Inspection on 15/02/06 for Outlook House

This inspection was carried out on 15th February 2006.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Outlook House 28/09/06

Outlook House 19/07/05

Outlook House 04/03/05

Outlook House 14/09/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Outlook House 74 Redhill Drive Brighton East Sussex BN1 5FL Lead Inspector Linda M Boereboom Unannounced Inspection 15 February 2006 01:30 Outlook House DS0000014219.V284198.R01.S.doc Version 5.1 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 Outlook House DS0000014219.V284198.R01.S.doc Version 5.1 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. Outlook House DS0000014219.V284198.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Outlook House Address 74 Redhill Drive Brighton East Sussex BN1 5FL 01273 555252 01273 558676 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) The Outlook Foundation Vacant Care Home 15 Category(ies) of Learning disability (15) registration, with number of places Outlook House DS0000014219.V284198.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The maximum number of service users to be accommodated is fifteen (15). Service users must be aged between eighteen (18) and twenty-five (25) years on admission. Service users with a learning disability only to be accommodated. However during six one week periods throughout a calendar year for the purposes of assessment visits only where the number of service users accommodated will be sixteen (16). 19th July 2005 Date of last inspection Brief Description of the Service: Outlook House is registered for up to fifteen young adults between the age of eighteen and twenty-five years old who have a learning disability. The home offers a programme of further education and life and vocational skills over a maximum period of seven years. This is with the intention of residents developing sufficient skills and confidence to be able to live an independent life as is possible when they leave. The Outlook Foundation, a registered charity established the home in 1997. The Foundation has also developed properties into independent living flats for some residents to move into upon completion of the programme at Outlook House. Outlook House is a large detached Edwardian property located on the outskirts of Brighton. It is presented over four floors, basement, ground floor, first and second floors, with residents accommodation consisting of fourteen single bedrooms and one Bed-sit. Communal space includes a large lounge and dining room, music room, conservatory, resident kitchen, home economics room, a learning centre and a large terraced rear garden. The home owns two mini buses and a car. The homes literatures states that the home is dedicated to quality living and training in preparation for independence, appropriate to individuals ability. Outlook House DS0000014219.V284198.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place during the afternoon of 15 February 2006; Mrs Jean Marshall, the Director of the Outlook Foundation and also the Registered Provider of the home facilitated it. During the inspection the Inspector was able to look at the home’s administration processes, speak with staff, tour the premises and speak with some of the residents, including a visiting relative. Feedback was given to Mrs Marshall at the end of the inspection. This is the second inspection report written since April 2005, in order to get a more balanced view this report should be read in conjunction with the report written in July 2005 as jointly they cover all forty- three of the National Minimum Standards. The Inspector would like to thank Mrs Marshall and staff for their hospitality and for making the inspection a pleasant and positive one. What the service does well: Outlook House provides residents with comfortable surroundings that are spacious and well maintained. The environment has a home-from-home feel. In addition there is a large garden for residents and their visitors to enjoy in the summer months. The home has a comprehensive assessment procedure that ensures that residents are only accommodated if their needs can be met and they are able to undertake the programme offered by the home. It is the ethos of the Outlook Foundation to give residents as much opportunity as possible to undertake educational and occupational pursuits that will enable them to leave the home equipped with the necessary skills to help them move into more independent lifestyles. Throughout their time in the home residents are constantly encouraged and supported to take as much responsibility as possible with the help and guidance of the dedicated team of workers. Comments made to the Inspector by residents included: ‘I love my room’, ‘the staff are lovely’, ‘I love chef’s cooking’, ‘the staff are very caring and if I need a doctor they call one’, and ‘life skills teaching is good, I really like cooking!’ A visitor in the home said she is always made welcome when visiting her daughter and that the home communicate well in all aspects of her daughters care needs and social arrangements. Outlook House DS0000014219.V284198.R01.S.doc Version 5.1 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. Outlook House DS0000014219.V284198.R01.S.doc Version 5.1 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 Outlook House DS0000014219.V284198.R01.S.doc Version 5.1 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 the following standard(s): 5, all other standards were assessed at the last inspection in July 2005. The home ensures that each resident has a written agreement that outlines his or her terms of residency in the home. EVIDENCE: Residents in the home are all funded by their own local authority, currently there are residents from Hampshire, Hertfordshire, Surrey, London Boroughs, East and West Sussex, Brighton and Hove, and Birmingham. Each resident has a contract with their funding authority and a resident’s agreement with the Outlook Foundation. The Registered Provider and Inspector discussed the involvement of family, friends and staff who are encouraged to assist residents with their contracts. Contracts are in a written format, however the Residents Handbook and statement of purpose are both written and pictorial. The handbook is extremely well presented and covers all aspects of life in the home. It includes photographs of all the staff and answers any questions residents may have when moving