.doc Version 5.2 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. 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. Service users benefit from having their views listened to and are protected by the homes policies and practices. EVIDENCE: There were clear policies in place covering complaints, whistleblowing and protecting vulnerable adults. Staff spoken with were clear about these policies and they had been covered in-depth during their induction training and throughout further training on specific topics. The complaints policy had been put into a format designed to be more accessible to people living in the home and service users spoken with confirmed they had received a copy of the policy and were clear about how to make a complaint if they felt the need to. There was a clear system in place for recording and responding to complaints, and one complaint had been received over the past twelve months. There was a record on each person’s file of the personal property they had in the home. Service users spoken with said they felt safe in the home. Some people living in the home, where appropriate, were supported to use independent advocates. Clear guidelines were in place where the behaviour of some people living in the home might have an adverse effect on themselves or on other people living in the home. Harestock Hostel DS0000040578.V347439.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Service users benefit from living in a clean, comfortable and safe environment, but would benefit from the organisation of use of the premises reflecting their needs. EVIDENCE: There had been a recommendation from the previous inspection that service users on respite/emergency/short-term placements and those in long-term placements should occupy separate premises, unless benefits for both groups can be demonstrated. This had not been addressed. The respite area of the home is used for people who have not been found a permanent place to live as well as people staying for respite. One person has lived in this area of the home for nearly two years and has still not been found somewhere more permanent to live. At his review meeting in February 2007 it was stated that his stay at the home was set-up for six months for a shortHarestock Hostel DS0000040578.V347439.R01.S.doc Version 5.2 Page 16 term assessment and that it is important that he now has somewhere more permanent to live. It goes on to state that he has become territorial and has difficulty sharing the respite unit with anyone who comes in for short stays and that he will behave inappropriately towards them. Staff said that this person’s behaviour “escalates” when people are using the respite service. There was a complaint from someone using the respite service that she was unable to prepare her own breakfast and help herself to tea and coffee because the cupboards were kept locked. The cupboards were locked in response to the needs of the person who had been living in the unit for nearly two years. It is clear that the fact that people using the respite service have to share the premises with someone who has lived there nearly two years is causing problems to both parties and benefits neither. One person living in the residential part of the building currently has some health issues and is having to sleep in the respite part of the home due to not being able to use the stairs safely. The service aims to maintain a homely feeling in the house and the furniture and fittings are domestic and comfortable. Service users were encouraged to be involved in choosing colours and furniture for the communal parts of the home as well as for their own individual rooms. There were orientation boards placed around the home so that people living in the home could finds out the day, date, weather, activities and which staff were working. Clear infection control policies were in place and staff spoken with were aware of these and of the need to maintain a comfortable and appealing environment for people living in the home. Service users spoken with in the residential part of the service said the home was always clean, but still comfortable and a nice place to live. Most service users were involved in maintaining the cleanliness and tidiness of the building and took pride in having a nice environment. Harestock Hostel DS0000040578.V347439.R01.S.doc Version 5.2 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 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 good This judgement has been made using available evidence including a visit to this service. Service users benefit from being supported by adequate numbers of welltrained staff and are protected by the home’s recruitment policies and practices. EVIDENCE: Staff training records showed that people working in the home received a wide range of training opportunities relevant to their work. Sixty-three per cent of staff in the home have, or are working towards, an NVQ 2 in care. Staff spoken with were knowledgeable and demonstrated skills and understanding in working with people who have a learning disability. Staff observed on the day of the inspection were skilled in communicating with people living in the home. They also reported that the training they received was informative and interesting and that they had no outstanding training needs. Harestock Hostel DS0000040578.V347439.R01.S.doc Version 5.2 Page 18 Training needs were formally identified with the line manager and staff were also supported to attend other courses that came up which they had a particular interest in. The home has a training plan in place. Rota’s showed that there were sufficient staff on duty at all times and this was confirmed in discussion with staff working on the day of the inspection visit. Staff spoken with and observed during the inspection visit were conscientious, enthusiastic, skilled and focussed on the needs of people living in the home. Recruitment records demonstrated that staff are not employed in the home without all necessary checks being in place, including references, Criminal Records Bureau check and POVA First check. At present there is no administrative support in the home and these tasks are being undertaken by senior care staff. There is also a vacancy for one member of night staff. These shifts are currently being undertaken by care staff and by agency staff. There is a low staff turnover and many staff have been working at the home for a long time. Harestock Hostel DS0000040578.V347439.R01.S.doc Version 5.2 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 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 adequate This judgement has been made using available evidence including a visit to this service. Service users benefit from living in a safe home where their views are considered. They would benefit further from the service meeting the requirements made in inspection reports. EVIDENCE: At the time of the inspection there was no Manager as the previous one had left. The Inspector was informed that there had been interviews held for a new Manager and that an appointment had been made, but people had not yet been informed who the new Manager was. A Deputy Manager from one of the organisation’s other homes had been put in place to manage this home until the new Manager takes up the post. Harestock Hostel DS0000040578.V347439.R01.S.doc Version 5.2 Page 20 The fact that the requirements and recommendations from the previous inspection had not been fully addressed indicates that the service has not been managed consistently and effectively since that time. Staff reported that there were a number of outstanding building issues that had not been dealt with over a long period of time. One of the houses needed blinds fitted in the lounge as the sun shining through the window made it quite uncomfortable for people living there. They had also been asking for a better security system on the front door for a number of months and this had still not been addressed. However, staff did say that the building issues had been dealt with more rapidly since the temporary Manager had been in place. Good workplace risk assessments were in place and these were kept up-todate. Fire records in the home were also up-to-date and well kept. Health and Safety issues were highlighted by all staff in the home and staff spoken with were clear about their responsibilities in this area. Night staff were responsible for carrying out structured health and safety checks of the buildings and reporting these to the Manger for action. The home had some quality assurance processes in place, including regular monthly visits from senior managers, staff meetings and service user meetings. The Inspector was told that the views of parents and representatives of service users had been sought, but that only one response had been received. There was evidence that issues raised by service users during house meetings and through questionnaires had been addressed by the home. Some of the results of consultation had been shared with some of the people living in the home. The quality assurance processes continue to develop. Harestock Hostel DS0000040578.V347439.R01.S.doc Version 5.2 Page 21 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 2 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 2 X 2 X X 3 X Harestock Hostel DS0000040578.V347439.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 YA1 Regulation 4(1) (c ) Requirement The Statement of Purpose and Service User Guide must inform prospective service users and their representatives that emergency admissions sometimes occur, and of any impact this may have. This is requirement is outstanding from the previous inspection and has been repeated Care plans and risk assessments must be kept up-to-date and detail how the care and support is given to protect service users and meet their needs. This is requirement is outstanding from the previous inspection and has been repeated Timescale for action 30/11/07 2. YA6 15(2) 30/11/07 Harestock Hostel DS0000040578.V347439.R01.S.doc Version 5.2 Page 23 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 YA24 Good Practice Recommendations Service users on respite/emergency/short-term placements and those in long-term placements should occupy separate premises, unless benefits for both groups can be demonstrated. Harestock Hostel DS0000040578.V347439.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. Extracts may not be used or reproduced without the express permission of CSCI Harestock Hostel DS0000040578.V347439.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. 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!