Inspection on 19/11/08 for Point House

This inspection was carried out on 19th November 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Point House 27/09/07

Point House 03/11/06

Point House 06/09/05

Point House 15/04/05

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 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Point House 2 Sprowston Road Norwich Norfolk NR3 4QN 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: Ruth Hannent Date: 1 9 1 1 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. They reflect the things that people have said are important to them: 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. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 29 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 29 Information about the care home Name of care home: Address: Point House 2 Sprowston Road Norwich Norfolk NR3 4QN 01603427249 01603427249 sarah@pointhouse.uk.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Carol Cropley,Mr Aubrey Cropley care home 22 Number of places (if applicable): Under 65 Over 65 22 5 learning disability Additional conditions: Date of last inspection A bit about the care home 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. Care Homes for Adults (18-65 years) Page 4 of 29 Care Homes for Adults (18-65 years) Page 5 of 29 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 Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 29 How we did our inspection: This is what the inspector did when they were at the care home The inspection was carried out by reading the information sent on the Annual Quality Assurance Assessment (AQAA). Surveys that were received from staff, health professionals and residents were read. Any notifications received by the commission since the last inspection from any stakeholders or the home themselves were studied. A visit to the home was undertaken lasting 6 hours where a tour of the building took place, records were looked at and resident, relatives and staff were spoken to. What the care home does well The home has a team of staff who work well together to ensure the home offers continuity of care. Each staff member know the residents likes and dislikes and understand their needs, which are recorded fully in the persons care plan. They also ensure that residents are actively involved in the day to day running of the home, from whos turn it is to do what chore, to the fun things like planning outings or what to have for the weeks meals. Residents do have person centered lifestyles with the home trying to ensure that interests and wants are met. The Care Homes for Adults (18-65 years) Page 7 of 29 families are encouraged to be part of the life at Point House and visitors are welcomed at any time. What has got better from the last inspection Since the last inspection the home has improved the recording and building of care plans. Involvement is continuing to improve with residents who interact with staff at all times. The manager now works with experts who she consults with and who assist in the completion of areas requiring reports such as fire risk assessments, asbestos surveys and health and safety surveys of the home. The training and qualifications for staff are supported by agencies from Norfolk and Suffolk who find the best support required to tailor it to the needs of Point House. The manager tries many resources before finding the most suitable and value for money. Care Homes for Adults (18-65 years) Page 8 of 29 What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Ruth Hannent Care Homes for Adults (18-65 years) Page 9 of 29 33 Greycoat Street London SW1P 2QF 02079792000 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 10 of 29 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 11 of 29 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 . Information about the home is offered to prospective residents to enable them to decide if the home is suitable. Prospective residents do have a full assessment to ensure the home can meet the residents needs prior to admission. Visits prior to admission are encouraged so prospective residents can trial the service offered. Evidence: The home has an assessment process that is used to build the care plan information. The person most recently admitted to Point House has been in the home for 12 months and on talking to the family the process of moving her in was carried out thoroughly and successfully, with the support of a Social Worker and the management of the home, working together with the family to make the transition as smooth as possible. Information about the home is shared with any prospect residents and visits to the home are encouraged prior to decisions being made as to the suitability of the home. Care Homes for Adults (18-65 years) Page 12 of 29 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 can be assured that their aims and personal goals will be reflected in their care plan. Residents are actively involved in decisions about their lives ensuring their well being. Evidence: Care plans were looked at in detail for 4 residents. The information is held in large comprehensive files with very clear details logged on the care requirements and plans for the future aims and objectives. Many of the plans contain life skills to be acheived and how the home supports the resident to develop their own skills. The pages were all signed by the residents to show they had taken an active part in the writing and reviewing of their care plan. On talking to the residents it was clear they know they had a care plan but it was not so easy to ascertain how much they understood about the document. On talking to the Manager, the home is looking at various styles of picture formats that will enable those who find reading difficult, an easier way to be Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: involved in the their own care plans. The 8 surveys received and the information written on the Annual Quality Assurance Assessment (AQAA) tells of the way residents interact and make decisions about their own lives. On talking to 2 residents it was clear that they are involved in all aspects of their care with the support of staff and outside agencies. On the day of this visit a Social Worker had been called in to discuss a plan for one of the residents. This resident was the centre of the conversation and was very much involved in the decision. Within each care plan a separate risk assessment is positioned by each care need to reflect at a glance the care activity and then any risk that is identified. Again the resident has been involved in these risk assessments with each risk signed by the resident. Each care plan folder also has a record of a description of the resident and a recent photograph in case an unexplained absence occurs. Care Homes for Adults (18-65 years) Page 14 of 29 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 