Inspection on 25/02/08 for Just Homes

This inspection was carried out on 25th February 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

Just Homes 26/06/06

Just Homes 20/09/05

Just Homes 26/04/05

Just Homes 21/12/04

Just Homes 31/07/04

Just Homes 06/02/04

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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 Just Homes 3 Newhill Purley On Thames Reading Berkshire RG8 8AY Lead Inspector Yvonne Souden Key Unannounced Inspection 25th February 2008 2:00 Just Homes DS0000011212.V357835.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 Just Homes DS0000011212.V357835.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. Just Homes DS0000011212.V357835.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Just Homes Address 3 Newhill Purley On Thames Reading Berkshire RG8 8AY 0118 962 4887 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) Mrs Pamela Mary Eales Mrs Susan Donovan Care Home 3 Category(ies) of Learning disability (2), Learning disability over registration, with number 65 years of age (1) of places Just Homes DS0000011212.V357835.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th June 2006 Brief Description of the Service: Just Homes provides residential care and accommodation for 3 adults who have learning diabilities. The home is a detached bungalow furnished and decorated to a high standard, with a small landscaped back garden with seating provided. There are 3 single bedrooms, an office, kitchen, bathroom, lounge/dinette and laundry. The home has car-parking facilities for approximately two cars; off road parking is available and a bus stop is opposite the home. Just Homes has a Statement of Purpose and Service Users Guide available on application to the home. Just Homes DS0000011212.V357835.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This is the first inspection the Commission for Social Care Inspection (CSCI) has undertaken within the inspection year 1/04/07 to 31/03/08. The evidence obtained to inform this report include a 4-hour site visit to the service that enabled the inspector to observe care practice, and speak to the people who use the service, staff and the deputy manager. The registered manager was on leave at the time of the site visit, but had completed an Annual Quality Assurance Assessment (AQAA) in December 2007, which was used to inform this report. The AQAA gave us information about the people who use the service and the staff team, and information about how the home is managed. We also used information obtained from surveys’ that had been completed by the people who use the service with support from the registered manager, and surveys from relatives of those people and staff. Documentation viewed by the inspector at the site visit was also used to inform this report. From the evidence seen by the Inspector and comments received, the Inspector considers that the home would be able to provide a service to meet the needs of individuals of various religion, race, or culture. The home follows the organisation’s policy and guidelines to manage issues relating to equality and diversity. What the service does well: The service provides a warm, safe, welcoming and comfortable environment for the people, who live there, and staff receive training and support to meet the health and social care needs of those people, as is detailed within their agreed plan of care. People who use the service are supported to live an active lifestyle and keep in touch with family and friends. The opinion of the people who use the service is valued and respected, and their independence is promoted by the choices they have made within an assessment of risk. Just Homes DS0000011212.V357835.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Just Homes DS0000011212.V357835.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 Just Homes DS0000011212.V357835.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): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who use the service had their needs assessed prior to moving into the home, and have their health and social care needs regularly reviewed to ensure the home can continue to meet those needs. EVIDENCE: The service users have lived in the home for several years. The files of two service users identified that their health and social care needs had been assessed prior to an agreed contract of care with the placement authority, and the service. Records identify that the service users’ care manager from Surrey social services visits the home annually to review their health and social care needs. Just Homes DS0000011212.V357835.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): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The assessed needs of the people who use the service is reflected within an individual plan of care that supports their decision making, and promotes their independence whilst minimising risk. EVIDENCE: The inspector viewed the files of two service users that contained letters of communication from health care professionals, a health book, six monthly reviews, risk assessments, and picture formatted care and support plans. The information gave a clear paper trail of how the service users’ needs are met whilst promoting their independence and minimising associated risk. The files also contained a short profile of the service users’ health and social care needs; the deputy manager confirmed that the profile was developed to use in an emergency, for example, to inform health care professionals how the needs of a service user is met should there be a hospital admission. Just Homes DS0000011212.V357835.R01.S.doc Version 5.2 Page 10 Separate to the service users file were service users’ daily report records that identify how the service users’ needs were met on the day and used to inform each change over of staff. The main files are heavy with documentation received since the service users’ admission, and some records proved hard to locate by the inspector and deputy manager, due to the bulk of paperwork within each file. This was discussed further with the deputy manager recommending an archived file, and a user-friendly file that contained only the most recent or relevant correspondence over a twelve-month period. This would ensure the folder was easy to manage each day, and would enable the user to find up to date and relevant information quickly with reference to the archived file as and when needed. Just Homes DS0000011212.V357835.