Inspection on 14/03/07 for John Turner House - Short Break Service

This inspection was carried out on 14th March 2007.

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... 10/03/06

John Turner House - Short Break... 11/07/05

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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Coopers Mill Ltd

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Paradise Lodge

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Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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 Inspection 14th March 2007 02:00 John Turner House - Short Break Service DS0000037688.V332539.R01.S.doc Version 5.2 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 John Turner House - Short Break Service DS0000037688.V332539.R01.S.doc Version 5.2 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. John Turner House - Short Break Service DS0000037688.V332539.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service John Turner House - Short Break Service Address Rotterdam Road Lowestoft Suffolk NR32 2EL 01502 405449 01502 405447 Inneka.winser@socserv.suffolkcc.gov.uk 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) Suffolk County Council Mrs Inneka Rae Winser Care Home 5 Category(ies) of Learning disability (5) registration, with number of places John Turner House - Short Break Service DS0000037688.V332539.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To include one named service user for a period of 6 months. Date of last inspection 10th March 2006 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 single storey building and consists of a large kitchen/ dining room, spacious lounge with television and video. A smaller lounge with television and music centre is also available the service users. This room has a patio door leading to an attractive garden with a number of focal points such as a summerhouse and fountain. There are five single bedrooms all nicely furnished. 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. The sixth bedroom has been turned into an activity room with a wide range of equipment such as art and craft materials, a drum, jigsaws and optic lights. John Turner House - Short Break Service DS0000037688.V332539.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is based on the pre arranged key inspection of the service and has been written using accumulated evidence gathered prior to and during the inspection. The inspection focussed on the key standards for adults 18-65. The service provided documentation prior to the inspection day, this included a completed pre inspection questionnaire and a list of staff. The inspection was conducted by lead regulation inspector Iain Smith and lasted 3.15 hours during the afternoon and early evening period when the service users returned from their day care. The registered manager Inneker Winser was present and contributed fully to the inspection process. The inspection included examining two care plans, two staff files and interviewing those staff. What the service does well: What has improved since the last inspection? A number of requirements were made on the last inspection and they have been addressed.This included customers having risk assessments and staff files that required evidence of recruitment records. Hand washing equipment was available in all the toilets and bathrooms and the kitchen had a paper towels. The kitchen has a separate hand-washing basin in addition to a sink for the preparation of food and washing up. There is a dishwasher for the use of the majority of the plates and dishes. John Turner House - Short Break Service DS0000037688.V332539.R01.S.doc Version 5.2 Page 6 The automatic release on two bedroom fire doors has been rectified. The door to the small room where the refrigerator and freezer are standing was found not to be a fire door however the fire prevention officer recommended that the window to the room is opened and a window restrictor was fitted. 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. The summary of this inspection report can be made available in other formats on request. John Turner House - Short Break Service DS0000037688.V332539.R01.S.doc Version 5.2 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 John Turner House - Short Break Service DS0000037688.V332539.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2 was inspected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Customers can expect their needs to be assessed and considered prior to commencing their stay in the short break service. EVIDENCE: There was evidence that all customers had their needs assessed prior to commencing their stay in the short break service. This included those who were accepted for an emergency stay and those customers who staff had planned a visit for. The service had produced an emergency care plan form that identified the key needs for each individual and was completed on arrival. One customer’s assessment was viewed and found to include relevant information for example behaviour, social background and risk assessments. This customer was in the service during the inspection and nodded their head in agreement that they were happy staying in the service. The assessments for the planned admissions were seen. The information included, family and social contact, risk management, communication methods and physical and mental health needs. The manager stated that prior to customers using the short break service they are invited to visit for a cup of tea, a longer visit or stay for a night. John Turner House - Short Break Service DS0000037688.V332539.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6,7 and 9 were inspected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The customers can expect their needs to be identified in a plan and be encouraged to make decisions and to take risks as part of an independent lifestyle. EVIDENCE: Two care plans were examined and found to include information relating to the service users needs. Examples of the content of the care plan were communication, health, medication and social aspects of their life. One care plan stated that a carer was required to be with the customer at all times. The plan clearly identified that the reason was to ensure the service user did not harm themselves or others. A risk assessment relevant to this element of the customer’s needs was completed and the inspector observed this practice. In each of the customer’s plans risk assessments were included. Manual handling, environment and medication were examples of the assessments. One care plan stated ‘ encourage the customer to continue in their independence’. This included bathing and making tea. The customers who were using the John Turner House - Short Break Service DS0000037688.V332539.R01.S.doc Version 5.2 Page 10 service were seen to be returning from their day centre placements. One customer stated that they could decide what they watch on television in the evening. The staff stated that the customer would make a mark against the programme of their choice. This demonstrated that the customer was making a personal choice. John Turner House - Short Break Service DS0000037688.V332539.