Inspection on 11/07/05 for John Turner House - Short Break Service

This inspection was carried out on 11th July 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 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

John Turner House - Short Break... 27/11/08

John Turner House - Short Break... 14/03/07

John Turner House - Short Break... 10/03/06

John Turner House - Short Break... 15/02/05

John Turner House - Short Break... 11/10/04

John Turner House - Short Break... 17/03/04

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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 John Turner House - Short Break Service Rotterdam Road Lowestoft Suffolk NR32 2EL Lead Inspector Iain Smith Announced 11 July 2005 th 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. John Turner House - Short Break Service I54-I04 S37688 John Turner House - SBS V229750 050711 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service John Turner House - Short Break Service Address Rotterdam Road, Lowestoft, Suffolk, NR32 2EL 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) 01502 405449 01502 405447 None Suffolk County Council Post Vacant Care Home 5 Category(ies) of LD 5 registration, with number of places John Turner House - Short Break Service I54-I04 S37688 John Turner House - SBS V229750 050711 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 15.02.05 Brief Description of the Service: John Turner short break unit is located in Lowestoft on a site shared with other Suffolk Social Services for people with learning disabilities. Within walking distance are facilities for example newsagents, grocers, public houses, parks and the Lowestoft college. The main shopping centre is about 15 minutes walk. John Turner short break is a ground floor building and consists of a large kitchen/ dining room, spacious lounge with TV and Video. There is a patio door leading into an enclosed garden, 5 bedrooms with washbasin, wardrobe, mirror, chest of drawers and chair. Three bedrooms have rise and fall beds to manage service users needs more effectively. There are three separate toilets, two bathrooms with hoists and a shower room. Wheel chair users are able to access all parts of the building. John Turner House - Short Break Service I54-I04 S37688 John Turner House - SBS V229750 050711 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was arranged as an announced inspection, the first inspection for the year 2005/2006. The visit commenced at 08.50 and lasted four hours 10 minutes and was conducted by Iain Smith, Regulation Inspector. During the inspection one resident was spoken to, in addition to the members of staff and the newly appointed manager. A tour of the premises was made and communal areas visited. Four resident and three relative questionnaires were received prior to the inspection and comments are included in the report. What the service does well: What has improved since the last inspection? Since the last inspection in February 2005 the service has had the opportunity to review the medication policy and procedures. The staff now ensure that all medication is dispensed and administered by the same person, therefore eliminating the possibility of the incorrect drug being given to the customers. The statement of purpose has been updated to include all services provided and the name of the new manager. There are now service agreements for all customers. This was a requirement from the last inspection that has been addressed in a positive way. John Turner House - Short Break Service I54-I04 S37688 John Turner House - SBS V229750 050711 Stage 4.doc Version 1.40 Page 6 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. John Turner House - Short Break Service I54-I04 S37688 John Turner House - SBS V229750 050711 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 John Turner House - Short Break Service I54-I04 S37688 John Turner House - SBS V229750 050711 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) 1,2,3,4and 5. People who use the service receive clear information to enable them to make a choice about whether or not they wish to use the service. Each customer’s needs are assessed prior to his or her placement in the short break service. EVIDENCE: The Statement of Purpose and Service User Guides were available for the prospective customers and their families. The manager stated that all customers receive the service user guide, this is produced as a booklet and informs customers about the staffing, the training that the staff receive and the aims and objectives of the service. The statement of purpose states that the short break service provides care for periods of at least one overnight stay. One customer stated that they were staying in the service for two weeks and would then hope to return home. The prospective customers are assessed prior to their placement in the service. One customer’s file was examined and found to include an emergency checklist. The customer was admitted as an emergency and there was evidence that there was adequate information provided, to enable the staff to care for the individual, however a care plan should be produced. The manager stated that each prospective customer visits the service and spends some time with the staff. John Turner House - Short Break Service I54-I04 S37688 John Turner House - SBS V229750 050711 Stage 4.doc Version 1.40 Page 9 The service has introduced a service agreement for all