Inspection on 13/02/06 for Homewood

This inspection was carried out on 13th February 2006.

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

Homewood 10/12/07

Homewood 13/06/06

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Southfields

Thorndene

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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 Homewood 15 Shakespeare Road Worthing West Sussex BN11 4AR Lead Inspector Ms B Tye Unannounced Inspection 13th February 2006 09:30 Homewood DS0000064915.V283597.R01.S.doc Version 5.1 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 Homewood DS0000064915.V283597.R01.S.doc Version 5.1 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. Homewood DS0000064915.V283597.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Homewood Address 15 Shakespeare Road Worthing West Sussex BN11 4AR 07903 234457 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) Sutton Court Associates Ltd Faith Anne Hickman Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Homewood DS0000064915.V283597.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Homewood is a care home registered for up to six service users in the category LD (Learning Disabilities 18-65 years). The establishment is a spacious converted premises situated close to Worthing town centre. Public transport services are easily accessible. Accommodation is provided over two floors and all rooms are single occupancy with en-suite facilities. The service is privately owned and the registered provider is Sutton Court Nursing Associates. Mr N Ramdin is the Responsible Individual on behalf of the organisation. Ms Faith Hickman is the Registered Manager in charge of the day to day running of the home. Homewood DS0000064915.V283597.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on the 13th February 2006. Prior to the inspection, information held on file was examined including any official documentation relating to the home. On the day of the inspection, the inspector found some residents were dressed and socialising with staff in the dining room area, two residents were still in bed. The Inspector noted a relaxed atmosphere at the home. Service users laughed and joked with the staff and were happy to engage with the Inspection process. The Senior on duty, Mrs Elaine Munn assisted the Inspector, as the manager was on annual leave. Mrs Munn was able to provide information and relevant files as requested. The Inspector examined residents files, Policies and Procedures, Risk assessments, Training files, Medication records and all Health and Safety Checks. In addition she toured the premises, interviewed two staff, spoke to residents and viewed their rooms. Overall quality of care was found to be good and administration systems were comprehensive, well ordered and up to date. What the service does well: The home is well decorated with a good standard of furnishings providing the residents with a pleasant and comfortable living environment. The inspector concluded the office systems at Homewood are very well organised. Information held on file was up to date and in good order. Despite the absence of the manager the inspector was able to easily locate information needed to undertake the inspection. Staff spoken to stated they found the management of the home to be inclusive and supportive. Comprehensive individual plans had been developed for each service user respecting their right to choice and lifestyle. Detailed risk assessments for all aspects of the residents care have been recorded on their files. This enables them to make informed choices and promotes their independence where possible. The home has a complaints procedure in place, which has been produced in symbol form for the residents. The inspector observed relaxed and confident interactions between residents and staff. Homewood DS0000064915.V283597.R01.S.doc Version 5.1 Page 6 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 report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Homewood DS0000064915.V283597.R01.S.doc Version 5.1 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 Homewood DS0000064915.V283597.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1-5 Prospective residents are provided with all the information needed to make an informed decision, prior to admission of the home. Where possible a transition period to the home is agreed between involved parties. Each potential resident is given the opportunity to visit and have a trial stay if required. Terms and Conditions for each resident is provided and kept on individual files at the home. EVIDENCE: Prospective residents and their carers are provided with all relevant information to make an informed decision about the home. Residents have the opportunity to discuss their expectations and these are recorded as part of the assessment process. The inspector viewed an up to date Service Users Guide and Statement of Purpose. This is available in symbol and picture format to assist residents in understanding what the home has to offer. Each resident is given the opportunity to visit the home prior to admission, as many times as they feel necessary. This gives them the opportunity to meet other residents and staff, therefore contributing to a smooth transition process. Homewood DS0000064915.V283597.R01.S.doc Version 5.1 Page 9 A contract of Terms and Conditions are provided to each resident on admission. A key worker assists individuals to understand its content prior to signing. A copy of each contract is kept on residents care files. Homewood DS0000064915.V283597.