Inspection on 26/07/05 for Pippin House

This inspection was carried out on 26th July 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

Pippin House 11/01/07

Pippin House 09/02/06

Pippin House 19/10/04

Pippin House 04/05/04

Pippin House 18/09/02

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 Pippin House 8 Keyberry Park Newton Abbot Devon TQ12 1BZ Lead Inspector Mark Sharman Announced 26 July 2005 th 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. Pippin House D54-D07 S3776 Pippin House V224125 260705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Pippin House Address 8 Keyberry Park, Newton Abbot, Devon, TQ12 1BZ 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) 01626 354521 01626 360260 mary.parsons@rnid.org.uk RNID Care Services South West and Wales Ms Mary Jennifer Parsons Care Home 8 Category(ies) of Learning disability (8), Mental disorder, registration, with number excluding learning disability or dementia (8), of places Sensory impairment (8) Pippin House D54-D07 S3776 Pippin House V224125 260705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 19/10/04 Brief Description of the Service: Pippin House is a specialist resource operated by The Royal National Institute for Deaf People and registered to accommodate people between the ages of 18 and 65. All of the residents are profoundly deaf, but are in residential care due to a range of learning disabilities, including autistic spectrum disorder, and/or mental health problems. The focus of the work undertaken at Pippin House is to enable the residents to achieve their maximum potential in an environment of acceptance, and great emphasis is placed on achieving communication with them. The home is a detached house in a quiet residential area less than a mile from the town centre. It has a large, secluded garden and a car parking area. Each resident has a single bedroom with his/her own toilet and shower facilities, located over three floors. On the ground floor there is a communal lounge, dining room, conservatory, kitchen and laundry, and there is an office. There is no lift and the building is not suitable to accommodate anyone with significantly impaired mobility. Pippin House D54-D07 S3776 Pippin House V224125 260705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A pre-inspection questionnaire completed by the manager was received before the inspection. Also received were six comment cards completed by residents, five from relatives and two from care managers. The inspection was announced and lasted about eight hours. Six of the residents were spoken to, with help from the staff, and six staff were also spoken to. A small sample of care records was inspected, and a tour of the whole building was made. What the service does well: What has improved since the last inspection? No requirements or recommendations were made following the last inspection. Pippin House D54-D07 S3776 Pippin House V224125 260705 Stage 4.doc Version 1.40 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Pippin House D54-D07 S3776 Pippin House V224125 260705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Pippin House D54-D07 S3776 Pippin House V224125 260705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2. The needs, abilities and aspirations of any potential resident are assessed before admission to the home. EVIDENCE: In fact no new resident has been admitted for well over a year. In all cases a professional assessment is received by the home, and the assessment process always includes at the very least a visit and an overnight stay (more probably two nights). The new resident’s compatibility with the existing residents is an important factor taken into account. Two residents’ individual files were inspected, and one of these contained a Care Management assessment/care plan completed by a local authority care manager. All of the residents have come to Pippin House from previous residential placements, and in each case the previous care plans were provided to the home. Pippin House D54-D07 S3776 Pippin House V224125 260705 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9. There is an individual care planning system which provides staff with the information required to meet residents’ needs. The residents are encouraged and supported to make decisions in all areas of their lives, including activities involving an element of risk. EVIDENCE: Two of the residents’ files were seen which contained assessments of need, risk assessments and care plans. The care plans are reviewed by home staff (key worker, a senior support worker and the resident) three monthly when goals are reviewed, and there is an annual review to which the resident’s care manager and relatives (if appropriate) are invited. Examples of both types of review were seen. Residents may manage their own money to the extent that they are able, and one manages his weekly money without assistance. There were many examples of residents being enabled to take risks, following assessment of risk by staff. Some go out unaccompanied, for example out shopping or to college. Two of them use trains and buses alone, and another comes and goes as he wishes (and sometimes goes to a pub). One of the residents went to a local gymnasium during this inspection. Recent holiday activities have included Pippin House D54-D07 S3776 Pippin House V224125 260705 Stage 4.doc Version 1.40 Page 10 canoeing and abseiling, and photographs of residents doing this were displayed. There were many examples of risk assessments carried out in respect of activities undertaken by residents. Pippin House D54-D07 S3776 Pippin House V224125 260705 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 15 and 16. There is an emphasis on creating as normal a lifestyle as possible for the residents, including opportunities for education and work experience. They are able to have appropriate relationships with relatives and friends, and there is substantial contact with the local community. EVIDENCE: Most of the residents’ activities take place in the community. College courses attended by residents were just coming to an end for the summer holiday, although two residents did attend the local adult education centre on the day of the inspection. Several of them also attend courses at the Teignmouth and Dawlish colleges, such as keeping fit, pottery, woodwork and carpentry. Work placements have been found in the community, and one resident does some paid gardening work for a number of acquaintances. Local facilities are used regularly, such as a local gymnasium/leisure centre, adult education centre, shops and pubs. The home has ample transport provision, having its own modern minibus and a car. Some of the residents regularly go to a local supermarket on their own, and most of them were looking forward to going to Pippin House D54-D07 S3776 Pippin House V224125 260705 Stage 4.doc Version 1.40 Page 12 a local discotheque in the evening. All are going on holiday together this summer, except one who prefers to stay at the home. Most have regular contact with their families, and their bedrooms contained a lot of family photographs. One said that she had just had a holiday with her mother. The