Inspection on 06/09/05 for Point House

This inspection was carried out on 6th September 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

Point House 19/11/08

Point House 27/09/07

Point House 03/11/06

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 Jerry Crehan Announced 6 September 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. Point House i55 s27360 pointhouse v241082 060905 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Point House Address 2 Sprowston Road, Norwich, Norfolk, NR3 4QN 01603 427249 01603 419339 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) Mr Aubrey Cropley Miss Sarah Jane Cropley Care Home 22 Category(ies) of Learning disability (22), Learning Disability over registration, with number 65 (5). The total number not exceed 22. of places Point House i55 s27360 pointhouse v241082 060905 stage 4.doc Version 1.40 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 20 service users accommodated at the home at the time of the inspection. Date of last inspection 15th April 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 i55 s27360 pointhouse v241082 060905 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over 6 hours. Opportunity was taken to tour the internal and external premises, look at care records and policies, and communicate with many of the service users accommodated at the time of the inspection both individually and in groups. Staff members and the manager were also spoken to. A single comment card was received prior to the inspection from a service user, which was favourable about the service provided by the home. What the service does well: What has improved since the last inspection? What they could do better: Further attention is required to address the home’s arrangements for medication administration, recording and storage to comply with the Standard and to reduce potential risks. Point House i55 s27360 pointhouse v241082 060905 stage 4.doc Version 1.40 Page 6 Consideration should be given to the operation of a system for calculating staff numbers required to meet the current and changing needs of service users. The promotion of the outdoor area would enhance the communal space offered by the home. 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. Point House i55 s27360 pointhouse v241082 060905 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 Point House i55 s27360 pointhouse v241082 060905 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) 1, 2, 5 There is adequate information for prospective service users and others about the home and its services. EVIDENCE: Point House provides clear information that would enable prospective service users to make an informed choice as to whether and how the home could meet their needs. The home has developed an effective tool to assist in undertaking preadmission assessments. At the home’s last inspection a requirement was made, as there was evidence that this tool had not been used to its full effect in assessing the needs of a prospective service user. On re-inspection no new service users have been accommodated, however, this issue will be addressed at future inspections. Individual contracts setting out terms and conditions of residence were evident in service users files seen. Point House i55 s27360 pointhouse v241082 060905 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) 6,8,9,10 There are good care planning and risk assessment systems in place. Service users are able to participate in and influence the running of the home. EVIDENCE: Service users spoken to appeared aware of their individual plans and evidently assisted in their completion. Individual plans have been refined since the last inspection, and it is clear that plans were the subject of ongoing review at intervals frequent enough to address aspirations for service users. Service users spoken to individually and as a group described how are consulted about, and participate in the running of the home. A service user described ‘residents meetings’ to discuss issues and to deal with problems or disagreements. Service users also described choices in relation to meals and menu setting, indicating that there is now a choice of main meal each day. Service users indicated that their opinion is sought in relation to the appointment of new staff and prospective service users also. There was evidence of risk assessments covering a range of areas associated with supporting independence. Risk assessments are regularly reviewed. Confidentiality issues are evidently understood at the home. There are secure arrangements for the storage of records. Point House i55 s27360 pointhouse v241082 060905 stage 4.doc Version 1.40 Page 10 Point House i55 s27360 pointhouse v241082 060905 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) 11, 14, 16 The home satisfactorily caters for the lifestyle preferences of service users, and promotes independence. EVIDENCE: The majority of service users at the home attend off site day services; however, a programme of activities is available at the home also. One service user spoken to indicated that they had recently secured work with a local employer, and was looking forward to the independence this would provide. Another service user described the recent opportunity to attend the ‘Special Olympics’. At the time of the inspection a number of service users were undertaking a bowling trip. It was apparent that there has been little opportunity to utilise the home’s patio area during the summer. This is an important communal area as there is limited outdoor space available at the home. Service users spoken to appeared interested in the possibility of having a barbecue in this area. Rights and responsibilities are respected and recognised at the home; service users have unrestricted access to all areas except the manager’s office and other people’s bedrooms. Service users choose to hold their own bedroom door keys. Point House i55 s27360 pointhouse v241082 060905 stage 4.doc Version 1.40 Page 12 Point House i55 s27360 pointhouse v241082 060905 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) 19 & 20 Arrangements for the safe handling and administration of medicines require further development; otherwise service users healthcare needs are well attended to. EVIDENCE: There is evidence of access to a variety of health professionals for service users at the home, including the community nurse, therapists and district nurse. A number of service users have responsibility for their own medication. These arrangements are supported by risk assessments, which have been extended (since