Inspection on 02/08/05 for Phillips House

This inspection was carried out on 2nd 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

Phillips House 18/11/08

Phillips House 18/12/06

Phillips House 09/03/06

Phillips House 01/02/05

Phillips House 19/08/04

Phillips House 18/02/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Phillips House 5 Jesmond Road Clevedon North Somerset BS21 3RA Lead Inspector Catherine Hill Announced 2 August 2005 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. Phillips House D53-D02 S8111 Phillips House V232235 02.08.05 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Phillips House Address 5 Jessmond Road Clevedon North Somerset BS21 7SA 01275 873447 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) Freeways Trust Limited Mrs Nikki Jones Care Home - Personal Care Only 13 Category(ies) of Learning Disability - (13) registration, with number of places Phillips House D53-D02 S8111 Phillips House V232235 02.08.05 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 13 persons aged 18 - 65 years with learning disabilities. 2. May accommodate one named person over the age of 65 for respite care only. Conditions of Registration will revert to age 18 -65 when this person leaves. 3. Mrs Jones shoud have monthly support from a professional mentor for twelve months following registration in addition to the regular supervisory support she receives from her line manager. 4. Mrs Jones should achieve the Registered Manager Award and training in the care of people with learning disabilities within one year of registration. Date of last inspection 1 February 2005 Brief Description of the Service: Phillips House is a community home for people with learning disabilities, and is part of the Freeways Trust. The home predominantly provides residential support on a permanent basis, but has one bedroom that is used for respite care, and offers occasional day care support. The home is on three floors and is set in a residential area within easy access of the town centre, the sea front and local amenities. Most residents are in their forties or fifties. Phillips House D53-D02 S8111 Phillips House V232235 02.08.05 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted over the course of one day, from mid-morning until early evening, and focused on issues outstanding from previous inspections and on spending time with the residents and staff. Some of the homes records were checked, including the Service Users Guide, records relating to residents personal care, records of residents cash and valuables, menu records, and staff records. Six of the residents visitors completed CSCI comment cards prior to this inspection, and one family wrote to the inspector. Three of the residents completed CSCI comment cards with support from staff. The inspector spoke with 11 of the residents and with a visitor, as well as with a couple of the staff on duty and the newly registered manager. Everyone was satisfied with the services provided by the home, and felt that the staff team is open to negotiating satisfactory solutions to any problems. One person commented that care standards are excellent but was concerned that there may not be much room for flexibility in staffing levels if any extra input is required. In practice, the home manager has been able to agree extra hours for clients who need additional input. There have been a lot of new staff appointed over the past year, but the changes have been well managed and everyone seems to be adapting well. There have also been several changes of manager in the last couple of years, but many comments were made during this inspection about how approachable and supportive Nikki Jones, the recently registered manager, is. What the service does well: The staff team is very resident-focused, and continuously works to put residents more at the centre of the running of the home. The residents were very satisfied with their lives at the home, and felt that they get good support from staff. One resident became distressed during this inspection, but staff handled the incident in a way that helped to defuse it and allowed the resident to become calm again without losing face. There is a good system of recording in place, and this is being well used. Phillips House D53-D02 S8111 Phillips House V232235 02.08.05 stage 4.doc Version 1.30 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. Phillips House D53-D02 S8111 Phillips House V232235 02.08.05 stage 4.doc Version 1.30 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 Phillips House D53-D02 S8111 Phillips House V232235 02.08.05 stage 4.doc Version 1.30 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) 1-5 Prospective residents and their carers get a good level of information about the home before moving in. EVIDENCE: The Statement of Purpose has been expanded and revised, and gives a good depth of information, particularly about staff qualifications and experience. The home s Service Users Guide has been updated since the last inspection, and doubles as a very clear and straightforward residents contract. This does not include all the information required, but the homes practice is to give a copy of the Statement of Purpose out to anyone whos interested, ensuring that they have all the information they need to make an informed decision. These documents and a copy of the latest inspection report are all kept on display in the office. Residents are now asked to sign a copy of their contract. The residents agreement has pictures, as does the newly drawn up information on what to expect on admission to the home. Staff go through these documents with each person. Phillips House