Inspection on 23/08/05 for Michael House

This inspection was carried out on 23rd August 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

Michael House 10/04/07

Michael House 09/01/06

Michael House 23/11/04

Michael House 05/07/04

Michael House 24/03/03

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Michael House MacCallum Road Enham Alamein Andover, Hants SP11 6JA Lead Inspector Laurie Stride Unannounced 23/08/05 10.15am 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. Michael House H54 s12058 Michael House v237039 230805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Michael House Address MacCallum Road, Enham Alamein, Andover, Hants, SP11 6JA 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) 01264 345800 Enham Mrs Karen Mary Sawyer CRH 23 Category(ies) of PD, PD(E) registration, with number of places Michael House H54 s12058 Michael House v237039 230805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Agreement has been given for two named persons over 65 years of age to be accommodated at the home (dates are 12.01.27 and 31.07.35). Date of last inspection 23/11/04 Brief Description of the Service: Michael House is part of The Enham Organisation situated in the village of Enham Alamein, Andover in Hampshire. The purpose-built establishment is registered for 23 physically disabled service users. The establishment is one of four residential settings on the large site. The main building of Cedar Park houses the medical consulting area and some leisure activities. Michael House provides physical and emotional support to individuals who have a physical disability, sensory impairment or learning disability. The purpose of this service is to enable people with disabilities to realize their full potential both by listening to their expectations, providing a structured work setting, assessing their needs and by providing advice and guidance from health care sources. Michael House H54 s12058 Michael House v237039 230805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first of two annual unannounced inspections and lasted approximately four hours. The inspector spoke with three residents and was assisted by the senior support worker in the absence of the registered senior care home manager. A partial tour of the premises was undertaken and samples of the home’s records were inspected. What the service does well: 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. Michael House H54 s12058 Michael House v237039 230805 Stage 4.doc Version 1.40 Page 6 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 Michael House H54 s12058 Michael House v237039 230805 Stage 4.doc Version 1.40 Page 7 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 Residents benefit from a thorough assessment of their needs and abilities before admission to the home. EVIDENCE: There had been one new admission to Michael House in the last 12 months and records were on file relating to the assessment of the person’s needs. These included reports from the previous placement, relevant professionals and the home’s initial assessment. A very comprehensive assessment of need over a period of approximately three weeks is part of the introduction to Michael House. This process is undertaken in William House, one of the neighbouring units where an assessment flat is available for general admission to the site. The process consists of monitoring applicants’ needs and abilities and also incorporates an assessment within the resource and development centre. The comprehensive package is formulated with an aim towards the development of life skills in general and is undertaken by many of the professionals employed at Enham. Interim reviews are held and records are kept of these. The recently admitted resident confirmed s/he was now settling in at Michael House. Michael House H54 s12058 Michael House v237039 230805 Stage 4.doc Version 1.40 Page 8 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 clear and consistent care planning and risk assessment systems in place to provide staff with the information they need to meet residents’ needs. The home provides residents with opportunities and assistance to make decisions about their lives. EVIDENCE: A sample of three resident’s care plans was inspected. These contained details of professional, family and social contacts, physical and mental health information, personal support needs, goal plans, teaching / training plans and risk assessments. A separate file contains support guidelines in brief for each resident and this is useful for new staff who need quick access to current and concise information. Support guidelines include a section that states how each resident wishes the care and support to be carried out. ‘Permission to share’ information forms were included and those seen had been signed by the resident. The home was in the process of reviewing the format of care plans. In-house reviews are held every six months and there is an annual review attended by the social service care managers and families. Reports of these showed that the effectiveness of care plans was continually assessed. The review programme is also shared, where relevant, between the residential Michael House H54 s12058 Michael House v237039 230805 Stage 4.doc Version 1.40 Page 9 home and the development programme teams so that residents’ goals and needs are fully discussed and appropriate support is agreed. In conversation three residents confirmed that staff respected and assisted their right to make decisions. Relevant risk assessments and any limitations on individual choices are recorded in care plans. Information about advocacy services is available and had previously been referred to for one resident. Residents handled their own financial affairs in accordance with their assessed needs and abilities and all received their full personal allowances. Individual support and tuition regarding finances was detailed in service user’s personal files. Thorough and comprehensive risk assessments were on file for each resident. These indicated the level of risk identified for each activity, for example accessing the community or self-administering medication, and