Inspection on 03/11/06 for Point House

This inspection was carried out on 3rd November 2006.

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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Point House 19/11/08

Point House 27/09/07

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 09/07/2008.

CARE HOME ADULTS 18-65 Point House 2 Sprowston Road Norwich Norfolk NR3 4QN Lead Inspector Mr Jerry Crehan Key Unannounced 3rd November 2006 09:30 Point House DS0000027360.V318809.R01.S.doc Version 5.2 Page 1 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 Point House DS0000027360.V318809.R01.S.doc Version 5.2 Page 2 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 Stationery 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 DS0000027360.V318809.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Point House Address 2 Sprowston Road Norwich Norfolk NR3 4QN 01603 427249 01603 419339 sarah@pointhouseuk.com www.pointhouse.uk.com Mr Aubrey Cropley Mrs Carol Cropley Miss Sarah Jane Cropley Care Home 22 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Category(ies) of Learning disability (22), Learning disability over registration, with number 65 years of age (5) of places Point House DS0000027360.V318809.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 6th September 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 DS0000027360.V318809.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection compromised an unannounced visit to the home that took place over 7.5 hours on 3rd November. Opportunity was taken to tour the premises, look at care records and policies, and communicate with the home’s service users in addition to its staff the deputy manager and the manager. The inspection report reflects evidence from inspection of Key Standards and other National Minimum Standards. Ten comment cards were received from service users prior to the inspection. These reflect the positive view tenants hold about their home. Five respondents indicated that they do not go shopping for food. The range of weekly fees for the home is from £348. What the service does well: What has improved since the last inspection? The arrangements for the storage and recording of medication at the home have improved following additional training since the last inspection. A requirements and recommendations made at the last inspection have also been acted upon. There is evidence of considerable internal redecoration around the home and improvement to the external patio area to the rear of the home. An ongoing programme of refurbishment and redecoration is required as service users have a heavy impact on the environment. Point House DS0000027360.V318809.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Point House DS0000027360.V318809.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Point House DS0000027360.V318809.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 & 5 Quality in this outcome area is adequate as not all of the required information is available to potential servcie users. However, the needs and aspirations of people thinking about moving into the home are assessed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service has a ‘Statement of Purpose’ that does not set out all of the information required by Regulation. The size of rooms in the home, the fire precautions for the home and the home’s procedure for dealing with complaints (including timescales) are not included. The manager explained that this information is available but has not been included into the Statement of Purpose document itself (see requirement). Assessments (including pre-admission assessment) for recently accommodated service users were in evidence and were satisfactory. The manager or deputy manager is responsible for pre-admission assessments. There was evidence of the home’s standard contract having been issued to service users and of the placing authorities contract. Contracts seen do not provide sufficient information regarding transport costs that may be applied, whether the cost of a holiday is covered within the basic contract price, or any other extras. The manager indicated that she is currently revising the standard form of contract; this was seen and would satisfactorily address the issues above. Point House DS0000027360.V318809.R01.S.doc Version 5.2 Page 9 Point House DS0000027360.V318809.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, & 9 Quality in this outcome area is good as service users needs and goals are reflected in their individual plan. Service users make decisions about their lives with assistance as necessary and are supported to take risks as part of an independent lifestyle. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A sample of individual care plans was reviewed. These indicate service user involvement, set out health and care needs, reflect goals or aspirations for each service user. There was evidence of care plan review taking place at least six monthly and involving service users. Service users spoken with were familiar with the review process and indicated that they attend their reviews. Care plans for service users include individual goal setting, for example to attend a men’s group for one service user and to improve cooking skills for another. Additional day-to-day information regarding tenants is recorded in the home’s diary and in a communication book (see recommendation). Point House DS0000027360.V318809.R01.S.doc Version 5.2 Page 11 There is evidence of the involvement of local independent advocacy services to support service users where they wish, and evidence from service users of their active involvement in self-advocacy groups. A range of appropriate risk assessments for service users to support independence and safety underpins the care plans. A risk assessment should be in place for a service user who prefers to have their bedroom door propped open at night and for periods during the day. This should consider the potential risk from fire of the arrangement (see requirements). Point House DS0000027360.V318809.