Inspection on 05/03/07 for Purplett House Residential Home

This inspection was carried out on 5th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Similar services:

Wakes Hall

165 Putnoe Lane

Claremont House

Sun Court Nursing Home

Bramley Avenue (73)

15 Bramble Close

Dolphin Court

Fen Road

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

CARE HOME ADULTS 18-65 Purplett House Residential Home 10 Purplett Street Ipswich Suffolk IP2 8HH Lead Inspector Deborah Kerr Unannounced Inspection 1st March 2007 09:00 Purplett House Residential Home DS0000067479.V331220.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Purplett House Residential Home DS0000067479.V331220.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Purplett House Residential Home DS0000067479.V331220.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Purplett House Residential Home Address 10 Purplett Street Ipswich Suffolk IP2 8HH 01473 603133 01473 603133 katrina.butler@sanctuary-housing.co.uk 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) Sanctuary Care Limited Katrina Louise Butler Care Home 10 Category(ies) of Physical disability (10) registration, with number of places Purplett House Residential Home DS0000067479.V331220.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th December 2005 Brief Description of the Service: Purplett House is a purpose built residential home offering support and accommodation to ten adults with physical disabilities. The home was first opened in 1991, and was leased from Shaftesbury Housing Association and administered and staffed by Ashley Homes Ltd. Purplett House is now owned and run by Sanctuary Care who completed the take over of Ashley Homes Limited in June 2006. The home is sited within a mixed housing complex within easy reach of the town centre of Ipswich and all its facilities and resources. Local shopping facilities are also available. The home has ten bedrooms, all offer single occupancy and all have en-suite facilities. Communal areas include a spacious kitchen/dining room and lounge for of service users. Whilst the majority of service users accommodation on the ground floor of the home, there are two self-contained flats second floor, which have their own living, sleeping, bathroom and facilities. These bedrooms are accessed via a shaft lift. the use is sited on the kitchen The ultimate aim of the home is to support residents to become more independent and to facilitate their moving on into a less supported form of accommodation. The home’s statement of purpose and service user guide is in the process of being updated to reflect Sanctuary Care as the owners and was not available for inspection. The most recent inspection report by the Commission for Social Care Inspection (CSCI) was available in the entrance hall for people to read, along with Sanctuary Care newsletter ‘Care Speak’ informing service users of the new management structure and information about Sanctuary Care. Each service users fees are calculated according to their needs and include additional funding for extra support hours to enable the service user to access work and leisure opportunities with in the community. Purplett House Residential Home DS0000067479.V331220.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place on a weekday lasting six and three quarter hours. This was a key inspection, which focused on the core standards relating to adults, aged 18-65 and the progress made to address the six requirements set at the last key inspection in December 2005. The report has been written using accumulated evidence gathered prior to and during the inspection. This included information taken from seven service users ‘Have your say’ comment cards. Additionally, a number of records were reviewed including those relating to service users, staff, training and policies and procedures. Time was spent with four service users, two staff and the homes’ manager who accompanied the inspector on a tour of the home. What the service does well: What has improved since the last inspection? Six requirements were made at the previous inspection. Evidence obtained during today’s visit found the home have complied with all the requirements. Two service users files confirmed that the home is now completing pre admission assessments before being offered permanent placements. Care plans contain detailed generic risk assessments which look at the risk to service users for all aspects of their daily routines. In the majority of activities there was no or minimal risk, however where service users are considered to be at risk the generic risk assessment cross references and guides staff to more specific assessments. These were in the process of being updated. A previous requirement was made to ensure service users are provided with adequate lighting. The service user had requested dimmer light bulbs; these have been replaced with normal wattage to provide suitable lighting in their room. Purplett House Residential Home DS0000067479.V331220.R01.S.doc Version 5.2 Page 6 To protect service users health, safety and welfare previous requirements were made for the kitchen-cleaning rota to correctly reflect the frequency kitchen equipment is cleaned. The cleaning rota seen confirmed this. Action had been taken to ensure that bicycles were housed outside and were not being stored indoors. The fire logbook confirmed that fire-fighting equipment around the home is being checked on a monthly basis. A surveyor has visited the home and there are plans to refurbish the communal bathroom and undertake maintenance work, which includes replacing all external doors and a replacement call system. A programme of redecoration would benefit the home especially the corridors, which are quite dark. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Purplett House Residential Home DS0000067479.V331220.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Purplett House Residential Home DS0000067479.V331220.