CARE HOME ADULTS 18-65
Little Westover 23 Bereweeke Avenue Winchester Hampshire SO22 6BH Lead Inspector
Craig Willis Unannounced 22.08.05 13:00 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. Little Westover H54 S11825 Little Westover V243828 220805 tb.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Little Westover Address 23 Bereweeke Avenue Winchester Hampshire SO22 6BH 01962 840098 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) Stonham Housing Association Limited Mr Brian Tolliss CRH 7 Category(ies) of LD Learning Disabilities registration, with number of places Little Westover H54 S11825 Little Westover V243828 220805 tb.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: There are no additional conditions of registration. Date of last inspection 12.01.05 Brief Description of the Service: Little Westover is registered to provide care and accommodation for seven people with learning disabilities. The home is situated in a residential area of Winchester, approximately 200 metres from a local shop and bus stop serving the city centre. Each service user has their own single bedroom and share the use of lounge, dining room, conservatory, kitchen and two bathrooms. There is a large garden to the front and rear of the home and parking space for several cars. The home is owned and managed by Stonham Housing Association. Little Westover H54 S11825 Little Westover V243828 220805 tb.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over four hours. The inspector met with four of the service users, two members of staff, the manager and a visiting community support worker. A tour of the home took place. What the service does well: What has improved since the last inspection? The conservatory at the back of the home has been replaced, making a safe and more pleasant room for service users. The carpets in the hallways have been replaced, making the entrance to the home brighter and more welcoming. Reports made of monthly visits to the home by senior staff in Stonham are now being sent to the Commission for Social Care Inspection. These reports demonstrate that the organisation has regular consultation with service users.
Little Westover H54 S11825 Little Westover V243828 220805 tb.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. Little Westover H54 S11825 Little Westover V243828 220805 tb.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 Little Westover H54 S11825 Little Westover V243828 220805 tb.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) 2 The home has good systems to assess the needs and aspirations of service users, which gives staff accurate information to meet their needs. EVIDENCE: The records of three service users were viewed and each contained a needs assessment. This document set out the assessed needs and aspirations of service users. No service users have moved into the home since the last inspection. Little Westover H54 S11825 Little Westover V243828 220805 tb.doc Version 1.40 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9 There are good care planning and risk assessment systems in place, which provide staff with the information required to meet the needs of service users. Service users are supported to make decisions about their lives. EVIDENCE: The records of three service users were viewed during the inspection. Each service user had an individual plan, which set out how their assessed needs should be met. The plans also contain goals for service users’ personal development. Since the last inspection these plans have been partially transferred to a new format that is to be used throughout Stonham. The files contained all of the old information, which made them difficult to understand. The manager reported that staff were receiving training on the use of the new format in September and once the work is completed to transfer the information to the new documents, old information will be archived. The individual plans were reviewed every month, with evidence of staff consulting with service users and recording their views of the support they receive. Details of the assistance service users need to make choices, such as communication needs and how to offer choices were included in the individual plans.
Little Westover H54 S11825 Little Westover V243828 220805 tb.doc Version 1.40 Page 10 Risk assessments had been completed for each service user, detailing what specific risks they face and action that staff should take to reduce the risks. Little Westover H54 S11825 Little Westover V243828 220805 tb.doc Version 1.40 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 17 Service users are supported to take part in a wide range of activities that they enjoy and are active members of their local community. Dietary needs of service users are well catered for with a balanced and varied selection of food available EVIDENCE: Service users said they take part in a number of activities, including football, gardening, yoga, visits to the library and a walking group. One service user works at a local hardware shop and attends a community project based on a smallholding. One service user works in two local charity shops, with assistance from a community support worker. Some of the service users attend local churches. During the inspection one service user was supported to go out to do some food shopping for the home. The home has a planned menu that provides a varied and balanced diet. The manager reported that alternative meals were always available if required and meal times were flexible to meet the needs of service users. Service users spoken with said that they liked the food. Little Westover H54 S11825 Little Westover V243828 220805 tb.doc Version 1.40 Page 12 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 and 20 The personal care and health needs of service users are met, with evidence of access to a range of NHS services. The medication system at the home is well managed, which protects service users. EVIDENCE: Service users spoken with said that staff treated them well and provided personal care in the way that they preferred. Details of how personal support should be provided were included in the individual plans. Records indicated that service users are supported to attend a range