in. Outlook House DS0000014219.V284198.R01.S.doc Version 5.1 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 the following standard(s): 6 and 10, all other standards were assessed in July 2005. Staff in the home are pro-active in ensuring that residents assessed and changing needs are reflected in their life-skills and care planning. Staff are trained in the importance of confidentiality and residents are made aware that information personal to them is treated with disgression and all records appropriately stored. EVIDENCE: Each resident has his/her own care plan and life-skills programme. The Registered Provider showed the Inspector the new personal planning books that are to be used in the immediate future to aid both staff and residents with the planning of social, emotional and physical care. The new handbooks are presented with symbols, pictures and writing in order that they suit residents’ individual needs. Plans for care and life-skills are agreed at each review meeting with relevant healthcare professionals, the resident, and his/her family who are invited to attend. Each resident is allocated a key-worker on admission to the home. Plans are reviewed six monthly with the appropriate healthcare professionals; the process is ongoing within the home and changed as necessary. Outlook House DS0000014219.V284198.R01.S.doc Version 5.1 Page 10 The home has a confidentiality policy in place that is also reflected in the handbook and statement of purpose. The Inspector and Registered Provider agreed that this would also be reflected in the home’s Residents Charter. The office in the home has lockable facilities to ensure that all residents and staff files are safe. All policies used by the home are available to residents and their relatives. Outlook House DS0000014219.V284198.R01.S.doc Version 5.1 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 the following standard(s): 11,15 and 17. All other standards were assessed in July 2005. Residents are given opportunity for their own personal development and are encouraged to keep family links and form friendships of their own both within and outside the home. The home’s chef is pro-active in providing nourishing meals that residents enjoy, giving them choice and also encouragement to eat healthily. EVIDENCE: Residents are encouraged to maintain links with their families and former friends as well as friendships with people outside the home. The residents’ handbook makes reference to entertaining guests and reflects that the home offers the opportunity for residents to find out about different religions and faiths and attending places of worship if they choose with the help of staff. The Registered Provider confirmed this. The Registered Provider is aware of the emotional needs of the residents and told the Inspector that should a resident wish to have a ‘special’ relationship then counselling and advice would be sought by the home from relevant healthcare professionals on sex education. The home has a sexuality policy in place, which is due to, be reviewed in June 2006. The Inspector spoke with Outlook House DS0000014219.V284198.R01.S.doc Version 5.1 Page 12 residents about their friendships and social life and all made positive comments about their holidays and trips out organised by the home. The Inspector was able to see the kitchen area and speak with the home’s chef who has been in post for eight years. Residents’ choose their meals for the week with the help of the chef who encourages them to eat a varied diet that is nourishing, and to try different foods. The Inspector saw a daily diary of meals prepared; a separate record is kept of the meals eaten by each individual resident. Any resident with special dietary requirements is catered for; advice is sought from a nurse and dietician. The home has a kitchen with separate workstations on the first floor where residents who are having life skills cooking classes are able to prepare their own meals. The Inspector spoke with one resident who confirmed that she enjoyed planning, shopping and cooking her meals with the support of a trained member of staff. Residents eat together with staff on duty in the home’s dining room. All kitchen areas in the home were seen to be very clean and tidy and well organised with adequate safety signage. Outlook House DS0000014219.V284198.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 and 21, all other standards were assessed during the inspection in The home has sufficient systems in place to ensure that the management of medication protects the residents. EVIDENCE: The Inspector was able to look at the MAR (medication administration records) and residents records and found them to be up to date and signed. On the day of inspection seven residents took responsibility for administering their own medication. The Inspector noted that they had been risk assessed to do so and that locked facilities were available for them to keep the medication safe. Through conversation it was concluded that the Deputy Care Manager would speak to the local pharmacist and devise a system for recording that these residents had taken their medication. Currently, signatures are being entered by care staff that prompt each resident to take their medication, but do not witness the medication being taken. A system must be put in place that protects each member of staff should a mistake occur. One resident was on controlled medication; this had been entered accurately in the relevant record book. The medication cabinet was well organised with no evidence of stockpiling and no out of date medication or lotions. The Deputy Care Manager said that all staff are trained in the administration of medication by herself or the Care Manager however external trainers are also used. Outlook House DS0000014219.V284198.R01.S.doc Version 5.1 Page 14 The Inspector and Registered Provider discussed the home’s death and dying policy that was in place, however as the residents are young adults this has not been experienced. Outlook House DS0000014219.V284198.