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): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are supported to lead a fulfilled lifestyle from the choices they have made within their capabilities. People who use the service are supported to maintain links with family and friends, and are provided a healthy and nutritious diet to meet their individual dietary needs. EVIDENCE: Staff support service users’ to lead a fulfilled lifestyle, this was evident from documentation viewed, surveys and observation. Two service users are unable to verbally communicate. The homes Annual Quality Assurance Assessment (AQAA) completed by the registered manager states that the home could improve communication skills by sending staff on communication training, but this has not been arranged. Staff and the service users were observed to be comfortable in each other’s company communicating from the use of body language, and signs and symbols. The Just Homes DS0000011212.V357835.R01.S.doc Version 5.2 Page 12 service users’ individual activity plans detail outings within the community and of attending clubs. The organisation has a qualified activity co-ordinator who visits the service users weekly to deliver a programme of one to one activity. The inspector observed staff reassure a service user with patience, respect and understanding as the service user continually demanded their attention. The service user told the inspector that she was looking forward to going out that evening, and was also looking forward to a family member visiting. Surveys from relatives of the service users’, say the home always help the service user to keep in touch with them, and support the service users’ to live the life they choose. The registered manager informed the Commission on the 13th September 2007 that the residents and staff were going on holiday September 2007; records at the inspection identified that the holiday had taken place and was enjoyed by all. Service users were observed to enjoy their evening meal. The meal was detailed within a picture-formatted menu plan and fresh fruit and vegetables were available. The dietary need of a service user who is vegetarian was met. Just Homes DS0000011212.V357835.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): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service receive support to meet their personal and health care needs, and are protected by the homes policy and procedure in the administration of their medication. EVIDENCE: The registered manager reports within the homes Annual Quality Assurance Assessment that they have started to complete health plans as sent to them by the community nurse, and that they need to fully implement these. Some detail was observed to be entered into the service users individual ‘Health Book’, provided from Berkshire West NHS, and it would be good practice to complete those records to promote multi–agency working and meeting the health care needs of the service users. Support plans and other records identify that the service users’ personal and health care needs are met, and clearly demonstrate health care appointments for example; dental, psychiatrist appointments, flu vaccinations and psychologist review of medication. Records shows that staff administer service users’ medication from a monitored dosage system as reviewed regularly by a pharmacist, and identify that staff have received medication training. Just Homes DS0000011212.V357835.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service and their representative know who to go to if they have a concern or complaint. People who use the service are protected from abuse. EVIDENCE: A picture formatted complaint policy and procedure was observed in a service users room, and a complaint logbook is used to record concerns and complaints. People who use the service and their representatives feel listened to and say within surveys received that they know how to make a complaint. The home’s Annual Quality Assurance Assessment (AQAA) completed by the manager in December 2007, said the service had not received any complaints. The Commission for Social Care Inspection has received no formal complaints about the service provided within this inspection year. Staff said they have attended safeguarding adult training; October 2006 training records confirmed this. The home has a copy of Local Authority Multiagency Safeguarding Adult policy and procedures. The manager reports in the AQAA that no safeguarding adult referrals or investigations have taken place within this inspection year. Records identify that a service user will hit out unpredictably at staff and service users’. Risk assessments detail measures to take to safeguard the service user and others within the home, and minutes of team meeting discuss ways to manage the service user’s behaviour. Staff show an awareness of the Just Homes DS0000011212.V357835.R01.S.doc Version 5.2 Page 15 service users needs, how to communicate with the service user and offer reassurance. Staff said that they are confident in the management of the service user’s behaviour to ensure others are safeguarded from physical abuse. The registered manager did not state in the AQAA if the home has a physical intervention, restraint policy and procedure and the manager was not available at the inspection to discuss further. Records identify that the home has a physical intervention, restraint policy. Staff said there are no forms of restraint used within the home. Records and discussions with staff identify that some staff have attended Strategies for Crisis Intervention training through a previous employer, but staff employed by the service have not attended Strategies for Crisis Intervention training or similar, and say they would welcome training to ensure they are managing unacceptable displays of behaviour within Department of Health Guidelines to safeguard the people who use the service. Just Homes DS0000011212.V357835.