of health services including, GP, dentist, speech and language therapist, and neurologist. Records of appointments contained details of the advice given by the practitioner. The manager reported that he was consulting with the care manager of one service user about the aftercare needed following a proposed hip replacement. The medication administration records had been fully completed and medication was appropriately stored in a locked cabinet. Records were available of medication received, administered and returned to the pharmacy and the stock of medication matched the records. Staff had received training in the administration of medication from a community pharmacist and the manager reported that all staff were booked to complete accredited medication training through a local college in September. Little Westover H54 S11825 Little Westover V243828 220805 tb.doc Version 1.40 Page 13 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) 23 The home has suitable procedures in place to protect service users from abuse and staff have a good understanding of adult protection issues. EVIDENCE: Two of the staff were spoken with, both of whom demonstrated a good understanding of adult protection issues and action they would take if abuse was reported or suspected. The home had a copy of the Stonham adult protection policy and the procedure followed by the local authority. Service users’ money held by the home was stored in a locked drawer in the office in individual tins. The balance of three tins were checked and matched the records and withdrawals on bank statements also matched the records. Little Westover H54 S11825 Little Westover V243828 220805 tb.doc Version 1.40 Page 14 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 and 30 The systems for maintaining and cleaning the home are good, which provides a homely and safe environment for service users. Service users’ bedrooms are individualised and suit their needs. EVIDENCE: Since the last inspection the conservatory has been replaced, as the wood in the old one was rotting. New carpets have been fitted in the hallway on both floors. The home is well maintained and the manager reported that the decoration of communal areas was due to be completed by the end of the year. The home was well furnished, with good quality, domestic style furniture. The patio door to the conservatory was very difficult to open as there was a problem with the runners. The manager reported that this was due to be replaced. This will be followed up at the next inspection. The bedrooms of three service users were seen during the inspection. All of the bedrooms had been personalised and service users said they contained all that they needed. None of the rooms had en-suite facilities, although all had a wash basin. The home was clean and hygienic, with separate laundry facilities capable of washing soiled clothing. Protective clothing was available for staff.
Little Westover H54 S11825 Little Westover V243828 220805 tb.doc Version 1.40 Page 15 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) 35 The home has a generally good training programme, however, delays in completing refresher courses may leave staff without the knowledge to meet service users’ needs. EVIDENCE: The manager reported that the refresher courses for some staff on first aid, food hygiene and fire safety had not been completed. Requests to the training department have been made and the manager reported that he hopes these updates will be completed at the next available opportunity. This will be followed up at the next inspection. The training needs of all staff have been identified and courses are being applied for. Staff spoken with said that they received good training, although one staff member said some of the courses were not specifically geared to the needs of people with learning disabilities. This member of staff said that they always followed up with the trainer if there was any doubt about how to apply the knowledge. Little Westover H54 S11825 Little Westover V243828 220805 tb.doc Version 1.40 Page 16 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) 39 and 42 The home has good systems to ensure the safety and welfare of service users and to consult with service users to review the service provided. EVIDENCE: Since the last inspection the Commission for Social Care Inspection has been receiving monthly reports of visits to the home made by the manager’s supervisor. These reports indicate that service users are consulted about the service they are receiving. The manager reported that Stonham had recently held an “accessibility day”, in which all service users in the Winchester area were invited to a local hotel. Service users were consulted on the service they receive and what changes could be made to make it better. Monthly service users’ meetings are also held in the home, giving service users the opportunity to comment on the service they receive. The fire alarm, fire extinguishers, electric system, water tanks and gas system had all been serviced. Assessments had been made of chemicals used in the home, which were stored in locked cupboards. Bath and shower hot water
Little Westover H54 S11825 Little Westover V243828 220805 tb.doc Version 1.40 Page 17 temperatures were recorded weekly. Fridge and freezer temperatures were recorded daily. Staff had received in-house fire safety training. Little Westover H54 S11825 Little Westover V243828 220805 tb.doc Version 1.40 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23
ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 x 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x x x 3 Standard No 31 32 33 34 35 36 Score x x x x 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Little Westover Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x H54 S11825 Little Westover V243828 220805 tb.doc Version 1.40 Page 19 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 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 Good Practice Recommendations Little Westover H54 S11825 Little Westover V243828 220805 tb.doc Version 1.40 Page 20 Commission for Social Care Inspection 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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