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good. The home caters effectively for the lifestyle abilities and preferences of service users. Links with the community resources are well maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Some service users prefer to remain at the home to take part in activities during the day. These service users play their part in the day to day running of the home, assisting in cooking or domestic tasks, or going shopping. Other service users have access to further education at Norwich City College, attend voluntary work placements, or attend day centres in Norwich. Service users were supported to gain access to local community facilities during the inspection; others accessed the local community independently. The home has its own transport. Staff and service users referred to participating in leisure activities at the home such as bingo, snooker, darts board games and ‘personal grooming’. As indicated above, the home’s standard form of contract is currently being revised, and should include arrangements (where relevant) for a holiday as Point House DS0000027360.V318809.R01.S.doc Version 5.2 Page 13 part of the basic contract price. Holidays to Break’s Sandcastle centre have been accessed in the past though this has ceased due to the service’s closure. The manager indicated that alternative holiday options were being explored, with the involvement of service users. Service users spoken with stated that they could see friends or relatives when they wish. During the inspection a service user was supported by staff to make contact with a relative by telephone. Service users have unrestricted access to all areas of the home except office areas and other people’s bedrooms. Service users choose to hold their own bedroom door keys. Service users have lockable storage facilities within their own rooms, all of which are single. Carers and managers were observed talking to and interacting with service users throughout the inspection visit. First names are used as the preferred form of address for carers. Meals at the home are prepared by a part time cook and by care staff. All staff indicated they had received basic food hygiene training, which was supported in training records seen. The main meal on weekdays is taken in the evening, and at weekends during the day. Service users comments about the food on offer was positive, indicating that meals were good and that there was choice. Menu’s seen supported this with a choice of three main meal options, including special diets. The kitchen appeared well equipped; freezers, fridges and cupboards were well stocked. Fridge and freezer temperatures are maintained. The variable temperature of the ‘client kitchen fridge’ was brought to the manager’s attention. The manager explained this might be due to the door being left open. This is a matter that requires ongoing monitoring. It was recommended that fresh then frozen lunch meats are marked with the day they are defrosted; to ensure that they are used within safe specified timescales (see recommendations). Point House DS0000027360.V318809.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. Service users receive support in the way they require. Their personal and healthcare needs, including medication, are well attended to. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Personal care was provided to service users in such as way as to ensure their privacy and dignity. Some service user require assistance with personal care and hygiene, others require prompts and other indirect support from staff. The individual preferences of service users are set out in their care plans and in ‘pen picture’ records. Key workers are designated to take responsibility for aspects of care, planning and advocacy with service users. Records reviewed indicate that service users health is carefully monitored and that access to GP’s, dental services, flu vaccination, diabetes review, eye screening and foot screening are being supported. There are service users accommodated at the home who have responsibility for their own medication. These arrangements are supported through risk assessment and the provision of a suitable safe storage facility. On review of medication no discrepancies were identified, and records were very good. There are good arrangements for the storage of medication and controlled Point House DS0000027360.V318809.R01.S.doc Version 5.2 Page 15 medication. It is recommended that medication due to be returned to the pharmacy be stored separately from other medication to reduce the risk of its being wrongly administered (see recommendations). Point House DS0000027360.V318809.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 &23 Quality in this outcome area is good. Arrangements for protecting and responding to the concerns and complaints of service users and staff are good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a detailed complaints procedure and information on how to make complaints is available in the home. Information in comment cards suggests that service users have an awareness of how they may make a concern or complaint known; generally this is by telling a support worker. All of the comment cards received from service users indicate that they feel safe at the home and that they know who to tell if they are unhappy. Service users responses usually indicate that they would tell their key worker if they were unhappy. The home’s complaints record was reviewed. The outcome of the complaint are recorded and signed off by either the manager or deputy. The manager confirmed that she had received no complaints from those outside of the home since the last inspection. The complaints procedure is posted in the entrance foyer of the home and there is a comments book available also. Records of tenant’s monies were reviewed and were satisfactory. The home has relevant policies and procedures, which relate to the protection of service users from abuse. A procedure for responding to allegations of abuse is in place that carers are aware of. Care staff spoken to and records seen provided evidence of relevant training in recognising signs of abuse. Point House DS0000027360.V318809.