Inspection on 02/08/05 for Prospect House Residential Home

This inspection was carried out on 2nd August 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Prospect House Residential Home 31/07/07

Prospect House Residential Home 23/08/06

Prospect House Residential Home 24/01/06

Prospect House Residential Home 16/03/05

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Prospect House Residential Home 4 Prospect Road Cinderford Gloucestershire GL14 2DY Lead Inspector Ms Tanya Harding Announced 2 August 2005 09:30 nd 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. Prospect House Residential Home D51_D03_S61957_ProspectHouse_V236989_020805_Stage4_A.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Prospect House Residential Home Address 4 Prospect Road Cinderford Gloucestershire GL14 2DY 01285 653159 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) The Silver Rooms (Stroud) Ltd Graham Emery(to be registered) Care Home 9 Category(ies) of Learning Disability (9) registration, with number Learning Disability - over 65 (9) of places Prospect House Residential Home D51_D03_S61957_ProspectHouse_V236989_020805_Stage4_A.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 16/03/05 Brief Description of the Service: Prospect House is a detached residential care home set in its own grounds near the centre of the town of Cinderford. It is registered for nine adults with Learning Disabilities. All of the bedrooms are single and some have en-suite facilities. On the ground floor there is a lounge, dining room, kitchen, laundry, toilet, shower room with a toilet and three bedrooms, one of which has its own entrance. On the first floor there are six bedrooms, a bathroom, toilet, storeroom and sleep-in room/office. There are spacious grounds surrounding the house. Prospect House Residential Home D51_D03_S61957_ProspectHouse_V236989_020805_Stage4_A.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 7 hours and was conducted by Inspectors Simon Massey and Tanya Harding. Documentation and recording was examined and an inspection was also undertaken of the environment. The inspectors met with the manager and the Registered Provider and also interviewed staff and service users. A number of relatives also visited the home during the day and were interviewed by the inspectors. The recent change of owner and appointment of a new manager seems to have had a positive impact on the quality of the service provided. Although much remains to be done in order for the home to meet the National Minimum Standards for Younger Adults there is now evidence of commitment from the new provider and the new manager that the shortfalls will be addressed. What the service does well: What has improved since the last inspection? There have been many positive changes in the home in the past few months including an investment in the building and the environment. Some new furniture has been purchased for communal areas and these now look more homely and welcoming. The new manager has identified a number of areas for improvement and has started to put new and improved systems in place. This includes improvements to recording systems, care planning and the medication administration systems. The links with families and relatives are being re-established. Comments were made by the relatives that this will enable better communication to be maintained and promote a more open relationship with the staff in the home. Comments were made by the service users about the home becoming a better place to live. There appeared to be more opportunities for people to go out to do the activities they enjoyed. Prospect House Residential Home D51_D03_S61957_ProspectHouse_V236989_020805_Stage4_A.doc Version 1.40 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. Prospect House Residential Home D51_D03_S61957_ProspectHouse_V236989_020805_Stage4_A.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 Prospect House Residential Home D51_D03_S61957_ProspectHouse_V236989_020805_Stage4_A.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 The home has an existing Statement of Purpose and Service User but plans are in place to update and improve these to reflect the changes in the home. EVIDENCE: The home will be producing a new Statement of Purpose and Service User Guide. When completed copies must be supplied to the Commission. The home has been working with the Community Learning Disabilities to complete updated assessments on the service users. Prospect House Residential Home D51_D03_S61957_ProspectHouse_V236989_020805_Stage4_A.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 The manager and the staff team have put work into improving the care planning process. Information in care files may not always fully reflect the needs and wishes of the service users. EVIDENCE: All service users now have up to date care plans in place but there is a need to further develop these. This needs to be done in consultation with the Community Learning Disabilities Team and the placing authorities. Plans should include clear goals and objectives and when these are to be reviewed. The manager explained his plans to hold Individual Planning meetings to commence the reviewing process. There has been some improvement in the daily recording. Daily records should provide more information and detail about how service users are supported and whether they enjoy taking part in particular activities. The details provided here should be factual and correspond to assessed needs. Person centred approach should be considered in all care planning activities. Prospect House Residential Home D51_D03_S61957_ProspectHouse_V236989_020805_Stage4_A.doc Version 1.40 Page 10 Prospect House Residential Home D51_D03_S61957_ProspectHouse_V236989_020805_Stage4_A.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) 12, 13,15, 16 and 17 There are increased opportunities for service users to take part in meaningful activities in the home and in the community. Service users appeared more relaxed and confident in the home. The atmosphere in the home was very positive and welcoming. EVIDENCE: Evidence from discussions with staff, service users and relatives demonstrated that there were more activities on offer for people who live in Prospect House. These included trips out, college courses, visits to friends and families, shopping trips and greater involvement in the household chores. With plans to increase staffing further, service users will have more opportunities to go out in smaller groups and one to one with staff. The inspectors were able to talk to several relatives on the day of the visit. The majority of the comments were positive although some concerns remain. The manager is planning to meet with all the relatives to establish better links and involvement with the home. Prospect House Residential Home D51_D03_S61957_ProspectHouse_V236989_020805_Stage4_A.doc Version 1.40 Page 12 Staff and service users were very positive about the improvement in the quality and the quantity of the food provided. The kitchen contained stores of fresh and packaged food and menus had been revised to incorporate people’s personal tastes. Opportunities for service users to take part in food preparation have increased. Prospect House Residential Home D51_D03_S61957_ProspectHouse_V236989_020805_Stage4_A.