Inspection on 03/11/05 for Huish House

This inspection was carried out on 3rd November 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 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 15/03/06

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 3rd November 2005 10:00 Huish House DS0000039967.V261485.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 Huish House DS0000039967.V261485.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. Huish House DS0000039967.V261485.R01.S.doc Version 5.0 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.V261485.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for 12 persons in categories LD and PD Date of last inspection 23rd November 2004 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.V261485.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over four hours. The inspector 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 inspector also look 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 procedures. What the service does well: 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. Huish House DS0000039967.V261485.R01.S.doc Version 5.0 Page 6 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.V261485.R01.S.doc Version 5.0 Page 7 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): 2,3,4 The admissions procedure is well planned and includes the service user and their advocates throughout the process. EVIDENCE: A comprehensive pre-assessment procedure was evidenced. A senior manager undertakes initial consultation with other professionals and considers the assessment of the referring social worker, teachers, parents and NHS specialists involved. The inspector looked at the documentation relating to the last individual to take up residence. This appears to evidence that the individual was fully involved in the admission process. The documentation evidences that the home’s manager and other staff visited the prospective service user in their home environment and at their school to build a holistic picture of this individuals needs. The individual also attended the home to meet the other service users and have short week end breaks to get to know the surroundings. Following on from these visits and discussions with the individual, their parents and other interested individuals a draft plan of care had been drawn up and agreed with the individual and their advocates. Huish House DS0000039967.V261485.R01.S.doc Version 5.0 Page 8 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): 7,8,9,10 The care planning is good and builds on the initial assessment documentation. 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: The inspector sampled the care plans and considered them to be well laid out and organised. They evidenced assessments and inputs from a range of specialists ranging from occupational therapists to art therapy. There was 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 is also made. There are individual risk assessments and protocols for managing specific support needs. The documentation acknowledges that making choices and developing independence is problematic especially for those individuals who require routine and boundaries. Huish House DS0000039967.V261485.R01.S.doc Version 5.0 Page 9 The manager and inspector discussed how the service user is made aware of what is in the plan. They were informed that some have the main points of their plan represented pictorially, but for most the plan is reinforced through staff working to the agreed routines and aspirations of that plan. It is acknowledged that for some service user their comprehension limits their ability to understand some of concepts. The majority of service users were observed using various areas of the home and engaging in activities of their choice with staff. Staff communicated well with service users. Their preferences were noted and were a basis for planned activities and all interaction with them. Huish House DS0000039967.V261485.R01.S.doc Version 5.0 Page 10 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 In general terms opportunities for personal development are only limited through the individuals ability. The service works hard to maintain a professional relationship with those people important to the service user. EVIDENCE: Through very general 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 or music therapy others are in the community and are more social such as pub meals, swimming or shopping. The inspector noted that the home works with the families of the service users to ensure satisfactory outcomes for the individuals who live at the home. The manager informed the inspector that people important to the service user regularly visit the home. They inspector was also informed that some service user go home on an as and when basis. The inspector observed that there were enough food stocks of both fresh and other foods to provide the basis for a nutritious meal. Staff informed the Huish House DS0000039967.V261485.R01.S.doc Version 5.0 Page 11 inspector that they were aware of the individuals likes and dislikes and provided that the choices made by the individual ensured a degree of a balanced diet their wishes would be met. Huish House DS0000039967.V261485.R01.S.doc Version 5.0 Page 12 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): 19,20 The records observed demonstrate that the service users health care needs are acknowledged and acted upon in a proactive way. More staff needs to be trained in the safe handling and administration of medication. EVIDENCE: The records observed evidence that service users have regular health care checks from the GP and community nurse. They also see other professionals including a psychiatrist, psychologist and physiotherapist. The inspector viewed the relationship between the service users present at the time of the inspection as both empathetic and professional. It was also observed that staff use positive encouragement to gently assist the individual when making choices. 