Inspection on 15/04/05 for Point House

This inspection was carried out on 15th April 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Point House 19/11/08

Point House 27/09/07

Point House 03/11/06

Point House 06/09/05

Point House 07/02/05

Point House 29/06/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Point House 2 Sprowston Road Norwich Norfolk NR3 4QN Lead Inspector Jerry Crehan Unannounced 15th April 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. Point House I55s27360pointhousev221395150405(4).doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Point House Address 2 Sprowston Road Norwich NR3 4QN 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) 01603 427249 01603 419339 Mr Aubrey Cropley Mrs Sarah Jane Buckles Care Home 22 Category(ies) of Learning disability (22) registration, with number of places Point House I55s27360pointhousev221395150405(4).doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: The home is registered to accommodate a maximum of 22 service users who have learning disability. There were 10 service users in residence at the time of the inspection. Date of last inspection 7th February 2005 Brief Description of the Service: Point House is a care home offering accommodation for up to 22 adults with learning difficulties. The home is situated about 1 mile from the centre of Norwich and is close to many amenities. There are local shops and a regular bus service to the city. The home has bedrooms on both the ground and first floor with easy access to bathroom/shower facilities. There is a car parking area at the front and side of the property with a paved patio at the rear of the property. Point House I55s27360pointhousev221395150405(4).doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 6 hours. Opportunity was taken to tour the premises, look at care records and policies, and talk to service users relatives and staff. Most of the eleven service users at home at the time of the inspection were seen and spoken to during the day. What the service does well: What has improved since the last inspection? What they could do better: The provider has been required to ensure that all appropriate employment checks on prospective staff are carried out for the protection of service users. The newly developed pre-admission tool for assessing the needs of prospective service users should be robustly used to full effect to assist in ensuring that the home can adequately meet the needs of those service users referred. A system should be implemented to keep on top of the homes repairs and maintenance, otherwise it is clear that the heavy impact service users have on the environment will compromise the homely feel to Point House. Point House I55s27360pointhousev221395150405(4).doc Version 1.20 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Point House I55s27360pointhousev221395150405(4).doc Version 1.20 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 Point House I55s27360pointhousev221395150405(4).doc Version 1.20 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 & 4 Some progress had been made in assessing the aspirations and needs of prospective service users since the last inspection, though there is scope for further improvement. EVIDENCE: Since the last inspection the tool used by the home for preadmission assessments has been further developed. However, on review it appeared that the new tool had not been used to full effect. Needs arising from acknowledged mental health needs had not been robustly explored or explained in documents reviewed. The opportunity for prospective service users to visit the home prior to admission has clearly been available for some time. Service users who have lived at the home for several years indicated that they had been provided with this opportunity. A service user more recently accommodated said that they ‘had a look around before I moved here, and they let me stay for the afternoon’. Point House I55s27360pointhousev221395150405(4).doc Version 1.20 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 There is a consistent care planning system in place that is completed in conjunction with service users. Service users make decisions and choices independently, and receive support where appropriate. There does not appear to be regular, or systematic review of individual aspirations. EVIDENCE: Individual care plans had clearly been developed with service users. Many care plans seen were signed, and a small group of service users explained that they had helped with their care plans. One person stated that ‘staff will help us with some things, but leave us to do what we can do’. It was apparent that the home respected service users right’s to make decisions. Evidence of specific ‘contracts’ was seen aimed at supporting this right and limited only through the assessment process. As individual aspirations change over time, so the individual care plan should reflect these changes. It was not clear that plans were the subject of ongoing review at intervals frequent enough to address aspirations for some service users. Point House I55s27360pointhousev221395150405(4).doc Version 1.20 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 15 & 17 The home caters adequately for the lifestyle of service users with diverse needs and preferences. Those service users who remain at Point House during the day do not benefit from an extended activities menu. EVIDENCE: A proportion of service users from Point House attend day care services outside of the home in supported or other community settings. The home’s activities coordinator in making toys and designing cushions with textiles was supporting a number of service users. This option is available for two days each week. One service user indicated that there was ‘not much to do on other days’. Service users described participation in local community activities such as voluntary work for the meals on wheels service and ‘People First’ group. A relative of a service user was visiting the home at the time of the inspection. Other service users described contact with friends and relatives inside and outside the home. Service users indicated that there was access to a pay phone in the home, and that staff were good at supporting their privacy when making or receiving calls. Point House I55s27360pointhousev221395150405(4).doc Version 1.20 Page 11 Care staff prepare meals at the home. Service users said that they were satisfied with their diet and that there was choice available if menu options were disliked. Point House I55s27360pointhousev221395150405(4).doc Version 1.20 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 & 20 Service users personal and healthcare needs are well attended to. Use of risk assessment should be expanded where service users self medicate. EVIDENCE: Feedback from service users reflected that they felt well cared for and (as already indicated earlier in this report), that