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 9 & 10 Individuals, their families or representatives are involved in producing detailed care plans. These reflect their changing needs and personal goals. Residents confirmed they were supported to make choices about their lives. Detailed risk assessments have been completed for each individual in respect of their needs and agreed limitations. EVIDENCE: The inspector examined the residents care plans. Each plan is generated from pre-admission assessments and information from involved professionals. Plans seen covered all aspects of the individuals health, personal and social needs. All plans are signed by the residents to reflect their involvement in the care planning process. In addition to this, the manger has devised an overview of each residents care needs. These cover behaviour, routines, personal care and appropriate responses from staff. Homewood DS0000064915.V283597.R01.S.doc Version 5.1 Page 11 Changes to care plans occur as needs of the resident change or following a formal review. This demonstrates the care provided at the home is in line with the residents changing needs. Homewood has devised detailed risk assessments for each resident in relation to their needs, behaviours and agreed limitations. This gives staff detailed information about how to deal with behaviours correctly and allows informed choices to be made in supporting individuals to achieve independent living. The inspector found these were very detailed and in good order. The inspector examined recording sheets for each resident. These detailed any significant event, which needed to be handed over to other staff at shift change. One member of staff confirmed the information exchange was very good and she was always made aware of relevant issues at handover, prior to her shift starting. This ensures consistency for residents in relation to their care needs. Residents personal information is held on files in a locked staff office, ensuring confidentiality of personal information, within the home. Homewood DS0000064915.V283597.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 13, 14, 15 & 17 The outcome for the residents in terms of personal development and activities provided was good. Residents spoken to were enthusiastic about the activities they took part in. Relationships outside the home are encouraged and supported by staff. The menu at Homewood offers a range of healthy balanced meals. EVIDENCE: An activities programme for residents is devised on an individual basis dependant on need. Residents go on outings as a group and daily as individuals. Activities include in house crafts, visits to the library, local shops, walks to the beach, bowling, swimming and community events. Some residents attend day centres, college and organised social activities. The inspector noted that each activity is risk assessed in detail. Residents spoken to by the inspector all confirmed the staff support them to pursue a range of activities. The inspector noted there was a good balance achieved between supporting residents to participate in activities and Homewood DS0000064915.V283597.R01.S.doc Version 5.1 Page 13 encouraging independence where possible. Activities attended by the residents are recorded as part of the care planning process. The inspector observed a relaxed and friendly rapport between staff and residents. Demonstrating an awareness of how to communicate according to the individuals needs and behaviours. Residents and information seen on care plans confirmed family contact is promoted. Some residents have home visits on a regular basis. Visitors are welcome to the home and a policy is in place to support this. The kitchen area was very clean and tidy. Food is stored appropriately and it was noted there was fresh fruit and vegetables available, to ensure residents benefit from a healthy balanced diet. The inspector examined menus for the home. Residents confirmed they liked the food and were consulted on about what they liked to eat. A staff member stated if residents changed their minds on the day an alternative could be offered. Packed lunches are prepared for residents who attend college or day centres. Those who remain at the home are offered a choice for lunch on the day. Hot and cold drinks facilities are available for residents on request. Residents have the opportunity to assist staff in cooking regularly in the home and will shop and prepare the ingredients to promote independent living skills. A rota is displayed in the kitchen and each bedroom to show when each resident is due to help staff with kitchen duties. Homewood DS0000064915.V283597.