CARE HOME ADULTS 18-65
Innova House Care Home Forest Avenue Forest Road Mansfield Nottinghamshire NG18 4BX Lead Inspector
Stephen Benson Unannounced Inspection 18th January 2006 09:30 Innova House Care Home DS0000008702.V279706.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 Innova House Care Home DS0000008702.V279706.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. Innova House Care Home DS0000008702.V279706.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Innova House Care Home Address Forest Avenue Forest Road Mansfield Nottinghamshire NG18 4BX 01623 626252 01623 650099 enquiries@innovahouse.com 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) Dr Sudaram Rai Dr Chandran, Dr M Cheedella Mr Paul Blaker Care Home 15 Category(ies) of Physical disability (15) registration, with number of places Innova House Care Home DS0000008702.V279706.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. All residents will be in need of care and accommodation as a result of brain injury 26/09/05 Date of last inspection Brief Description of the Service: Innova House is a care home registered to provide personal care and accommodation for up to 15 younger adults who fall within the categories MH and PD with have an acquired brain injury. Since the last in section some bedrooms and the ground floor lounge have been refurbished. The home accommodates people for short or long term care, respite care or emergency admissions and can provide day care. This number is likely to be reduced as part of the ongoing improvement of the accommodation. The home is located on the outskirts of Mansfield town centre close to shops, pubs, the post office and other amenities. The home was opened in August 2000 and consists of a converted and extended domestic dwelling. All of the home’s bedrooms are single, and 6 of the bedrooms have en-suite facilities. Bedrooms are located on 2 floors and there is a passenger lift. The home has a small paved garden and use of a nearby allotment. There is ample car parking available. Innova House Care Home DS0000008702.V279706.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was the second of two unannounced inspections carried out between April 2005 and March 2006. The inspection lasted for 3 ½ hours and the inspection focussed on key standards not inspected at the last visit. The main method of inspection used was called case tracking which involved selecting 3 residents and tracking the care they receive through the checking of their records and discussing this with them. Other residents were spoken with and additional records were seen. A discussion was had with the manager, care staff on duty, relatives and care practices were observed. A tour of the premises was undertaken. What the service does well:
The home has a thorough admission process to ensure that the needs of anyone moving into the home can be met. A relative and a resident confirmed that they met with staff to discuss the home prior to moving in. Residents are supported to make decisions about their lives and are involved in decisions made about the running of the home including staff training and selecting new staff. Residents said that they found reviewing their care plans worthwhile and talked about increasing their independence. Routines of the home are flexible, whilst supporting residents to fulfil their individual commitments. Residents said they were happy with the food provided and are looking forward to being involved in some food preparation and cooking when the OT kitchen becomes operational. The home has suitable arrangements for the storage and administration of medication. Residents confirmed that they are given their medication when needed and one resident has had her medication stopped due to progress she has made. There has been considerable refurbishment of a number of areas of the home over the last year which residents spoke positively about. An outside smoking area has been provided so the main building can maintain a no smoking policy. There is a good system of staff training in placed and residents said that they have also been involved in this. The manager is suitably qualified and experienced and was spoken highly of for his leadership and motivation skills by both residents and staff.