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): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who use the service live in a clean, fresh, homely and comfortable environment. EVIDENCE: The home is a small comfortable bungalow that is adequate in size to meet the needs of the people who live there. Staff obviously take pride by ensuring service users’ live in a safe, homely, clean and fresh environment that has no offensive odours. Management and staff confirmed that new furnishings and flooring have been provided since the last inspection to improve the comfort, safety and hygiene of the home. Staff have attended food hygiene and infection control training. Hand washing equipment and protective clothing was observed to promote infection control, and the homes laundry has a washing machine with sluicing facility. Just Homes DS0000011212.V357835.R01.S.doc Version 5.2 Page 17 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service know the staff and have their needs met by a competent, trained and qualified staff team, and are protected by the homes recruitment procedure. EVIDENCE: Training records and discussions with the deputy manager and staff team identify that over 75 of staff have an NVQ in. Records of a newly recruited staff member detailed certificates of training that confirmed her skill and experience in meeting the needs of people with a learning disability. The staff member received an induction covering terms and conditions, policies and procedures, and principles and philosophy of care. Training records of existing staff confirm continual development to improve their knowledge and skills. The staff rota identifies sufficient staff are employed to meet the needs of the service users. The deputy manager reports that they have a for a full time carer and that existing staff and bank staff cover those hours; agency staff have been used twice in six months. The organisation has a recruitment policy and procedure that is are clearly practiced by management, but some staff recruitment files identify gaps within Just Homes DS0000011212.V357835.R01.S.doc Version 5.2 Page 18 their employment history and some employment references were not written on the previous employers headed paper/or stamped by the previous employer to evidence authenticity. This was discussed further with the deputy manager who confirmed improvements would be made to ensure the month and year of employment is included within the staff members’ employment history, and that gaps would be explained, for example gap year from college/university. The deputy manager also confirmed that greater care would be taken to ensure proof of references obtained. Records identify that police checks within POVA First and CRB were obtained on all staff prior to an agreed contract of employment. Staff probationary, supervision and appraisal records were viewed that demonstrate staff receive support and one to one supervision from management. Just Homes DS0000011212.V357835.R01.S.doc Version 5.2 Page 19 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A qualified and competent manager manages the home, and quality assurance systems are in place to ensure people who use the service are safe, and are afforded choice in their lives. EVIDENCE: The registered manager was on annual leave at the time of the inspection, but records identify that the manager continually updates her knowledge and skill to manage the service. It was evident that a clear system of quality assurance is promoted by management within the home to ensure the needs of the service users are met, and to promote the safety of the service users, staff and visitors to the home. Just Homes DS0000011212.V357835.R01.S.doc Version 5.2 Page 20 Weekly fire safety checks are maintained with fire risk assessment reviewed 21/03/07. A senior manager within the organisation undertakes regulation 26 inspections that report on standards and outcomes within the home. Records identify that a regulation 26 inspection was completed 21/02/08, prior to this CSCI inspection, that looked at finances, records of complaints, incident/accident book and visits by the proprietor, those records were also viewed by the CSCI inspector. The views of the people who us the service and staff are valued, this was evident from records of staff and service user meeting and from discussions with staff and a service user. Training records of management and staff identify up-to-date health and safety training received, and discussions with staff and supervision records seen evident that staff feel supported in meeting the needs of the people who use the service. Just Homes DS0000011212.V357835.R01.S.doc Version 5.2 Page 21 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 4 25 X 26 X 27 X 28 X 29 X 30 4 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 Just Homes DS0000011212.V357835.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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. 1 Refer to Standard YA23 Good Practice Recommendations The manager should look at training for staff to improve staff awareness of the homes Physical Intervention Restraint policy and procedure and Department of Health Guidelines on restraint, to ensure only good practice and the safety of the people who use the service. The manager should improve staff application forms to include: full date of employment history, with explanations of any gaps. The manager should ensure staff references are detailed on the previous employers headed paper or stamped by the previous employer to evidence authenticity. 1 YA34 Just Homes DS0000011212.V357835.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Oxford Office 4630 Kingsgate Oxford Business Park South Cowley Oxford OX4 2SU 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 Just Homes DS0000011212.V357835.R01.S.doc Version 5.2 Page 24 - 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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