Inspection on 07/03/07 for Hobbs Field

This inspection was carried out on 7th March 2007.

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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hobbs Field 07/12/05

Hobbs Field 22/08/05

Hobbs Field 08/12/04

Hobbs Field 24/05/04

Hobbs Field 06/03/03

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

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 Mr E McLeod Unannounced Inspection 7th March 2007 10:00 Hobbs Field DS0000037439.V328294.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hobbs Field DS0000037439.V328294.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hobbs Field DS0000037439.V328294.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hobbs Field Address Leechpool Lane Horsham West Sussex RH13 6AG 01403 254114 01403 750915 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) www.westsussex.gov.uk West Sussex County Council Mr Paul Kelsey Care Home 15 Category(ies) of Learning disability (15) registration, with number of places Hobbs Field DS0000037439.V328294.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th December 2005 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-to-day running of the establishment is Mr Paul Kelsey. Hobbs Field DS0000037439.V328294.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was arranged to update assessments of key standards from the National Minimum Standards made at the previous inspection. The key unannounced inspection visit to the home was undertaken by one inspector on the 7th March 2007 from 9.35 a.m. until 4.35 p.m. The registered person had completed a pre-inspection questionnaire and information from this plus evidence from previous inspections has been used to inform the planning and inspection process, and this report. Evidence gained during the inspection visit also informs this report. On the day of the inspection visit, the inspector spoke with four residents, three staff, the registered manager, and a visitor to the service. A partial tour of the premises was made. The inspector sampled three sets of admission records for residents, and four sets of care plans. Three sets of staff recruitment and training records were also sampled. The inspector observed interactions between staff and residents. A number of policies, procedures, and health and safety records were also sampled. What the service does well: What has improved since the last inspection? Improvements to the premises since the previous inspection include the provision of new dining room flooring and some redecoration in bedrooms. Arrangements for recording fire training completed by staff have improved. Hobbs Field DS0000037439.V328294.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Hobbs Field DS0000037439.V328294.R01.S.doc Version 5.2 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 Hobbs Field DS0000037439.V328294.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. YA2 Prospective residents’ individual aspirations and needs are assessed. EVIDENCE: The registered manager has advised the Commission that the current scale of charges is £62.35 per week. Three sets of pre-admission assessments were sampled, which indicated that pre-admission assessments completed by the social services department are being obtained. It was discussed with the registered manager Mr Kelsey that the home is not carrying out written pre-admission assessments on prospective residents, and therefore is not evidencing their own assessment of the resident’s needs or their reasons for believing the residents needs can or cannot be met in the home. However, no requirement has been made concerning this, as all Hobbs Field DS0000037439.V328294.R01.S.doc Version 5.2 Page 9 residents are receiving an external assessment of their needs before admission. Mr Kelsey advised that prospective residents visit the home before admission, including initial visits, visits for tea, and overnight stays. Hobbs Field DS0000037439.V328294.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. YA6, YA7, YA9 Residents know their assessed and changing needs and personal goals are reflected in their individual Plan. Residents make decisions about their lives with assistance as needed. EVIDENCE: Three sets of resident’s care plans were sampled, which indicated that residents have a care plan, and that their care needs are being reassessed on a regular basis. One resident interviewed showed the inspector a copy of her most recent care plan review meeting, and said she had found the meeting useful. Hobbs Field DS0000037439.V328294.R01.S.doc Version 5.2 Page 11 Staff interviewed said that each resident has a key worker, who has a role in ensuring that residents have the information, assistance and communication support they need to make decisions about their lives. For one resident who wishes to live more independently, this has included support and advice to enable her to walk to and from the shops on her own. Staff interviewed advised that they offer assistance where residents ask for support with budgeting or managing their finances. Care plans seen indicate that risk assessments are in place, for example a risk assessment where a resident is being supported to hold and administer her own medicines. It was the observation of the inspector that residents were being treated with respect, and no incidents indicated that residents were being discriminated against on account of their disability, gender or race were noted. Hobbs Field DS0000037439.V328294.