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 inspector noted that only a minority of staff had been trained in the safe administration of medication, the manager acknowledged this shortfall. Huish House DS0000039967.V261485.R01.S.doc Version 5.0 Page 13 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): No complaints have been made to either the home or directly to the regulator, similarly no vulnerable adults issues have been raised either. Therefore, these standards were not assessed. EVIDENCE: Huish House DS0000039967.V261485.R01.S.doc Version 5.0 Page 14 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): 25,26,28,29,30 The home is comfortable and to a greater degree well maintained. EVIDENCE: At the time of the unannounced inspection the home was found to be clean and comfortable. The service users rooms are personalised to reflect their individual tastes and preferences. Attention to detail is evident for example; specialist lighting arrangements have been installed in order to enhance the little sight a visually impaired person has. This enables them a degree of independence within their own room. A lot of the furniture in the home suits the ambience of this large and impressive building. A number of the beds are grand by design including a four-post bed. The large lounge has comfortable seating; the dinning areas are informal and comfortable. The home has bedrooms on the ground and upper floors. The ground floor is fully accessible to those who require the assistance of a wheelchair. Additional ramps and lifts have been installed to allow a good degree of accessibility to and lower floor activity areas. Huish House DS0000039967.V261485.R01.S.doc Version 5.0 Page 15 The top floor of the building contains a small office and two large training areas for staff. At the time of the inspection one of the training areas ceiling showed signs of damp. The manager confirmed that the cause of this had been repaired. Huish House DS0000039967.V261485.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): 32,34,36 Improvements in obtaining statutory training for the staff group have been made. The organisation produces a document that states that Criminal Records Bureau checks have been undertaken; it would be helpful if this document was signed and dated. EVIDENCE: The previous requirement to ensure staff receives statutory training is evidenced in the staffing records. The staffing records sampled evidenced that prospective employees submit an application form that provides reference details, past experience and disclosures relating to their health and criminal convictions, if any. The organisation completes a formal interview, takes up references and caries out a Criminal Records Bureau check before commencing to start a new employee. The records relating to who had been checked against the Criminal Records Bureau was not dated or signed to identify the person responsible, this is a weakness in the system. During the sampling of the staffing records the inspector noted that staff undergo one to one formal supervision on a regular basis. This compliments the ongoing informal supervision that happens on a day-to-day basis. Huish House DS0000039967.V261485.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): 37,41,42 The home is well managed and provides needs lead service. The manager needs to ensure that effective infection control measures are in place and that risk assessments acknowledge how the service users are using the home. EVIDENCE: The inspector viewed a number of key documents during the inspection ranging from care plans to staffing records, these documents were found to be well laid out and in good order. The staff the inspector spoke with said that the manager was approachable and fair, often working with them and the service users. During the tour of the premises and the inspectors’ observations it was noted that service users, supported by staff, would enter the kitchen and prepare food and drinks for themselves. On several occasions the inspector noted that hygiene practices, such as washing hands were not always observed. Through discussion with the manager it was established that a comprehensive risk assessment was not in place to address infection control issues in the kitchen Huish House DS0000039967.V261485.R01.S.doc Version 5.0 Page 18 i.e. acknowledging how the kitchen is accessed and by whom, in particular what to do if there is an identified issue in the kitchen area. One other area the inspector was concerned about was the laundry. These floors being permeable and so hard to clean effectively. Huish House DS0000039967.V261485.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 4 3 3 x Standard No 22 23 Score x x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score x 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score x 3 3 x 3 3 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 3 16 x 17 Standard No 31 32 33 34 35 36 Score x 3 x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Huish House Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x x x 3 2 3 DS0000039967.V261485.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 13(3) Requirement Timescale for action 12/01/06 2 YA42 The registered manager must carry out a risk assessment relating to the floor covering in the laundry area and take action to minimise any risks identified. 13(3)(4)(c The registered manager must ) carry out risk assessments relating to the use of the kitchen by service users and how this may undermine infection control policies. 12/01/06 Huish House DS0000039967.V261485.R01.S.doc Version 5.0 Page 21 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 YA20 Good Practice Recommendations The registered manager should consider ensuring that training is made available with regards to increasing the numbers of staff who have been trained in safe medication practices. The registered manager should consider ensuring that training is made available with regards to vulnerable adults procedures The registered manager should ensure that key documentation such as Criminal Records Bureau documents are both signed and dated by the recording individual 2 3 YA23 YA23 Huish House DS0000039967.V261485.R01.S.doc Version 5.0 Page 22 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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