Inspection on 30/08/06 for Homewood

This inspection was carried out on 30th August 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 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

Homewood 15/10/07

Homewood 22/09/05

Homewood 14/12/04

Homewood 06/07/04

Homewood 11/02/04

Homewood 12/08/03

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Dalewood Respite Care

Orchard,The

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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 Liz Palmer Unannounced Inspection 30th August 2006 10:00 Homewood DS0000037194.V309735.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 Homewood DS0000037194.V309735.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. Homewood DS0000037194.V309735.R01.S.doc Version 5.2 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.V309735.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd September 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 is 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. Fees are £48.25 per week Homewood DS0000037194.V309735.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and included discussions with staff, service users and sampling of care records and staff files. A senior carer assisted with the inspection. The requirement from the last inspection has been met and two requirements were made as a result of this inspection. What the service does well: What has improved since the last inspection? What they could do better: The home must make any extra charges are clear to service users. Homewood DS0000037194.V309735.R01.S.doc Version 5.2 Page 6 The recording of medication must be kept accurate and up to date to ensure the safety of service users. 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.V309735.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 Homewood DS0000037194.V309735.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ needs are assessed prior to a service being offered by the home. EVIDENCE: The assessment and care plan for one service user currently in a respite bed were looked at. A care manager’s assessment was available and guidelines from other professionals were also in place. Homewood DS0000037194.V309735.R01.S.doc Version 5.2 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, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are involved in drawing up their care plans enabling them to have their views and wishes taken into consideration. Service users are supported to make their own decisions and take risks. EVIDENCE: Three care plans were sampled. These were clear, detailed and reviewed monthly by key workers. There was evidence that annual reviews take place with input from care managers and other professionals where appropriate. Some service users have person centred plans in place. All service users would benefit from this and staff spoken to said the home is committed to ensuring that they have them. It is something staff have been working on, evidence of this was seen. Service users spoke about their key workers and gave examples of how they are supported by them. Through observation it was evident that service users are able to make decisions about their lives. Staff were seen asking service users what they would like to do that day. Service users said they are able to choose how they spend their time, when they get up and go to bed. Homewood DS0000037194.V309735.R01.S.doc Version 5.2 Page 10 Independence is encouraged within a risk taking framework. Risk assessments are in place and regularly reviewed. Homewood DS0000037194.V309735.R01.S.doc Version 5.2 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, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from the current arrangements for opportunities for social activities, community access and support with relationships. New charges being introduced for transport may mean service users will be unable to continue with some of their activities. Daily routines ensure service users’ rights are respected. EVIDENCE: Service users have a programme of activities based around their individual needs and choices. A pictorial timetables was in place for one person to enable them to know what their planned activities were. Service users were seen to be supported to do a variety of activities during the inspection. One service user was supported to attend a day service, another requested to go for a walk and another requested to go shopping and was supported to do this. Others were seen to be offered to go swimming, one declined and his choice was respected. Five service users were spoken to and all said that they mostly have enough to do. They said they use the local shops, pubs and attend the Homewood DS0000037194.V309735.R01.S.doc Version 5.2 Page 12 local Gateway club. Some were talking about a recent holiday they had been on. Two service users said they go and stay with their families every weekend, others said they are supported to keep in touch with families and friends. Staff commented that new charges being introduced for service users for transport may restrict their activities. Staff were concerned that, for example, service users now having to pay for their transport to day services may not be able to afford to attend in the future. The system of charging is new and no evidence of the impact on service users was available. A requirement for charging people has been made. A recommendation for the home to monitor the impact on service users was also made. Service users have keys to their bedrooms, one service user said they were really glad they could lock their room as it made them feel their things were safe. Daily routines in the home are flexible. Service users said they can stay up late and choose how to spend their time. One said there are set times to have drinks but they can ask in between times. Others confirmed that they can ask for drinks when they want one. One service user said he makes his own breakfast and evidence of others being involved in food preparation was seen in their care plans. Special dietary needs are recorded and service users are supported on an individual basis to maintain a healthy diet. Comments such as ‘very nice’ were made about the food. Homewood DS0000037194.V309735.R01.S.doc Version 5.2 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, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users receive the support they need to maintain their health and wellbeing. Improvements are needed to the procedure for recording medication is given. EVIDENCE: Details of personal support needed are recorded in care plans. Emotional needs are detailed and strategies for supporting people are in place. Preferences are stated and levels of support are determined by levels of ability and personal choice. Specific health issues are recorded and evidence showed that healthcare