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. YA12, YA13, YA15, YA16, YA17 Residents are able to take part in age, peer and culturally appropriate activities. Residents are part of the local community. Residents have appropriate personal, family and sexual relationships. Residents’ rights are respected and responsibilities recognised in their daily lives. Residents are offered a healthy diet and enjoy their meals and mealtimes. EVIDENCE: Staff interviewed provided examples of how residents have been encouraged to develop their self-confidence and social skills. On the day of the inspection, a number of residents had been attending further education and support centres, and residents interviewed said they had enjoyed their day. Hobbs Field DS0000037439.V328294.R01.S.doc Version 5.2 Page 13 Residents interviewed said they enjoyed the opportunities to go out to the local shops, and two residents said they were involved in planning a pub lunch outing in conjunction with the Friends of Hobbs Field group. Residents make use of other community facilities, and can attend evenings arranged by a local church group. Evening activities include a ready and able club on Monday evenings, the church group on Wednesdays, and a Gateway club on Thursdays. Swimming, snooker, badminton are also provided for residents. Staff support residents’ contact with families though chatting to parents after weekends away, and residents might ask staff to support them make phone calls to residents or friends. Staff interviewed provided examples of how residents’ independence is supported by having the support they need, and how residents individual choice is encouraged – such as by being part of interviews for prospective staff. Menus seen indicate that a balanced diet is being provided. Residents told the inspector that the main evening meal that day would be lamb, but that they could ask for cheese on toast if they didn’t want the lamb. Residents said they enjoyed the food provided. The provision of 2 dining rooms helps ensure a calm, relaxed atmosphere at meal times. Hobbs Field DS0000037439.V328294.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. YA18, YA19, YA20 Residents receive personal support in they way they prefer and require. Residents’ physical and emotional needs are met. Residents retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. EVIDENCE: Each resident has a key worker, who assists him or her in looking after their finances, personal care appointments, and keeping their room tidy. One member of staff said that residents most appreciate staff being able to sit and listen, have patience and a sense of humour. The inspector observed that staff have good listening skills and communicate with residents on an equal level. Staff interviewed gave examples of how care tasks, such as support with bathing, are done in the way that residents would prefer. Care plans sampled also indicate how the resident’s wishes are to be observed. Hobbs Field DS0000037439.V328294.R01.S.doc Version 5.2 Page 15 One member of staff said developing trust was important. One resident has developed her confidence by being supported to walk to the shops on her own, and is now moving towards independent living. Residents have a health plan with the local surgery, and visit the practice nurse for checks such as blood pressure once per year. As part of the plan, staff keep a record on health issues for the individual resident, which are then taken to the annual appointment for the resident. The local learning disability team maintain a liaison with the service. GPs review residents’ medication every six months. Care plans seen indicate that residents’ health needs are being met, and residents interviewed said they were feeling well. Staff receive medication training and must have a certificate in this before they start to administer medication. Manufacturers’ information on medicines administered is held in the home, and medication returns are done weekly. Medication records and arrangements for the storage of medication were sampled. The inspector was advised by the Registered Manager that two residents take their own medication, and those residents hold their medication under lock and key. A risk assessment for one of the self-medicating residents was seen, although this had not been updated or recorded as reviewed since 2003. Based on the home’s good record of previous compliance, the inspector accepted the manager’s verbal commitment to ensuring all medication risk assessments would be reviewed at an early juncture. Hobbs Field DS0000037439.V328294.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. YA22, YA23 Residents feel their views are listened to and acted on. Residents are protected from abuse, neglect and self harm. EVIDENCE: The complaints procedure is displayed in a picture format in the home. The complaints record was sampled, and the most recent complaint recorded had been investigated and appropriately handled. On the day of the inspection, a neighbour visited to raise some concerns about a diseased tree overhanging their property, and the registered manager was to seen to deal with these concerns in a friendly and cooperative manner. Procedures for the protection of vulnerable adults are in place, and staff receive training in adult protection issues. One member of staff interviewed gave an example of when staff acted to protect a resident in an abusive situation. 14 of the residents handle their own financial affairs, and the manager does not act as appointee for any residents. Hobbs Field DS0000037439.V328294.R01.S.doc Version 5.2 Page 17 Hobbs Field DS0000037439.V328294.