Inspection on 22/08/05 for Hobbs Field

This inspection was carried out on 22nd 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

Hobbs Field 07/03/07

Hobbs Field 07/12/05

Hobbs Field 08/12/04

Hobbs Field 24/05/04

Hobbs Field 06/03/03

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Thorndene

Insight - Eastchurch

Southfields

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33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Hobbs Field Leechpool Lane Horsham West Sussex RH13 6AG Lead Inspector Mrs Kerry Leppard Announced Monday, 22 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. Hobbs Field H60-H11 S37439 Hobbs Field V236406 220805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Hobbs Field Address Leechpool Lane, Horsham, West Sussex, RH13 6AG 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) 01403 254114 01403 750915 hobbsfield.ss@westsussex.gov.uk West Sussex County Council Social and Caring Services Mr Paul Kelsey CRH(PC) - Care home only 15 Category(ies) of LD-Learning disability, 15 places registration, with number of places Hobbs Field H60-H11 S37439 Hobbs Field V236406 220805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8 December 2004 Brief Description of the Service: Hobbs Field is a care home for younger adults, registered to accommodate fifteen service users with a learning disability. The home consists of two houses named Longleat and Woburn, accommodation is provided in fifteen single occupancy bedrooms. The property is situated in a residential area close to Horsham town centre and has its own secluded garden. The Registered provider is West Sussex County Council, the Responsible Individual on behalf of which is Mr. John Dixon. The Registered Manager, responsible for the day-today running of the establishment is Mr Paul Kelsey. Hobbs Field H60-H11 S37439 Hobbs Field V236406 220805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted on Monday 22nd August 2005 between 10am and 7.15pm and was announced. The registered manager accompanied the inspector on a tour of the premises and pointed out changes and improvements since the last inspection. The inspector met thirteen residents during the course of the inspection and spoke with four on an individual basis. Not all residents were able to communicate with the inspector and therefore some periods of observation were spent in both houses. The inspector spoke with the staff on duty. A community nurse and day centre manager who visited Hobbs Field during the inspection and are in regular contact with the staff and residents, also spoke with the inspector. The inspector received eight resident and six relative/visitor comment cards. Results and comments from these will be incorporated into this report. What the service does well: What has improved since the last inspection? A substantial amount of work has been done since the last inspection to address the requirements and recommendations that were made. Hobbs Field H60-H11 S37439 Hobbs Field V236406 220805 Stage 4.doc Version 1.40 Page 6 Medication records have been improved to reflect the receipt and administration of medicines more accurately and a homely remedy policy has been implemented. Works have been undertaken to meet the requirements of the fire officers’ report and some redecoration and refurbishment has taken place. Staff records have been transferred to Hobbs Field in accordance with the Care Homes Regulations and are available for inspection. Residents care records and ‘passports’ have been changed and the information recorded in them is now very comprehensive and easy to follow. Pictures and symbols have also been used to make the records accessible to the residents. 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. Hobbs Field H60-H11 S37439 Hobbs Field V236406 220805 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 Hobbs Field H60-H11 S37439 Hobbs Field V236406 220805 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) 2, 4 & 5 Prospective residents needs are assessed. Prospective residents are given the opportunity to visit and ‘test drive’ the home. Each service user has an individual statement of terms and conditions. EVIDENCE: Three residents records were sampled by the inspector, each of these included an assessment of the resident done by a social worker before the resident came to live at Hobbs Field. Residents come to Hobbs Field for tea visits and/ or short stays to see if they like it before coming to live in the home. The records sampled by the inspector included terms and conditions, which had been signed by the resident. A picture and symbol format of the terms and conditions has been used to ensure the information is accessible to the residents. Hobbs Field H60-H11 S37439 Hobbs Field V236406 220805 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 Residents are involved in reviewing their goals and personal plan. Personal planning involves residents in making decisions about their lives. Residents are supported to take risks. EVIDENCE: It was evident that a lot of effort had been put into residents’ individual plans following the last inspection. Records are now impressively comprehensive and easy to follow. ‘Passports’ have been put together using pictures and symbols, these give details of each residents background, needs and abilities, like and dislikes, their keyworker’s role and personal plan goals. All three records sampled by the inspector included a recent review at which the resident, their relatives and staff were present. The inspector noted that an advocate had been used to facilitate one of the three meetings to ensure the resident was involved in the decision making process. Residents’ records included risk assessments in relation to identified risks such as road safety. One of the three records also included a risk assessment in Hobbs Field H60-H11 S37439 Hobbs Field V236406 220805 Stage 4.doc Version 1.40 Page 10 relation to the resident’s