Inspection on 26/08/08 for Penshurst

This inspection was carried out on 26th August 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

Penshurst 14/03/07

Penshurst 17/11/05

Penshurst 30/11/04

Penshurst 27/07/04

Penshurst 16/03/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Penshurst 24 Spring Hill Ventnor Isle Of Wight PO38 1LF     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Mick Gough     Date: 2 6 0 8 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Penshurst 24 Spring Hill Ventnor Isle Of Wight PO38 1LF 01983 853184 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): Type of registration: Number of places registered: Mrs Eveline Anne Basile Mrs Eveline Anne Basile care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 3. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). 0 Over 65 0 Date of last inspection Brief description of the care home Penshurst is a home providing care and accommodation for three adults with a learning disability. The home is owned and managed by Mrs Basile. It is a large three storey Victorian residence located in a central part of Ventnor town, close to its shops and amenities. While there is no off road parking, the large town centre car park is very close by and on road parking outside the home is sometimes available. Service users? accommodation is on the first and second floors, and would, in a general sense, be unsuitable for individuals with mobility difficulties as there is no passenger or stair lift. There is an attractive and reasonably sized rear garden, which is available for use by residents. Care Homes for Adults (18-65 years) Page 4 of 26 Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support peterchart Concerns, complaints and protection Environment Staffing Conduct and management of the home Poor Adequate Good Excellent How we did our inspection: This report details the evaluation of the quality of the service provided at Penshurst and takes into account the accumulated evidence of the activity at the home since the last inspection, which was carried out in March 2007. The inspection took into account the homes Annual Quality Assurance Assessment (AQAA) that was forwarded to us prior to a site visit to the premises and this provided us with good information about the home. Included in the inspection was an unannounced site visit to the home, which took place on the 26 August 2008. Evidence for this report was obtained from reviewing the homes completed AQAA, reading and inspecting records, touring the home and from observing the interaction Care Homes for Adults (18-65 years) Page 6 of 26 between staff and users of the service. It was also possible to gain the views of the people living at the home and we had the opportunity to speak with two residents and the homes manager/provider who assisted us throughout the visit. The home is registered to provide support for 3 residents who have a learning or physical disability and at the time of the inspection there were 2 people living at the home. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line – 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective service users aspirations and needs are assessed before they move into the home. Evidence: Residents told us that they were very happy living at the home and that there assessed needs were being met. There have been no new admissions to the home since 1983 and the manager/provider told us that she would only admit new residents after a thorough assessment of their needs. The assessment would include visits to the home, overnight and weekend stays and a trial period to ensure that needs could be met and that both existing residents and any new resident would get on well together. Care Homes for Adults (18-65 years) Page 10 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents assessed needs and personal goals are reflected in an individual plan of care and they are supported to make decision about their lives with assistance. Residents are supported to take responsible risks and this allows them to live an independent lifestyle as much as possible. Evidence: Residents living at Penshurst are central to the home’s care planning process/programme; and the manager knows and understands the needs and abilities of the people living with her at the home. The care planning documents in use are not traditional care plans but they are valuable documents that provide good evidence of the lifestyles of the people residing at Penshurst. The home employs no staff that require direction via a plan of care. Care planning records were reviewed during the Care Homes for Adults (18-65 years) Page 11 of 26 visit and were found to contain useful and important information about the residents and they reflected their needs and wishes. Residents are fully able and empowered to make decisions for themselves and live as individuals within a group setting. We spoke to both of the residents who live at the home and they told us that they are supported to make their own choices and decisions and these are respected. Care plans and the homes completed AQAA provided us with information on the choices made by individuals. Residents are supported to take risks as part of their independence. Formal risk assessment were not in place but from discussions with the manager and with residents it was clear that residents are encouraged to participate in activities, which contain some risks, independent shopping, etc. However, the potential for any harm to come to the person is limited via the home’s risk management process. Care Homes for Adults (18-65 years) Page 12 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are encouraged and supported to be part of the local community and to be involved in appropriate activities. They benefit from support to maintain social contacts and daily routines at the home respect their rights and responsibilities. Meals at the home are flexible and residents benefit from a healthy diet. Evidence: None of the residents have expressed any interest in gaining any form of employment or education and residents told us that they are very happy at the home and have no wish to obtain any form of employment. Care Homes for Adults (18-65 years) Page 13 of 26 None of the residents have regular visitors but the manager told us that visitors are welcome at anytime and this was confirmed in the homes completed AQAA. One resident keeps in touch with family through the exchange of birthday and Xmas cards. We were informed that both residents are well known in the local community and one resident is able to access the community independently and goes down to local shops on his own. However both residents require support to go further distances. Residents told us that they regularly take trips out into the community to visits pubs, cafes, garden centers and shops and the home encourages and promotes community socialisation. We observed the proprietor interacting with residents and their preferred form of address was used. Both of the residents who we spoke to made it clear that they were very happy at the home and it was clear that everyone gets on well together. They told us that they help out around the home and that they keep their room clean and tidy with some help from the proprietor, they said that they like to be involved in the day to day running of the home. Routines in the home respected residents rights to be involved as much or as little as they wanted. Residents told us that they enjoy and appreciate