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5, Quality in this outcome area is adequate. Prospective service users can be confident that the pre admission process will fully identify their needs and aspirations. However, they cannot expect to have a contract setting out their terms and conditions of residence, which reflects their current fees. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The homes statement of purpose and service user guide is currently being revised by the senior management of sanctuary care as the owners and was therefore unavailable for inspection. A service users care plan states they are unable to read or write. Information provided to service users about the home, such as care plans and contracts should be made available in formats suitable for their needs. Service users care plans and personal files confirmed that pre admission assessments were being carried out, received and considered by the service prior to admitting service users into the home. As part of the admissions process, service users stay at the home for a four-day assessment. During the trial period a more detailed written needs assessment is completed and costed to ensure that the needs of the service user can be met at Purplett House. As part of the assessment further consideration is given to meeting their specialist needs, both care plans seen confirmed that service users had access to speech and language therapist, physiotherapist and the brain injury rehabilitation centre, Icanhoe in Stowmarket. Purplett House Residential Home DS0000067479.V331220.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9, Quality in this outcome area is good. Service users can expect to be supported to take risks and make their own decisions. However, consideration should be given to how a service users behaviour is managed so that they do not impact on the freedom and choice of the other service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each service user is provided with a very detailed plan of care. The plans are “person centred” and contain a detailed breakdown of the assessed needs of the service user and the support and interventions required to meet those needs. Service users personal preferences were noted, including religious observances and name by which they wish to be known. Service users are encouraged and supported to make decisions around their everyday lives and to maximise their independence. One service user rang the home during the inspection to say they were on their way home. They had stayed the weekend with friends. On their return they spoke with the inspector confirming they regularly stayed with friends or relatives and could come and go as they please. Purplett House Residential Home DS0000067479.V331220.R01.S.doc Version 5.2 Page 10 Service users, who are able, are supported to manage their own finances. A service user spoken with confirmed they had an appointment at the benefits agency. This was to discuss how much they were able to earn without affecting their benefits as they had the opportunity to consider taking in some paid hours with a local support group. They were also considering their future looking into the possibility of applying for direct payments to pay for care to support them to live in their own home. A service users care plan identified that their relatives managed their finances. The service user does have personal monies held in the safe at the home and was aware they could access their money and had a reasonable understanding of its value. The home has implemented generic risk assessments, which look at the risks for service users in all aspects of their daily routines. These were in the process of being reviewed and updated. The majority of the daily activities had no or minimal risk, however where service users are considered to be at risk, for example smoking the generic risk assessment cross references and guides staff to more specific assessments. In most cases these assessments detailed the actions taken to minimise the risk to the service users and their immediate environment, without restricting their chosen activity. However, where a risk had been identified to a service user with diabetes and their choice to eat unsuitable foods, the kitchen cupboards are locked preventing access to food. The risk assessment identified that the service user can become verbally aggressive towards staff and other service users if they were not able to access food of choice or do not like what is being offered. Consideration should be given to how the service users behaviour is managed so that this does not impact on the freedom and choice of the other service users. By locking the kitchen cupboards the other service users are restricted access to food as and when they choose. This was discussed with the manager who acknowledged the concern, however explained that service users could access food whenever they chose as the staff work twenty four hours a day and there is always some one available. The manager confirmed that staff were wary of the service user when they became agitated and had arranged training for staff called ‘Keep your self safe’ however this had been cancelled. They have now been given responsibility for the training budget for the home and are looking to book further training. In the mean time they confirmed that the staff at the Icanhoe rehabilitation centre are helping to support and monitor the service users behaviour. Purplett House Residential Home DS0000067479.V331220.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17, Quality in this outcome area is excellent. People who use this service are able to make choices about their life and are supported to develop skills for independent living. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home was able to demonstrate that service users right to live ordinary and meaningful lives. One service user spent time talking with the inspector and confirmed they attend a range of college course and action groups where they are included in debating issues which affect them as an individual and the wider community. For example, they attend a group called ‘People First’ where they have been discussing disabilities, equality and the environment and as a group are challenging transport issues for people with disabilities. They have enrolled on a nine-month college course to study the policies and procedures around disabilities. Additionally, they have completed a British Sign Language course and work’s voluntarily with ACE an advocacy service and a school for the deaf children supporting people with a hearing impairment. Another service user is currently being supported to find voluntary work at a charity shop in the town. Purplett House Residential Home DS0000067479.V331220.R01.S.doc Version 5.2 Page 12 Service users are encouraged to be involved in all areas of daily living in the home. Each person is allocated duties each day, which involve domestic chores with regards to preparing and tidying up after meals and emptying house hold rubbish bins. The home had not received their delivery of eggs on the day of the inspection and a service user was observed volunteering to walk to the local shop to buy some for the cook to finish baking. The ultimate aim of the home is to support service users to become more independent and to facilitate their move into a less supported form of accommodation. Care plans evidenced that service users are supported to develop their independent living skills. Each service user is allocated “social hours” where they are provided with a one to one worker. This additional support enables them to develop skills for living independently, complete domestic chores and pursue leisure activities. Several service users are supported to access college courses and day services, such as Wood n stuff in Stowmarket, which is a resource centre that produces wooden articles for sale and Headway, a day centre which provides both leisure and life skill opportunities. Service users are supported to access resources within their own community such as theatres, shops, pubs and the cinema. The home also accesses the services of a disability organisation called “challenges” which provides organised outings for people with disabilities. A list of forthcoming events was advertising fishing, Abba Magic evening, Freeport retail park shopping and a trip to see Phil Cool, the comedian at a local theatre. A service user commented, “ I have a brilliant social life”. Service users are supported to attend religious services of their choice. One service user is supported through a risk management framework to observe their own religious practice of praying in the privacy of their own room with lighted candles. A priest visits the home regularly to visit service users. Visitors and family members are welcome at the service up until 10.30 at night. A resident spoken with confirmed they have regular contact with their family and friends and will stay with friends most weekends. Time was spent talking with the cook. They are employed between 2 – 7 each weekday to prepare supper for the service users. During the day service users choose their breakfast and what they wish to have for lunch. There is a 4-week rolling menu, which is discussed and agreed with the service users, this is reviewed and changed regularly. Two choices of meal are offered everyday, with the exception of Sunday’s when all service users chose to have a Sunday roast. Tonight’s supper was a choice of chicken tikka massala or sausage rolls. A service user spoken with commented, “Food is brilliant, I loved the sausage rolls”. The cook is responsible for ordering the food and does a monthly order of dry and frozen foods and weekly fresh meat, fruit and vegetable order from local suppliers. Milk and diary produce is delivered direct to the home. Fridge and freezers were seen with a stock of good quality foods. Food seen was being stored in line with the food safety legislation. Purplett House Residential Home DS0000067479.V331220.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20, Quality in this outcome area is good. People living in the home can expect to receive specialist support and advice as needed from physiotherapists, speech therapists and other healthcare professionals as required and be protected by the homes medication procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Detailed plans are in place, which identify the level of support service users require when receiving personal care setting out preferred routines. Staff were seen responding promptly to service users request to shower, they acted sensitively to their request and supported them to attend to their personal hygiene in private. A service user was observed to have chosen items of clothing they wished to wear after their shower. Where service users have been identified as having a communication difficulty they have been supported to access the speech and language therapist and have been provided with technical aids and equipment. The manager spoke of one service user’s talking aid, which is constantly loosing its memory and has to be sent away for repair. They had arranged for staff to be trained to re programme the memory, unfortunately the trainer was unavoidably delayed and had to cancel the training. An alternative date is to be arranged. Purplett House Residential Home DS0000067479.V331220.R01.S.doc Version 5.2 Page 14 The care plan of one service user had a detailed moving and handling assessment, which identified a range of equipment provided to maximise their safety, independence and comfort. The assessment referred to the service user being strapped into their wheelchair and shower chair with a lap belt and foot straps and having