Inspection on 29/04/05 for Homeside

This inspection was carried out on 29th April 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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Homeside 04/09/07

Homeside 22/11/06

Homeside 22/11/05

Homeside 04/10/04

Homeside 15/07/04

Homeside 03/09/02

Similar services:

Pemdale

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

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

CARE HOME ADULTS 18-65 Homeside 6 Great North Road Welwyn Herts AL6 0PL Lead Inspector Jeffrey Orange Unannounced 29 April 2005 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. Homeside Version 1.10 Page 3 SERVICE INFORMATION Name of service Homeside Address 6 Great North Road Welwyn Herts AL6 0PL 01438 716442 01727 842904 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) Candour Care Services (Homeside Limited) Ms Angela Weston Care Home 4 Category(ies) of LD 4 registration, with number LD(E) 4 of places Homeside Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: There are none Date of last inspection 04 October 2004 Brief Description of the Service: Homeside is registered to provide care and accommodation for up to four adults with a learning disability, up to four of whom may be over the age of 65 years. The home is owned and operated by Candour Care Services and consists of a detached bungalow, situated in the Oaklands area of Welwyn. There is a garden and parking area to the front and a large rear garden which can be accessed by service users with appropriate supervision. The home is conveniently situated for local facilities, with public transport available in nearby villages and the shopping and leisure provision of Welwyn Garden City is able to be accessed using the homes own minibus. Homeside Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Overall this was another very positive inspection, with a high standard of care being provided to residents who have a range of quite challenging needs. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Homeside Version 1.10 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Homeside Version 1.10 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4,5 There have been no new admissions to the home. Service Users’ needs are well known and documented and the whole basis of the care services provided is individual and person centred. EVIDENCE: Homeside was specifically set up and equipped to meet the needs of residents with complex emotional, communication and behavioural needs as a result of their autism. The home has a very settled group of residents who have lived there since it was opened. The home has a comprehensive assessment, care planning and review process that is well documented, clear and easily accessible. The process of review, involving a range of associated health and social care professionals is fully recorded and takes place on a regular, routine basis, as well as when additional input may be required, for example in the case of a resident with a deep vein thrombosis or specific nutritional needs. Homeside Version 1.10 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9 Homeside operates a key worker system, which enables carers to develop a particularly good insight into the care needs and preferences of particular residents. The staff team encourage the resident’s to express their feelings appropriately. Activities both within and outside the home are developed within a risk assessment framework, which tries to balance the need for protection of the residents and others with the need to try new things and go to new places. EVIDENCE: Staff were seen to be treating residents very much as individuals and had a good understanding of their needs and preferences, and this is supported by a very good standard of individual, person centred, care planning documentation. They have also built up close links with the families of residents where this is possible and also with a range of associated health and social care professionals. Risk assessments were seen to be in place and subject to review. Homeside Version 1.10 Page 9 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) 11,12,13,14,15 The appointment of an activities organiser has improved the provision of structured activities, backed up by an activities care plan. Staff seem to be genuinely committed to developing new opportunities for the residents, subject to risk assessment and taking into account the significant support required by the residents if they are to access community facilities. EVIDENCE: Activity care plans were seen, which provide an individual, person centred approach to activities for each resident. Reviews held in December indicated that no holidays had been taken during the previous year. The funding of holidays by the placing authority remains problematical and means the home has to seek alternative sources of funds to enable the residents to have a break away from the home. During the inspection one resident was supported to use the craft and multisensory room, whilst others went for a ride in the mini-bus. Homeside Version 1.10 Page 10 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 are able to exercise choice; within the context of the particular need they have, as a result of their disability, for a stable, consistent routine to avoid possible anxiety and distress. Standards of medication practice and recording was generally satisfactory. EVIDENCE: All four care plans and activity care plans were seen and provide evidence of a process of evaluation, revue and the involvement of a range of health and social care professionals in each case. Medication practice in the morning of the inspection was observed and records checked. With some minor adjustments recommended, the standard found was very satisfactory. Homeside Version 1.10 Page 11 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 Policies and procedures, together