Inspection on 30/01/06 for Herbert House

This inspection was carried out on 30th January 2006.

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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Herbert House 20/02/09

Herbert House 06/03/07

Herbert House 24/08/05

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 Inspection 30th January 2006 13:15 Herbert House DS0000028638.V266805.R01.S.doc Version 5.0 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 Herbert House DS0000028638.V266805.R01.S.doc Version 5.0 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. Herbert House DS0000028638.V266805.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Herbert House Address Christie Miller Road Salisbury Wiltshire SP2 7EN 01722 413244 01722 416096 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) Rethink Mrs Marion Yeates Care Home 15 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (15) of places Herbert House DS0000028638.V266805.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th August 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 DS0000028638.V266805.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one afternoon in January. There were ten residents living at Herbert House. Although one was in hospital, several were at home. Time was spent talking to the manager and three care staff, touring round the premises and talking to residents. Records examined included care assessments, care plans, and staff training records. What the service does well: What has improved since the last inspection? What they could do better: The premises have some recent re-decoration. However, the smoking room was in a state of disrepair, with dirty walls and a broken lampshade. The home’s annual quality was due to be sent out again, and there were hazardous materials lying loose in a bathroom, when they should have been stored away in a locked cupboard. The manager has been asked to make sure that all these matters are dealt with. Herbert House DS0000028638.V266805.R01.S.doc Version 5.0 Page 6 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 DS0000028638.V266805.R01.S.doc Version 5.0 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 Herbert House DS0000028638.V266805.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following 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 new resident was at home during the inspection, and had completed various short visits as well as an overnight stay. Herbert House DS0000028638.V266805.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 and 7 Care plans reflect the needs and personal goals of residents, which means that staff are able to support them in the way they wish. Residents are assisted where necessary to make decisions about their own lives 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. The care plan of the newest resident was examined. It contained very detailed referral information, and had been updated that very day, following a review meeting. Residents are supported to make decisions about their own lives with guidance from the staff. They are encouraged to manage their own finances wherever possible, and to be as self sufficient as possible. Where restrictions are in place, for example to limit self harm or harm to others, this is clearly recorded and guidelines are drawn up for staff to follow. Herbert House DS0000028638.V266805.R01.S.doc Version 5.0 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 the following standard(s): 15 and 16 Residents can have as much or as little contact with family and friends as they wish, and are encouraged and supported by staff. Residents’ rights are respected and responsibilities recognised in their daily lives. EVIDENCE: Residents can entertain family or friends either in the privacy of their own bedrooms or in the communal areas available. Staff encourage and support links between residents and their families, although the frequency of contact varies depending on individual circumstances. Residents can choose when to be alone or in company, and when not to join an activity. They have unrestricted access to the home and grounds, and can come and go as they please. Several residents had gone out to day services on the day of the inspection, but some were at home. Staff enter residents’ bedrooms only with the individual’s permission, and were seen to knock on the bedroom door and wait for response. Residents’ responsibility for housekeeping tasks, such as doing their laundry or tidying their room is specified in their care plan. All residents take turns at cooking for the house, and it is the expectation that everyone sits down to eat supper together. Herbert House DS0000028638.V266805.R01.S.doc Version 5.0 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 the following standard(s): 19 Healthcare needs of residents are written in care plans so that they can receive support in the way they need and prefer. EVIDENCE: Residents do not require staff support in relation to their personal care. Patterns of daily living mean that residents can choose when to get up, go to bed, when to have a bath and what clothes to wear, although personal hygiene is encouraged by staff. 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. Herbert House DS0000028638.V266805.R01.S.doc Version 5.0 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 the following standard(s): 23 The policies and procedures the home has in place try to ensure that residents are safeguarded from abuse and harm. EVIDENCE: The home has copies of the “No Secrets” document, as well as the organisational policy and procedure on responding to allegations of abuse. A “Whistle Blowing” procedure is available for all staff, and they are encouraged to report any incidences of poor practice. Rethink has introduced its own training for staff working with Vulnerable Adults. Herbert House DS0000028638.V266805.R01.S.doc Version 5.0 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 the following 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. It was recommended at the last inspection that consideration should be given to replacing this, and to installing a shower. This has not been actioned, and the same recommendation has again been made. The fence outside the house only partially shields the home, and various people use the side entrance of the house as a public pathway. Similarly, any movement by residents can be observed by neighbours. Consideration should be given to extending the fence round the Herbert House DS0000028638.V266805.R01.S.doc Version 5.0 Page 14 fron garden in order to offer residents security and privacy.The smoking room was in a poor state, with dirty walls, and a space where an old air vent had been removed and the space not repaired. There was also a broken lampshade in the room. The manager has been asked to make sure that this room is redecorated and the broken lampshade replaced. Herbert House DS0000028638.V266805.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 35 and 36 Residents are supported by competent and qualified staff, and by the home’s supervision policy and practices. EVIDENCE: Three members of staff are currently doing NVQ level 3, with one to start in April. One is doing NVQ Level 4 and is registered to do the Registered Managers Award. All new staff undergo full induction training before registering for their NVQ. Examination of staff training files showed that recent staff training has included drug and addictive behaviour. There was no structured method in place which would highlight when any updates for mandatory training were due, and a recommendation has been made that this is put into place. Supervision takes place on a regular monthly basis, with the manager supervising the senior staff and the senior supervising the rest of the care staff. Herbert House DS0000028638.V266805.R01.S.doc Version 5.0 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 EVIDENCE: The manager has been registered with the Commission for Social Care for several years, and has almost completed her Registered Managers Award. She is experienced in working with people with mental ill health. Staff members spoken to said how supported they feel by the manager in particular, and by colleagues in general. The organisation held a Health & Safety audit in 2004, and the home was found to be of a good standard. Mental health services Wiltshire are in a state of change, and staff are ensuring that residents are kept aware of progress, and what it might mean for them. However, there had been no service user questionnaire sent out for some time, and the manager has been asked to ensure that this is done. 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 Herbert House DS0000028638.V266805.R01.S.doc Version 5.0 Page 17 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 are due to be done again in November 2006. Fire drills are held on a quarterly basis. During a tour of the premises, it was noted that materials which should have been stored in a locked cupboard under Control of Substances Hazardous to Health Regulations (COSHH) were lying loose in a bathroom. The manager has been asked to ensure that this matter is dealt with and that all such materials are kept locked up in future. Herbert House DS0000028638.V266805.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X 3 x Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X X 3 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Herbert House Score X 3 X X Standard No 37 38 39 40 41 42 43 Score 3 X 2 X X 2 x DS0000028638.V266805.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? No 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 2 3 Standard YA24 YA39 YA42 Regulation 23 (2) (d) 24 (1) (a) (b) 13 (4) (a) Requirement The smoking room must be redecorated and the broken lampshade replaced. The home’s quality assurance questionnaire must be sent to all residents. All hazardous materials must be kept in a locked cupboard at all times. Timescale for action 30/04/06 30/04/06 30/01/06 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 Refer to Standard YA24 YA24 YA35 Good Practice Recommendations Consideration should be given to replacing the bath with flaking enamel, and to installing a shower. Consideration should be given to extending the fence round the fron garden in order to offer residents security and privacy. A training matrix should be set up which will help indicate when updates of mandatory training are due. Herbert House DS0000028638.V266805.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham 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 DS0000028638.V266805.R01.S.doc Version 5.0 Page 21 - 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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