Inspection on 03/08/05 for Hope House

This inspection was carried out on 3rd August 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 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

Hope House 09/03/09

Hope House 07/03/07

Hope House 26/01/06

Hope House 24/01/05

Hope House 09/06/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Hope House No 1 Hope House, Wainwright Way Grange Farm, Kesgrave Ipswich IP5 2XG Lead Inspector Joe Staines Announced 3 August 2005 rd 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. Hope House I54-I04 S28573 Hope House V218404 050803 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Hope House Address No 1 Hope House, Wainwright Way, Grange Farm, Kesgrave, Ipswich, IP5 2XG 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) 01473 612198 01473 611782 Rethink Disability Ltd Mrs Judith Carol Williams Care Home 4 Category(ies) of Physical Disability (4),Learning Disability (4) registration, with number of places Hope House I54-I04 S28573 Hope House V218404 050803 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 24/01/05 Brief Description of the Service: Hope House is a registered care home for younger adults, first registered in March 2002. It provides residential care for four young people with profound / multiple physical and learning disabilities. The property is owned by Orbit Housing Association who retain responsibility for repairs, maintenance, and upkeep of the premises. Hope House is a purpose-built ground floor unit of accommodation, situated at the end of a cul-de-sac in Kesgrave, Ipswich, close to shops, services, and facilities. The home has it’s own minibus for transport purposes, and there are local bus services within walking distance of the home. Each service user is provided with a private well equipped single bedroom. En-suite facilities are shared between two service users of the same gender. The home has been designed, furnished and equipped for young people with physical disabilities, based on specialist advice. There is ceiling tracking, hoisting equipment, and bathroom and toilet facilities designed to meet the needs of people with disabilities. Hope House is small, accessible, and homely in appearance. The communal areas are open plan, and based in the centre of the building. There is a Snoozelum, and Ball Pool. A small conservatory leads directly from the communal living area into the garden. Service users also make good use of their personal bedroom areas, particularly when they need time to relax, unwind, and have quieter time. Hope House I54-I04 S28573 Hope House V218404 050803 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was undertaken by Joe Staines, Regulation Inspector. The inspection took place between 12.15pm and 5pm. Mrs Judith Williams (Registered Manager) who was present throughout, and informed the inspection process in an open and positive manner. The inspection focussed on issues identified at previous inspections, and the inspection of a number of standards, identified by the Commission for Social Care Inspection as key standards, which must be assessed at least once over a twelve-month period. The inspectors examined a total of 4 service users files, and observed the care and interaction between staff and 4 residents (all of whom have profound disabilities) as part of the inspection, some in their rooms, and some during the course of the day in communal areas. Staff files and policies and procedures were examined. A visiting health care professional was interviewed, with positive comments made about the home. Two separate staff interviews were undertaken, along with detailed a discussion with the manager, and regional care manager on behalf the registered proprietors. What the service does well: Service users need help with all aspects of their daily lives, and this was being provided. Service users benefited from day care activities, some of which were now funded by Direct Payments, and this provided 1:1 staff to support service users with activities of their choice. The home ensured that a wide range of stimulating activities were available, both within the home, and through attending external facilities. The routines of the home were designed to fit in with service users arrangements, choices, and preferences. The home had an individual comprehensive care plan system, covering a wide range of needs, and identifying how those needs would be met. They include clear instructions for supporting service users in all aspects of their lives and including their preferences, and choices, where these had been expressed, or were known. Hope House I54-I04 S28573 Hope House V218404 050803 Stage 4.doc Version 1.40 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. Hope House I54-I04 S28573 Hope House V218404 050803 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Hope House I54-I04 S28573 Hope House V218404 050803 Stage 4.doc Version 1.40 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 standard(s) 2 The home has good systems for, and has achieved, the thorough needs assessment, of service users living there. EVIDENCE: No new service users had been admitted to the home since it opened in March 2002, and as a consequence, no new assessments had been undertaken. However, the files of the current service users included recorded reviews of relevant assessments, which demonstrated