with staff training are in place to protect the residents. The involvement of families and a range of health and social care professionals, provide external checks and balances on behalf of the residents. EVIDENCE: Appropriate policy documents have been seen and staff training files include details of training for staff in issues around abuse and the need to protect vulnerable adults. Homeside Version 1.10 Page 12 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) 24,25,28,30 The premises are suitable for the complex and challenging needs of the residents, who require a small scale, structured environment. The large gardens, which include specially adapted swings and sitting out areas provide an opportunity for exercise and activity outside of the home under supervision. EVIDENCE: The challenging nature of the residents places some practical limitations upon the furniture and fittings that are suitable/practical. Those communal and residents’ rooms seen were comfortable, domestic in style and in the case of bedrooms, appropriately personalised for each resident in line with their interests and assessed needs. The home was clean and free from unpleasant smells throughout this inspection. Overall the scale of the home is domestic rather than institutional which is preferable, plans that are in hand for possible extension, should improve the facilities offered whilst not losing the essentially domestic nature of the home. Homeside Version 1.10 Page 13 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) 32,33,35,36 Staffing levels were adequate on the day and provided that agreed staffing levels are maintained at all times, should continue to be so. Staff receive a range of appropriate training. Led by the Manager and Proprietor, staff have the required range of skills and experience to offer a safe and fulfilling home for the current residents, with their particularly challenging care needs. EVIDENCE: Staffing rotas were seen, staff interaction with residents was observed to be very good especially in the capable and professional in the way they carried out their duties. The home’s staff have achieved a good level of appropriate NVQ training at levels 2,3 and 4. Records of supervision schedules and minutes of staff meetings were seen. There was a slight discrepancy on some occasions between the staffing levels recorded by the placing authorities reviews of December 2004 and actual Homeside Version 1.10 Page 14 rotas. It is understood from discussions with the manager that additional staff have been recruited, which it is expected will assist in maintaining staffing at agreed levels on all occasions. It is recognised that the very particular and challenging care needs of the current residents makes the use of agency staff particularly problematic as they would require considerable induction and familiarisation time before they were effective and acceptable to the residents. Homeside Version 1.10 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) 37,38,39,41,42 The management team, including the proprietor, have created a very positive atmosphere in the home, which is transmitted both by staff and residents. The standard of record keeping is very good. The need to provide certain statutory reports to the CSCI was discussed with the proprietor and readily agreed. EVIDENCE: The manager and assistant manager have both completed NVQ level 4 qualifications in care. The manager is now to undertake the Registered Manager’s Award. Staff meeting records were seen. There has been a great improvement in the labelling and storage of foodstuffs since the last inspection when it was an issue. Medication records were satisfactory and the care planning documentation is again very good, providing staff with the information they require to provide Homeside Version 1.10 Page 16 person centred care, and recording with appropriate detail, issues and incidents that affect the well-being of residents. Candour Care Services have successfully obtained accreditation by BSI to ISO9001 for residential care for people with learning disabilities and are now working towards accreditation by the National Autistic Society, hopefully by the end of 2005, which will be a major achievement. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 Score 3 3 x 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x x 3 x 3 Standard No Homeside Version 1.10 Score Page 17 LIFESTYLES Standard No 11 12 13 14 15 16 17 Score 3 3 3 2 3 x x 31 32 33 34 35 36 x 3 3 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 2 x 3 2 x Homeside Version 1.10 Page 18 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 YA39 Regulation 26 Requirement The registered provider must supply to the Commission a report of visits made to the home in accordance with the requirements of the Care Homes Regulations 2001 The registered person must give notice to the Commission without delay, of the occurrence of events set out in the Care Homes Regulations 2001 Timescale for action From 29.4.05 and thereafter From 29.4.05 and thereafter 2. YA42 37 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. Refer to Standard YA14.4 YA20 Good Practice Recommendations The home should attempt to identify the necessary funds to enable residents, if they choose, to have the opportunity for a holiday outside of the home during 2005. Where medication is put into pots to take to the resident for administration, the pot should be marked with the name of the resident to avoid any confusion at the point of administration. The temperature of the medication cupboard should be taken and recorded daily and action taken if it regularly exceeds recommended levels. Homeside Version 1.10 Page 19 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City Herts 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 Homeside Version 1.10 Page 20 - 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!