do take part in the local community and have access to a variety of activities according to likes and dislikes. Families, friends and professionals are welcomed in the home and encouraged to be involved. Residents are involved in the decision making and responsibilities in their everyday lives ensuring their rights are respected. Residents do enjoy their meals and are actively involved in the choices. The balance between choice and healthy meals is not always clear to ensure a good diet for all is available. Evidence: On the day of this visit many of the residents were out taking part in various day time Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: activities. The home is positioned close to the town centre of Norwich and residents have access to lots of facilities. As well as taking part in life skills within the home such as shopping, cooking and cleaning they also visit the local pub, go out for meals, visit zoos, museums, bowling and the seaside. Within the home there are two large flat screen televisions with a DVD player, a computer with internet access and various games for all. According to one resident Bingo is great fun. Another said how much he enjoys the darts games and the surveys received all talked positively of the activities available. Visitors were coming and going throughout the day and were each welcomed and offered a drink. Two family members spoken to felt the home made them welcome and were planning a visit again the following week to take part in the annual review. Each resident has their own key to their bedroom door and staff do not enter without permission.The home also hold regular residents meetings that were noted took place in March, June, August and October. The residents spoken to feel they are listened to, even if sometimes they do not get what they want. The meals are planned with the residents and is usually part of the conversation in residents meetings. We saw the menus on display and noted that every few weeks residents plan the whole menu with whatever choice they would like. The home does try to keep a balance on the likes of residents and the need for a balanced meal. One concern was shared regarding one resident who needs to eat a low fat healthy diet and suitable food was not always available in the home. This was discussed with the relative and will be part of the agenda at the meeting due. Care Homes for Adults (18-65 years) Page 16 of 29 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 who do require personal care support will be offered it in a manner preferred. The health care support is met appropriately and timely to ensure the physical and emotional needs are in place. Residents are protected by the homes policies and procedures on managing medication. Evidence: The majority of the residents at Point House manage their own personal care and the home has no special aids or equipment in place to assist with transfers or personal care tasks except for the walk in showers. The Home has recently needed to support people with prompts and encouragement and the improvement in one particular situation has been noted and recorded in the daily progress reports. The residents spoken to said they would be happy to have assistance from any of the staff if they needed it. According to the Manager, the home has a good relationship with the local GP who is in Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: close contact with the home. The Senior on duty spoke of the support offered such as the reviewing of any new medication or if someone was ill. The residents are also visited by the Community Nurse as required and all visits and outcomes of the visits are recorded in the residents notes (seen). Also noted was the visits by the optician and the appointments made for hospital visits. The medication in the home is held in the locked staff room in a designated trolley. Creams and liquids are in a locked cupboard divided into pigeon hole type compartments for each resident. Some liquids were looked at that were dated correctly on opening and all the medication administration record sheets appeared correct. The charts are divided into three folders according to the time of day the medication is administered and each one held a current photograph of the resident. The staff who are trained to administer medication did not have a sample signature in the medication records folder but there was a copy held in the staff members personnel file. It is recommended that samples of signatures of staff who will be administering medication be held in the medication administration records. The returned medication is also recorded and signed by the pharmacist on a form that could be improved on to show clearly who was the staff member returning it and who is the Pharmacist receiving it. No resident during this visit was managing their own medication. One resident did start to manage her own and a risk assessment was seen but she no longer felt able and asked the staff to help her. This was recorded on the risk assessment and dated appropriately. Care Homes for Adults (18-65 years) Page 18 of 29 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 . Residents can be reassured that their concerns will be listened to and acted upon. Policies and procedure are followed to ensure residents are protected from abuse. Evidence: During the tour of the home it was noted that a complaints book was held in the staff room. The staff had recorded any small concern and the Manager will check the book and deal with any of the concerns. On talking to one resident and by all the surveys returned from residents all felt able to talk to the manager about any worries or concerns. A notification had been received at the Commission recently that showed the detail the home had gone into to rectify a situation. This was managed well and the outcome was satisfactory for all involved.The family members spoken to are happy to discuss their concerns and will ensure they are listened to in a meeting planned for the following week. The home does ensure that staff are trained in understanding and protecting any resident from potential abuse. Training records of staff are held in the office and are reviewed. On talking with a staff member they told of their understanding of blowing the whistle and each personnel folder seen had a signed copy of the policy on whistle blowing to prove staff had read the policy. Staff are employed only when they have a POVA first check and are not left unsupervised without a CRB in place. Care Homes for Adults (18-65 years) Page 19 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Some of the areas around the home are not homely giving an institutionalised appearance. Some parts of the home have poor lighting making the areas potentially unsafe. The carpets that are in the communal areas are stained and need replacing. Evidence: This home has been established as a care home for many years. The home has been extended in the last few years and can accommodate up to 22 residents. People with a physical disability could not live at the home due to the narrow corridors and stairs to get to the different floors. As you enter the home, once you have been through the entrance lobby, you come to a large, spacious lounge that then goes through to a large sitting/dining area with a residents kitchen. A resident was making his own drink and residents were giving him their requests. On walking the building it was noted that some areas are not very well lit especially where there is no natural light. The main concern is the number of bathrooms without windows that appeared dim and on pulling across the shower curtain made the area even darker. This appeared unsafe and brighter lighting needs to be in place. Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: The bedrooms are personalised with residents able to choose colour and furnishings when they arrive at the home. It was noted that a number of rooms had only washable flooring in the bedrooms and not carpet. This does not give the appearance of warmth and is a little institutionalised. The carpets in the corridors and communal areas are in need of replacing. Throughout the home there are areas that are being freshly painted but it appeared in many areas showing half completed rooms/corridors etc. Throughout the tour of the home all areas appeared clean and tidy. The laundry room is spacious and has commercial style washing machines to manage any temperature required. Each resident has their own small wash basket and use the laundry facilities as part of their life skills support. Care Homes for Adults (18-65 years) Page 21 of 29 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 . Residents are supported by competent and qualified staff. The storing of records of recruitment could be improved to ensure they are all in place. Staff are trained to carry out their roles effectively for the benefit of the residents. Supervision for all staff is carried out regularly. Evidence: On the day of this visit there were 2 carers on the early morning shift with another arriving at 10am. The Manager was around all day and an administrator until 2pm. With many residents out for day events the home had only 7 residents at home and no one appeared rushed and duties were being carried out in a timely manner. The staffing levels increase at the weekend which was seen on the rota in the office. This is to ensure the residents who want to participate in activities over the weekend have more staff around to offer the support. On looking at the records held in the office it was evident that the staff have a full induction following the Skills for Care programme. On checking the list of staff there were only 2 existing staff who are still to complete the NVQ 2 in care and once the new staff have completed their induction they also will be put forward for the award. 6 staff had returned a completed survey prior to this inspection and everyone stated the home support their induction and Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: training needs. A Senior staff member talked of the training and support offered to staff. Supervision notes were seen that are held with staff every two weeks during induction and then every 8 weeks thereafter. The personnel files were looked at with 4 picked at random from the selection. The home manager has been reducing the files and putting some away into storage. On searching it was difficult to find all the required paperwork for all staff members such as a second reference or forms of identification. Although they are available the search in the stores created problems and the need to have the paperwork easily accessible needs to be in place. Care Homes for Adults (18-65 years) Page 23 of 29 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 do benefit from a well run home. Quality Assurance procedures are in place for monitoring and reviewing the quality delivered. Safe working practices are in place to ensure the health, safety and welfare of residents are promoted and protected. Evidence: The registered manager has been working at the home for many years. She has achieved her Registered Management Award (RMA) in December 2007 with a certificate on display in the entrance to the home. She carries out her role competently and is very involved with the team of staff who interact well. The home conducted a quality assurance survey with questions sent out to relatives and health professionals. The response returned (seen during this visit) gave very Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: positive comments such as good support and improved dramatically. The manager said they do listen to comments and work on improving all the time. The home has records of the procedures used to ensure the home is safe at all times. Records seen on this visit included fire alarm checks carried out weekly, emergency lighting checks and water temperature checks. There is a current comprehensive asbestos survey report and a building fire risk assessment both seen and discussed. The accidents and incidents are recorded in a designated book and checked daily by the manager. Care Homes for Adults (18-65 years) Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes  No  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 26 of 29 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 Description 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 Description Timescale for action 1 24 23 The home must ensure the lighting in the home is suitable. 01/02/2009 The areas with low lighting could potentially be unsafe. 2 34 19 01/01/2009 The home must keep evidence of personnel in a locked cabinet that includes the information and documents of people working in the home. (Schedule 2) To ensure residents are protected and supported by people who are appropriately employed. 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 27 of 29 1 17 The home needs to consider the support required to ensure a varied and healthy diet is included and is balanced with the choices and likes of residents. It is recommended that all signatures of staff who are trained to administer medication have a copy of their signature within the records for medication administration. It is recommended that the form used for medication returns shows clearly who is signing the document. The completion of decorating/refurbishing/carpeting should be prioritised to prevent many areas looking incomplete. Residents own rooms should be carpeted to give a homely comfortable environment. 2 19 3 4 5 19 24 26 Care Homes for Adults (18-65 years) Page 28 of 29 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. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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