Innova House Care Home DS0000008702.V279706.R01.S.doc Version 5.1 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. Innova House Care Home DS0000008702.V279706.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 Innova House Care Home DS0000008702.V279706.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): 2 New residents are assessed prior to admission to ensure that their needs can be met. EVIDENCE: The home is in the process of changing their documentation for recording assessments and care plans. Plans for 2 recently admitted residents were seen and these contained information about the assessed needs of residents. Staff said that they are informed about any new resident and their needs prior to admission. A resident and their relative said that they met with staff from the home to discuss the care the resident will require prior to admission. Innova House Care Home DS0000008702.V279706.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 and 9 The care planning system could be improved. Residents are supported and encouraged to be involved in decisions about their lives and to be independent. EVIDENCE: Care plans present a holistic picture of residents, which is clearly written and includes details of residents’ strengths, values beliefs and feelings. They also detail thinking and communication, contact and delivery, maintaining control, equipment, physical health and behaviours difficult to manage. Although the standard of information contained is of good quality, it is poorly organised and the system will be greatly improved when the new care plans are implemented. Residents said that they discuss their care plans with their keyworkers. The home encourages residents to make decisions about their lives and provides support for them to do so. There is a residents committee, which is chaired by one of the residents and residents are consulted about the running of the home and have participated in staff training and recruitment. A resident and relative said they had been involved in a review of the care plan and felt this was worthwhile and want to continue to do this. Innova House Care Home DS0000008702.V279706.R01.S.doc Version 5.1 Page 10 There is a risk management document included as part of the care plan, which identifies support residents need to take responsible risks. One resident talked about how she wants to be as independent as possible and said she has an understanding with staff that they will assist her in doing so. Staff said that they encourage residents to be independent. Innova House Care Home DS0000008702.V279706.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): 16 and 17 Residents are supported to take on responsibilities. Residents are provided with a health diet. EVIDENCE: Each resident has a weekly programme of activities they take part in both in and out of the home. There are set days for college courses and residents are supported to comply with their daily commitments. Routines are more flexible at weekends. Residents are in charge as to how they plan their day. A relative described how her relative has a routine planner to help remind him of his daily routine. Residents said that they go to bed when they want and can move freely around the home. The cook is currently pursing a further career opportunity so care staff have assumed responsibility for cooking meals. There is an emphasis on healthy eating and fruit is always available. Residents said they enjoy their food and have plenty to eat. Residents are looking forward to being able to use the OT kitchen, which is reportedly almost ready to bring into operation. Innova House Care Home DS0000008702.V279706.R01.S.doc Version 5.1 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): 18, 19 and 20 Residents are able to determine what and how they receive personal support. Closer monitoring is needed to ensure all residents healthcare needs are being met. Suitable arrangements are in place for the storage and administration of medication. EVIDENCE: Residents decide upon their daily routine and staff are deployed to support them in this. One resident described having an understanding with staff, saying that she wants to be more independent and staff are helping her to achieve this. Staff also described the resident as wanting to gain as much independence as possible. The change in care planning system will include keeping records of when residents receive any healthcare input. Currently records kept do not allow staff to monitor when some routine healthcare appointments are due. Residents said they can contact the doctor whenever they wish Medication is appropriately stored in a locked room where there is both a drug trolley and fridge. There are no residents currently assessed as being able to self medicate. A relative said that she had requested a review of a resident’s medication which had been carried out and is waiting for a dentist appointment to be made. Residents said that staff give them their medication when needed,
Innova House Care Home DS0000008702.V279706.R01.S.doc Version 5.1 Page 13 one resident said proudly that she is no longer taking any medication as staff had worked to get her off all the medication she was taking. Innova House Care Home DS0000008702.V279706.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): None EVIDENCE: Innova House Care Home DS0000008702.V279706.R01.S.doc Version 5.1 Page 15 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 The home is well maintained and an emphasis is placed on residents safety. EVIDENCE: Many areas of the home have been refurbished over the last year and residents said they were happy with the improvements. One room is currently out of use due to not having a carpet and consideration is being given to placing some form of a preventative barrier at the top of the stars for the safety of wheelchair users using the lift. A summer house has been provided for those wishing to smoke. Residents said they were looking forward to the OT kitchen coming into use, and those with mobility problems do not have access to the laundry. Innova House Care Home DS0000008702.V279706.R01.S.doc Version 5.1 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 and 35 Staff receive the training they require to carry out their duties. EVIDENCE: Training is given a high priority by the management of the home. Staff said they receive regular training and residents said they have joined in some of the staff training. Residents also said that they felt that staff were properly trained in the work they do. Records are made of all training undertaken by staff, which show all mandatory training is provided in addition to other courses relevant to the registration of the home. Staff are also enrolled onto NVQ training courses. Innova House Care Home DS0000008702.V279706.R01.S.doc Version 5.1 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 The home is well managed. EVIDENCE: The manager has considerable relevant experience, an RGN and has completed the Registered Managers Award. Staff and residents spoke highly of how the home is managed. Innova House Care Home DS0000008702.V279706.R01.S.doc Version 5.1 Page 18 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 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 4 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 4 X X X X X X Innova House Care Home DS0000008702.V279706.R01.S.doc Version 5.1 Page 19 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 2 Standard YA6 YA19 Regulation 15 13 Requirement Introduce the new care planning system Ensure that residents healthcare needs are being fully monitored Timescale for action 01/05/06 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. Refer to Standard Good Practice Recommendations Innova House Care Home DS0000008702.V279706.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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