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Residents receive personal care and support as detailed in their care plans. All the care plans examined showed detailed information and action plans relating to physical and emotional needs of each resident. Observations and feedback from residents showed these needs were being met by the home. Medication is stored and labelled appropriately. The inspector found that MAR sheets had been amended and there were some gaps in recording. A requirement has been made in respect of this. EVIDENCE: Care plans seen by the inspector held information relating to all aspects of healthcare and medication for individuals. The records were up to date and in place, which ensures good staff practice is upheld. Personal care and support is provided in line with care planning and residents preferences are identified to ensure appropriate action by staff. Some staff tasks are gender specific according to the needs and wishes of the residents. Homewood DS0000064915.V283597.R01.S.doc Version 5.1 Page 15 Residents are registered with the local GP and have access to all NHS entitlements. Records of all dental and GP appointments are held on file. Individual files show residents have access to community health specialists to ensure all aspects of their health needs are met both by the home and wider community. A key worker system is in place to enable residents to talk through day to day issues and any aspect of their care on a weekly basis. Staff support individuals to access community agencies when needed and will accompany residents to appointments as required. Policies and procedures relating to all aspects of healthcare and medication administration are in place and up to date. Medication is suitably stored in locked cabinets in the staff office. On examination of medication charts, the inspector found most were not completed correctly and there were some gaps where staff should have signed for medication. A requirement has been made in respect of this, to ensure the manager monitors medication recording and staff adhere to the homes policies and procedure when dispensing. Homewood DS0000064915.V283597.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 - 23 The home has a complaints log in place which is supported by an up to date complaints policy and procedure. A complaints procedure is available to residents and their families in the Statement of Purpose and Service Users Guide in symbol format. All staff receive training in respect of working with vulnerable adults as part of the LDAF training undertaken by staff. They also complete ‘Working with Vulnerable Adults’ training as part of the homes rolling staff training programme. EVIDENCE: The home has a detailed procedure for complaints, which is included in the Service Users Guide and Statement of Purpose, providing residents with clear information about how to complain. All complaints information is printed in a format suitable for residents to ensure they are clear about their rights within the home. The complaints log was seen, there have been no official complaints at the home since it opened. Residents have three monthly meetings, which provide them with a forum to talk about issues of concern. In addition to this, the key worker system gives residents with the opportunity to talk on a one to one basis. Staff confirmed the director also speaks to the residents on a regular basis, to gain feedback about any issues arising in the home. Homewood DS0000064915.V283597.R01.S.doc Version 5.1 Page 17 Adult Protection policies and procedures are detailed and up to date. Staff will use these alongside County Procedures and guidelines, which are available in the staff office. Staff are due to start the Learning Disability Assessment Framework Assessment training during 2006. In addition they undertake in house staff training for Working with Vulnerable Adults. This ensures they are able to meet residents needs appropriately, therefore reducing risk within the home. It also provides staff with clarity about reporting procedures, should suspicion of abuse arise. Homewood DS0000064915.V283597.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 - 30 The home overall offered a very comfortable and clean living space for residents. Residents rooms contained personal possessions and all those seen by the inspector were clean, tidy and offered a good standard of décor. Environmental Risk Assessments have not been undertaken for the premises. Residents en-suite bathrooms contained uncovered radiators which pose a possible risk of scalding to the residents. Requirements were made in respect of these issues. EVIDENCE: There is a large modern lounge connected to the spacious dining area, with TV and stereo equipment for use by all residents. The dining room is adjacent to a light, brightly decorated kitchen, which residents have access to for cooking and drink making facilities (with staff assistance). Another large lounge at the front of the house serves as a quiet area for residents. Residents rooms are a good size and furnished in their individual styles with personal possessions and pictures. Homewood DS0000064915.V283597.R01.S.doc Version 5.1 Page 19 Residents are responsible for cleaning their own rooms with assistance from staff. Some residents participate in cleaning the communal parts of the home under staff supervision to promote daily living skills and provide a sense of ownership. The home has a large, mature garden, with a lawned area for residents to make use of, in the warmer weather. A laundry room provides a large washing machine with sluice facilities and tumble dryer and is kept locked for reasons of safety. Staff training files contained Food and Hygiene and Health and Safety certificates. This training promotes good practice in respect of hygiene and reducing the risk of infection spreading throughout the home. A fire alarm and emergency lighting system is in place. Records showed these are checked and serviced on a regular basis to ensure the safety of staff and residents. There are sufficient toilets throughout the building. Each bedroom has en-suite facilities and the inspector found that radiators in these bathrooms were switched on but not covered. This could pose a risk of scalding or injury. A requirement was made to ensure radiators are switched off until they are covered and safe. There are no environmental risk assessments in place for the premises. A requirement has been made to ensure the registered manager identifies any areas within the home, which pose a risk to the occupants and identify ways for such risks to be eliminated or reduced. Homewood DS0000064915.V283597.