professionals are involved when necessary. A review of one person by a clinical psychologist stated they were very pleased with the progress the service user had made and praised the home for it’s management and guidelines. Other evidence of community nurse involvement was seen and records of outcomes of visits to doctors were on individuals’ files. Service users said they would tell someone if they felt unwell and would be supported to see a doctor if they needed it. They said they felt safe and well looked after. Homewood DS0000037194.V309735.R01.S.doc Version 5.2 Page 14 Staff spoken to were aware of service users emotional and physical needs and spoke in a sensitive and supportive way about service users. Interactions between staff and service users were friendly and supportive. Medication procedures were sampled. The homes’ policy includes that two staff responsible for administering medication and only trained staff are permitted to do this. Guidelines for one service users PRN medication was seen. Storage was suitable and a record of incoming medication is held. Records were checked and two omissions were noted. Two of the staff on duty that day said it was their error and they corrected it during the inspection. A requirement for records to be kept up to date was made. Homewood DS0000037194.V309735.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users feel they views are listened to. Service users are protected by the policies and practices in the home. EVIDENCE: Service users have access to a complaints procedure. Those spoken to said they would know who to complain to. Some said they would talk to their key worker and others said they would talk to the manager. All were confident that they would be listened to and have their concerns addressed. One service user gave an example of how she had moved bedrooms because she had been unhappy ‘upstairs’. Throughout the inspection staff were observed listening to service users, respecting their views and acting upon them. One complaint has been made since the last inspection this is currently being addressed according to the home’s policy. The home operates the Hampshire Adult Protection policy. Two of the staff spoken to staff had received specific training in Adult Protection, one more recent member of staff had not but she had read the home’s policy and was aware of her responsibilities within it. Homewood DS0000037194.V309735.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A clean, comfortable and safe environment is provided for service users. EVIDENCE: A partial tour of the home was undertaken. All areas seen were clean and safe and made homely by photographs, pictures and ornaments. There is adequate communal space providing televisions, table football, quiet areas and a large dining area next to the recently refurbished kitchen. There is a program for cleaning the home and procedures in place regarding infection control. Staff in the kitchen wore suitable clothing and promoted hygiene in the kitchen. Staff are trained in health and safety, food hygiene and fire safety. The requirement regarding staff training in fire safety and carrying out fire drills has been met. Service user bedrooms were seen to reflect their personal preferences and individual personalities. Homewood DS0000037194.V309735.R01.S.doc Version 5.2 Page 17 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, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are protected by the home’s recruitment procedures and supported by trained and competent staff. EVIDENCE: Staff spoken to were competent and confident in their roles. They were clear about the support required for individual service users and spoke highly of the training they receive. Training includes mandatory courses such as, Health and Safety, Manual Handling and First Aid. Other training available so enable staff to meet individual needs of service users includes, Communication, Challenging Behaviour, Autism and Person Centred Planning. One member of staff talked about their induction programme and the Learning Disability Accredited Framework training that she had undertaken. Of the eight staff three staff are currently trained to National Vocational Level two, one has level three and four staff are due to start working towards level two in January 2007. Files of two new staff were seen and they had evidence of a suitable application form, two written references, criminal record check and a protection of vulnerable adults check. Homewood DS0000037194.V309735.R01.S.doc Version 5.2 Page 18 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, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a well run home that reflects their views and opinions. EVIDENCE: The home is well run with a stable management team and happy work force. Service users are consulted on the running of the home at their regular residents meetings and via the regulation 26 monitoring visits that take place monthly. Twice a year questionnaires are sent to families to ask them for their views of the home. Service users came in and out of the office throughout the inspection to ask for assistance or make requests. It is evident they are confident about giving their views and expect to have them listened to. Health and Safety is maintained by regular servicing of equipment such as hoists and the central heating system. Environmental Health visited in June this year and no requirements or recommendations were made. A Fire and Homewood DS0000037194.V309735.R01.S.doc Version 5.2 Page 19 Safety officer from Hampshire Fire service visited in April this year and again no recommendations or requirements were made. Homewood DS0000037194.V309735.R01.S.doc Version 5.2 Page 20 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 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 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 2 X 3 X 3 X X 3 X Homewood DS0000037194.V309735.R01.S.doc Version 5.2 Page 21 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 YA14 Regulation 16 Requirement The registered person must ensure that any charges made to service users outside their terms and conditions, including for transport, are clearly recorded stating the reasons and circumstances under which they will be charged. The registered person must ensure that records relating to medication administration are accurate. Timescale for action 01/11/06 2 YA20 13 01/11/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA14 Good Practice Recommendations The registered person should monitor the impact of charging service users for transport. Homewood DS0000037194.V309735.R01.S.doc Version 5.2 Page 22 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.V309735.R01.S.doc Version 5.2 Page 23 - 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. 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