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) 18, 19 and 20 Service users’ personal care, emotional and health needs are being supported in a more appropriate way. Service users are supported to take medication and procedures are in place to ensure this is done correctly. EVIDENCE: The support needs of one person have been reviewed and more appropriate provision has been put in place. This means that the person can be kept safe at night in a way, which protects their privacy and dignity. For one person a behaviour management plan and observation charts have been developed so that staff have a better understanding of the person’s behaviours and respond as needed. Health and Social care professionals have been consulted on this. Records seen provided evidence that people have access to medical professionals when necessary. Medication cabinet has been moved to a more secure location. Medication storage and administration were found to be in order. Prospect House Residential Home D51_D03_S61957_ProspectHouse_V236989_020805_Stage4_A.doc Version 1.40 Page 14 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 and 23 Service users views are listened to and systems to protect people from financial abuse have been implemented. Efforts by staff and the management have resulted in service users having increased confidence. EVIDENCE: The complaint procedure in an accessible format is available in each bedroom. The manager said that he will be sending a copy of the procedure to all the carers and relatives. Service users were noticeably more open and confident in their interactions with the staff, manager, other service users and the inspectors. They said that they would feel comfortable in raising concerns with the new manager and the new provider and found them approachable. The manager has attended a course in Protection of Vulnerable Adults. The home is required to provide all staff with training in this area. Service users’ finances were not examined during this visit. Regular contact has been maintained between the provider and the Commission to establish a safe and satisfactory system for managing service users’ personal finances. There was evidence that service users now have access to their personal monies and have the opportunity to decide how to spend it. Prospect House Residential Home D51_D03_S61957_ProspectHouse_V236989_020805_Stage4_A.doc Version 1.40 Page 15 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 There have been some improvements to the environment making the home appear more homely and more safe for staff and service users. Further improvements are needed to make the facilities in the home more suitable to the needs of the residents and to improve the lifestyle for each person. EVIDENCE: The exterior of the house has been rendered and painted. The garden is being better maintained and some fruit trees have been planted. The communal areas have been altered and improved with new dining room furniture having been purchased. The registered person has provided a schedule for the completion of the remaining work as identified in the previous report. Some work has started to improve the upstairs bathroom and some of the bedrooms. The following repairs and improvements were still outstanding at the time of the visit and must be addressed. • • repairs to bedroom taps replacement of bedroom carpets D51_D03_S61957_ProspectHouse_V236989_020805_Stage4_A.doc Version 1.40 Page 16 Prospect House Residential Home • • • • • repairs to toilet doors in bedrooms replacement of blind in upstairs bathroom and redecorate room replacement or repair of all bedroom furniture replacement of rotten window frames The registered provider hopes to improve the kitchen and the laundry facilities in the near future. This needs to be done in consultation with the Environmental Health Department to ensure that all the necessary improvements are made. The security of the grounds was discussed and the provider has agreed to consider whether greater use of the outside gates could improve the security for some of the service users. The provider has advised that hazardous steps outside the back of the house have been made safe. Personal protective equipment has been provided to comply with the infection control legislation. Prospect House Residential Home D51_D03_S61957_ProspectHouse_V236989_020805_Stage4_A.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) 33 and 34 Minimal staffing levels are being maintained to ensure basic care needs are met. However, increased staffing would provide further benefits to the service users and build on the improvements noted in this report. Shortfalls in the recruitments procedure may compromise the safety and welfare of the residents. EVIDENCE: Staff have received new contracts and staff handbook. There are now at least two staff on each shift in addition to the manager. The new manager is hoping to employ an additional member of staff to work two afternoons a week. This is to enable more activities to take place outside of the home. The manager is also in the process of recruiting a senior so that the management cover can be extended to weekends. It is recommended that when the re-assessments of needs are completed for all service users, another review of the staffing levels takes place to ensure that all the identified needs can be appropriately met. There are still some staff shortages with some staff having to provide cover over a double shift. Ongoing recruitment was evident. Prospect House Residential Home D51_D03_S61957_ProspectHouse_V236989_020805_Stage4_A.doc Version 1.40 Page 18 There have been some staff changes since the last inspection. The previous acting manager has retired and several new staff have been recruited. Some had not yet commenced employment at the time of the visit. The home is now funded to provide waking night staff. This will replace the sleeping in arrangements currently in place. The manager will need to consider providing a suitable job description for this role. The current application form seems to be significantly out of date as it states ‘ you are entitled to withhold information about convictions spent’. This is no longer the case for positions which involve contact with vulnerable adults. The manager explained that new applications forms