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,15,16 and 17 were inspected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Customers can expect to take part in activities, be part of the community and have appropriate personal and family relationships. They can also expect their rights to be respected and they are offered a healthy diet. EVIDENCE: The short break service offers respite care to customers who wish to stay either as a one off visit or for a number of visits each year. Customers who arrive for a break also attend day placements when they are in the community therefore; the manager is committed to continue this arrangement. In the care plans there was a record that customers attended a range of day care placements including The Lowestoft Centre, where they will be involved in drama and dance and the Aspire Centre. This centre offers educational opportunities to the customers. The manager stated that each customer had the opportunity to use the activities room that was created by the staff over 12 months ago. This room John Turner House - Short Break Service DS0000037688.V332539.R01.S.doc Version 5.2 Page 12 was decorated and equipped with play, leisure and art materials. There was a music centre, small snooker table, jigsaws and painting material. The customers were encouraged to use the room when they were in the short break unit. One customer showed the inspector their paintings that they had completed the day before the visit. The customer smiled when they looked at the paintings. The manager stated that the next leisure project for the service was to create a barbeque area in the courtyard of the building. The staff stated that evening activities were arranged for the customers depending on the availability of staff and the needs of the customers. This would include visits to the shops, pubs and church. One member of staff stated ‘I make sure that each customer gets out.’ One customer had chosen to stay in their room when they returned to the service and prior to tea. A member of staff was seen to knock on the door and gain permission before entering the room. Staff were observed to speak to each customer by their preferred name and show respect to them. The manager stated that if a customer has a friendship or relationship with another customer then the staff would support that customer and ensure the care plan reflected the approach and support the customer required. The evening meal on the day of inspection was chicken in a sauce with rice. The daily menu reflected this and the member of staff responsible for assisting with the preparation of the meal stated that customers are encouraged to assist if they chose to. The menu reflected a choice of food at breakfast time for example toast and cereals. The food preparation area had increased in size with the installation of a large worktop and new sinks. The dining table was set with a place setting, and cutlery with condiments. The food stores were seen and they contained a wide selection of fresh and frozen food. Each customer was responsible for preparing their packed lunch for the following day The staff stated that they would assist a customer of they wanted assistance. John Turner House - Short Break Service DS0000037688.V332539.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18,19 and 20 were inspected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The customers can expect personal support and staff ensure that the customer’s health care needs are met. The service ensures that customers are protected by the medication policies and procedures. EVIDENCE: The two care plans that were examined evidenced that each customer had chosen their routines for the day. Examples were, the way the customer required assistance to get up and dressed in the morning. Staff were observed to be listening to the customers when they explained their activities for that day. One member of staff was sitting with a customer and asking how their day had been and the customer smiled and nodded that their day had been enjoyable. The manager stated that all customers were registered with a GP, some had a dentist and others attended out patient appointments at the local hospital. The care plans evidence that customers attended a GP appointment and there was a record of those visits. One member of staff stated that they had taken a customer for an out patient appointment to the hospital, stayed with them and brought them back to the service. Another care plan evidenced that a John Turner House - Short Break Service DS0000037688.V332539.R01.S.doc Version 5.2 Page 14 Community Psychiatric Nurse attended one of the customers on a regular basis. The medication policy and procedure was examined and found to be appropriate to ensure customers were protected. One staff member was designated to administer the medication. The same person was in charge of the shift at the service. They were observed to open the secure medicine cabinet that was kept in the office and locate the Medication Administration Records (MAR). Each MAR chart was checked individually and the medication taken out and given to the person, signed for before moving on to the next customer. Each customer was responsible for bringing into the service their own medication and there was a record for each drug logged in a book and signed for by the member of staff checking it in. There was in addition a record of each medication that was taken out when the customer finished their stay at the short break service. There were no controlled drugs in the cabinet. In the care plans there was clear evidence that each customer had their preference to either self medicate or the staff administer the medication. John Turner House - Short Break Service DS0000037688.V332539.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23 were inspected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Customers can expect their views to be listened to and action on and they are protected from abuse, neglect and self-harm. EVIDENCE: The complaints procedure was evident in the service and it was included in the statement of purpose. The complaints procedure was entitled ‘Having your say’ and Suffolk Social Services produced it. The name, address and telephone number of the Commission for Social Care Inspection was included in the document. There were no complaints received since the last inspection in March 2006. The service had a complaints log in the office. Training records evidence that staff had attended the Protection of Vulnerable Adults (POVA) and managing challenging behaviour training. One member of staff ‘I have attended the POVA training recently’. The multi-agency staff POVA policy was seen and it was kept in the office for staff to refer to. One customer who was in the service during the inspection presented with the risk of self harming and harming others however there was a member of staff who had been allocated to accompany the person at all times. This member of staff was an additional person on shift. John Turner House - Short Break Service DS0000037688.V332539.