customers. It includes the name and address of the individual, services provided and fees to be paid. John Turner House - Short Break Service I54-I04 S37688 John Turner House - SBS V229750 050711 Stage 4.doc Version 1.40 Page 10 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) 6,7,8,9 and 10 The staff team are committed to ensure care plans are developed and relevant to reflect the changing needs of each customer. EVIDENCE: Each customer has their own care plan, based on the original assessment of the social worker and the staffs own assessment. The customer, who had been admitted to the scheme as an emergency, did not have a care plan. The manager stated that the staff would support and care for the customer, based on the information on the emergency checklist of needs. The care plan would then be developed during the customers stay at the service. The remaining four customers each had a care plan, detailed and includes regular reviews. One customer was in the scheme at the time of the inspection, the other four had left for day placements. This customer stated that they were waiting for transport to take them to a day care centre in Lowestoft. They said that they enjoyed going to the centre but was looking forward to attending the recycling centre where they worked when they were at home. It was evident that the customers do not spend time in the scheme during the day and the social workers and staff encourage them to attend employment or a day centre facility. John Turner House - Short Break Service I54-I04 S37688 John Turner House - SBS V229750 050711 Stage 4.doc Version 1.40 Page 11 The customers are encouraged to prepare their own meals on return from their placement. There is a kitchen area where staff will assist the customers to prepare and cook meals. John Turner House - Short Break Service I54-I04 S37688 John Turner House - SBS V229750 050711 Stage 4.doc Version 1.40 Page 12 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) 11,13 and 14 The customers have the opportunity to participate in the local community. EVIDENCE: Each of the five customers takes part in daily occupation with day centre placements. This ensures the customers maximise their independence and mix with other people. This information was stated in the care plans. As the customers were at day placements some of these standards were not assessed on this occasion. The service has recently developed an activities room. The creation of this area was financially supported from external funding. This area offers the customers the opportunity to sit and relax, play games or watch videos. John Turner House - Short Break Service I54-I04 S37688 John Turner House - SBS V229750 050711 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) 20 The service has robust policies and procedures to ensure that customers are protected when dealing with medication. EVIDENCE: The medication policy was examined and found to be relevant for the service. This stated clearly the procedure for the checking, administration and storage of medication. The service has recently reviewed their policy and practices. The customer’s medication administration records (MAR) charts were checked and found to include signatures for medication given to the customers. There were no controlled drugs in the medicine cabinet however, if there were, there was no controlled drugs book to record the drugs. John Turner House - Short Break Service I54-I04 S37688 John Turner House - SBS V229750 050711 Stage 4.doc Version 1.40 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 standard(s) 22 and 23. The service has a clear policy and procedure in place for dealing with allegations or suspicions of abuse. Staff receive appropriate training and development. EVIDENCE: The service has the appropriate protection of vulnerable adults (POVA) policy and procedures in place. These policies inform all staff how to recognise abuse and the procedures for reporting such incidents. Some of the staff have applied to attend external POVA courses and are waiting for a place to be allocated to them. The complaints procedure is in place with staff being instructed on induction. There have been no complaints received in the service although the service does not have the required record log. The complaints procedure is entitled ‘having your say’ and is a standard social care document. The service does have a pictorial edition of the complaints procedure and they make this available to all customers. John Turner House - Short Break Service I54-I04 S37688 John Turner House - SBS V229750 050711 Stage 4.doc Version 1.40 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 standard(s) 24,25,26,27,28,29 and 30. The environment is well maintained and provides excellent personal and communal provision. EVIDENCE: The accommodation is well maintained and provides space for individual or group living. There is a large lounge area where the television is located and an activities room where customers can spend time. One member of staff stated ‘the customers have their own space’. The corridors that join the lounge, bedrooms and bathroom areas are wide and if the service accommodates for a customer with a wheelchair there is sufficient space to move around. The service has a range of aids, adaptations and equipment designed to meet the needs of the customers who use the service. John Turner House - Short Break Service I54-I04 S37688 John