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Residents are protected by the homes attitude and training on complaints and the protection of vulnerable adults. EVIDENCE: The home has a complaints procedure in place that is reflected in the residents’ handbook and statement of purpose. It is also on view in the home. The last recorded complaint was on 23/11/05; this included the response by staff and the action taken. One resident when asked said she would go to the Registered Provider or her key-worker if she had any concerns or wanted to make a complaint and confirmed that staff are very kind and do listen to residents. Residents are having lessons in community safety and attend an anti bullying workshop run by staff. There is a protection of vulnerable adults policy in place and all staff are Criminal Records Bureau checked prior to employment; the Registered Provider is aware of the necessity to undertake checks before employing a new member of staff. Refresher courses for staff are undertaken in-house by Outlook’s personnel however Brighton and Hove council training department are also used. The Registered Provider told the Inspector that any Pova issues that have been raised in the past have been external to the home. Residents are encouraged and supported to manage their own finances. A system has been set up whereby any savings they accrue above a certain threshold, is transferred by them personally to a bank or post office. Outlook House DS0000014219.V284198.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed at this inspection. EVIDENCE: Although these standards were not fully assessed, the Inspector noted that the home was very clean and tidy with sufficient bathrooms and toilets and enough shared spaces for the residents. There was safety signage in all parts of the home. Bedrooms were comfortable and individualised and residents that the Inspector had conversations with said they liked their bedrooms and were able to have their own belongings and posters around them. Outlook House DS0000014219.V284198.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 all other standards were assessed in July 2005. The home is pro-active in providing staff training ensuring they are able to meet the needs of the residents; in addition the homes recruitment policy is robust and ensures the suitability of staff to the work they perform. EVIDENCE: The Inspector was able to look at staff files and found them to have sufficient information including photographs, ID, references, job descriptions and evidence of training undertaken. All staff are Criminal Records Bureau checked by the home. The Administrative Assistant in the home keeps comprehensive records of all training undertaken. At the time of inspection, nine staff were undertaking NVQ level 2 and three had already achieved the qualification. The Deputy Care Manager was undertaking NVQ level 3 and the Care Manager already having completed level 3 was undertaking level 4. Basic training in the home includes food hygiene, first aid, fire safety, makaton (sign language), protection of vulnerable adults, life skills and the administration of medication. All staff receive induction training and attend team-building sessions. There are also opportunities to attend training sessions about specific conditions that residents may have e.g. autism. The Registered Provider reviews the home’s budget on a monthly basis to make sure there is always enough revenue to provide the training required by staff. Each staff member has an on-going training needs analysis that is Outlook House DS0000014219.V284198.R01.S.doc Version 5.1 Page 18 identified through supervision and appraisal. The Outlook Foundation’s policy is to promote staff from within before recruiting from outside the home. Outlook House DS0000014219.V284198.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 40 and 43, all other standards were assessed in July 2005. The home has clear lines of accountability that are respected by staff and residents. Policies and procedures in the home are regularly reviewed, protect residents and staff and available at all times to staff, residents and visitors. EVIDENCE: The Inspector was able to look at the homes policies and procedures and found them to be up-to-date and regularly reviewed, dated and signed. Policies and procedures are kept at five sites throughout the home in order that staff and residents have immediate access to them All staff are asked to read the policies when they commence employment and sign a declaration stating they have done so. Senior staff help with development and administration. The home has charitable status and is a company registered by guarantee. It is run by a board of directors. The Registered Provider who is also on the board of directors is in the home each day until the Care Manager becomes registered with the Commission for Social Care Inspection. The home has a variety of sub committees, senior management meetings take place once every three weeks. Staff meetings occur weekly and every three weeks a Outlook House DS0000014219.V284198.R01.S.doc Version 5.1 Page 20 meeting takes place with both care and admin staff. Residents meetings are held each Monday at 4.30pm where residents write their own agenda and run the meetings themselves with the support of staff. Minutes are taken for all meetings in the home and records kept. The Inspector found staff and resident files to be clearly organised and divided into different sections making them easy to use. It was evident that there are clear lines of accountability within the home that are recognised by both residents and staff. Outlook House DS0000014219.V284198.R01.S.doc Version 5.1 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 X 3 X 4 X 5 3 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 X 25 X 26 X 27 X 28 X 29 X 30 x 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 X X X 3 LIFESTYLES Standard No Score 11 3 12 X 13 X 14 X 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 3 X X X 3 X X 3 Outlook House DS0000014219.V284198.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? yes 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 YA20 Regulation 13(2) Schedule 3 (3i) Requirement The home to suitably record medication that is self administered be residents but prompted by staff ensuring staff to not sign as having administered it themselves. Timescale for action 01/03/06 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 YA10 Good Practice Recommendations The residents’ charter to make reference to confidentiality in the home. Outlook House DS0000014219.V284198.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Outlook House DS0000014219.V284198.R01.S.doc Version 5.1 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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