Inspection on 22/09/05 for Homewood

This inspection was carried out on 22nd September 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Homewood 15/10/07

Homewood 30/08/06

Homewood 14/12/04

Homewood 06/07/04

Homewood 11/02/04

Homewood 12/08/03

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Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Homewood Enham Lane Charlton Andover Hampshire SP10 4AN Lead Inspector Mrs Pat Trim Unannounced Inspection 22nd September 2005 02:30 Homewood DS0000037194.V252264.R01.S.doc Version 5.0 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 DS0000037194.V252264.R01.S.doc Version 5.0 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 DS0000037194.V252264.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Homewood Address Enham Lane Charlton Andover Hampshire SP10 4AN 01264 324200 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) Hampshire County Council Mr John Coleman Care Home 14 Category(ies) of Learning disability (14) registration, with number of places Homewood DS0000037194.V252264.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th April 2005 Brief Description of the Service: Homewood is a Local Authority home providing care and accommodation for fourteen service users who have a learning disability. Two places are used for short stay or emergency placements for service users living in the community. Accommodation is provided on two floors and comprises fourteen single bedrooms. There are three lounges and two dining rooms on the ground floor and a lounge/diner on the first floor. The provider is Hampshire County Council and the registered manager, Mr. John Coleman. The home is situated in a quiet residential area, close to local shops, amenities and public transport. Andover town centre is a mile away. The home has car parking space to the rear of the property. Access to the main door is down a ramped slope. The home has an enclosed garden. Homewood DS0000037194.V252264.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second statutory inspection for the year 2005/2006 and was unannounced. It was undertaken by one inspector in 3.5 hours. The focus of the inspection was to make sure previous requirements had been acted on and to assess the core standards not covered during the last inspection. During the inspection the inspector was able to speak with six of the fourteen residents and three of the ten staff. Information was also obtained from comment cards completed by residents and relatives and the pre-inspection questionnaire. Some care records were viewed and a brief tour of the premises took place. Time was spent discussing the impact on residents of the imminent refurbishment of the kitchen and the resignation of the cook. The people living in the home were asked how they would like to be referred to in this report. They chose the title “resident” and this term is used throughout. For an overview of how the home is meeting the core standards in 2005/2006, both reports should be read. What the service does well: What has improved since the last inspection? Following requirement made at the last inspection the medication procedures have been amended to include guidance for staff on the administration of medication given “when required”. This will make sure a consistent approach is applied to administering it. Homewood DS0000037194.V252264.R01.S.doc Version 5.0 Page 6 Work is being carried out by residents and staff to develop care plans that are based on what the residents hope to achieve in their daily lives. These are in a form that can be understood by everyone. 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 DS0000037194.V252264.R01.S.doc Version 5.0 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 DS0000037194.V252264.R01.S.doc Version 5.0 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): 2 Residents can be confident that their wishes and needs will be fully assessed prior to their admission and that they will be offered a place only if these needs can be met. EVIDENCE: There was an opportunity to speak with a resident who had recently moved to the home. The placement was a short term one, whilst the resident was supported to develop the skills he would need to live independently. The resident confirmed that this was what he wished to do. Information about the resident’s needs and wishes had been gathered from the resident himself, his care manager and other involved agencies. Meetings had been held between the resident, staff at Homewood and the care manager to establish what support would be needed and how this could be achieved. In the last report, the possible changes to care provision were discussed. The deputy manager confirmed that no decisions had been made and the service continued to provide long and short-term placements, with some residents coming for long-term assessment. As stated in the last report, when a decision has been made, the statement of purpose must be amended to reflect these changes. Homewood DS0000037194.V252264.R01.S.doc Version 5.0 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 the following standard(s): 6 The service is actively involving residents in care planning and the use of regular reviews makes sure care plans reflect the wishes and aspirations of residents. EVIDENCE: There was evidence that residents are now being more involved in care planning. Residents have a personal care plan that identifies any support required in personal care such as help with washing and dressing. They also identify what residents can do for themselves and where prompting is required rather than physical assistance. These are regularly reviewed. Residents confirmed that staff are aware of their needs and only give support where it is wanted. Staff spoken to were able to describe the individual support needs of residents. Residents also work with their key worker to write down their wishes and aspirations for each year. These can be in pictorial form to help them understand the process. These identify wishes such as learning to cook or manage money. They also give residents the opportunity to review their Homewood DS0000037194.V252264.R01.S.doc Version 5.0 Page 10 activities programme and to say if they want to change anything. These plans are reviewed at least annually. Homewood DS0000037194.V252264.R01.S.doc Version 5.0 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 the following standard(s): 12 and 17 The involvement of residents in the review of their care plans makes sure they are able to join in activities that meet their needs and that they enjoy. Meals are provided that offer residents a choice of meals they enjoy. EVIDENCE: Residents said they were able to take part in activities that they enjoyed. Feedback forms also identified that residents were very satisfied with the opportunities they had. Popular activities included local clubs, where residents were able to meet friends outside Homewood and going out for meals. There was evidence that when a resident no longer enjoyed an activity they were supported to say so and to choose something else. The development and regular review of care plans that identify residents’ wishes and aspirations (see standard 6) make sure that residents are able to do activities they like. They are involved in reviews so that plans can be amended to meet changing needs. Homewood DS0000037194.V252264.R01.S.doc Version 5.0 Page 12 Residents were supported to attend educational opportunities at the local college. These included numeracy skills and art classes. Support workers from a local service helped residents develop daily living skills such as managing their money, shopping for food and cooking. Some residents