service users have the autonomy to independently attend to those aspects of their care they are able to. Medication records seen were found to be satisfactory. Accredited training for staff not yet trained in the administration of medicines was said to be in the process of being sourced from a pharmacist. However, these staff, it was said, does not have responsibility for administering medication. Some service users indicated that they are responsible, where appropriate, for administering their own medication and supported by risk assessments with the exception of inhalers for the treatment of asthma. Point House I55s27360pointhousev221395150405(4).doc Version 1.20 Page 13 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 Arrangements for protecting and responding to the concerns of service users and staff are satisfactory. EVIDENCE: A procedure for responding to allegations of abuse is in place. Staff spoken to appeared aware of the procedure and its function. Service users indicated that if they had a concern they would speak to either the manager or their key worker. Point House I55s27360pointhousev221395150405(4).doc Version 1.20 Page 14 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 home provides largely safe and homely environment. However, open fire doors, minor repairs and notices throughout the home compromise this. EVIDENCE: The home provides an environment that is in a reasonable state of repair, though it would appear that minor repairs are not dealt with swiftly. This is evidenced by a shower door that does not close, missing bath plugs, a missing toilet seat, a broken lock to a male toilet door, two holes in the kitchen wall (one next to light switch wiring). Toilets and bathrooms would benefit from towel rails as hand towels had been discarded on the floor in places. It is recommended that regular environmental audits are carried out and repairs required noted and addressed. A number of designated fire doors were not closed, or where appropriate, locked. There should be a review of the large number of posters and notices (including the use of ‘private’ signs) in evidence throughout the home. These create an institutional feel to a home that otherwise maintains a relatively homely ambience. The home appeared clean and hygienic, though could be improved with the fitting of towel rails for service users. Point House I55s27360pointhousev221395150405(4).doc Version 1.20 Page 15 Point House I55s27360pointhousev221395150405(4).doc Version 1.20 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 & 34 The procedure for the recruitment of staff is not robust and does not provide the safeguards to offer adequate protection to service users at the home. Service users benefit from a staff group and individual key workers who are clear about their role. EVIDENCE: Service users spoke favourably about the staff group at the home. A number of service users remarked on the importance to them of the support provided by their key worker. A clear job description for care staff was in evidence, a copy of this available on the staff notice board. At the home’s last inspection it was noted that a new staff member had been recruited without CRB, POVA check or references. Although CRB and POVA checks have been obtained, there remains only one ‘telephone’ reference on file. These recruitment practices do not afford service users with protection. A thorough recruitment procedure should be demonstrably in place ensuring the protection of service users. Point House I55s27360pointhousev221395150405(4).doc Version 1.20 Page 17 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) 38 & 42 The home appears well managed through the joint efforts of the manager and deputy manager. Health and safety matters are compromised by recruitment procedures, risk assessment and fire door practices. EVIDENCE: The manager and deputy manager take responsibility for separate areas of the running of the home in order to avoid confusion. Both staff and service users alike indicated that they felt the home was well run and that the manager was approachable and pleasant. Relevant health and safety training for staff was in evidence including moving and handling, first aid, fire and food hygiene training. Extending training to include infection control is recommended. Matters previously referred to in this report, namely recruitment practices, risk assessment and fire door practices, compromise the health and safety of service users. Point House I55s27360pointhousev221395150405(4).doc Version 1.20 Page 18 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 x 3 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 x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 Point House x 3 3 x 3 Standard No 31 32 33 34 35 36 Score 3 x x 1 x x I55s27360pointhousev221395150405(4).doc Version 1.20 Page 19 16 17 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 x 2 x Standard No 37 38 39 40 41 42 43 Score x 3 x x x 2 x Point House I55s27360pointhousev221395150405(4).doc Version 1.20 Page 20 Yes 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 2 Regulation 14(1)(a) Requirement The registered person shall not provide accommodation unless the needs of the service user have been assessed by a suitably trained person, in consultation with the service user or their representative. The registered person must undertake and record risk assessments for service users wishing to self-administer medicines in order to assist in ensuring such medicines are safely managed. Risk assessments must be reviewed at regular intervals as appropriate. The registered person must ensure that all appropriate employement checks are carried out prior to employment. Timescale for action 30 April 2005 2. 20 14 30 April 2005 3. 34 19 & Schedule 2 Immediate and Ongoing RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Point House I55s27360pointhousev221395150405(4).doc Version 1.20 Page 21 1. 2. 3. 4. 5. 6 12 24 24 42 It is recommended that further attention should be given to the ongoing review of individual aspirations. It is recommended that service users who remain at Point House during the day benefit from an extended activities menu. It is recommended that regular environmental audits are carried out and repairs required noted and addressed. It is recommended that there should be a review of the large number of posters and notices (including the use of ‘private’ signs) in evidence throughout the home. It is recommended that training for staff is extended to include infection control. Point House I55s27360pointhousev221395150405(4).doc Version 1.20 Page 22 Commission for Social Care Inspection 3rd Floor, Cavell House St Crispins Road Norwich NR3 1YF 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 Point House I55s27360pointhousev221395150405(4).doc Version 1.20 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. 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