CARE HOME ADULTS 18-65
Principle House 95 Ringwood Road Walkford Christchurch Dorset BH23 5RA Lead Inspector
Tracey Cockburn Unannounced Inspection 12:30 15 November 2005
th Principle House DS0000031699.V266049.R01.S.doc Version 5.0 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 Principle House DS0000031699.V266049.R01.S.doc Version 5.0 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. Principle House DS0000031699.V266049.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Principle House Address 95 Ringwood Road Walkford Christchurch Dorset BH23 5RA 01425 277707 01425 277026 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) Principle Care Ltd Mrs Lisa Trepka Rudkin Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Principle House DS0000031699.V266049.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Staffing levels must be calculated using the Residential Forum`s `Care Staffing` model (published 2002) The registered manager Mrs Lisa Trepka Rudkin must attain level 4 NVQ awards in management and care by December 2006. 28th April 2005 Date of last inspection Brief Description of the Service: Principle House opened in August 2002. It is registered to provide accommodation and support to 6 adults who have a learning disability. The home is situated in Walkford, Christchurch, on the main road through town. It is a family style home and similar in appearance to the other houses in the road. All 6 bedrooms are single with en-suite facilities. There is a large lounge dining room, separate kitchen and gardens to the rear of the house. There is parking at the front of the house. Accommodation is on 2 floors, there is also an office and staff sleep in room. Local shops are within walking distance and there is a bus route into the neighbouring town of Christchurch. Principle House DS0000031699.V266049.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place unannounced over 2 hours. The purpose of the inspection was to review the requirements and recommendations from the previous inspection in February 2005. This was the first inspection for the registered manager who was appointed in May 2005. Care records were seen and support staff were spoken to briefly as were some residents. 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. Principle House DS0000031699.V266049.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Principle House DS0000031699.V266049.R01.S.doc Version 5.0 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 the following standard(s): None of these standards were assessed at this inspection. EVIDENCE: Principle House DS0000031699.V266049.R01.S.doc Version 5.0 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 the following standard(s): None of these standards were assessed at this inspection. EVIDENCE: Principle House DS0000031699.V266049.R01.S.doc Version 5.0 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 the following standard(s): 12,13,15,16,17 Residents participate in activities, which are appropriate to their age, culture and peer group. Residents are part of the local community taking part in activities, which interest them. Residents have relationships with family and friends of their own choice. Residents rights and responsibilities are respected in their daily lives which means they are encouraged and supported to lead ordinary lives. Meals are healthy and mealtime’s flexible to suit resident’s lives. EVIDENCE: During the course of the inspection residents were arranging to go off and attend their afternoon activities, which range from volunteer work to activities such as arts and crafts and gardening. Each person’s activities were different and arranged around their interests and abilities. They had come home for lunch from activities with support staff in the morning. The activity rota seen
Principle House DS0000031699.V266049.R01.S.doc Version 5.0 Page 10 also showed that residents are taking part in community activities of their choosing. One resident said he was going out to take part in gardening. There was also evidence that residents go to the pub, eat out and go to the local shops. The manager said that there were enough staff on duty each day to ensure that residents were able to participate in the activities which interested them. There were 4 staff on duty in the morning 3 in the afternoon and 2 night staff. One resident who is interested in music and movies has DVD, CD’s and a TV and music centre in her room. The daily records for residents demonstrated that family links are maintained and that they are able to see the people they want. The manager said that one resident has a girlfriend but that he was probably too shy to talk about it. Staff were observed entering a residents bedroom only after knocking and asking if they could go in. a member of staff opened the door but this was only because all the residents sere having lunch. Residents are able to choose whether they spend time alone or in company. The manager said that residents are involved in preparing the evening meal but there is a member of staff who prepares lunch. Residents are encouraged to be involved in household tasks. The manager said that there is a variety of meals on offer and fresh fruit is always available. Each week at the house meeting residents are asked what meals they would like to see on the menu for the following week. Their wishes and preferences are taken into account and they are sometimes involved in shopping. The lunch on the day of the inspection was observed as happening at the pace of individual residents, so some eat quickly and left and others were slower. The manager said she has tried to find a suitable training course for staff relating to relationships but has had trouble finding a suitable course, she said she is continuing to look. She also said that she is considering contacting various organisations to enable residents to access advice on male health and sexuality. Principle House DS0000031699.V266049.R01.S.doc Version 5.0 Page 11 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 the following standard(s): 20 The homes policies and procedures protect residents. EVIDENCE: All residents’ files contain information on the original assessment, which details whether or not they are able to administer their medication. The manager acknowledged that if they felt through the course of a year that a resident might be able to self medicate they would discuss this during the course of the care plan review with all parties present. Currently no residents manage their own medication. This has been clearly documented in there care plans. The manager explained the process for PRN medication. The manager or the oncall manager can only agree this. There is a clear procedure, which the manager says all staff are aware of. Principle House DS0000031699.V266049.R01.S.doc Version 5.0 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 the following standard(s): 23 The policy, procedure and training of staff should protect residents from abuse. EVIDENCE: All staff undertake adult protection training, the manager arranges this through the local authority. Principle House DS0000031699.V266049.R01.S.doc Version 5.0 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 the following standard(s): 30 The home is clean and appears hygienic which gives a good impression to visitors. EVIDENCE: During the inspection, the home was noted to clean, there was clean linen on residents beds. The staff were observed clearly away the lunch dishes and tidying the dining table. There is a separate laundry room in the house. The home also had infection control policies and staff have received training in health and safety. Principle House DS0000031699.V266049.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34,35,36 Recruitment practice within the home has improved this means that residents are protected. Training provided for staff means that staff that have received the right training to ensure that each resident’s needs are fully met. Staff receive the support and supervision they need to do the job well, however not all advice and supervision is properly recorded to ensure continuity on actions agreed with the manager. EVIDENCE: The manager said that she now ensures that she explores the gaps in employment record when interview all prospective employees and she gave an example of a recent interviewee where the gaps in employment were explained by the person taking time off to raise a family. The manager also explained that she now writes all the information relating to employment gaps on the interview record. All care and support staff attend a 3 day course which covers the foundation training of modules 1&2 relating to LDAF training. The manager said that she is about to start the round of staff appraisals, she is working towards up dating the supervision records for all staff and acknowledged that not all discussions she has with staff are recorded especially with the new staff, therefore the recommendation will be repeated. The manager has undertaken supervision and appraisal training.
Principle House DS0000031699.V266049.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 The manager understands her role and responsibilities and residents benefit from her ability to run the home well. EVIDENCE: The manager has been in post since May 2005. She is currently in the process of working towards her NVQ 4 in management and care. She also undertakes training such as adult protection to ensure that her practice is current. Principle House DS0000031699.V266049.R01.S.doc Version 5.0 Page 16 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 x x x Standard No 22 23 Score x 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score x x x x x Standard No 24 25 26 27 28 29 30
STAFFING Score x x x x x x 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 2 16 3 17 Standard No 31 32 33 34 35 36 Score x x x 3 3 2 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Principle House Score x x 3 x Standard No 37 38 39 40 41 42 43 Score 3 x x x x x x DS0000031699.V266049.R01.S.doc Version 5.0 Page 17 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 Refer to Standard YA15 YA36 YA36 Good Practice Recommendations Staff should receive training and information on personal relationships and sexuality in relation to supporting adults who have a learning disability. The manager should ensure that all staff receive at least 6 supervision sessions a year which are clearly recorded. The manager should ensure that an accurate record is kept of all discussions, which relate to the care and support of residents and the individual work and development agreed. Principle House DS0000031699.V266049.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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