Inspection on 15/03/06 for Huish House

This inspection was carried out on 15th March 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

Huish House 16/04/08

Huish House 10/10/07

Huish House 19/12/06

Huish House 03/11/05

Huish House 23/11/04

Huish House 09/06/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Huish House Huish Episcopi Langport Somerset TA10 9QP Lead Inspector John Hurley Unannounced Inspection 15 March 2006 11:40 th Huish House DS0000039967.V283873.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 Huish House DS0000039967.V283873.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. Huish House DS0000039967.V283873.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Huish House Address Huish Episcopi Langport Somerset TA10 9QP 01458 250247 01458 259384 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) Home First & Foremost Ltd Gary Jason Stickley Care Home 12 Category(ies) of Learning disability (0), Physical disability (0) registration, with number of places Huish House DS0000039967.V283873.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for 12 persons in categories LD and PD Date of last inspection 3rd November 2005 Brief Description of the Service: Huish House provides a home for up to 12 adults between the ages of 18 and 65 who have a learning disability and associated needs including autism, sensory impairments, physical disability and epilepsy. Huish House is owned by Voyage, a company that provides residential services for people with a learning and associated physical disability in Somerset. The home provides an attractive and spacious environment in a semi rural location near Langport. The individual’s rooms are decorated in individual styles and furnished in an eclectic manner. There is a range of communal spaces complemented by activity rooms Adaptations are provided to meet the individual and collective needs of service users. Huish House DS0000039967.V283873.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over five hours. Two inspectors carried out this inspection. They spoke with the manager and several staff during the inspection; they also observed the service users going about their daily routines. The inspector toured the premises and observed most of the communal spaces, kitchens and a sample of the service users own personal rooms. The inspectors also looked at a number of key documents held at the home including service user care plans, staff documentation and a sample of the health and safety policies and a number of the organisations procedures. What the service does well: What has improved since the last inspection? What they could do better: As reported at the last inspection the administrative procedure relating to Criminal Records Bureau needs to be more stringent. The recommendation made during the last inspection has not been taken up; a requirement will now be made to ensure this is addressed. Huish House DS0000039967.V283873.R01.S.doc Version 5.1 Page 6 The registered manager needs to ensure that all accidents are cross-referenced in the individuals files and if required an updated risk assessment carried out relating to the recorded incident. It would be helpful if the organisations vulnerable adults policy gave permission to the alerter to contact the statutory agencies, police, social services or the regulator, if they have concerns over a vulnerable adult. The organisation needs to ensure that a copy of the service users contract is available in the service users file. 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. Huish House DS0000039967.V283873.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 Huish House DS0000039967.V283873.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): 5 A copy of the service users contract was not available at the home. EVIDENCE: The registered manager informed the inspectors that no new service user has taken up residence since the last inspection the records confirm this. Standards one to four have been assessed during preceding inspections and found to meet or exceed the standards required. Therefore these standards were not assessed during this inspection. During a sample check of the service users documentation the inspectors noted that a copy of the service users contract was not on file. Huish House DS0000039967.V283873.R01.S.doc Version 5.1 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): 6,7,8 The care planning is good and reviewed at regular intervals. The limitations placed on the service users with regards to their lives is agreed with the service user and all stake holders as appropriate. EVIDENCE: Two care plans were case tracked on this occasion. These demonstrated good medical care provision. The care plan evidenced assessments and inputs from a range of specialists ranging from occupational therapists to art therapy. One timetable seen outlined the following activities: cookery, swimming, physiotherapy, sensory lounge, massage, aromatherapy, music therapy, and arts & crafts. There continues to be sufficient evidence to suggest that the care plans are reviewed on a six monthly basis or sooner if the need arises. A monthly check on the care plans continues to be made. The majority of service users were observed using various areas of the home and engaging in activities of their choice with staff. Staff worked in a respectful way and communicated well with service users. A profile of the Huish House DS0000039967.V283873.R01.S.doc