Inspection on 12/09/05 for Portland House Care Home

This inspection was carried out on 12th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Portland House Care Home 05/11/08

Portland House Care Home 10/08/06

Portland House Care Home 12/01/06

Portland House Care Home 24/02/05

Portland House Care Home 15/09/04

Portland House Care Home 16/02/04

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

CARE HOME ADULTS 18-65 Portland House Care Home 113 & 114 Portland Road Nottingham NG7 4HE Lead Inspector Meryl Bailey Unannounced 12 September 2005 at 9:30 am 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. Portland House Care Home C53 C03 S2240 Portland House V246945 120905 Stage 2.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Portland House Care Home Address 113 & 146 Portland Road Nottingham NG7 4HE 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) 0115 978 7840 0115 978 9995 Networking Care Partnerships (SW) Ltd Ms Catherine Moir Care Home (CRH) 27 (Twenty Seven) Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (MD) - 27 (Twenty Seven) of places Portland House Care Home C53 C03 S2240 Portland House V246945 120905 Stage 2.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24/03/05 Brief Description of the Service: Portland House Care Home provides accomodation and care for up to 27 younger adults with mental health problems. The home is comprised of two houses situated on opposite sides of Portland Road, which is within in a residential area just outside Nottingham City Centre. The larger House is named Portland House and the an annexe is Hemsley House. There is good access into the City Centre via the tram route and there are two local parks within walking distance. Portland house is not accessible by wheelchair uses as the entrance is approached via a flight of stone steps. Hemsley House has level access, but no lift to the first floor bedrooms. Portland House Care Home C53 C03 S2240 Portland House V246945 120905 Stage 2.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and conducted by one inspector during one morning. Many of the current 24 service users were at home and one was in hospital. The manager and four support staff were present. Some service users and staff gave their views about the care provided, but no relatives or friends were present on the day of this inspection. The communal areas of each house were inspected and a sample of bedrooms was also seen. What the service does well: What has improved since the last inspection? 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. Portland House Care Home C53 C03 S2240 Portland House V246945 120905 Stage 2.doc Version 1.40 Page 6 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 Portland House Care Home C53 C03 S2240 Portland House V246945 120905 Stage 2.doc Version 1.40 Page 7 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 Needs are comprehensively assessed. EVIDENCE: There was a detailed assessment on file for the most recently admitted service user. This was completed with the service user on the day he arrived at the home. Assessment sheets are signed by the service user. Portland House Care Home C53 C03 S2240 Portland House V246945 120905 Stage 2.doc Version 1.40 Page 8 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 and 9 Care and support planning is undertaken, but plans are not all up to date. Risks are assessed and individuals are encouraged to maintain independence. EVIDENCE: Two individual plans were examined in detail and a third was seen briefly. Discussion was also held with the care manager. It was clear that care is planned and some detailed goal centred plans had been established. However, there were inconsistencies in that new information had not been transferred to the overall plan and the current plan was not clear in all areas. It is recommended that all plans be reviewed every six months to ensure they are totally up to date and that anyone with changing needs, particularly if over 65 years, have their plans reviewed and updated at least monthly. One service user’s file contained signatures of staff to show they had read the plan. Risks were assessed as part of care planning and service users had signed some of these assessments. There was some regular reviewing of these, but changes were not transferred to the overall plan. Most of the service users were independently accessing local facilities. Portland House Care Home C53 C03 S2240 Portland House V246945 120905 Stage 2.doc Version 1.40 Page 9 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 Service users are encouraged to take part in appropriate activities. EVIDENCE: An activities co-ordinator is employed on two mornings per week to arrange appropriate activities. Some service users go to a drop in centre, two attend a cookery class, one goes to college regularly and one does voluntary work. Others have developed their own routines in and around the home. Portland House Care Home C53 C03 S2240 Portland House V246945 120905 Stage 2.doc Version 1.40 Page 10 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 and 20 Personal support needs are agreed with service users. Health needs are monitored and met by relevant outside professionals. Current practises are not encouraging compliance with taking medication and more flexibility with the timing of accessing medication and better recording is needed. EVIDENCE: In one support plan the personal support needs were detailed and individual service users said they were satisfied with the support they receive from staff. Health care appointments were recorded on service users’ files and there were examples of multi disciplinary meetings with health professionals and service users. Community Psychiatric Nurses were involved with many of the service users and their visits to the home were recorded. An examination of the Medication Administration Record Sheets showed a high level of non-compliance in taking medication, particularly for morning doses. Staff confirmed that medication is issued at set times and that it is collected from the medication room by service users. Those who are either not up by 10am or have gone shopping do not receive their morning medication and have to wait until 2pm. Portland House Care Home C53 C03 S2240 Portland House V246945 120905 Stage 2.doc Version 1.40 Page 11 The manager should review this practise and ensure service users have the opportunity to access their medication at other times during the morning and that doctors’ prescriptions for the timing of medication are always followed. The records were incomplete in places, showing neither signature that medication was taken nor reason code for not taken. Also, some once-a-day medication was taken at different times of the day and it was not clear from records if it was always offered at the same time. One instruction from the pharmacist read, “to be taken as directed” and this needs to be clarified. Portland House Care Home C53 C03 S2240 Portland House V246945 120905 Stage 2.doc Version 1.40 Page 12 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 Staff are aware of local procedures in protecting service users, but need clarification about using these procedures and need to be aware of the amendments. EVIDENCE: The manager has a copy of the Nottinghamshire