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is adequate A comfortable and safe environment internal environment is provided for service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The premises are suitable for the homes stated purpose. The interior accommodation is in a reasonable state of repair, with adequate furnishings and fittings. Service users have a heavy impact on the environment. A service user returning home from the pub the night before the inspection had removed signage from other service users bedroom doors, and had put a hole in a toilet door. The manager was observed addressing the resulting arrangements for repair on the day of the inspection. There is evidence of considerable internal redecoration to improve the appearance of the home. The home is accessible for any person using a wheelchair to mobilise. The home is in a good state of repair externally. There is a paved BBQ area with seating and tables. There is new external signage, which the deputy Point House DS0000027360.V318809.R01.S.doc Version 5.2 Page 18 manager indicated as being necessary as it is difficult for visitors to the home to find it. She also indicated that the home has been confused with a mobility equipment shop next door. All bedroom doors are lockable. Toilets and bathroom areas likewise – a broken lock identified at the last inspection had been repaired. The deputy manager indicated that the shower was not working, however, there are sufficient baths available to service users. Premises were clean and hygienic. Point House DS0000027360.V318809.R01.S.doc Version 5.2 Page 19 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good. A competent staff team who have access to good induction and ongoing training supports service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There were sufficient numbers of staff on duty at the time if the inspection visit to meet the needs of the twenty service users accommodated. There is a staff group of eleven care staff excluding the manager and deputy. Five care staff have achieved NVQ 2 training (or above), a further three staff are currently undertaking this training (see requirements). From discussion with support workers and a review of personnel files, it was evident that tenants are protected by good recruitment practices. Evidence of POVA and CRB checks and references were seen in files. A concern has been raised by another care provider that they had been informed by Point House that they do not provide staff references. This was discussed with the manager shortly after the inspection. The manager confirmed that she had sought advice from ACAS and that the home now has a ‘no-reference’ policy. However, the manager added that where she had particular concerns about somebody she would pass these on verbally. Point House DS0000027360.V318809.R01.S.doc Version 5.2 Page 20 Records for staff training indicate access to full induction training for staff. This was confirmed in discussion with support workers. Evidence of training for staff in first aid, fire, manual handling, basic food hygiene, infection control and medication were seen. Staff have also received training on recognising signs of abuse. Point House DS0000027360.V318809.R01.S.doc Version 5.2 Page 21 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. The systems for service user consultation are good and extend to others associated with the home. Relevant health and safety policies promote the health and safety of service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has significant experience and has recently successfully completed the Registered Manager’s Award. Staff at the home commented that they have confidence in the manager and find her approachable. Quality assurance strategies include questionnaires for those associated with the home. The manager stated that she provides individual responses to those who make comment, and that results of quality surveys are published on the home’s website. A comments book is available in the foyer of the home to any Point House DS0000027360.V318809.R01.S.doc Version 5.2 Page 22 visitors. Some comments had been entered, and these were complementary. Staff and service user meetings take place regularly and minutes of these were seen during the inspection visit. Relevant health and safety policies are in place, and training for staff, including moving and handling, first aid, fire and food hygiene training, support practices. A recent comprehensive fire safety risk assessment had been carried out by a consultant commissioned by the home. The manager had evidently acted upon recommendations. Point House DS0000027360.V318809.R01.S.doc Version 5.2 Page 23 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 Standard No Score 1 2 2 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Point House DS0000027360.V318809.R01.S.doc Version 5.2 Page 24 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 YA1 Regulation 4(1)(c) & Schedule 1 13(4)(a) Requirement Timescale for action 30/11/06 2. YA9 3. YA32 18(1)(a) The registered person must ensure that the Statement of Purpose consists of matters listed in Schedule 1. The registered person must 03/11/06 ensure that all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety. The registered person must 31/12/06 ensure continued progress toward meeting a minimum ratio of 50 NVQ 2 (or above) trained staff. 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 YA6 Good Practice Recommendations It is recommended that the use of the home’s communication book for recording information about tenants cease, as this information may not meet the DS0000027360.V318809.R01.S.doc Version 5.2 Page 25 Point House 2. 3. YA17 YA20 requirements of Data Protection Legislation. It is recommended that fresh then frozen lunch meats are marked with the day they are defrosted; to ensure that they are used within safe specified timescales. It is recommended that medication due to be returned to the pharmacy be stored separately from other medication to reduce the risk of its being wrongly administered. 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