Inspection on 09/08/05 for Hixberry Lane

This inspection was carried out on 9th 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Hixberry Lane 18/07/07

Hixberry Lane 22/11/06

Hixberry Lane 10/01/06

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Hixberry Lane Respite Care Unit 3 Hixberyy Lane St Albans Hertfordshire AL4 OTZ Lead Inspector Bijayraj Ramkhelawon Unannounced 9 August 2005 10:00 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. Hixberry Lane Respite Care Unit I52 s64245 hixbery lane v243372 090805 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Hixberry Lane, Respite Care Unit Address 3 Hixberry Lane St Albans Hertfordshire AL4 OTZ 01727 753142 01727 753141 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) Hertfordshire County Council Care Home 4 Category(ies) of LD Learning Disability - 4 registration, with number PH Physical Disability - 4 of places Hixberry Lane Respite Care Unit I52 s64245 hixbery lane v243372 090805 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 18/03/04 Brief Description of the Service: Hixberry Lane is a 4 bedded respite care unit, currently owned by Hertfordshire County Council, which provides respite care for people with a learning disability. There are three other separate units, all managed together from the main office in the building at 3 Hixberry Lane, but only the respite care unit is registered. This unit is on the ground floor and comprises of 4 bedrooms with ensuite facilities. There is a small garden at the front but there a lager one at the rear which is shared with service users from other units.The building at Hixberry Lane is sited next door to Butterwick Day Centre. The main town of St. Albans, with its extensive facilities, is a short drive away. Hixberry Lane Respite Care Unit I52 s64245 hixbery lane v243372 090805 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a positive unannounced inspection and feedback received mostly from staff was excellent. The management of the unit was open and transparent with adequate information about this unit available to service users and visitors. All four service users were out of the unit attending the day care centre or engaged in community activities. Care plans were well documented and reflected the changing needs of service users. However, there were areas to be developed which are reflected in the report and include adherence to fire safety regulation, risk assessment, repair works to be carried out and the provision of moving equipment for service users with disabilities. What the service does well: What has improved since the last inspection? The home has a new manager who has introduced a key and link worker system. There is regular formal supervision provided to all care staff. Hixberry Lane Respite Care Unit I52 s64245 hixbery lane v243372 090805 stage 4.doc Version 1.40 Page 6 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. Hixberry Lane Respite Care Unit I52 s64245 hixbery lane v243372 090805 stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Hixberry Lane Respite Care Unit I52 s64245 hixbery lane v243372 090805 stage 4.doc Version 1.40 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 standard(s) 1-5 Adequate information was available to current and prospective service users and their families. Assessments of needs were carried out to ensure that staff have sufficient information on each person’s needs prior to an offer of respite care is made. EVIDENCE: The home has a Statement of Purpose and the Service user’s Guide and both documents were available to service users and their families. All service users were referred through the Local Authority. Care plans were comprehensive and met the requirements of this Standard. However, the service users’ License Agreement have been devised but not signed by either party. Staff said that these would be signed when individual ‘whole life review’ are held. Service users and their families were given the opportunity to visit and view the place prior to a planned offer of respite care was made. The trial period gave more time for the staff to further assess the needs of the service users. This unit also provide emergency admissions. Hixberry Lane Respite Care Unit I52 s64245 hixbery lane v243372 090805 stage 4.doc Version 1.40 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 standard(s) 6,7, & 9 Care plans were detailed and comprehensive. Information on all assessed health care needs, social needs and risk assessments were carried out. However, care plans should be reviewed with the service user at least every six months. At the time of the inspection all four service users were attending the day centre. EVIDENCE: Each service user had a care plan generated from the Care Management Assessment and the homes own assessment which covered all aspects of personal and social support and healthcare needs. However, it was noted that care plans were not reviewed at least every 6 months and updated to reflect the changing needs. Individual records/care plans were kept in one of the cabinets in the kitchen. Hixberry Lane Respite Care Unit I52 s64245 hixbery lane v243372 090805 stage 4.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) 11, 12,13&17 Service users were encouraged to make choices in relation to their food, clothes and activities to optimise their abilities in developing their skills. They were also encouraged and supported to pursue social and leisure activities as stated in their individual care plan. EVIDENCE: Service users attended the ‘Butterwick’ day centre. Staff spoken to said that service users were encouraged to make choices in relation to their food, clothes and activities to optimise their abilities in developing their skills. Service users were offered a choice of suitable menus, which meet their dietary needs and individual preferences. Hixberry Lane Respite Care Unit I52 s64245 hixbery lane v243372 090805 stage 4.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) 18,19 and 20 There was good record keeping of service users health care needs. However, it was required that risk assessment must be carried out for service user who is on Warfarin medication and a policy and procedures for self administration of medication should be devised. The manager must discuss and agree with relatives a safer system for medicines being brought by service users. EVIDENCE: A key worker system is in place and all service users have a care manager. Service users were registered with their own GP nearer to their place of residence. They brought with them sufficient medication to last their stay. It was noted that medicines were dispensed in dossette boxes by relatives and the empty containers sent to the unit did not have clear instructions on the labels. These stated that medicines must be given ‘as directed by the prescriber’. It was also noted that risk assessment was not carried out for service user who was on Warfarin. This may leave the service use at risk if they fell or if given certain citrus fruits. Staff must be provided with all the relevant information to provide care in a safe manner. There was no policy and procedures for self administration of medication. This should be addressed as service users should be enabled to maintain responsibiility for their own medication where no risk has been identified. Hixberry Lane Respite Care Unit I52 s64245 hixbery lane v243372 090805 stage 4.