Inspection on 16/05/05 for Huntley Residential Care Home

This inspection was carried out on 16th May 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Huntley Residential Care Home 17/08/06

Huntley Residential Care Home 14/11/05

Huntley Residential Care Home 15/11/04

Huntley Residential Care Home 16/07/04

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

CARE HOME ADULTS 18-65 Huntley 76 Richmond Road Worthing West Sussex BN11 4AF Lead Inspector Kathy Allen Announced 16 May 2005 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. Huntley v220483 h60-h11 s14580 huntley v220483 160505 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Huntley Address 76 Richmond RoadWorthingWest SussexBN11 4AF 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) 01903 231931 Corich Community Care Mrs Lisa Ford CRH 11 Category(ies) of Learning Disability (LD) registration, with number of places Huntley v220483 h60-h11 s14580 huntley v220483 160505 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 Up to 11 male and or female service users in the category Learning Disability may be admitted/accommodated.2 One service user over 65 years of age with a learning disability may be accommodated.3 No service users over 65 years of age may be admitted.4 The total number of service users accommodated must not exceed 11. Date of last inspection November 5th 2004 Brief Description of the Service: Huntley is registered to provide care and accommodation for up to 11 adults with a learning difficulty between 18 - 65 years of age. A condition of the registration enables one person over the age of 65 years to remain accommodated. It is converted detached house in a residential area within walking distance of the town of Worthing therefore close to all of its amenities. The accommodation is situated on the ground and first floor although there is no lift between the floors. There are two double and seven single rooms, one of which has en-suite facitlies. The owner has been granted planning permission to extend the property to provide all single bedrooms and improve the bathrooms. There is a good size rear garden which is accessible from the house however it requires maintainance to ensure it is safe for residents. Huntley v220483 h60-h11 s14580 huntley v220483 160505 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Prior to the inspection a review was made of the contact between the home and the Commission for Social Care Inspection (CSCI) since the last inspection, which included an analysis of incident reports and those of other statutory bodies. In addition, Comment Cards were distributed to relatives and professional involved with the home. The inspection took place over seven hours on Monday May 16th 2005. On the day of the inspection a tour of the premises and observation of the care provided was made. Time was spent with residents although discussion with the inspector was limited due to their learning difficulties. Interviews were conducted with two care staff, the cook, the manager and the owner. A selection of statutory records, resident and staff files were seen. What the service does well: What has improved since the last inspection? The lounge has had a new carpet, pictures and furniture providing an interesting and stimulating environment for residents. Huntley v220483 h60-h11 s14580 huntley v220483 160505 stage 4.doc Version 1.40 Page 6 Staffing numbers have been increased so that residents lead more fulfilling lives. 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. Huntley v220483 h60-h11 s14580 huntley v220483 160505 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 Huntley v220483 h60-h11 s14580 huntley v220483 160505 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) EVIDENCE: Huntley v220483 h60-h11 s14580 huntley v220483 160505 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) 6,7,9 Residents assessed and changing needs are reflected in their individual plan so that their needs are met. Residents make decisions, with assistance, ensuring that they have a say in how they live their lives. Staff support residents in taking risks as part of an independent lifestyle. EVIDENCE: Three residents files were inspected and they all contained detailed care plans giving clear information about residents needs and how they would be met. For example, one young person’s stated that he “will wear age appropriate clothes” and he was wearing a denim jacket and jeans. Another said she needs a “quiet place to eat” and she had her breakfast with staff in a smaller dining room. Staff described how they looked after residents including any restrictions placed on residents which were mainly there for safety reasons. For example, one person can be obsessive about cars and therefore needs to be closely supervised when out. Staff showed one resident two different jackets so he could decide which one to wear. Another person was able to use the brakes on his wheelchair and he was prompted to do so. Huntley v220483 h60-h11 s14580 huntley v220483 160505 stage 4.doc Version 1.40 Page 10 One person has an independent advocate. Another person’s parent has decided that he should move to another home and the manager is liaising with his social worker in order to advocate on his behalf regarding this matter. Risk assessments are recorded in areas such as leaving the premises, activities (eg trampolining, cooking), choking and epilepsy. Residents lead an active life (see Lifestyle) and staff were given training in epilepsy before they are given responsibility for a resident who suffered from seizures. Huntley v220483 h60-h11 s14580 huntley v220483 160505 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) 12,13,15,16,17 Good opportunities are provided for residents to participate in appropriate activities