Committee for the Protection of Vulnerable Adults (NCPVA) policy and procedures, but recent amendments had not been added and it is recommended that the manager obtain these as soon as possible. There were records of reporting to Social Services the abuse of service users from another service user and some appropriate action had been taken, but this had not been done as part of the NCPVA protection procedures. Notifications of alerts of possible abuse must be completed as detailed in the procedures. The manager had arranged further training on protection for 19th October 2005 for herself and another member of staff. Other training for most staff regarding dealing with challenging behaviour was planned for the day following this inspection. Portland House Care Home C53 C03 S2240 Portland House V246945 120905 Stage 2.doc Version 1.40 Page 13 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, 26 and 30 Regular maintenance is carried out, but some refurbishment and redecoration is needed in Portland House. Communal areas are cleaned regularly but measures need to be put in place to ensure cleanliness of all bedrooms, whilst continuing to respect individual lifestyles. Hemsley House is well maintained and clean. EVIDENCE: Both houses were inspected. There were no concerns about Hemsley House, which has a lounge, kitchen, five single bedrooms two bathrooms and a staff office. All areas of this smaller house were found clean and appropriately decorated. Portland House was found clean in most areas, but one bedroom had been neglected. The untidiness may have been due to the preferred lifestyle of the occupant, but the room must be cleaned regularly to ensure safety from infection. Some major areas of the house were in need of redecoration and refurbishment. The stair carpet was very old and worn in communal areas; the entrance hall and stairs need redecorating. A plan for redecoration must be formulated and carried out. Portland House Care Home C53 C03 S2240 Portland House V246945 120905 Stage 2.doc Version 1.40 Page 14 The bedrooms seen varied and reflected individual choices. All have sufficient furniture and fittings. Some have en-suite facilities and there are toilets and bathrooms close to other rooms. The grounds of both houses were maintained and provide outdoor space for service users. Portland House Care Home C53 C03 S2240 Portland House V246945 120905 Stage 2.doc Version 1.40 Page 15 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) 33 and 34 The staffing hours of the home are appropriate for the needs of the current service users. Recruitment procedures for permanent staff protect service users, but these procedures do not extend to agency workers and there is a risk that appropriate checks have not been carried out. EVIDENCE: There were two separate staffing rotas for the two houses. In Portland House a care manager and two other support staff were on duty for 18 service users, with additional domestic staff. In Hemsley House there were two support staff for five service users. These two staff also covered domestic duties. The registered manager is in addition to this, together with an activities coordinator, a handyman and administrative person. Support staff worked 12hour shifts 8am to 8pm. Staffing at night was two at Portland House and one at Hemsley House. The same four agency staff were used to cover shifts where needed. Staff files were well organised and contained the references, application form, terms and conditions, job description and evidence of Criminal Record Bureau checks. However, there was no evidence of relevant checks having been carried out on staff from agencies and the manager must ensure these checks have been done before accepting staff from agencies. Portland House Care Home C53 C03 S2240 Portland House V246945 120905 Stage 2.doc Version 1.40 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 and 42 The home is run by a manager registered with the Commission. Health and safety are generally promoted. EVIDENCE: Since the last inspection the manager has been registered with the Commission and was appropriately experienced and competent to run the home. Specific qualifications of the manager and staff will be assessed at the next inspection of this service. The fire officer inspected risk assessments and saw all exit routes on the day of this inspection. There were no concerns expressed by the fire officer and related paperwork was praised. Records are maintained of regular health and safety checks and servicing of equipment. Staff have received training in safe working practices. The carpeting on the stairs is worn as stated under Standard 24 and needs to be monitored for any risk of tripping. Another concern about health and safety has been expressed about a room not cleaned and a requirement for this is made under Standard 30. Portland House Care Home C53 C03 S2240 Portland House V246945 120905 Stage 2.doc Version 1.40 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x 3 x x Standard No 22 23 ENVIRONMENT Score x 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x 3 x x x 2 Standard No 11 12 13 14 15 16 17 x 3 x x x x x Standard No 31 32 33 34 35 36 Score x x 3 2 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Portland House Care Home Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 x x x x 3 x C53 C03 S2240 Portland House V246945 120905 Stage 2.doc Version 1.40 Page 18 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 YA 20 Regulation 13(2) Requirement Ensure all staff are following procedures for administering medication and either signing or entering a reason code if the medication is not taken by individual service users. Formulate a plan for the internal redecoration of Portland House. Ensure room 3 is initially thoroughly cleaned and then on a regular basis. Ensure Criminal Record Bureau checks have been carried out before accepting staff from agencies. Timescale for action Immediate 12th September 2005 31st October 2005 30th September 2005 Immediate 12th September 2005 2. 3. 4. YA 24 YA 30 YA 34 23(2)(d) 23(2)(d) 19 and Schedule 2 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 YA 6 Good Practice Recommendations Review each Support Plan every six months to ensure they are totally up to date. Where there are changing needs, particularly for those over 65years, review plans at least monthly. C53 C03 S2240 Portland House V246945 120905 Stage 2.doc Version 1.40 Page 19 Portland House Care Home 2. 3. 4. YA 20 YA 20 YA 23 Review current practise and ensure service users have the opportunity to access their own prescribed medication between 10am and 2pm. Clarify directions from the General Practitioner regarding instructions that state to be taken as directed Make all staff aware of the need to follow the Nottinghamshire Committee for the Protection of Vulnerable Adults (NCPVA) policy and procedures and obtain a copy of the amendments to these procedures. See www.nottsadultprotection.org.uk Portland House Care Home C53 C03 S2240 Portland House V246945 120905 Stage 2.doc Version 1.40 Page 20 Commission for Social Care Inspection Edgeley House Tottle Road Riverside Business Park Nottingham, NG2 1RT 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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