Inspection on 24/08/05 for Herbert House

This inspection was carried out on 24th August 2005.

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

Herbert House 20/02/09

Herbert House 06/03/07

Herbert House 30/01/06

Herbert House 26/11/04

Herbert House 27/07/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Herbert House Christie Miller Road Salisbury Wiltshire SP2 7EN Lead Inspector Alyson Fairweather Unannounced 24 August 2005 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Herbert House D51_D01_S28638_HerbertHouse_V208997_240805_stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Herbert House Address Christie Miller Road Salisbury Wiltshire SP2 7EN 01722 413244 01722 416096 herberthouse@rethink.org Rethink Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Marion Yeates Care Home 15 Category(ies) of MD Mental Disorder registration, with number of places Herbert House D51_D01_S28638_HerbertHouse_V208997_240805_stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 26th November 2005 Brief Description of the Service: Herbert House is a care home offering accommodation and personal care for up to fifteen people who have a mental health need. The home is run by Rethink and is located in Salisbury. Public transport, shops and other amenities are nearby. It is an attractive home, with accommodation over two floors, including a lounge, a large kitchen and dining room, and a conservatory. It is light and airy, with comfortable furnishings, and all residents have single bedrooms with en-suite showers. There is a separate flat available for two people who wish to retain more independence. There are large mature gardens at the rear of the house, and parking at the front. Herbert House D51_D01_S28638_HerbertHouse_V208997_240805_stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one afternoon in August. There were ten residents living at Herbert House, several of whom were at home. Time was also spent talking to the manager and three care staff, and visiting the flat where two residents live more independently. Records examined included care plans, complaints and health and safety files. 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. Herbert House D51_D01_S28638_HerbertHouse_V208997_240805_stage4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Herbert House D51_D01_S28638_HerbertHouse_V208997_240805_stage4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 and 4 Prospective service users have their needs, hopes and goals assessed and recorded before they move in to the home so that staff know how best to support them. They can visit the home before they move in to see if it is the right place for them. EVIDENCE: There is a well-established process for the assessment of prospective users. Referrals are usually initiated by other professionals, as residents of Herbert House have generally come from other settings within the mental health system. The referring mental health teams provide a copy of the most recent Care Programme Approach (CPA) plan, which gives details of how the potential resident can best be supported with their mental health needs. A risk assessment form is also sent to the referrer at this stage. Information is gathered from individual residents during their trial visits about their hopes for the future and what they would like to do with their daily routine. Records showed that a detailed range of information is obtained, and clearly set out what needs a person has, and what support the home will provide. One potential resident was visiting the home during the inspection, and was going to stay overnight and meet the other residents. Herbert House D51_D01_S28638_HerbertHouse_V208997_240805_stage4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 and 9 Care plans reflect the needs and personal goals of residents, which means that staff are able to support them in the way they wish. They are supported to take risks where appropriate, and encouraged to be as independent as possible. EVIDENCE: Each resident has a care plan which is reviewed on a regular basis by the resident and their key-worker. Care plans focus on individual’s strengths as well as any need or problem, and contain sections on communication abilities, domestic abilities, mental health, physical health and sleep patterns, among others. Residents have the opportunity to record their comments on the reviewed care plan. A daily dairy is also kept for each resident, and this records what they have done during the day. Each resident has a keyworker, and staff spoken to were very sensitive to the needs of residents and the different approaches needed by individuals to help build their confidence. Each resident also has a care plan meeting (CPA) on a regular basis with the local Community Mental Health Team (CMHT). While staff at Herbert House take great care to make sure that residents sign and agree the home’s care plans, it Herbert House D51_D01_S28638_HerbertHouse_V208997_240805_stage4.doc Version 1.40 Page 9 was disappointing to note that the ones sent to the home by the CMHT have no resident signature. It is recommended that the manager should explore ways of ensuring that any CPA plan is signed by the resident. Risk assessments had been done for each resident and these included things such as relationships, finances and smoking safely, and ways of minimising risks were identified. Residents are, however, supported to take acceptable risks as part of their independent lifestyle, and these are reviewed on a regular basis. One resident uses a symbol cane when outside, and the keyworker concerned reminds him to take it with him when going out, and has discussed his personal safety when crossing roads. Herbert House D51_D01_S28638_HerbertHouse_V208997_240805_stage4.doc Version 1.40 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 17 Social and leisure activities are varied and tailored to individual need, with residents choosing what they wish to do. Mealtimes are an enjoyable time, and residents are offered a healthy diet. EVIDENCE: Residents have access to a range of community activities. These include gardening, attending day centres, shopping, going to the gym, arts and crafts, football, snooker, going to the library and looking after an allotment. Several of the residents enjoy music, and one writes his own songs and plays the guitar. Residents are encouraged to participate in a number of activities as part of the Recovery model of mental health, and a guest speaker has been invited to the residents’ meeting to give information about vocational rehabilitation. All residents take turns at cooking for the house, and it is the expectation that everyone sits down to eat supper together. Residents are aware of healthy eating, and varied meals are prepared, with fresh fruit and vegetables being readily available. One resident prepared a delicious curry for supper on the day the inspection took place. Herbert House D51_D01_S28638_HerbertHouse_V208997_240805_stage4.doc