enjoyed gardening and were helping staff outside during the inspection. The main meal of the day is sometimes served at lunchtime and sometimes during the evening. This is dependent on what activities are taking place during the day. Residents said they were able to make choices about what they ate and the monthly menu showed at least two choices for each main meal. Feedback from residents, both verbal and written, was very positive about the quality of meals provided. On the day of the inspection it was decided to get a take away and residents chose from sausage, fish or pie and chips. All said they loved to have a take away. The deputy manager explained that the kitchen was about to be refurbished. The home’s cook had also just left. Meals were being prepared and cooked by staff which could have an impact on staffing levels. The need to review how these two issues will be managed was discussed and the registered manager asked to contact the Commission for Social Care Inspection to explain what arrangements have been made. Homewood DS0000037194.V252264.R01.S.doc Version 5.0 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 the following standard(s): 18 Detailed care plans and the staffs’ knowledge of residents’ individual needs ensure that residents receive personal care support they need in the way they want it. EVIDENCE: Care plans gave detailed guidance about the support residents required. Residents were encouraged to contribute to the plan. Residents said that staff were aware of their needs and gave them help when they required it. They felt they were encouraged to do as much for themselves as they could. Staff were able to describe what help individuals required and where they needed prompting rather than physical support. During handover a number of care issues were identified and discussed, with staff contributing from their knowledge of the resident. Homewood DS0000037194.V252264.R01.S.doc Version 5.0 Page 14 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): 23 Robust policies, procedures and staff training in Adult Protection procedures protect residents from the risk of abuse. EVIDENCE: The home has a policy and procedure for the protection of vulnerable adults that is based on Hampshire’s procedure. Staff were able to describe their responsibility to report any incident of abuse and to identify the policy that underpins this. Training records identified that all staff have had recent training in working with the policy and procedure. They have also had training in working with challenging behaviour. Residents have opportunities to discuss their feelings and concerns and said they felt confident to do so with staff and management. They can use the complaints procedure or regular resident meetings. They also have the opportunity to speak to a representative of Hampshire social services during the monthly visit to audit the service. Records are kept of any money held on residents’ behalf. Finances are regularly checked to make sure the amount held tallies with the written record. Homewood DS0000037194.V252264.R01.S.doc Version 5.0 Page 15 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 The provision of new furniture provides residents with a more comfortable environment. EVIDENCE: Since the last inspection, new armchairs have been supplied for communal areas. The kitchen is about to be refurbished, which will provide a better environment for residents and staff. It will also provide a more hygienic environment for food preparation. Homewood DS0000037194.V252264.R01.S.doc Version 5.0 Page 16 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 and 35 Staff are supported to develop their skills through training so they can provide care that meets residents’ needs. Staff have a wide range of experience and qualifications that enable them to support residents in their daily living. EVIDENCE: The inspector was able to speak with staff on duty during the inspection. One had only been working in the home for two months, the others for several years. The new member of staff was completing an induction programme that included basic training such as moving and handling and social care skills such as principles and values of care. She confirmed she had been regularly supervised during her induction by the registered manager and had started the learning disability accredited framework (LDAF) training. She completed other training prior to her employment. Other staff on duty had a wide range of training and experience. Basic courses had been attended such as moving and handling and first aid. They had also attended training to develop their skills in working with residents with learning disability, such as approach training (challenging behaviour), person centred planning and communication. Homewood DS0000037194.V252264.R01.S.doc Version 5.0 Page 17 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): 39 and 42 There are robust arrangements in place to provide residents with the opportunity to provide feedback on the service they receive. The health and safety of residents is being compromised by the failure to provide regular staff training in fire safety. EVIDENCE: Residents confirmed they have a wide range of opportunity to provide feedback about the service they receive. The home has regular residents’ meetings and minutes are taken. Residents are able to give feedback at their reviews about the way the service enables them to achieve their wishes and aspirations. The home is audited on a monthly basis by Hampshire social services and residents are invited to give their views about the service. The deputy manager confirmed that the views of long and short stay residents and their families are obtained annually when they are sent a questionnaire about the service. Homewood DS0000037194.V252264.R01.S.doc Version 5.0 Page 18 A list of all service contracts was given by the provider in the pre-inspection questionnaire. A sample of these records were viewed. These provided evidence that equipment and utilities such as gas and water are regularly serviced and monitored. Staff training records and information given by staff confirmed that residents are supported in all aspects of health and safety by well-trained staff with the exception of fire training. The deputy manager confirmed staff had not received fire training for some months. Training records identified 18th August 2004 as the last time staff attended training. The need for fire training was highlighted in a Regulation 26 visit in August 2005 and records showed that the person responsible for fire training in the home had continually contacted Hampshire social services to try and arrange training. This should now be organised as a matter of urgency and a requirement is made at the end of this report. Homewood DS0000037194.V252264.R01.S.doc Version 5.0 Page 19 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 X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X X X 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Homewood Score 3 X X X Standard No 37 38 39 40 41 42 43 Score X X 3 X X 2 X DS0000037194.V252264.R01.S.doc Version 5.0 Page 20 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 YA42 Regulation 23 Requirement All staff must receive fire safety training and fire drills in accordance with fire safety guidance. If necessary consult with Hampshire Fire and Safety officer. Timescale for action 01/11/05 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 DS0000037194.V252264.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 DS0000037194.V252264.R01.S.doc Version 5.0 Page 22 - 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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