an ongoing process of reviewing and updating care plans as service user’s needs changed. Hope House I54-I04 S28573 Hope House V218404 050803 Stage 4.doc Version 1.40 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 standard(s) 6 & 9 People who use the service can be confident that the care plans and risk assessment processes ensure that changing needs and goals of service users are reflected, and support is available that enables service users to take reasonable risks, as part of their lifestyle. EVIDENCE: Each service user who lives at the home has an individual comprehensive care plan, covering areas such as individual care needs, activities, independence needs, equipment guides, risk assessments, reviews, records of daily monitoring where necessary, and monthly summaries of the service user’s progress at the home. The documentation covers a wide range of needs, and how those needs would be met, including clear instructions for supporting service users in all aspects of their lives, from intimate personal care such as bathing and toileting, to moving and handling, and to include their preferences, and choices, where these had been expressed, or were known. The care plans provided evidence that the needs of service users are regularly reviewed, and that care plans are updated accordingly. Hope House I54-I04 S28573 Hope House V218404 050803 Stage 4.doc Version 1.40 Page 10 Risk assessments were seen in relation to individual service users. These were designed to a specific format, to identify potential or known risks, and to establish strategies for eliminating those risks as far as possible. There were also risk assessments for a variety of leisure activities, taking place outside of the home, plus moving and handling, taking medication, getting dressed, continence, hair-pulling, bathing, privacy, and going out in the minibus. Parents had been involved in some of the decision-making processes about what were acceptable/unacceptable risks. Hope House I54-I04 S28573 Hope House V218404 050803 Stage 4.doc Version 1.40 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 standard(s) 12, 13, 14, 16 & 17 The home provides care for profoundly disabled young adults, and has put a great deal of effort into enabling them to take part in a wide variety of stimulating and age appropriate activities, therefore this standard is exceeded. These activities include accessing community facilities, leisure activities and resources. The daily routines of the home ensure that service users rights are respected, and choice and flexibility are available. The diet provided by the home was healthy and arranged with the preferences and routines of service users in mind. Hope House I54-I04 S28573 Hope House V218404 050803 Stage 4.doc Version 1.40 Page 12 EVIDENCE: All of the residents have reached school leaving age. The change to direct payments has resulted in a range of structured day care programmes being set up, based on the individual needs of residents, including a combination of activities, some arranged and provided by the home, and others structured around attending the Genesis Day Service, which is situated locally. The examination of care plans showed that rising and retiring times were according to choices and preferences, but also in accordance with planned day care activity. Other activities arranged and supported by the home included, spa sessions, swimming, massage, trips into Ipswich, carriage/horse riding, haircare, manicures, bingo, trampolining, cinema, bowling, sensory sessions, cooking and art activities. Attendance at many of the above listed activities involved engaging with the wider community and with other young adults with learning difficulties. Routines were flexible. Meals were cooked to coincide with the time of evening when all the service users were home, and also to coincide with the timing of those medications that needed to be administered alongside food. Care plans also included the identified preferences of residents. An example of good practice was a record of responses to stimulation, following the use of different sensory equipment for one particular resident. Staff were observed talking to residents, not above them, or exclusively amongst themselves. During the inspection, residents were observed to have free access around the building. The examination of the menus provided by the home as part of the pre inspection material confirmed that meals provided were in line with the identified preferences of residents, and included a range of nutritious options. Hope House I54-I04 S28573 Hope House V218404 050803 Stage 4.doc Version 1.40 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 standard(s) 18 & 20 The home provides personal care and support in line with service users preferences and individual needs. Medication is generally well administered and recorded, although the manager must ensure that all non blister pack medications are able to be reconciled before this standard can be said to be fully met. EVIDENCE: Each of the care plans examined contained clear and detailed information about the personal support needs of individual residents. These included bathing, toileting and moving and handling. Preferences were noted, and the content was clearly focussed on the needs of the person concerned. The assisted bathrooms were equipped as needed to support