D53-D02 S8111 Phillips House V232235 02.08.05 stage 4.doc Version 1.30 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) 6-10 Residents are involved in and consulted on the support they are given, and are able to pursue their preferred lifestyles to a good extent. EVIDENCE: Care plans have been drawn up in the form of Person-Centred Plans. Freeways policy on care plans stresses that the individual should be in charge of their own goals, and fully involved in the whole process. There is a picturesupported information sheet on care planning for clients use. The PersonCentred Plans sampled had been written from the residents point of view, and in many cases in their own words. These are generally reviewed every six months for the younger residents, and monthly for the people who are over retirement age. Residents care records gave an excellent level of detail and really reflected the person, their views and preferences. They included notes of their daily preferred routines, such as what they like for breakfast and the order in which they like to get up in the mornings. Phillips House D53-D02 S8111 Phillips House V232235 02.08.05 stage 4.doc Version 1.30 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) 11-17 Residents are getting good opportunities to have varied and interesting life experiences. EVIDENCE: Several of the residents gave the inspector a detailed breakdown of their weekly activities, and their enthusiasm showed that they get a lot of satisfaction from these. People get to spend a good deal of one-to-one time with their key workers, and some people plan their own activities independent of the home. Residents felt that this is their home - they do not have to ask staff permission to make themselves a drink or snack, and simply let staff know if they are going out at any time. Key workers plan activities for the week ahead with the residents in their key groups. Key workers are responsible for helping each person to maintain family contact, and support residents to phone their families or to send cards. Key workers also let families know about any significant events that their relative wants them to be involved in. Phillips House D53-D02 S8111 Phillips House V232235 02.08.05 stage 4.doc Version 1.30 Page 11 Nikki Jones wrote to all the relatives about the inspection and asked if they would like to meet the inspector to make comments. Residents and staff have been learning Makaton in an effort to communicate better with a couple of residents who rely mainly on Makaton signs to make themselves understood. Residents plan the menus with support from staff. Phillips House D53-D02 S8111 Phillips House V232235 02.08.05 stage 4.doc Version 1.30 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) 18-21 Residents health care needs are being well met. EVIDENCE: Care records were well organised, so that it is easy to track different aspects of each persons care. This is particularly true with health care records, and it was clear that health care checks are frequently arranged on each persons behalf. Key workers carry out a monthly room check and health check with each resident as a further way of ensuring safety and well-being. The District Nurse with responsibility for providing insulin injections to one resident has given training to those staff to whom she has delegated responsibility, and has confirmed this in writing to the home. Medications practice and records were generally good, but the staff who receive medications into the home need to make a note on the record of the date and number of medications received, and to sign this. Staff are liaising closely with external health care professionals regarding the changing needs of one of the residents. This is being managed with sensitivity Phillips House D53-D02 S8111 Phillips House V232235 02.08.05 stage 4.doc Version 1.30 Page 13 and consideration for the person s feelings, involving the person in all relevant decisions. Phillips House D53-D02 S8111 Phillips House V232235 02.08.05 stage 4.doc Version 1.30 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 & 23 Concerns are taken seriously, and appropriate action is being taken to protect residents. EVIDENCE: No complaints have been received by CSCI. One complaint has been made to the home by a resident, regarding this persons life goals, and the home has referred him to Bristol Social Services Department with a request for a Community Care Assessment. The residents felt that they can talk to the staff, and that staff listen to them properly. Some residents are unhappy about the behaviour of one person in the group, but felt that staff give them good support to deal with this. Due to many staff changes, both at the home and in Freeways organisation itself, the complaints procedure had become outdated by the time of the last inspection. This has now been updated and includes photos of the current staff, the new manager, the senior managers within the organisation, and this inspector. Freeways guidance on confidential reporting of malpractice - Do the Right Thing - is very clear and emphasises the duty to report any concerns. Phillips House D53-D02 S8111 Phillips House V232235 02.08.05 stage 4.doc Version 1.30 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) 24-30 The environment is pleasant and homely, and is well suited to residents needs. EVIDENCE: Most areas of the home have been decorated within the last year or so, and the overall impression is of a welcoming and pleasant environment, well-suited to the residents needs. Three of the bedrooms are below the minimum size of 10 square metres, and Freeways is currently looking at ways of improving this