challenging behaviour. This assessment clearly defined the behaviour that is challenging, why it may occur and the action to be taken by staff to deal with the behaviour. Staffing issues, such as unplanned absence and lone working have been incorporated into this and the information had been shared with the resident’s social worker. Hobbs Field H60-H11 S37439 Hobbs Field V236406 220805 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 15, 16 & 17 Residents take part in appropriate activities and are part of the local community. Residents have opportunities to maintain relationships. Residents’ rights and responsibilities are recognised. Residents are offered a health diet and meal times are enjoyed. EVIDENCE: All of the residents who completed a comment card said that suitable activities are provided. Residents told the inspector about a variety of activities that they participate in and enjoy including summer school activities, attending day centres, working in a local café and attending the ‘ready and able’ club. Two residents were going to a leisure centre during the evening of the inspection to play badminton and tennis. Hobbs Field H60-H11 S37439 Hobbs Field V236406 220805 Stage 4.doc Version 1.40 Page 12 One resident told the inspector that she enjoys going out with her family and friends and goes to church. A visitor comment card included “whenever I have been to see my sister, I have always been welcomed and got on with staff” All of the relatives/visitors who completed a comment card said that they are welcomed into the home and are able to see their friend/relative in private. The inspector observed that residents’ rights to choose how they spend their time is respected and supported by staff at Hobbs Field. Seven residents who completed a comment cards said their privacy was respected, the remaining resident said they did not know and another commented that although staff respects their privacy, other residents do not always. Residents share some responsibilities for maintaining the cleanliness of communal areas including washing up, drying up and laying the tables for meal times for which a rota has been put together. All of the residents who completed a comment card said that they liked the food provided at Hobbs Field. The inspector spent time with residents whilst they ate their evening meal, which they enjoyed. A variety of food was provided dependent upon residents’ choice and needs and staff were available to offer support sensitively if it was needed. Residents are able to use kitchen areas independently and many keep snacks and drinks in their bedrooms, one resident commented “I am very pleased to now have a fridge in my own room” Hobbs Field H60-H11 S37439 Hobbs Field V236406 220805 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 & 20 Residents received the support they need, as they prefer. Hobbs Field seeks support from other professionals to meet residents physical and emotional health needs. Residents self-administer their medication if this is safe, otherwise the home manages medication. Some procedures have been improved to ensure this is done safely to protect residents EVIDENCE: Residents ‘passports’ clearly set out the level of support that each resident requires and the tasks with which they are independent to ensure their personal care needs are met. Resident likes and dislikes are also recorded to assist staff to know their preferences. The records sampled show that Hobbs Field seek the support of other professionals such as psychiatrists, clinical psychologists, speech and language therapists and dieticians to ensure all aspects of residents health and well being are met. One resident and his keyworker discussed with the inspector the keyworker’s role in supporting residents to attend health related appointments. The inspector met a community nurse who was visiting the home to provide Hobbs Field H60-H11 S37439 Hobbs Field V236406 220805 Stage 4.doc Version 1.40 Page 14 support to manage one resident’s challenging behaviour, feedback from the nurse was positive about the standard of care provided at Hobbs Field. Medication received into the home is recorded appropriately and records are now being made on a monthly basis of the quantity of medication given to another party, such as a day centre for them to administer to residents. A homely remedy policy has been introduced. It is recommended that all homely remedies stored and used be included on the list relating to the policy. It is also recommended that care plans be devised to ensure that staff have clear guidance in relation to the administration of ‘as required’ medication. Hobbs Field H60-H11 S37439 Hobbs Field V236406 220805 Stage 4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 Residents’ views are listened to and acted on. The availability of the complaints procedure could be improved. Residents are protected from abuse, neglect and self-harm. EVIDENCE: Although residents’ terms and conditions that are shared in picture format include information about the complaints procedure, four residents who completed a comment card said they did not know who to speak to if they were unhappy with their care. Similarly, half of the relatives/visitors who completed a comment card said that they were not aware of the home’s complaints procedure. The inspector concluded that this might be because the procedure is not displayed in the home. One complaint had been recorded, this was received from a resident and the written response addressed each point made. House meetings are held for residents to provide feedback and a member of kitchen staff told the inspector that residents are asked for feedback on the menu and their likes and dislikes are taken into consideration when preparing the menu. Six residents who completed a comment card indicated that they would like to be more involved in decision making within the home. Staff receives training provided by the