which provides them with educational and stimulating experiences. Residents are part of the local community. Good support is given to families and residents, which help them maintain contact. Staff respect residents rights which enables them to make day to day choices. The food provided is satisfactory so that residents receive a good diet in suitable surroundings. EVIDENCE: A person is employed to provide an activity programme throughout the week for all of the residents. They go to an activity centre run by the owners of the home, a day centre and participate in the homes own programme. Activities include trips out, cooking, walks, trampolining, art and craft, aromatherapy, shopping, make up sessions and bowling. Integration into the community is achieved by using public transport, cafes, and pubs and other public amenities. Two staff, two residents who use a wheelchair and one independent older lady went out on the train on the day of the inspection. Huntley v220483 h60-h11 s14580 huntley v220483 160505 stage 4.doc Version 1.40 Page 12 Two residents go home to their parents most weekends. Others have more limited contact. One person was recently contacted by her sister who she had not seen for many years. The home was careful to ensure that the person was bona fide and supported and encouraged the visit. One resident is due to go into hospital and although that persons parent will be there staff will also stay at the hospital for support. Staff said that personal care was an “important part of their job” and that they ensured that this was done privately. A record is kept of residents preferred form of address and this is used. All bathrooms and toilets have locks and they are due to be fitted to bedrooms. Staff interact well with residents. For example, when preparing to go out they were reminded where they were going, when they were going and were not kept waiting unnecessarily. Residents have unrestricted use of the home unless a risk assessment deems otherwise. For example one person is prone to entering other residents rooms and taking their belongings so staff monitor this so that she can still move freely around the house. Those dependant on wheelchairs cannot go upstairs as there is no lift. Meals are organised by the cook in discussion with staff. The menu is varied and balanced. The cook said she is developing the menu so that less processed food is being used. A low cholesterol diet is being provided for one resident as advised by he doctor. There are two dining rooms and one is used for people who are more settled at meal times. The furniture is due to be replaced in the near future meanwhile it is adequate. Residents weight is monitored. Huntley v220483 h60-h11 s14580 huntley v220483 160505 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) 18,19 Personal support is provided in line with individual care plans and in a flexible manner. Physical and emotional needs are met which enable residents to lead a fulfilling life despite their health problems. EVIDENCE: When helping a resident into a wheelchair staff were careful to let them help themselves as much as possible eg putting down the foot plate themselves. On entering the ‘people carrier’ a member of staff placed their hand over one resident’s head to ensure they did not hit it. Getting up and going to bed times are flexible at the weekend. The oldest person in the house gets up late morning during the weekend. Technical aids include high-low beds, a hoist, handrails and wheelchairs. Male staff provide personal care to male residents and female to female residents. It is undertaken in their room or bathroom. Residents have access to health care such as smear tests, dental care, chiropodist and opticians. One person has special shoes and sees a specialist for these. Huntley v220483 h60-h11 s14580 huntley v220483 160505 stage 4.doc Version 1.40 Page 14 Health is monitored and recently led to a check up for one person whose demeanour had changed. This led to a thorough check up via her GP and the necessary treatment. As previously stated one person is due to stay in hospital with an ongoing health problem. The manager and a member of her staff will be staying with the resident for support and an anticipated speedy recovery. Huntley v220483 h60-h11 s14580 huntley v220483 160505 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) 22,23 Residents views are listened to and acted upon. Residents are protected from harm. EVIDENCE: There is a written complaints procedure although any complaint would come from a representative due to the residents learning difficulties. A parent made a complaint to a social worker which was passed on to the manger of the home. She was able to clarify the situation and the matter was resolved promptly to everyone’s satisfaction. Neither relative who returned comments cards had ever made a complaint about the home and no complaints have been received by CSCI. The home has a copy of West Sussex Multi Agency Adult Protection Procedures. Staff were able to describe the symptoms which they might expect in someone who had been abused. They gave examples such as being “withdrawn, losing appetite, change of mood, wouldn’t let you touch them”. They understood who to report any concerns to and said that they would report to the Social Services or Police if they had any concerns about the senior management of the home. Staff showed a caring attitude towards residents and a genuine commitment to their wellbeing. Huntley v220483 h60-h11 s14580 huntley v220483 160505 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) 24,30 The home is comfortable, homely and safe. The house is clean and hygienic throughout. EVIDENCE: Communal space consists of a good-sized lounge, large hall and two dining rooms, which give