standard for existing residents. All bedrooms are single, and one has an ensuite toilet. It was a requirement of the inspection a year ago that rooms 7 and 8 were redecorated, and this has now been done in consultation with the residents who occupy those rooms. The toilet by the office and the bathrooms have also been redecorated, and a new shower seat has been fitted in the downstairs bathroom. It was also a requirement that window restrictors are fitted in line with health and safety guidelines, and the final restrictor was being fitted today. Phillips House D53-D02 S8111 Phillips House V232235 02.08.05 stage 4.doc Version 1.30 Page 16 Freeways and the homes staff have worked hard to make the back garden safely accessible to all residents, and the risk assessment on using the gardens has been reviewed by the homes manager. Care staff are also responsible for ensuring that the environment is kept clean and tidy. Residents take a share of this work, according to individual ability. Phillips House D53-D02 S8111 Phillips House V232235 02.08.05 stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 35 Residents benefit from a competent and well-trained team of staff. EVIDENCE: Rotas showed that there are two staff on each daytime shift. The manager works office hours and is additional to these basic staff levels. The then-acting manager was reminded at the inspection a year ago that the home needs to be able to demonstrate that each staff member has at least three paid days training per year. The staff records sampled showed that this minimum requirement has been greatly exceeded for all staff except one. The manager explained the circumstances of this failure to meet the standard, and is dealing with the issue under the homes disciplinary procedure. Phillips House D53-D02 S8111 Phillips House V232235 02.08.05 stage 4.doc Version 1.30 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) 37-43 The home is well run, people are properly consulted, and management systems promote safety. EVIDENCE: Nikki Jones is a Registered General Nurse with experience of working with elderly people with Alzheimers. One of the conditions of her registration as manager of this home is that she achieves NVQ 4 and the Registered Managers Award within a year, and another is that she received professional support from a suitable mentor. An experienced manager of another Freeways home is undertaking this role in addition to the supervisory support the manager receives from a member of Freeways senior management team. The manager and staff are strongly committed to empowering the people who live in the home, and have embarked on a review of every aspect of their work in an effort to identify ways of putting the residents more firmly at the centre of all decision-making. The team has recently reviewed the format of the key Phillips House D53-D02 S8111 Phillips House V232235 02.08.05 stage 4.doc Version 1.30 Page 19 worker log and redesigned it to prompt staff to discuss goals and action plans with residents. Residents gave examples of ways in which they are given choice and control, and conversations with them revealed that they are well informed about what goes on in the home. Staff felt similarly well supported by the manager, and described a democratic style of management. Task lists for each shift have been drawn up and are displayed on the office noticeboard. Staff have delegated responsibility for some aspects of the running of the home, according to individual interest and special skill. Some of the policies and procedures were sampled, and these gave clear and succinct guidance to staff. All guidance is regularly reviewed to ensure it is up to date. Thorough records are kept of residents cash or valuables handled by the home. Individual financial risk assessments are in the process being revised in consultation with residents. These are exceptionally thorough, and include sections on coin recognition, ability to sign ones name, ability to add or subtract sums, understanding of bank accounts and statements, ability to keep PINs safe, street awareness, and understanding of budgeting. Freeways Trust is currently looking at ways of enabling residents to retain even more control of their own finances, and hopes to set up a system in the near future whereby residents benefits are paid into their own accounts, and residents then make their own fee payments to the Trust. A member of Freeways senior management team visits the home unannounced every month and complete a detailed report of that visit. Residents and staff are invited to be involved in these visits and to give their views to senior managers, and a good sample of records are checked on each occasion. Phillips House D53-D02 S8111 Phillips House V232235 02.08.05 stage 4.doc Version 1.30 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 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Phillips House Score 3 3 2 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 4 3 3 3 D53-D02 S8111 Phillips House V232235 02.08.05 stage 4.doc Version 1.30 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 20 Regulation 17 Requirement A proper record must be kept of all medications received into the home. Timescale for action 2/8/05 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 Phillips House D53-D02 S8111 Phillips House V232235 02.08.05 stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Riverside Chambers Castle Street Tangier Taunton TA1 4AL 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 Phillips House D53-D02 S8111 Phillips House V232235 02.08.05 stage 4.doc Version 1.30 Page 23 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!