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&23 This unit has a complaints procedure and staff were aware of. At the time of the inspection a complaint under POVA was being investigated. EVIDENCE: The home has a complaints procedure in a booklet and leaflets about this were by the front door on the day of the inspection. A complaint was made by a service user and this was being investigated. The complaints records were checked during the inspection and were in order. The home has a ‘Whistle Blowing’ policy in place to ensure the safety and protection of service users (including passing on concerns to the CSCI), in accordance with the Public Interest Disclosure Act 1998 and Department of Health guidance No Secrets. Hixberry Lane Respite Care Unit I52 s64245 hixbery lane v243372 090805 stage 4.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 -27,29&30 The home provides a comfortable and well-maintained environment for the service users. Staff maintained a good standard of cleanliness and hygiene. However, the water marks on the cracked ceiling in the lounge and the lino strips coming off the wall in the bathroom must be repaired. The home must provide a hoist for service users with physical disabilities. EVIDENCE: The home meets the required standards in providing living space for service users. The premises were safe, accessible, comfortable, clean and free from offensive odours. Each room has sufficient light, heat and ventilation. All rooms are for single accommodation with ensuite facilities. Service users’ bedrooms included all the necessary furniture and lockable storage space for the safekeeping of personal belongings and valuables. Each bedroom is attractively decorated. However, It was noted that there were watermarks on cracked ceiling in the main lounge and that the lino strips were peeling off the wall in the bathroom. It was also noted that a hoist is not provided for service users with physical disabilities. Hixberry Lane Respite Care Unit I52 s64245 hixbery lane v243372 090805 stage 4.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) 31-36 There was adequate number of staff rostered on duty both on days and at nights. Staff spoken to were confident of their knowledge of the needs of the service users and felt well supported in their work. EVIDENCE: Staff were aware of and promoted the main aims and values of the home including the key worker system. Staff confirmed that they have received a job description on starting employment and they undergo a period of induction. Staff were knowledgeable about the needs of service users and received regular, recorded formal supervision and an annual appraisal. Staff files inspected did not have all the required documents but these were kept at New Barnfields, Human Resource Department for Hertfordshire County Council. Hixberry Lane Respite Care Unit I52 s64245 hixbery lane v243372 090805 stage 4.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) 37-43 The management within the home was proactive and effective in ensuring that the needs of the service users were being met. A monthly written report on the conduct of the home was supplied to the Commission. A quality assurance system based on seeking the views of service users, relatives and other stakeholders has yet to be developed. To protect both service users and staff fire doors must only be held open by means approved by the Fire Safety Officer. EVIDENCE: Staff spoken to said that they were happy to be working at the home and that the manager enabled them to support service users in meeting their needs. She was also approachable, supportive and encouraged staff to develop their skills and to keep abreast of development in this field of care. The processes of managing and running the home were open and transparent. Regular staff meetings are provided. Hixberry Lane Respite Care Unit I52 s64245 hixbery lane v243372 090805 stage 4.doc Version 1.40 Page 16 The home’s policies and procedures were kept in the office and were available to staff. Staff spoken to said that they adhered to the policies and procedures of the home. All staff have completed the statutory training to maintain safe working practices and the home complies with all relevant legislations to safeguard the health, safety and welfare of service users and staff. All staff who handled food have undertaken food and hygiene training. Fire drills, alarm tests and emergency light checks were carried out on a regular basis. Accidents, injuries, incidents of illness were recorded and reported. Valid insurance cover for legal liabilities to employees, service users and third party persons to a limit commensurate with the level and extent of activities undertaken or to a minimum of £5 million is in place. A quality assurance system based on seeking the views of service users, relatives and other stakeholders has yet to be developed. It was noted that the fire door of the lounge was wedged open. Fire doores must only be held open by methods approved by the Fire Safety Office. Hixberry Lane Respite Care Unit I52 s64245 hixbery lane v243372 090805 stage 4.doc Version 1.40 Page 17 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 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 3 3 3 N/A 1 3 Standard No 11 12 13 14 15 16 17 3 3 3 x x x 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Hixberry Lane Respite Care Unit Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 2 3 3 1 3 I52 s64245 hixbery lane v243372 090805 stage 4.doc Version 1.40 Page 18 yes 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. 2. 3. 4. 5. Standard A 20 A 24 A 24 A 29 A 42 Regulation 13(2) 23(2)(b) 23(2)(b) 23(2)(n) 23(4)(c) (iii) Requirement A Risk assessment must be carried out for any service user who is on Warfarin medication. Water marks and cracked ceiling in the lounge must be repaired. Lino strips coming off the wall in the bathroom must be repaired. Moving equipment/ hoist must be provided for service users with physical disabilities. Fire doors must only be held open by means approved by the Fire Safety Officer and not wedged open. Timescale for action 30/09/05 30/09/05 30/09/05 11/11/05 09/08/05 and Henceforth 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 A6 A20 A39 Good Practice Recommendations Care plans should be reviewed with the service user at least every six months. A Policy and procedures for self medication should be devised. The home should develop a quality assurance system based on seeking the views of service users, relatives and other stakeholders. I52 s64245 hixbery lane v243372 090805 stage 4.doc Version 1.40 Page 19 Hixberry Lane Respite Care Unit Hixberry Lane Respite Care Unit I52 s64245 hixbery lane v243372 090805 stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City AL7 3BQ 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 Hixberry Lane Respite Care Unit I52 s64245 hixbery lane v243372 090805 stage 4.doc Version 1.40 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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