Version 5.1 Page 10 service users likes and dislikes are included in the individuals care plan. This forms a basis for planned activities and all interaction with them. Huish House DS0000039967.V283873.R01.S.doc Version 5.1 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): 12,13,14,15,17 Service user’s personal development and wishes were being catered for within their abilities. The staff work hard to maintain a professional relationship with those people important to the service user. EVIDENCE: Through discussions with staff and looking at the recording in the service user files it is clear that a range of activities are provided. Some of these are in house, provided by visiting professions such as physiotherapy, massage or music therapy others are in the community and are more social such as pub meals, bus rides, swimming or a shopping trip. In a discussion with the home manager, the service user’s personal development and wishes were being catered for within their abilities. The inspectors noted that the home works with the families of the service users to ensure satisfactory outcomes for the individuals who live at the home. Huish House DS0000039967.V283873.R01.S.doc Version 5.1 Page 12 Input from the service users families forms the foundation of the service user’s development. The manager confirmed that people important to the service user regularly continue to visit the home. The care plans sampled included a clear inventory of service users belonging. The home would benefit from a record of disposed items as good practice. The inspector observed that there were enough food stocks of both fresh and other foods to provide the basis for a nutritious meal. The mealtime was discreetly observed. The staff assisted in a professional and inclusive manner. The food served was attractively presented and several choices were available including a healthy option. Huish House DS0000039967.V283873.R01.S.doc Version 5.1 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): 18,20 The records observed continue to demonstrate that the service users health care needs are acknowledged and acted upon in a proactive way. EVIDENCE: The records observed continue to evidence that service users have regular health care checks from the GP and community nurse. They also see other professionals including an optician, psychiatrist, psychologist and physiotherapist. The inspectors observed the staff offering to assist an individual with their personal care needs in a discreet manner. Due to the individual service user abilities at present no one self medicates. Appropriate policies and procedures are in place in relation to assisting with medication. The Medication Administration Record stored in the service user’s care plan evidenced that the medication were recorded and signed appropriately. The registered manager confirmed that a recommendation made during the last inspection to ensure more staff receive medication training has been attended to. One senior member of staff confirmed that they had just completed a course in safe handling and administration of medication. Huish House DS0000039967.V283873.R01.S.doc Version 5.1 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): 22,23 The organisations vulnerable adults policy could be reconsidered demonstrate further transparency and multi agency working. EVIDENCE: The registered manager informed the inspectors that no complaints had been made since the last inspection. (Similarly none have been reported directly to the regulator). The inspectors viewed the organisations complaints procedure. This is well written and includes time scales for acting on and addressing complaints made. To further enhance the complaints procedure it would be helpful if the organisation stated that at any time the complainant could contact the regulator to discuss their concerns. The Protection of Vulnerable adult’s policy was discussed with the registered manager. The registered manager was clear with regards what they should do if an issue was reported to them. Similarly the staff the inspectors spoke with was also clear as to the reporting procedures. Both of the verbal response demonstrated that action would be taken and the correct multi agency teams alerted. The organisational policy was sampled. It sets out the expectations of the alerter (staff) to report issues to the organisational line management structure. If the issue of concern relates to the staffs immediate line manager the policy instructs the person to go directly to their managers manager, and so on. to Huish House DS0000039967.V283873.R01.S.doc Version 5.1 Page 15 This may be a weakness in the procedure, as the member of staff may not wish to report to senior management their manager on suspicion alone. Stating in the policy that the staff member can go directly to any of the statutory agencies at any time to report their concerns could rectify this. Huish House DS0000039967.V283873.R01.S.doc Version 5.1 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): 24,28,30 The environment continues to be suitable to the needs of the service users. The home is clean and hygienic. EVIDENCE: The inspectors noted that there had been no significant alterations to the environment since the last inspection with the exception that the exterior rear elevation has been repainted and the sofits and associated fittings replaced. The home continues to clean and hygienic. The