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. YA24, YA26, YA28, YA30 Residents live in a homely, comfortable and safe environment. Residents’ bedrooms promote their independence. Shared spaces complement and supplement residents’ individual rooms. The home is clean and hygienic. EVIDENCE: The home has two interconnected houses (Woburn and Longleat), which are staffed and managed by one staff team. A partial tour of the premises was carried out. Improvements to the premises since the previous inspection include new settees, new flooring in a dining room, and the redecoration of some bedrooms. Hobbs Field DS0000037439.V328294.R01.S.doc Version 5.2 Page 19 The premises and the patio are being well maintained, and the patio and garden areas are accessible to residents. The environment is safe, homely and comfortable. There are two communal rooms which are combined sitting rooms and dining rooms, and which are comfortably furnished and with homely touches. Residents have access to parts of the main kitchen for making snacks and drinks. The laundry room is small in size, but during the inspection visit there were no indications that the laundry facilities were inadequate to meet residents’ needs. Kitchen records are kept to improve the safety of food provided. However not all of the Safer Food recording system has been implemented and this is referred to in the “Conduct and Management of the Home” section of this report. The home has bathrooms, shower rooms and toilets in each of the houses. It is recorded that one of the residents’ needs would be better met when a planned new bathroom/shower room is provided. Four bedrooms were visited. All the bedrooms visited had been personalised by the resident, and reflected the resident’s interests and lifestyle. All areas of the home visited were clean and hygienic. Hobbs Field DS0000037439.V328294.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. YA32, YA33, YA34, YA35 Residents are supported by competent and qualified staff. Residents are supported by an effective staff team. Residents and supported and protected by the home’s recruitment policy and practices. Residents’ individual and joint needs are met by appropriately trained staff. EVIDENCE: The registered manager had advised the Commission that 10 care staff and 3 domiciliary staff and in post, and that 10 care staff have NVQ level 2 or above. Two members of care staff and one agency staff were interviewed during the visit. Training and recruitment records for three members of staff were sampled. Hobbs Field DS0000037439.V328294.R01.S.doc Version 5.2 Page 21 The agency member of staff said she had been covering regular shifts here for 3 months, providing 1 to 1 support with resident M when she’s on duty. She said she doesn’t receive supervision, or attend staff meetings, and isn’t asked to attend in-house training. Care staff interviewed provided examples of the key work with residents which takes place, and said that regular staff meetings and supervision and training for staff are being provided. Care staff spoken to had good interactions with residents, have the necessary skills to carry out the job they do, and said they felt supported by the management arrangements in the home. On the day of the inspection visit staffing numbers were adequate to meet the individual and group needs of residents. However, for the resident group accommodated for whom it may take some time to build a trusting relationship it is important that managers ensure that the service is fully staffed by permanent staff and that the reliance on agency staff is reduced. Recruitment records sampled indicated that relevant references and checks are being obtained before a new member of staff starts working. An induction process for new members of staff is in place, but evidence of this was not available on the day of the inspection visit. Arrangements for staff training are in place, and some of the training follows Learning Disability Award Framework guidelines. Two sets of supervision records seen indicated that supervision is covering all recommended topics and is being provided regularly. Hobbs Field DS0000037439.V328294.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. YA37, YA39, YA42 The registered manager is qualified, competent and experienced to run the home and meet its stated purpose, aims and objectives. Residents are confident their views underpin all self-monitoring, review and development by the home. The health, safety and welfare of service users would be improved by full implementation of the Safer Food system of checks and safeguards. EVIDENCE: Staff interviewed felt that though the job was stressful, they felt supported by the manager, and there was a good atmosphere in the home. Hobbs Field DS0000037439.V328294.R01.S.doc Version 5.2 Page 23 The manager has continued to update his training and seek ways to further develop the service. Records for recent provider monitoring visits were sampled, which indicated that issues such as the need for better disabled bathroom facilities and a reliance on agency staff for the cover of staff vacancies were being brought to the attention of the provider. A survey of the views of residents, their relatives and staff on the service provided has been undertaken, and the results of this survey are now being collated. The manager has advised the Commission of some of the most recent services and inspections undertaken in respect of health and safety matters. The Environmental Health Department visit report for 24th July 2006 was sampled, and this requires that some of the Safer Food system of checks not implemented be implemented. Records seen by the inspector indicated that not all the required Safer Food checks are being implemented. Records for staff fire training were sampled, and the previous requirement made in respect of this is now assessed as met. The registered manager advised that the requirements of the most recent fire inspection visit have now been complied with. Hobbs Field DS0000037439.V328294.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 2 X Hobbs Field DS0000037439.V328294.R01.S.doc Version 5.2 Page 25 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 YA42 Regulation 12.1 (a) Requirement The registered person shall ensure that the care home is conducted so as to make proper provision for food practices which promote the health and welfare of service users Timescale for action 14/04/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Hobbs Field DS0000037439.V328294.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Hobbs Field DS0000037439.V328294.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!