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30 were inspected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The customers can expect to live in a service that is homely, safe and clean and tidy. EVIDENCE: The service offers a pleasant environment where there are wide corridors leading to the bedrooms, toilets, bathrooms and lounge and dining area. The external door is secures with a keypad therefore ensuring that customer’s property is protected and when they are in the service that no visitor is able to gain free access to the building. There is sufficient space in the bedrooms with a bed, wardrobe and chest of drawers. The lounge area is light and airy with a selection of chairs to offer the customers and placed in a variety of places within the lounge. The dining area is designed to allow customers to move freely around the tables and chairs and to select where they wish to sit. There were a number of hoists and the appropriate slings to enable staff to move and handle customers around the building and into and out of the shower and baths. The service is carpeted in the communal areas with the exception of the dining area. John Turner House - Short Break Service DS0000037688.V332539.R01.S.doc Version 5.2 Page 17 The service had a number of bathrooms and toilets and on inspection there was appropriate hand washing equipment for example a basin and liquid soap with paper towels. In the kitchen there was a separate hand washbasin in addition to a sink for the preparation food and washing up. There was a dishwasher for the majority of plates and dishes. John Turner House - Short Break Service DS0000037688.V332539.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32,34 and 35 were inspected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Customers can expect to be supported by staff that are competent, qualified and trained to meet the needs each person. The service’s recruitment policy and practices protect the customers. EVIDENCE: The customers are supported by competent and qualified staff, for example the training, development and skills they have are appropriate to meet the needs of each person. By speaking to staff and examining training records there was evidence that staff have the appropriate training. Examples of this included 55 of staff had achieved an NVQ two or three. Person centred planning, unisafe, POVA, loss and bereavement and mental health training for staff were records in the staff files and training records. Two staff files were examined to ensure the service has recruited them according to their policies and procedures. In the staff files there was evidence of a photograph, an enhanced Criminal Records Bureau (CRB) record, two references and a job description. Training records were included for example food hygiene and manual handling. John Turner House - Short Break Service DS0000037688.V332539.R01.S.doc Version 5.2 Page 19 One member of staff stated ‘there is plenty of training’. The manager stated that staff attend induction training at the commencement of their employment and are supervised until the member of staff is competent to work on their own. John Turner House - Short Break Service DS0000037688.V332539.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37,39 and 42 were inspected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Customers can expect to benefit from a well service and can be confident their views are sought. The health, safety and welfare of customers is promoted and they can expect to be protected. EVIDENCE: The registered manager stated that she has attended a number of training updates since the last inspection. This includes unisafe accreditation, manual handling, management and financial training. This has enabled her to maintain and improve her knowledge as the manager. The registered managers job description sets out her responsibilities for the day to day operation of the service. The service has a business plan that the manager and staff compiled. It includes the methods the service will use to undertake Quality Assurance systems. This includes service standards and carers assessments. The John Turner House - Short Break Service DS0000037688.V332539.R01.S.doc Version 5.2 Page 21 manager will send questionnaires to the relatives in addition to asking the service users for their comments. The questions include asking about the level of respite, systems for booking and the quality of the respite. The manager stated that in addition there are systems for assessing the national minimum standards, safe working environment and budget management. The health and safety information was kept in the service office where the relevant policies and procedures were available. There were risk assessments in place for all customers including manual handling and the environment. Accidents and incidents records were maintained and kept in the office. Additional health and safety policies included infection control, substances hazardous to health (COSSH) and fire precautions. The fire officer had completed a recent report for the service and this was seen during the inspection. The service has rectified the problem where the automatic fire release mechanisms were not working on the bedroom doors. The room where the fridge and freezer are located has a fitted window restrictor therefore ensuring there is sufficient circulation of air to reduce the heat generated from the two pieces of equipment. There was evidence in the two staff files that were examined of staff attending health and safety training. John Turner House - Short Break Service DS0000037688.V332539.R01.S.doc Version 5.2 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 Standard No Score 1 X 2 3 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 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 X John Turner House - Short Break Service DS0000037688.V332539.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action 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 John Turner House - Short Break Service DS0000037688.V332539.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ National Enquiry Line: 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 © 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 DS0000037688.V332539.R01.S.doc Version 5.2 Page 25 - 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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