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33 & 35 The staff employed to work at Homewood receive on going training to meet the assessed needs of the residents. Residents benefit from a well supported and effective staff team. EVIDENCE: The home provides an induction and training programme for staff members, including specialist training relevant to individuals assessed needs. Training records for staff indicated all staff have attended relevant training and records were up to date. The inspector was unable to access staff personnel files or supervision records as they were kept in a locked cabinet only accessible by the manager. These standards will be monitored at the next inspection. Evidence of meeting minutes and feedback from staff confirmed they attend staff meetings which enable them to participate in decision making processes at the home. Staff members confirmed they had undertaken an induction at the start of their employment. Staff training records seen by the inspector confirmed this. All staff spoken to praised the manger for her supportive and inclusive approach. Homewood DS0000064915.V283597.R01.S.doc Version 5.1 Page 21 The inspector concluded, following observation and discussion with the staff on duty that they were clear about their roles and responsibilities within the home. The home currently has a full staff compliment and does not use agency workers. This provides consistency of care to residents. Feedback from residents, staff interviews and observations led the inspector to conclude that the staff functioned effectively as a team and were supported by the management in doing so. Homewood DS0000064915.V283597.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 40, 41 & 43 Good practice in the home was evident. This was supported by efficient administrative systems, which promote the health, safety and welfare of the residents in respect of their assessed care needs. EVIDENCE: The inspector examined all safety records at the home including, fire records, training, food safety log, water temperatures, individual risk assessments, and incident log. They were all up to date and in good order promoting the welfare and safety of the residents. The inspector concluded the office systems at Homewood were very well organised. Despite the absence of the manager the inspector was able to easily locate information needed to undertake the inspection. To date the Commission has received detailed monthly Regulation 26 reports from the Registered Provider, in addition to any relevant Regulation 37 reports. Homewood DS0000064915.V283597.R01.S.doc Version 5.1 Page 23 Through observation the inspector concluded good practice in the home was evident. This was supported by efficient administrative and recording systems. The home has up to date policies and procedures in line with current legislation to safe guard the rights and interests of the staff and residents. Discussions and observations confirmed staff are given clear direction in their roles and good working practices are promoted through staff support and training. One staff member stated she felt the management were ‘very supportive’. A Quality Assurance report has yet to be undertaken, as the home has not been open for a year. This will be monitored at the next inspection. All care records were kept in a locked cabinet to maintain confidentiality. The inspector concluded that the overall care provision at the home is of a good standard and the conduct and management serves the best interests of the residents. Homewood DS0000064915.V283597.R01.S.doc Version 5.1 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 3 2 3 3 3 4 3 5 3 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 2 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 3 3 LIFESTYLES Standard No Score 11 3 12 X 13 3 14 3 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X X 3 3 X 3 Homewood DS0000064915.V283597.R01.S.doc Version 5.1 Page 25 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 2 3 Standard 24 24 20 Regulation 13 (4c) 13 (4a) 13 Requirement To identify any hazards within the home and where possible eliminate them. To cover radiators in residents en-suite bathrooms in order to eliminate risk of injury. To ensure all records relating to medication are up to date and accurate. Timescale for action 14/04/06 14/04/06 14/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Homewood DS0000064915.V283597.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Homewood DS0000064915.V283597.R01.S.doc Version 5.1 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. 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