registered manager, which assists them to identify abuse and protect residents from abuse. Hobbs Field H60-H11 S37439 Hobbs Field V236406 220805 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 & 30 Residents live in a safe, comfortable and clean environment. EVIDENCE: Works have been done to meet the requirements of the fire officers’ report and ensure the safety of the building. Both lounges have been redecorated and flooring in some residents’ bedrooms has been replaced. One bedroom still needs the flooring replaced. The two communal lounge/dining rooms are homely and comfortable and residents looked relaxed using these areas. Residents have furnished their bedrooms with their own belongings and it was evident in one bedroom that the keyworker had supported the resident to co-ordinate their bedroom very successfully. The inspector noted from the registered providers monthly reports that some of the equipment and furniture is no longer suitable for the changing needs of residents. A physiotherapist has visited to assess one resident’s needs in relation to showering and the registered manager is aware that some sofas are Hobbs Field H60-H11 S37439 Hobbs Field V236406 220805 Stage 4.doc Version 1.40 Page 17 too low for older residents. This should be taken into consideration in the budget and planning for Hobbs Field. Domestic staff is employed to assist residents to maintain a clean environment. Residents are involved in maintaining hygiene in the home. Hobbs Field H60-H11 S37439 Hobbs Field V236406 220805 Stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34, 35 & 36 Staff is competent and qualified. Staffing levels should be reviewed on an ongoing basis to ensure residents’ needs are met. Staff is recruited using a robust procedure that protects residents. Staff are supervised and supported. EVIDENCE: Staff who spoke with the inspector individually said that they had completed the Learning Disability Award Framework (LDAF) Induction when they started working at Hobbs Field. Staff also said that they have done various other training courses including health and safety topics such as fire, manual handling, food hygiene and infection control. Training in specific topics such a downs syndrome and dementia, autism and challenging behaviour has also been provided. Staff said they are supported to undertake training including National Vocational Qualifications (NVQs), currently 33 of the care staff at Hobbs Field is trained to NVQ Level 2 and five staff is currently working towards achieving the award. Hobbs Field H60-H11 S37439 Hobbs Field V236406 220805 Stage 4.doc Version 1.40 Page 19 Feedback from a variety of sources including the registered provider’s monthly reports, residents’ records and relative/visitor comment cards indicates that staffing levels do not always appear sufficient and consistency is sometimes lacking due to the use of agency staff. It is recommended that the registered persons review the staffing levels using the Department of Health guidance to ensure residents needs are met at all times. Three staff is on duty during daytime shifts, which operate, between 8am and 10pm, this includes one senior member of the team. At night one waking member of staff is on duty with one sleeping in member of staff. For the most part the registered manager’s hours are in addition to this, similarly some one to one support is being provided for one resident who currently presents challenging behaviour. The registered manager has not adjusted the night shifts as suggested at the last inspection but is looking at an alert system for staff to use when they are working alone and need to summon assistance. Staff recruitment records have now been transferred to the home and were available for inspection, those sampled indicate that the procedure used is robust and in accordance with the requirements of the Care Homes Regulations. Staff said they had an identified supervisor who provides regular supervision sessions and team meetings are also held, staff said they feel supported by these processes and by their colleagues. It was noted that staff felt there had been a recent improvement in them being listened to by the management. Hobbs Field H60-H11 S37439 Hobbs Field V236406 220805 Stage 4.doc Version 1.40 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 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) 41 Residents’ money is protected by the recording and storage procedures used by the home. EVIDENCE: Residents’ money is stored separately and securely. Records are maintained of money coming in, going out and the balance. Two records were sampled and were accurate. The registered manager explained that it is not practical for two staff to sign out money to residents and therefore this recommendation has not been implemented. Similarly records are made of items held for safe keeping but residents are not given a copy of the receipt. Hobbs Field H60-H11 S37439 Hobbs Field V236406 220805 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 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 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 2 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Hobbs Field Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x 3 x x H60-H11 S37439 Hobbs Field V236406 220805 Stage 4.doc Version 1.40 Page 22 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 Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 20 20 33 Good Practice Recommendations It is recommended that all homely remedies stored and used be included on the list relating to the policy. It is recommended that care plans be devised to ensure that staff have clear guidance in relation to the administration of ‘as required’ medication. It is recommended that the registered persons review the staffing levels using the Department of Health guidance to ensure residents needs are met at all times. 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