Inspection on 15/10/08 for Jack Howarth House

This inspection was carried out on 15th October 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Jack Howarth House 28/09/06

Jack Howarth House 16/01/06

Jack Howarth House 28/10/05

Jack Howarth House 27/01/05

Jack Howarth House 12/10/04

Jack Howarth House 23/03/04

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Jack Howarth House Hill Top Road Oxford Oxfordshire OX4 1PH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Andy McGuckin     Date: 1 5 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Jack Howarth House Hill Top Road Oxford Oxfordshire OX4 1PH 01865251271 01865204155 jolene.sims@scope.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) SCOPE Type of registration: Number of places registered: care home 9 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 physical disability Additional conditions: The total number of persons that may be accommodated at any one time must not exceed 9 Date of last inspection Brief description of the care home Jack Howarth House is situated at the top of a steep hill in a residential area of Oxford. The home is registered for nine people with a physical impairment. The home has only seven residents at present. The ground floor is fully accessible for people who use a wheelchair, has a spacious lounge, dining room and kitchen with views over a golf course. Residents have their own bedroom. All bedrooms bar one would not meet the minimum standard for room sizes if registered now. The home however makes the best use of them and they are all personalised to the residents taste. After consultation with residents the carpet has been changed in the communal areas for laminate flooring which is more suitable for wheelchair users. All current residents make use of wheelchairs either within the home or outside it. The home is run and managed by SCOPE, a national organisation with experience in Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 9 Brief description of the care home providing services for people with a physical impairment. Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The inspection took place on a weekday afternoon and lasted four hours. The inspection included a visit to the property, Inspection of core documentation, Consultation with service users, relatives and professionals associated with home. Discussion and feedback from staff, Discussion with the registered manager, a tour of the building re Health and Safety, and a review of the service Annual Quality Assurance Assessment ( AQAA ). Care Homes for Adults (18-65 years) Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The establishment provides prospective residents with sufficient information and the opportunity to visit the home prior to making a decision. Evidence: The home has developed a range of methods of communication to ensure that residents are kept informed about the home they are living in. Advocates and speech and language specialists are employed and have regular one to one sessions with residents. This enables the home to gain some idea of the aspirations of the individual residents and meet these needs where practical. Relatives and friends are also consulted to gain a rounded picture of skills and needs. Where possible and practicable prospective residents are encouraged to visit the home a few times before moving in. This ensures that they can meet the staff and residents and gain some insight into if the home will suit their needs. The organisation has written contracts with all residents’ representatives, which is normally the funding authority or relatives/advocates. The home has two vacancies at Care Homes for Adults (18-65 years) Page 9 of 26 Evidence: present. .The staff do their best to make it homely and comfortable. Care Homes for Adults (18-65 years) Page 10 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home offers residents the opportunity to pursue the lifestyle and friendship circles that the individual aspires to. Evidence: The inspector viewed all 7 residents files and care plans and was pleased to note that all files were well kept and written in plain English. Care plans were easily read and evidence was found that care needs were regularly reviewed. Individual care plans included consultation with service users in the decision making around their lives. Where risk is identified regarding activities, further assessments and consultation takes place to minimise this risk whilst at the same time ensuring as much independence as possible. Information held on residents is kept in a secure environment. Staff are aware of the need for professional confidentiality. A potential Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: barrier to the home being able to maximise residents full potential and activities are the inability to employ activities co-coordinators. The home have tried to overcome this by employing extra care co-coordinators who are able to take residents out. An extra barrier is the homes difficulty in recruiting drivers who are able to drive the homes mini bus, but evidence was found at inspection that residents were going out into the community at least once a week. Care Homes for Adults (18-65 years) Page 12 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home offers residents the opportunity to pursue the lifestyle and friendship circles that the individual aspires to. Evidence: Individual assessment and care planning ensure as much as possible that residents are engaged in age appropriate personal development. Residents take an active part in their local community with visits to local amenities, pubs, restaurants and sporting activities. Evidence was found at inspection that residents are being encouraged to take part in appropriate activities both inside the home and in the community. Care plans are regularly reviewed and evidence was found that residents are having regular contact with the community health care team. Care plans are presented in a visual format which is very understandable for new staff or for training this includes choice of food and activities. The home accesses specialist equipment when required staff are Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: trained in its usage and the equipment is regularly serviced. The home encourages the use of Advocates for those who require them. The home has good links with its neighbour which happens to be a golf club. The club have regular fund raising events and a yearly open day to which the residents and their families are invited. Club members also attend the home’s open day. The golf course provides a pleasant environment in which to relax in a countryside setting. Residents have appropriate personal and family relationships. At the last inspection the inspector could find no evidence that the sexual needs of its residents were being assessed or met. This has now been included in the person centered plan. Staff were observed to respect the rights and responsibilities of the residents’ daily lives. Residents were given personal space and time out as to their own preference. Menus are geared to the individual requirements and can be as flexible as needed. Nutrition and diet are given a high priority and are regularly monitored. Plans to employ a second activities co-coordinator have not been successful and the original cocoordinator has left. The home have taken on two extra care workers to fill this gap. The home are having difficulty getting drivers for the mini van. Both these factors may result in the residents not getting the level or frequency they