will be introduced which will include questions about medical issues. Seven staff files were examined for new and existing staff. There were still some gaps for new staff, but it is not anticipated that they will commence employment until all necessary information has been obtained. Other gaps were observed on staff files – ID was not always present, employment history was not always completed in full and reasons for leaving previous employment needed to be clarified. The manager must ensure that no staff are employed in the home until all necessary information about them is obtained as required by regulation. For staff who have been employed on the basis of previous CRB, a new disclosure must be requested to include the POVA check. Prospect House Residential Home D51_D03_S61957_ProspectHouse_V236989_020805_Stage4_A.doc Version 1.40 Page 19 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) 37,38 and 42 The appointment of the new manager has provided a long awaited stability to the home. There is a renewed confidence that the quality of the service will be further improved with implementation of better care planning and quality assurance systems. Shortfalls in health and safety monitoring and lack of necessary risk assessments may compromise the welfare of staff and service users. EVIDENCE: The new manager has made an application to the Commission for registration. He is undertaking the necessary training courses and has made arrangements for a monthly clinical supervision with a tutor from local college. This is seen as an important source of opportunities for the manager to develop his management style and to confirm suitability of systems he may be implementing in the home. Prospect House Residential Home D51_D03_S61957_ProspectHouse_V236989_020805_Stage4_A.doc Version 1.40 Page 20 Service users and staff told the inspectors how much more reassured they feel about the home making improvements now that there is a new provider and new manager in place. The manager advised that staff were welcoming the input through supervisions and access to training. He said that staff responded well to increased responsibilities and have shown motivation in meeting with the health professionals to discuss service users’ support needs. Staff said they had good support from the manager and found him approachable. Although quality assurance systems were not discussed in detail the manager has already initiated contact with families and has sent to the relatives questionnaires as a way of assessing their opinions of the changes in the home. The inspectors were able to speak to several relatives who welcomed the proposals for increased involvement with the home and better communication with their relatives. Whilst it is understandable that concerns may remain for some time, overall feeling was positive and encouraging. A detailed Health and Safety audit has been carried out by Mentor and advise has been issued to the home on the most critical areas and practices which require risk assessing. At the time of the visit these have not yet been initiated. There appears to be a considerable amount of work which needs to be undertaken to cover the necessary areas. Progress will be further assessed during the future visits. Records of fire alarm tests and emergency lighting tests were examined and showed that these are not always carried out consistently. This must be addressed. Staff interviewed confirmed that they received mandatory training in Food Hygiene, First Aid, Fire Safety and Infection Control. Prospect House Residential Home D51_D03_S61957_ProspectHouse_V236989_020805_Stage4_A.doc Version 1.40 Page 21 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 2 x x x x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x x Standard No 11 12 13 14 15 16 17 x 2 2 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x 2 2 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Prospect House Residential Home Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 3 x x x 2 x D51_D03_S61957_ProspectHouse_V236989_020805_Stage4_A.doc Version 1.40 Page 22 yes 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 1 Regulation 4 and 5 Requirement Provide updated copies of Statement of Purpose and the Service User Guide to the Commission Complete reassessments of need for all service users and ensure these are reflected in care plans Ensure care plans comprehensively cover all areas of support for service users Training in protection of vulnerable adults must be provided for all staff. Address outstading requirements to improve aspects of the environment and facilities in the home, as detailed in the text. Ensure that all required information is obtained for staff working or in the process of being employed in the home as detailed in the updated regulations and shedules. Obtain new CRB disclosures for staff who have been employed with a disclosure from previous employment. CRB checks are not transferable. Ensure fire alarms and emergency lighting tests are carried out with required Timescale for action 30th November 2005 31st January 2006 31st January 2006 31st January 2006 31st January 2006 31st December 2005 2. 3. 4. 5. 6 6 23 24 14 and 15 15 13(6) 23 6. 34 18 and 19 7. 42 23 and 13 31st December 2005 Page 23 Prospect House Residential Home D51_D03_S61957_ProspectHouse_V236989_020805_Stage4_A.doc Version 1.40 frequency. Implement recommendations from the Health and Safety audit to risk assess aspects of the service and the environment. 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. Refer to Standard 6 6 Good Practice Recommendations Care plans should be person centred and provide more detail about how service users want to be supported. Goals and aspirations should be clearly identified. Daily records should provide more detail about how people are supported to take part in activities and whether they enjoy these. The infromation in daily records should be factual and correspond to assessed needs of the individuals. Staffing levels should be reviewed when service users reassessments have been carried out. Staff ratios will need to reflect the assessed needs. Update application forms in line with current legislation to ensure all necessary information is being asked for. 3. 4. 33 34 Prospect House Residential Home D51_D03_S61957_ProspectHouse_V236989_020805_Stage4_A.doc Version 1.40 Page 24 Commission for Social Care Inspection 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester GL3 4AB 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. Extracts may not be used or reproduced without the express permission of CSCI Prospect House Residential Home D51_D03_S61957_ProspectHouse_V236989_020805_Stage4_A.doc Version 1.40 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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