communal areas are comfortable and suitable for the stated purpose. There is ample room for activities and one to one time. The service users rooms are decorated and fitted in accordance to the service user needs and wishes. The home is surrounded by a large garden, which includes a patio area with a pond. The inspectors were informed that the ground is well used by the service user during the summer for barbecues. Huish House DS0000039967.V283873.R01.S.doc Version 5.1 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): 31,32,33,34,35 Improvements in obtaining statutory training for the staff group continue to be made. Those who have recently been employed have a clear training agenda as part of their induction. The authentication of Criminal Records Bureau documentation is required. EVIDENCE: The inspectors spoke with staff at the home. They found that the staff were knowledgeable with regards to the service users needs and aspirations. They also observed that the staff group work well as a team and seniors managed situations, such as assisting individuals getting to dinner, proactively organising the staff team ensuring a positive outcome for the service user. The staff were further observed as dealing with situations in an unhurried manner, keen to assist through positive encouragement. The inspectors spoke with a recent member of staff about their experiences of joining the service. This individual was clear with regards to their role and how the needed to work with the service users. They also demonstrated that they were clear as to their own boundaries and knowledge base and felt comfortable to ask other staff members for help in dealing with situations that they had not encountered. Huish House DS0000039967.V283873.R01.S.doc Version 5.1 Page 18 On the day of the inspection, two staff files were sampled. The staffing records evidenced application form that provided; reference details, past experience and disclosures relating to their health and criminal convictions, if any. The organisation then completes a formal interview, take up references and carry out a Criminal Records Bureau check before recruiting a new employee. The organisation produces a document that states that Criminal Records Bureau checks have been undertaken. These documents are not signed, dated or the role of the signatory noted. Huish House DS0000039967.V283873.R01.S.doc Version 5.1 Page 19 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): 37,38,42 The home is presently well managed and provides a needs led service It would be helpful if reportable incidents are cross-referenced in the service user file so that any need to re assess risk is thoroughly monitored. EVIDENCE: The inspectors sampled a number of key documents during the inspection ranging from care plans to staffing records, these documents were found to be in good order. The inspector looked at the accident / incident book and noted an incident which would have prompted a review of the service user risk assessment. On checking the service users file it was noted that at the time of the incident the individual was experiencing some difficulties with their behaviour, but did not specifically highlight the incident recorded in the accident / incident book. The staff the inspectors spoke with said that the manager was approachable and fair, often working with them and the service users. New staff confirmed Huish House DS0000039967.V283873.R01.S.doc Version 5.1 Page 20 they felt supported by the staff team as a whole and would not hesitate in discussing issues with senior carers or the registered manager if they needed to. It was a previous requirement that the home manager ensures kitchen hygiene and infection control measures were being observed. This has been implemented and risk assessments are now in place. Huish House DS0000039967.V283873.R01.S.doc Version 5.1 Page 21 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 x 3 x 4 x 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 3 25 x 26 x 27 x 28 3 29 x 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 2 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 x x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 3 16 x 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 x 3 x 3 3 x x x 3 x Huish House DS0000039967.V283873.R01.S.doc Version 5.1 Page 22 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 YA5 Regulation 5 (c) Requirement The registered manager must ensure that a copy of the service users contract held on the individuals file The registered manager must ensure that key documentation such as Criminal Records Bureau documents are both signed, dated and the signatories job role clearly identified on any documentation presented to the inspector Timescale for action 01/04/06 2. YA34 19 (4b)(i) 01/04/06 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 2 Refer to Standard YA42 YA23 Good Practice Recommendations The registered manager should consider ensuring that all reportable incidents are cross-referenced in the service user documentation. The organisation may wish to consider its policy with regards to vulnerable adults so that it empowers the individual to contact either of the statutory agencies with their concerns. DS0000039967.V283873.R01.S.doc Version 5.1 Page 23 Huish House Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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. 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