Turner House - SBS V229750 050711 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35 and 36. There is a commitment to all staff accessing and receiving training. The training and development of staff are relevant for them to gain the skills and experience to meet the needs of the customers. EVIDENCE: There was evidence that new staff members receive comprehensive induction training. Training records are maintained and evidenced that staff have attended manual handling, protection of vulnerable adults, fire safety and unisafe training. All staff are supervised. There was evidence in each staff file that a record was kept and the manager stated that they would commence the supervision of their deputy. The staff were aware of their responsibilities, they each had a job description. The manager’s job description was not available to examine. The manager stated that this document was available from the social care human resource department. John Turner House - Short Break Service I54-I04 S37688 John Turner House - SBS V229750 050711 Stage 4.doc Version 1.40 Page 17 The service has an effective team to meet the needs of the customers. One member of staff stated ‘we carry on in a quiet way with every person using the service’ The staffing numbers working in the service are two community support workers during the day with one waking and one ‘sleep in’ member of staff at night with one administrative support. The manager is on duty during each day of the week with their deputy in support. The recruitment policies were examined and found to be relevant. The procedures are managed by a recruitment agency, coordinating the advertising and application forms. Two staff files were examined. Both files contained two references, a photograph and a copy of the birth certificate. One of the two files had a copy of the criminal records bureau (CRB) enhanced check. . John Turner House - Short Break Service I54-I04 S37688 John Turner House - SBS V229750 050711 Stage 4.doc Version 1.40 Page 18 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) 37,38,40,41 and 43. The manager is approachable and leads by example and involves staff in the running of the service. Policies and procedures within the service are relevant and kept safe and secure. EVIDENCE: The manager was appointed to the post in June 2004 and has made application to be the registered manager. They have experience in care and management and has completed their NVQ level 4 in management. The manager has attended training relevant to the post for example unisafe, manual handling and food hygiene. The staff stated that they are involved with staff meetings. Minutes from the staff meetings were kept and there was evidence that the meetings were held every six weeks. A range of subjects was discussed including health and safety, control of substances hazardous to health and shopping for the customers. John Turner House - Short Break Service I54-I04 S37688 John Turner House - SBS V229750 050711 Stage 4.doc Version 1.40 Page 19 Policies and procedures were examined. Examples were the health and safety, medication and lone working policies. The lone working policy included information for example details of the staff destination, estimated return time and transport arrangements time. These policies were kept safe and secure in the manager’s office. The service has a feedback sheet that relative and customers are requested to complete. This forms part of the quality control for the service. Three relatives questionnaires were returned to the inspector prior to the visit. There was a response to questions for example, ‘do staff welcome you in to the service?’ and ‘are you kept informed of important matters?’ John Turner House - Short Break Service I54-I04 S37688 John Turner House - SBS V229750 050711 Stage 4.doc Version 1.40 Page 20 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 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 x 3 3 x x x Standard No 31 32 33 34 35 36 Score 3 3 3 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 John Turner House - Short Break Service Score x x 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 3 x 3 I54-I04 S37688 John Turner House - SBS V229750 050711 Stage 4.doc Version 1.40 Page 21 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 34 Regulation 7,9 and 19 Schedule2 Requirement The registered person must ensure that a record is made available for inspection of all staff CRB enhanced checks. Timescale for action Immediate 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. Refer to Standard 6 20 22 Good Practice Recommendations Each customer should have a formulated care plan including those who are admitted as an emergency. There must be an appropriate controlled drugs record book kept at the service. A log book should be available to record any issues or complaints raised. John Turner House - Short Break Service I54-I04 S37688 John Turner House - SBS V229750 050711 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection 5th St Vincent House 1 Cutler Street Ipswich Suffolk, IP1 1UQ 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. Extracts may not be used or reproduced without the express permission of CSCI John Turner House - Short Break Service I54-I04 S37688 John Turner House - SBS V229750 050711 Stage 4.doc Version 1.40 Page 23 - 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. 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