could get from trained activities co-ordinators. Care Homes for Adults (18-65 years) Page 14 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have access to a full range of professionals who will ensure that their personal and health-care needs are met. Evidence: The inspector witnessed staff providing care to residents and communicating with them to ensure they were happy. Professional advice has been sought for one resident who has severe communication needs and evidence was found that the home were following the advice given. As far as is possible the home is meeting the physical and emotional needs of its residents. From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. The homes takes account of the individuals right to have their spiritual needs met and encourages residents in this. The right to have no spiritual persuasion is also respected. Inspection of the medication systems did not reveal any errors. The system is robust Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: and regularly spot checked. Medication is stored handled and recorded appropriately and the home has a written explanation of what the medication is for, its description, and any possible side effects. The commission finds this to be good practice and commends the home for this initiative. The inspector was of the opinion that aging, illness, and death would be handled with respect and to the individual’s wishes. Care Homes for Adults (18-65 years) Page 16 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has policies and procedures to enable residents and concerned individuals to make comments both positive and negative. Staff have received training in Adult Protection. Evidence: No complainant has contacted the Commission with information concerning a complaint made to the service since the last inspection. The inspector was shown the home’s complaints, concerns, compliments, policies and procedures and was assured that, where a complaint or concern was made, it would be dealt with in a speedy manner which residents and their families were happy with. Feedback from questionnaires indicated that people were aware of the complaints procedure and would know how to complain, but would more often than not take the matter up with the manager or key staff member. Staff have been trained in the Protection of Vulnerable Adults and in Adult Protection procedures. The home has a whistle blowing policy and staff spoken to felt safe enough to implement this policy if required. Care Homes for Adults (18-65 years) Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management and staff make the best of a poor environment to ensure residents feel safe in a homely environment. Evidence: Despite the age and layout of the building staff have managed to make the home as comfortable and homely as they can. A new kitchen has been installed and they have two spare bedrooms which can be used for private meetings or time out. As there are only seven residents as opposed to the usual nine, the home does not feel as institutional as on previous inspections. The home has purchased a state of the art large screen entertainment centre which will benefit all residents. Residents bedroom show individual taste and choice with many personal possessions and entertainment equipment in evidence. Where specialist equipment is required, it is provided by specialists in their field with staff being trained in its usage. Equipment is serviced regularly by contract. The home has sufficient toilets and bathrooms to meet the needs of its residents a new assisted bath was awaiting the completion of its installation. Bathrooms are sited to maximise Independence and privacy. The communal areas of the home are sufficient to complement and supplement the needs of the residents. The extensive grounds and surrounding golf course are a popular choice of activity in the good weather. Previous problems with the cleaning of the home have been addressed Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: by means of a cleaning rota. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Previous staffing issues have been resolved and the home is taking steps to ensure the home is staffed by committed experienced staff who are supported by senior managers. Evidence: The home has no registered manager at the present time and the home is being managed by 3 senior staff members. The organisation must identify an individual to be put forward as the registered manager under section 11 of the Care Standards Act. The inspector interviewed one member of staff and had informal interviews with the joint managers of the service. Evidence was found at inspection that the home were recruiting in an appropriate manner. The inspector looked at a random sample of staff files which included two new members of staff files. The home is advertising in the local and national press but many staff come by word of mouth or by previous contact with the home. Staff are interviewed and references taken up. Staff do not start working until all police and identification checks have been completed. The home was able to demonstrate that where a spent conviction showed up on a staff member they took appropriate steps to ensure that it would not have a bearing on the applicants suitability to do the job. Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: Evidence was found at inspection that staff were attending a wide range of appropriate training and that previous problems with staff not being supervised have been resolved. It is a pity that the home have been unable to recruit to the Activities Cordinator posts. They have however tried to overcome this difficulty by the addition of two extra care staff. This is not ideal and combined with the lack of drivers means that difficulties still arise in enabling residents to reach out of home activities. One resident did comment that he would like to go out more on his comment card. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management arrangements of the home could be improved. Evidence: The home has no registered manager at the present time and the home is being managed by 3 senior staff members. The organisation must identify an individual to be put forward as the registered manager under section 11 of the Care Standards Act. Service user’s rights and best interests appear to be met and the home has a range of policies and procedures to which staff are trained. These policies and procedures are there to ensure, where possible, residents are protected from harm or abuse and that their health and safety are paramount. The home is part of a larger organisation which operates at a national level and benefits from the competent and accountable management of its parent organisation.Given the current situation regarding the management of the home. the organisation must ensure that sufficient support is given to the management team Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: from the organisations senior management. Records required during the inspection were up to date and accurate. Records that are kept to comply with Health and Safety were inspected and found to be satisfactory. The commission has not received any complaints from members of the public. The home keep the commission fully informed of significant events. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 11 The home should continue to engage the services of Activities co-ordinators and identify or train staff to drive the mini-bus Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. 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