residents with personal care. Medication stores and records were examined. Records were kept of any errors in drug administration, along with the action taken by the manager. The manager reported that no training issues had been identified as a result of the one error recorded. An anomaly was identified in respect of the records, it was noted that it was not possible to reconcile the amounts of non blister pack medication held with the amounts identified as on the medication Hope House I54-I04 S28573 Hope House V218404 050803 Stage 4.doc Version 1.40 Page 14 administration sheets. The manager agreed to undertake an audit and report the findings to the Commission. Hope House I54-I04 S28573 Hope House V218404 050803 Stage 4.doc Version 1.40 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 standard(s) 23 The home has appropriate policies and procedures for protecting service users from abuse. EVIDENCE: The office contained copies of adult protection procedures and guidance for staff in what to do in the event of a suspicion or allegation of abuse. Staff who were interviewed by the inspector demonstrated, in response to specific questions, an understanding of the way to respond to such concerns. Hope House I54-I04 S28573 Hope House V218404 050803 Stage 4.doc Version 1.40 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 standard(s) 24 & 27 The home is comfortably decorated, furnished and maintained in a homely style. The bathroom and toilet facilities are modern, private and equipped to meet the needs of service users. Hope House I54-I04 S28573 Hope House V218404 050803 Stage 4.doc Version 1.40 Page 17 EVIDENCE: This inspection included a tour of all areas in the home. Everywhere was clean, organised, and free from hazards. There was a rolling programme for repairs, maintenance, and redecoration. The design and layout at Hope House was welcoming and comfortable. The premises were decorated in bright cheerful colours, appropriate to the age range of service users living there. In particular, bedrooms were highly personalised both in colour and content, with personal items designed both to relax or stimulate, and to reflect the personalities and individual choices of the service users. The two bathrooms, located in-between each pair of bedrooms, had direct access from either side. This meant that service users benefited from what were effectively en-suite facilities, with suitable aids and adaptations, and the facility to lock either of the two bathroom doors from either side. Therefore, privacy could be assured. In addition to the two main bathrooms, there was a separate toilet, with wash hand basin, located off the entrance hall. This met disability standards. For staff, there was a separate en-suite shower and toilet, located immediately off the staff room/office. This facility was used by day staff, as well as by those who slept in. Hope House I54-I04 S28573 Hope House V218404 050803 Stage 4.doc Version 1.40 Page 18 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) 31, 32, 34 & 35 Service users and staff are supported by a staff group with clearly defined roles. The home is progressing toward achieving the required ratio of NVQ (National Vocational Qualification) qualified staff. The recruitment practices of the home do not fully comply with the regulations and must be amended to ensure that all of the documents required are kept at the home. The training programme at the home is geared towards enabling staff to continue to meet the needs of service users, and to develop additional skills as they progress along their career. Hope House I54-I04 S28573 Hope House V218404 050803 Stage 4.doc Version 1.40 Page 19 EVIDENCE: Staff working at Hope House have job descriptions which clearly define their roles. During interview, all of the members of staff demonstrated an understanding of the needs of service users and the care plans in place for them. A wide range of policy documentation is also available to the staff in the office at the home. The pre inspection information provided by the home identified that 15 of the staff team had obtained the NVQ 2 or above, with a further 5 working towards this. Examination of the staffing rosters, provided as part of the pre inspection material, confirmed that these were completed at least one month in advance, so staff can plan for their off duty, and any gaps in staffing levels due to leave, sick leave or training courses, can be addressed. Staffing levels vary more since the introduction of direct payments for some service users, and the involvement of staff in the implementation of day care programmes. These arrangements have been agreed through the block purchase of staffing hours, under the direct payment scheme. A sample of staff recruitment records was examined. References were not present, and the manager reported that these were held at the head office of the organisation. There was also no evidence of satisfactory health checks being obtained. The manager reported that these documents were held at the head office of the organisation. The inspector informed the manager that this was not in accordance with the regulations and the documents referred to above must be held at the home in future. Staff have individual training portfolios, identifying training records and needs. The training records and discussion with members of staff