Version 1.40 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 20 Healthcare needs of residents are written in care plans so that they can receive support in the way they need and prefer. The home’s medication policies try to ensure that service users are safe when their medication needs are being met, and anyone wishing to self medicate is supported to do so. EVIDENCE: Residents do not require staff support in relation to their personal care. All residents are registered with a GP whilst living in the home, and all other medical professionals are seen as and when required. This varies according to the needs of individuals. The home has good links with local mental health teams, and can call for support if any crisis periods arise. All residents attend mental health reviews on a regular basis, and care plans can be amended at this time. One resident’s care records had shown that he had an allergic reaction to Ibuprofen, and had been advised not to use this medication again. This information had not been recorded on the medication chart, and the manager has been asked to ensure that this is done. Medication records will be examined more fully at the next inspection. Herbert House D51_D01_S28638_HerbertHouse_V208997_240805_stage4.doc Version 1.40 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 Residents are able to speak their mind about any concerns or worries, and know that something will be done about it. EVIDENCE: The home has a complaints procedure which gives details of the time in which complaints will be investigated, and who will be responsible for making sure it happens. It also gives details of how to contact the Commission for Social Care Inspection (CSCI).All residents are given a copy of the home’s complaints procedure when they come to live there, and the right to complain about services is reinforced at residents’ meetings. The complaints leaflet has been revised, although only the old copies were available, and the manager should make sure that all residents have an up to date copy. The manager and staff take all complaints seriously, and record the nature of the complaint, any action taken and the outcome, although these records are kept in various locations. It is recommended that all these records are kept together in the one file. Herbert House D51_D01_S28638_HerbertHouse_V208997_240805_stage4.doc Version 1.40 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 30 The care which residents and staff take to maintain the home means that residents live in a homely, comfortable safe environment, which is clean and hygienic. EVIDENCE: Herbert House is located in Salisbury and is an attractive home, with accommodation over two floors, including a lounge, a large kitchen and dining room, and a conservatory. It is light and airy, with comfortable furnishings, and all residents have single bedrooms with en-suite showers. These rooms were homely and contained individual personal items. Residents and staff share the domestic chores, and a cleaning rota is in place. The bathroom in the flat for two of the residents was in a poor state of repair, and the enamel had come off the bath in some places. Consideration should be given to replacing this, and to installing a shower. The home was clean and hygienic, with policies and procedures in place for the maintenance of the building. Herbert House D51_D01_S28638_HerbertHouse_V208997_240805_stage4.doc Version 1.40 Page 14 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 Residents are supported by an effective staff team. EVIDENCE: Staff spoken to were enthusiastic about the support they had from both colleagues and the manager, and felt able to question and discuss issues arising in the house. A communications book is also used by staff, and this records any incidents and appointments made for residents. Staff were seen to be extremely well informed about the wellbeing of all the residents, and able to discuss any detail. There was a good rapport observed between residents and staff. One visiting CPN said that one of his clients had been living in the house for around eighteen months, and that this person’s mental well being had improved greatly with the support and guidance of the staff team. He said, “If I ever became mentally ill, this is where I would like to be”. The mother of another resident telephoned, and was very complimentary of the care her daughter receives. Herbert House D51_D01_S28638_HerbertHouse_V208997_240805_stage4.doc Version 1.40 Page 15 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 The home’s health and safety policies and procedures, and the checks carried out, mean that residents’ safety and welfare are protected. EVIDENCE: The home has good fire safety policies and procedures in place. Water temperatures are tested on a weekly basis, and all staff have had food hygiene training, with food temperatures being recorded on a daily basis. Two staff members take responsibility for fire safety procedures, and the fire bell and emergency lighting are tested regularly. Fire extinguishers are checked annually by an outside contractor, and were due to be done again in November 2006. Rethink also undertakes regular Health and Safety Audits of the home. Fire drills are held on a quarterly basis, and it is recommended that the initials of all staff and residents who take part are recorded. Herbert House D51_D01_S28638_HerbertHouse_V208997_240805_stage4.doc Version 1.40 Page 16 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x x x 3 Standard No 31 32 33 34 35 36 Score x x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Herbert House Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x D51_D01_S28638_HerbertHouse_V208997_240805_stage4.doc Version 1.40 Page 17 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 20 Regulation 13 (2) Requirement Any allergic reactions to medication must be clearly identified on the medication administration record. Timescale for action 24/08/05 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. 2. 3. 4. 5. Refer to Standard 6 22 22 24 42 Good Practice Recommendations The registered person should explore ways of ensuring that any CPA plan is signed by the resident. All complaints records should be kept together in the one file. The registered person should make sure that all residents have the updated copy of the home’s complaints leaflet. Consideration should be given to replacing the bath with flaking enamel, and to installing a shower. The initials of all staff and residents who take part in fire drills should be recorded. Herbert House D51_D01_S28638_HerbertHouse_V208997_240805_stage4.doc Version 1.40 Page 18 Commission for Social Care Inspection Avonbridge House Bath Road Chippenham Wiltshire, SN15 2BB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Herbert House D51_D01_S28638_HerbertHouse_V208997_240805_stage4.doc Version 1.40 Page 19 - 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. 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