home is non-institutional in appearance and looks like a large family house. It was very clear from observation that the staff respect the residents’ privacy and dignity, for example getting an invitation before entering bedrooms. Bedroom doors are fitted with locks, and the residents were seen using their keys (which also operate the lock on the front door of the home). Pippin House D54-D07 S3776 Pippin House V224125 260705 Stage 4.doc Version 1.40 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 standard(s) 18, 19 and 20. The residents’ health is monitored very carefully, and external professional help is requested when felt necessary. There is a safe medication system. EVIDENCE: Personal support was provided in a way which maintained residents’ privacy and dignity. Times for getting up etc. are flexible (subject to commitments like attending college), and on the morning of the inspection two residents chose to “lie in” until late in the morning. Staff of both genders are employed, and the manager assigns key workers in a sensitive way. All residents are registered with a general practitioner. The individual files contained substantial evidence of health needs being attended to, and all health appointments are recorded. The files included a weight chart. All residents have six monthly dental checks (plus hygienist), and have an annual health check (an appointment letter was seen). The manager demonstrated detailed knowledge of the residents’ health needs. The home has a policy and procedure for the management of residents’ medication, which was securely locked away. A sample of medication administration recording sheets was seen. Staff authorised by the manager to administer medication are specifically designated, and have had in-house training. The issue of training was discussed, and professional training for Pippin House D54-D07 S3776 Pippin House V224125 260705 Stage 4.doc Version 1.40 Page 14 some staff is being arranged. This is recommended for all staff who administer medication. One of the residents applies his own creams. Pippin House D54-D07 S3776 Pippin House V224125 260705 Stage 4.doc Version 1.40 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 standard(s) 23. There are satisfactory arrangements to ensure that residents are protected from abuse. EVIDENCE: The RNID adult protection procedure was seen, and the home also has a copy of Devon County Council’s guidance on abuse. The staff spoken to said they have access to the home’s policies and procedures, and they were aware of the RNID whistleblowing policy. There was discussion with the manager about a recent incident of aggression by a resident towards a staff member. Some staff have received training in non-abusive intervention techniques. The personal money account of one resident was checked, and the cash held on his behalf was correct. The manager said that the residents’ personal money is checked as part of the spot checks carried out by regional staff (from Bath) regularly. Pippin House D54-D07 S3776 Pippin House V224125 260705 Stage 4.doc Version 1.40 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 standard(s) 24 and 30. Pippin House is comfortable and homely and with the appearance of a family house. It was clean and hygienic. EVIDENCE: The home is located in an attractive residential area and is non-institutional in appearance. It has a large garden (with greenhouse) which one of the residents helps to maintain. The communal rooms are comfortable and quite spacious. Some of the residents proudly showed the inspector their bedrooms, which were personalised and cosy. Each of them has his/her own toilet and shower facilities. There is a laundry room equipped with modern washing machines and dryer, and there is no need to carry laundry through the kitchen or dining room. Pippin House D54-D07 S3776 Pippin House V224125 260705 Stage 4.doc Version 1.40 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) 34 and 35. Staff morale is high, with a dedicated and enthusiastic workforce. The staff receive training appropriate to working with this client group, and the home’s recruitment practice is thorough. EVIDENCE: There is a standard recruitment procedure for new staff which is co-ordinated by the RNID regional office, including written references and a Criminal Records Bureau disclosure. Some staff files were seen and a sample of references and disclosures. The manager said that particular note is taken of the residents’ reactions to prospective new staff. The staff spoken to said that training opportunities are good. Half of the staff have NVQ level 2 or above, and many copy training certificates were seen in the staff files. There has been substantial training in the last year, a list of which was provided. The induction training for new staff is LDAF accredited. Pippin House D54-D07 S3776 Pippin House V224125 260705 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) 37, 39 and 42. There are a number of quality monitoring systems in place, and satisfactory arrangements for ensuring the residents’ health and safety. EVIDENCE: The views of the residents are sought continuously, and there are regular meetings with residents and senior staff. There are three monthly reviews of individual residents’ goals and progress. There is management overview from the RNID. This includes unannounced financial audit visits from time to time, and six monthly visits by the RNID’s national health and safety officer. The service manager provides monthly reports on the conduct of the home. There is a fortnightly staff meeting at the home. The registered manager is very experienced with this client group and is qualified in line with the National Minimum Standard (her RMA and NVQ4 care certificates were seen). With regard to health and safety all staff receive training in food hygiene, fire safety and first aid. Professional fire training has been arranged for the staff team in September this year. All hot water outlets (except one in the kitchen) are temperature regulated, and the manager said that upstairs windows are Pippin House D54-D07 S3776 Pippin House V224125 260705 Stage 4.doc Version 1.40 Page 19 restricted on a risk assessment basis. Risk assessments are carried out in respect of each resident, and the manager said they are not considered to be at risk from hot radiator surfaces. The RNID national health and safety officer does a health and safety audit at the home twice per year. Pippin House D54-D07 S3776 Pippin House V224125 260705 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 3 x x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 x Standard No 31 32 33 34 35 36 Score x x x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Pippin House Score 3 4 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x 3 x D54-D07 S3776 Pippin House V224125 260705 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 20 Good Practice Recommendations All staff should receive professional medication training. Pippin House D54-D07 S3776 Pippin House V224125 260705 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP 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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