included risk management plans and guidelines for staff. There were records of monitoring and reviewing risks and assessments were agreed and signed by residents or their representatives. Michael House H54 s12058 Michael House v237039 230805 Stage 4.doc Version 1.40 Page 10 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 15 The arrangements and facilities for residents’ personal development and acquiring employment skills are of a high standard. The service enables residents to access the community and promotes the maintenance of residents’ relationships. EVIDENCE: Care plans contain individual development programmes and support guidelines. All residents are encouraged to maintain and be involved in activities and interests which they held prior to admission and which are recorded on personal information. There are opportunities for residents to participate in structured programmes at the development resource centre and workshop, situated in close proximity to all the homes on the site. These programmes and facilities enable people with disabilities to take part in developmental and valued activities including work development. Residents commented that they enjoyed going to the centre. There are also opportunities for residents of Michael House to undertake unpaid employment in a variety of areas including administration and supervised maintenance, and some worked in a local charity shop. Michael House H54 s12058 Michael House v237039 230805 Stage 4.doc Version 1.40 Page 11 The home has a written policy on community links and social inclusion which aims to foster good working relationships with the local community and support residents in maintaining contacts. Residents talked about activities and using local services. The village provides nearby shops, bus and taxi services. Information is available to residents and staff about the Disability Discrimination Act, and staff undertake disability awareness training that is updated periodically. Newsletters and notices provide details of local services and activities. Staff rotas were organised to provide flexible cover according to resident’s needs and activities. Residents are supported to maintain family links and friendships inside and outside the home and relevant policies were in place. The visiting policy welcomes visitors at all reasonable times. Significant relationships are recorded in individual care plans and, as mentioned, relatives and representatives are involved in the review process. Arrangements were in place for resident’s visitors to stay overnight on occasions. The senior support worker confirmed that information and advice are provided if required to help residents to make appropriate decisions regarding their relationships. Michael House H54 s12058 Michael House v237039 230805 Stage 4.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 health and personal support needs of residents are well met with evidence of relevant professional consultation on a regular basis. The systems for the administration of medication are good with clear and comprehensive arrangements being in place to ensure residents’ medication needs are met. EVIDENCE: As mentioned previously, individual care plans include a section that states how each resident wishes their care and support to be carried out. A keyworker system is in place that helps to promote relationships of trust between residents and staff and provides a point of contact with the home for relatives and external agencies. Staff are trained in the principles of care and moving and handling techniques. Residents confirmed that they were happy with the assistance they received from staff, and that staff talk to and treat residents with respect. Residents have the technical aids and equipment they need for maximum independence, determined by professional assessment. The sample of care plans seen contained personal and general healthcare information, for example details of GP and other contacts, health action plans, allergies, and pressure sore risk assessments. Staff sign to say they have read and understood the guidelines for each individual and any changes are discussed at staff meetings and handovers. Health appointments and visits are recorded and files contained evidence of appropriate referral to healthcare specialists. There is currently on site access to a physiotherapist and an Michael House H54 s12058 Michael House v237039 230805 Stage 4.doc Version 1.40 Page 13 occupational therapist at various times. The district nurse had been contacted and was visiting at the time of the inspection in relation to a resident recently discharged from hospital. A visual assessment for one resident had recently led to changes to the markings around the premises to improve safety for all residents. A discussion took place about another residents changing needs and future care provision. The home has policies and procedures for dealing with medication and residents are enabled to retain, administer and control their own medication where appropriate. Each resident has their own locked medication cabinet in their accommodation and individual risk assessments for those who manage their own medication. The two members of staff administering medication sign the records. Staff are trained in the safe handling of medications and there are plans for the manager and senior staff to attend more in-depth training. A doctor countersigns monthly checklists and makes any changes to individuals’ medication. The senior support worker undertakes a monthly stock check and had developed a resource file for staff giving information about medications currently used in the home. Michael House H54 s12058 Michael House v237039 230805 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 The home has a suitable complaints procedure to ensure that residents’ views are listened to and acted upon. EVIDENCE: There is a complaint procedure, which is provided to all residents. The procedure includes the name and address of the Commission for Social Care Inspection (CSCI), timescales for responding to complaints and information about the appeals process. A form is used to record details of