residents a choice of where they want to be. The décor is bright and cheerful and the lounge has recently been improved with new pictures, carpet and furniture. Plans are in hand to replace the chairs and settee as well as the dining room furniture. The home is situated in a residential area and is in keeping with its surroundings. It is well lit and ventilated as well as accessible to all of the service users. A recent recommendation of the fire service has been acted upon. Recommendations from the Environmental Health Officer mean that the kitchen is due to be refurbished over the next three weeks. A recent survey has been conducted on the premises. Instructions have been given to a builder for the replacement of all old windows and the gutters are to be repaired or replaced. Huntley v220483 h60-h11 s14580 huntley v220483 160505 stage 4.doc Version 1.40 Page 17 There is level access to a good size rear garden. The garden does require some maintenance to ensure it is safe for residents and the owner confirmed that a new patio was due to be laid. A cleaner is employed at the home and he ensures that all areas are kept clean. During the kitchen refurbishment the area will be professionally cleaned. The laundry is situated away from food preparation areas. It is fitted with a washing machine that has an ‘extra hot wash’ and an industrial dryer. A wash hand basin is provided in the laundry. Huntley v220483 h60-h11 s14580 huntley v220483 160505 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) 31,33,35 Staff understand their roles and responsibilities so that they can care for residents with confidence. The staff team are effective and therefore able to meet resident’s needs. The service to residents could be enhanced by further training for staff such as National Vocational Qualifications. EVIDENCE: Staff support the aims of the home. One person said she enjoys it because the residents “can achieve and learn new things”. All staff sign to say they have read and understand the homes policies and procedures. Staff know their own limitations and one said that “going out with someone with epilepsy was a bit unnerving” but the home provided good training and support before she was allowed to take on this responsibility. Relationships with residents are built up through a key worker system. The staff team has been increased by approximately eighty hours per week. The plans which were made for residents each week could actually be carried out and they were less affected by staff leave and sickness. Huntley v220483 h60-h11 s14580 huntley v220483 160505 stage 4.doc Version 1.40 Page 19 Staff meetings take place about every three months and the minutes showed that the care of residents was discussed as well as team working. When asked what they thought about working at the home staff said it was “brilliant” and “I love it”. They also said that they “helped each other”. All new staff undertake a Learning Disability Award Framework induction programme after which they are assessed on their competence. They said that they were not “thrown in at the deep end” but received “brilliant support”. Further training opportunities are provided in areas such as epilepsy, fire safety and lifting and handling. The organisation has appointed a dedicated person with responsibility for training and development. The manager has put together a training needs assessment for her staff team. Huntley v220483 h60-h11 s14580 huntley v220483 160505 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) 40,42 The homes written policies and procedures comply with legislation so that resident’s rights and interests are safeguarded. The manager ensures the health and safety of residents and staff. EVIDENCE: There are policies and procedures in the home which are regularly updated. Staff sign to show that they have read these documents. A new policy has been drafted which states that the home does not physically restrain residents. However, it includes details of situations where restrictions may be placed on them for their safety. Staff receive training in fire safety, epilepsy, infection control and first aid. Plans are in hand to ensure that all staff have this training and that it is up to date. Hazardous substances were stored safely. Water temperatures are regulated and radiators covered. The recent Environmental Health Officers report made some recommendations and these are being acted upon including the installation of a new cooker and kitchen units. Huntley v220483 h60-h11 s14580 huntley v220483 160505 stage 4.doc Version 1.40 Page 21 Risk assessments are carried out in such area as cross infection, disposal of clinical waste, use of hot water etc. A record of accidents is kept and safety notices posted up around the house. Huntley v220483 h60-h11 s14580 huntley v220483 160505 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 x x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 4 3 x 4 3 3 Standard No 31 32 33 34 35 36 Score 3 x 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Huntley Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x x 3 x 3 x v220483 h60-h11 s14580 huntley v220483 160505 stage 4.doc Version 1.40 Page 23 Yes 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. 2. 3. 4. 5. 6. 7. 8. 9. Standard 26 24 Regulation 12 13 Requirement Locks must be fitted to residents rooms The garden must be cleared of all hazards Timescale for action 01.07.05 .1.07.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. 7. 8. Huntley Refer to Standard 35 Good Practice Recommendations The training and development plan should be implemented v220483 h60-h11 s14580 huntley v220483 160505 stage 4.doc Version 1.40 Page 24 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 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