the last inspection) to include the use of inhalers for the treatment of asthma. Risk assessments are evidently reviewed at appropriate intervals. A review of medication administration records highlighted a failure, in some instances, to indicate the prescribed dose on the medication administration record, a factor that presents an increased risk of error in administration. Accredited medication training has been provided within the home since the last inspection. The home’s arrangements for controlled medicines do not meet the standards. It is recommended that these medicines be kept in a controlled drugs register as an additional level of security, and as a matter of good practice. It is also recommended that these are stored in a cabinet that meets the Misuse of Drugs (Safe Custody) Regulations 1973 for the same reasons. Point House i55 s27360 pointhouse v241082 060905 stage 4.doc Version 1.40 Page 14 Point House i55 s27360 pointhouse v241082 060905 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) 22 Arrangements for making complaints are satisfactory. EVIDENCE: The home has a complaints procedure in place. Service users spoken to indicate that they could approach the staff of the manager if they had a concern or a complaint. Point House i55 s27360 pointhouse v241082 060905 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) 25,26,27,28,29 A comfortable and safe standard of accommodation, suitable to individual need is provided. EVIDENCE: The home provides an environment that is in a reasonable state of repair. Service users bedrooms that were seen contained evidence of personal possessions. Every bedroom is lockable and has lockable storage facilities for safe storage of belongings. Service users have elected to look after their own room keys. There are adequate toilet and bathroom facilities to meet individual need; a broken lock to the door of a toilet on the first floor does not support privacy. The home benefits from two large communal areas on the ground floor. One of these rooms is a lounge with television and a variety of seating; the other is a dining room. The dining room benefits from a small kitchenette area where service users can prepare food and drinks. As already indicated there is limited outdoor space, however, there is a small garden and patio area to the rear of the home. There is no specialist equipment at the home. Point House i55 s27360 pointhouse v241082 060905 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) 32,33,34,36 Staff at the home are well supported and employed in sufficient numbers to meet the service users needs. EVIDENCE: Staff rotas indicate the deployment of sufficient staff to meet service user need, and service users spoken to indicate that they feel their needs are adequately met. An effective staff team, who are well supported and supervised supports service users. However, the manager was not able to evidence how current staffing levels at the home are reached or assessed by the home. The home currently has a compliment of approaching 50 of NVQ level 2 trained staff, with further staff currently undertake training. Records were reviewed with supporting evidence that the home’s recruitment practices afford service users with protection this. A recruitment procedure is demonstrably in place ensuring the protection of service users. There is also evidence of a programme of regular staff supervision to benefit service users. The manager indicated that training in staff supervision for senior staff with this responsibility, would be provided as part of the home’s staff training programme. Point House i55 s27360 pointhouse v241082 060905 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) 39, 41, 42 The systems for service user consultation are good. Relevant health and safety policies promote the health and safety of service users. EVIDENCE: The home employs a number of methods to ensure service users views underpin the self-monitoring and review of its services. These include questionnaires and service users meetings. The manager has extended the use of questionnaires to incorporate the views of others associated with the home. The home demonstrated good record keeping practices ensuring service users confidentiality. Relevant health and safety policy and practice was in evidence to promote the health and safety of service users. This includes moving and handling, first aid, and fire training. Discussion took place as to the advantage of introducing fire safety training earlier in the staff induction training programme, as this currently takes place in the programme’s fourth week. This was accepted and agreed by the manager. Point House i55 s27360 pointhouse v241082 060905 stage 4.doc Version 1.40 Page 19 Point House i55 s27360 pointhouse v241082 060905 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 3 3 x x 3 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score x 3 3 2 3 3 x Standard No 11 12 13 14 15 16 17 3 x x 3 x 3 x Standard No 31 32 33 34 35 36 Score x 3 2 3 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Point House Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 3 x 3 3 x i55 s27360 pointhouse v241082 060905 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 20 Regulation 13.2 Requirement The registered person must make arrangements for the recording, handling, safekeeping and safe administration of medicines received into the care home. The registered person must ensure that premises are kept in a good state of repair. Timescale for action Immediate and Ongoing 2. 27 23(2)(b) 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. 1. 2. 3. 4. 5. Refer to Standard 14 20.7 20.11 32 33 Good Practice Recommendations It is recommended that ways be considered to utilise the patio area at the rear of the home. It is recommended that controlled drugs administered by staff are stored in a metal cupboard. It is recommended that the receipt, administration and disposal of controlled drugs are recorded in a controlled drugs register. It is recommended that the Registered Provider ensure continued progress toward meeting the 50 NVQ training requirement by 2005. It is recommended that the registered person explore systems for calculating staff numbers required. i55 s27360 pointhouse v241082 060905 stage 4.doc Version 1.40 Page 22 Point House Point House i55 s27360 pointhouse v241082 060905 stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection 3rd Floor, Cavell House St Crispins Road Norwich NR3 3BN 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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