complaints together with any action taken and outcomes. The complaints log was viewed during the inspection. No complaints had been received since the previous inspection by the home or by the CSCI. Michael House H54 s12058 Michael House v237039 230805 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 The provision of modern, purpose built accommodation ensures that residents live in a homely, safe and comfortable environment. EVIDENCE: A partial inspection of the premises was undertaken. The building is modern and purpose-built and able to accommodate wheelchair users with ease. Michael House is comfortable, bright, cheerful, airy, clean and free from offensive odours. All furnishings and fittings are of good quality and the décor is to a good standard. A resident gave permission to view their flat and this was individually personalised, well equipped and had a good outlook. Room measurements meet the requirements of the Commission for Social Care Inspection. En-suite facilities and Occupational Therapist assessed assisted baths are available. New bedroom overhead tracking hoists had recently been fitted. Local amenities and transport are available. There is a continual planned maintenance programme, which holds an annual budget. A maintenance team is employed by the organisation on a regular basis and are sited in the village. The fire safety officer visited the premises on 03/05/05 and a visit from the organisations health and safety department took place on 25/04/05. Michael House H54 s12058 Michael House v237039 230805 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) 33 and 35 Residents are supported and protected by suitable numbers of trained staff. EVIDENCE: The home’s rota clearly showed those staff members on duty or on training. At least three support workers were on duty for each day shift and the registered manager when on duty was additional to these numbers. There is one awake and one sleeping in member of staff overnight. Where a number of agency staff had been employed the home sought to book the same individuals. Permanent care staff also undertake some bank work at Enham and this gives continuity of care to residents. The home also employs two ancillary staff. Staff team meetings are held approximately every month and include discussion about resident issues, operational matters, health and safety and fire safety. It was not possible to access staff recruitment records in the absence of the registered manager and this standard will therefore be assessed at the next inspection. However, the manager had reported in the pre-inspection questionnaire that all staff working at the home had completed Criminal Records Bureau (CRB) checks. Michael House H54 s12058 Michael House v237039 230805 Stage 4.doc Version 1.40 Page 17 There are eleven care staff employed at the home of whom six had achieved NVQ level 2 awards or above. A further three members of staff were in the process of obtaining the awards and all staff were reported to hold current first aid certificates. New workers undergo a structured induction programme in line with the Skills for Care standards (formerly known as the Training Organisation for the Personal Social Services – TOPSS). The organisation provides staff with a rolling programme of statutory and other relevant training including, for example, health and safety, epilepsy, care planning, disability awareness, professional boundaries, risk assessment, behaviour labelled as challenging and protection of vulnerable adults. The programme runs every 3 months, allowing for new staff and refresher training. A training plan for the first half of the current year was on the office notice board. The senior care worker reported that a new training officer had recently taken up post and was updating the training calendar for the rest of the year. The registered manager had undertaken a moving and handling instructors course within the last twelve months. Michael House H54 s12058 Michael House v237039 230805 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) 42 The home has well organised systems in place that promote safe working practices. EVIDENCE: The home was able to demonstrate that safe working practices were promoted and maintained. All staff undertook training in fire safety, moving and handling, first aid, food hygiene and infection control. Fire safety records were up-to-date and complete regarding fire alarm inspections, extinguisher checks, fire procedure and evacuation training. Fire risk assessments for the premises were also on file with evidence of reviews. At the time of the inspection a problem with the fire alarm in one area of the home had been identified and an engineer called out to deal with the matter. General risk assessments for the environment were in place, for example in relation to transferring residents using an overhead hoist. Michael House H54 s12058 Michael House v237039 230805 Stage 4.doc Version 1.40 Page 19 Maintenance certificates and engineers reports were held on file including, for example, those for the aid-call system, hoists, elevator, washing machine and domestic appliances, gas safety and water safety analysis records. The home has an accident and incident log that includes procedures for taking action and reporting events. A health and safety review is held every six months and there is a maintenance team and manager for the site. Michael House H54 s12058 Michael House v237039 230805 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 x 4 x x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x x Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x x Standard No 31 32 33 34 35 36 Score x x 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Michael House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x H54 s12058 Michael House v237039 230805 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 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 Michael House H54 s12058 Michael House v237039 230805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton, Hants SO15 1GW 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. 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