the meals provided at the home, which are flexible and are adapted on a daily basis to meet people’s choices and wishes. Breakfast is normally cereals, toast and fresh fruit. Lunch is normally a snack type meal and the main meal is in the evening. The manager/proprietor knows both residents very well and knows their likes and dislikes and she tells them what is on for tea each day and residents are normally happy with this but if anyone would like something different then this is provided. The manager keeps a record of all food eaten by residents. Care Homes for Adults (18-65 years) Page 14 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive personal support in the way they prefer and their physical, emotional and health needs are met. The homes policies and procedures with regard to medication provide protection for residents. Evidence: We spoke to residents who told us that their personal care needs are met and care plans gave information on the level and type of support given. All personal care is delivered in accordance with the wishes of the residents and meets their needs. Both residents are able to carry out some of their own personal care needs, however one resident needs support with shaving and another needs support with bathing and dressing. Both residents are registered with a local GP surgery and both have community phsyciatric nurses who call on a regular basis. One resident has recently had his hearing tested and both residents have eye test through a local optician. The manager Care Homes for Adults (18-65 years) Page 15 of 26 told us that she has excellent relationships with the local surgery and any health care needs are met by the surgery or through GP referral. Both residents have foot care provided by a local chiropodist every 4 - 6 weeks. Medication is provided from a local pharmacist and the manager has undertaken a course in the safe administration of medicines and there are clear records of medication administered. The storage of medication was checked and this was suitable for its current purpose, however the home does not currently hold any controlled drugs. The law concerning the storage of controlled drugs has recently changed and the home was reminded that should there be a need for any controlled drugs to be held at the home, they must be stored in a proper Controlled Drugs Cupboard. A proper Controlled Drugs cupboard is one, which meets the standard set in the Misuse of Drugs (Safe Custody) Regulations 1973. Suppliers of CD cabinets can confirm that a cupboard meets the legal requirements. Care Homes for Adults (18-65 years) Page 16 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to express their concerns and have access to a robust, effective complaints procedure, are protected from abuse, and have their rights protected. Evidence: The homes completed AQAA told us that that a complaints process is available and that no complaints have been logged over the last twelve months, the manager confirmed this on the day of the visit. Residents told us that they had no concerns and that they would speak with the managing/proprietor over any issue that upsets or concerns them, and told us that they were sure that she would quickly sort out any problems. The manager told us that she was fully aware of the safeguarding adults procedure and knew who she should report to if she had any concerns. The AQAA told us that there had been no adult protection issues at the home and this was confirmed by the manager on the day of the visit. There were suitable arrangements in place for residents personal finances and there were clear records kept, which provided a clear audit trail. Care Homes for Adults (18-65 years) Page 17 of 26 Care Homes for Adults (18-65 years) Page 18 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a homely and comfortable environment and the home is clean and hygienic. Evidence: A tour of the home was conducted and all areas of the home were clean and furniture and fittings were of good quality. We saw a normal family home and the service was clean and hygienic. Both residents share an en-suite bedroom and this is their choice, the manager told us that she had 2 spare rooms and if any resident expressed a wish to have his own room then this could easily be arranged. Issues with regards to the design and layout of the home and its suitability for the long-term use of a client with increasing mobility issues has been identified at previous inspections and the manager told us that at present this was not presenting any problems and we spoke with the resident concerned and he told us that he had no problem getting around the home and was very contented at penshurst. There was a separate utility area which housed the washing machine and tumble drier and these were normal domestic machines. The manager told us that she carries out all of the laundry for residents and she has undertaken training in infection control and Care Homes for Adults (18-65 years) Page 19 of 26 suitable precautions were in place. Care Homes for Adults (18-65 years) Page 20 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient trained staff to support the people who use the service and appropriate recruitment checks are undertaken to protect residents. Evidence: As established at previous inspections there are no staff at Penshurst. With only two relatively independent residents the proprietor provides round the clock support, with backup from her son/daughter in emergency situations and absences’. At this inspection it was found that no changes have been made to the staffing situation at the home, although it was established that all parties involved in supporting the residents have been appropriately checked against the Criminal Records Bureau and Protection Of Vulnerable Adults registers. The manager has enrolled herself on a number of training courses which are provided by a local training agency and these include; Moving and handling, infection control, first aid, health and safety and food hygiene. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a well run home and their views and those of other interested parties are sought on how the home is meeting residents needs. The health, safety and welfare of residents are promoted and protected. Evidence: The manager has been running the home for over 20 years and she has the skills and experience required to ensure the home is well run and managed. Although there is no formal quality assurance systems in place the manager is in regular contact with outside agencies and they have indicated that they are happy with how the home is meeting residents needs. Residents spoken to told us how the manager involves them in decision-making and keeps them advised of developments, Care Homes for Adults (18-65 years) Page 22 of 26 i.e. decoration and planning holidays. The home does not involve residents in surveys but speaks to them directly and acts on any ideas that residents may have on how to improve the service provided for them. There were no health and safety concerns identified during the tour of the premises. The home has smoke detectors around the home and these are wired into the homes electrical system with battery back up in case of power failure. The manager is currently updating the homes fire risk assessment and certificates were in place and up to date for the homes fixed wiring and gas appliances. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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