identified the training undertaken by the staff team in the last 12 months, including NVQ 2 & 3, induction and foundation training, moving & handling, massage, food hygiene, p.e.g feed, sensory awareness, infection control, person centred planning, disability discrimination, safe handling of medication and a supervision workshop. Further training was planned in NVQ and profound learning disability training. The manager reported that the home had plans in place for external trainers to come to the home to talk about learning disability awareness framework training, and for the home to produce its own induction, linked to the “skills for care” standards. Staff inductions were ongoing, and recorded. During interview, care staff stated that they had found their inductions useful. Hope House I54-I04 S28573 Hope House V218404 050803 Stage 4.doc Version 1.40 Page 20 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, 39, 41 & 42 The manager is qualified at the appropriate level, and, with support from the organisation that runs the home ensures that the home is well run. The home must implement it’s service user/relatives/professionals survey forms to ascertain their views about the way the service is run before service users can be fully confident that their views underpin all self-monitoring, review and development of the home. The storage of records relating to service users was not comprehensively adequate, so did not fully safeguard service user’s rights and best interests. The manager ensures that the health and safety of service users is protected at all times. EVIDENCE: The registered manager has completed the registered managers award, confirming achievement of the equivalent of NVQ level 4 in both care and management. Quality monitoring was being undertaken by the organisation in the form of monthly monitoring visits. The reports completed following these visits were Hope House I54-I04 S28573 Hope House V218404 050803 Stage 4.doc Version 1.40 Page 21 being routinely sent to the Commission for Social Care Inspection until May 2005, when they stopped being forwarded. Quality assurance forms were seen in the home, which could be used to ascertain the views of people using the service, and of those who come into professional contact with the service. However, these forms had not been used to undertake a survey of views. Each service user had there own files, containing the relevant assessments, care plans, report, minutes and daily records maintained by the home in respect of the individual concerned. However, during the examination of records, it was noted that some incident reports, over two years old were filed in the homes health and safety folder, rather than the file belonging to the service user concerned. All of the home’s official records were stored in a lockable room; some were further secured by being stored in lockable filing cabinets. The home’s Certificate of Registration was on display in the entrance hall, and was accurate. The examination of the pre inspection material and records held at the home confirmed that the manager was ensuring that regular servicing of health and safety equipment, including fire equipment, gas and electricity supplies, along with a risk assessment for the control of substances hazardous to health. Hope House I54-I04 S28573 Hope House V218404 050803 Stage 4.doc Version 1.40 Page 22 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 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x 3 x x x Standard No 11 12 13 14 15 16 17 x 4 3 3 x 3 3 Standard No 31 32 33 34 35 36 Score 3 N/A x 2 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Hope House Score 3 x 2 x Standard No 37 38 39 40 41 42 43 Score 3 x 2 x 2 3 x I54-I04 S28573 Hope House V218404 050803 Stage 4.doc Version 1.40 Page 23 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 20 Regulation 13 Requirement The registered persons must ensure that procedures for recording the receipt, administration and isposal of medication, enables routine audits to take place on non blister pack medication. The registered persons must ensure that all of the information listed in Schedule 4 of the Care Homes Regulations 2001 is available for inspection at the care home The registered persons must establish and maintain a system for reviewing and improving the quality of care provided at the home, which involves seeking the views of service users and their representatives. Timescale for action 10th October 2005 2. 34 17 10th October 2005 3. 39 24 10th October 2005 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 41 Good Practice Recommendations The registered persons should ensure that all records held I54-I04 S28573 Hope House V218404 050803 Stage 4.doc Version 1.40 Page 24 Hope House in respect of service users, are stored in the individual files of the service user concerned, once their use as a working tool has come to an end, and not in the homes health and safety folder. Hope House I54-I04 S28573 Hope House V218404 050803 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection 5th Floor, St Vincent House Cutler Street Ipswich IP1 1UQ 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 Hope House I54-I04 S28573 Hope House V218404 050803 Stage 4.doc Version 1.40 Page 26 - 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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