bedsides and bumpers fitted to their bed. The supporting risk assessment identified the issue of restraint and deemed these actions a necessary health and safety requirement to prevent or minimise potential harm or injury to the service user. The assessment stated that the service user had been informed of the decision in relation to the risks but the question of their capacity to consent had been ticked as ‘NO’. This issue discussed with the manager, who was of the opinion that the service user was able to consent but does not always like wearing them. A service users care plan reflected that they had a food allergy and were likely to go into amphalaytic shock. All staff have been trained by the district nurse and staff at headway to use an Epi pen in case of emergencies. It is not clear that the service user actually has an allergy and the home have supported them to have tests. There have been no firm conclusion that they have an allergic retaion to this type of food and the home are gradually re introducing it back into their diet. Another service users plan confirms that service users are supported to access specialists particular to their individual needs. One service user has regular visits to and from the Icanhoe rehabilitation centre for brain injuries. There they receive support from physiotherapists and a speech language therapist. The home works to an efficient medication policy, which is supported by procedures and practice guidance. Staff are made aware through the induction process of the content of these procedures. Although medication practice was not observed on this occasion the Medication Administration Record (MAR) Charts seen for two service users confirmed these had been completed accurately with no gaps in signatures. Purplett House Residential Home DS0000067479.V331220.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23, Quality in this outcome area is good. Service users can expect to have their views listened to and be protected by the home’s policies and procedures for dealing with allegations of abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints book was seen. Neither the Commission for Social Care Inspection (CSCI) or the home have received a complaint about the service in the last 12 months. The complaints policy was seen on display in the entrance hall. However as previously mentioned consideration should be given to providing this information in a different format to service users who are unable to read or write so that they are aware of how to make a complaint. At the time of the inspection, the home was able to evidence that the majority of staff have attended mandatory training on the recognition and reporting of suspected abuse. Only three recently recruited staff have not attended the training, this has been scheduled for the 23rd March. The home have produced their own procedures for reporting incidents of abuse which reflects the local joint procedure for the Protection of Vulnerable Adults and provides clear guidelines to staff on what action to take following the reporting of suspected abuse. Purplett House Residential Home DS0000067479.V331220.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,26,27,28,29,30, Quality in this outcome area home enables service users appropriate to their specific available evidence including a EVIDENCE: Purplett House is a purpose built building for the care of people with physical disabilities and is therefore provided with appropriate accommodation, aids and adaptations. It forms part of a mixed housing complex within a residential area of Ipswich within easy reach of the town centre and all its facilities and resources. All areas of the home are wheelchair accessible. The home can accommodate up to ten residents. Eight bedrooms are sited on the ground floor of the property, and these are for single occupancy and benefit from ensuite facilities. There is a range of communal accommodation, which includes a spacious and pleasantly decorated lounge. Service users were observed playing chess, there was also a television and comfortable sofas and armchairs provided creating a comfortable environment for service users to relax and socialise in. is good. The physical layout and design of the to live in a safe and comfortable environment needs. This judgement has been made using visit to this service. Purplett House Residential Home DS0000067479.V331220.R01.S.doc Version 5.2 Page 17 Leading off form the lounge is a large kitchen/dining room, which was well equipped and had a service user resource area with low-sited kitchen equipment and storage. In addition to the lounge facilities, the home also has a very pleasant conservatory, furnished with sofas and chairs and where residents are permitted to smoke. This is also used as an area, which service users, can entertain visitors in private. Two semi-independent living flats are sited on the first floor of the home, which are self-contained and have their own kitchen, living room, bathroom and bedroom accommodation. These facilities were not examined at this inspection. Two service users rooms were viewed with the permission of the occupant. Their rooms were furnished to a good standard and contained personal belongings, which reflected the personal tastes and preferences of the individual service user. One of the service users confirmed they had made a painted, decorative wooden fish, which was hanging on the wall at wood n stuff day centre. Several service users had bought themselves equipment such as music centres, televisions and computers. A previous requirement was made about poor lighting in a service users rooms. The manager confirmed that the service user had requested dim lighting this has now been replaced with a normal light bulb and was seen to produce adequate lighting. The home has two communal bathrooms. One of the bathrooms has an assisted bath and the other has an unassisted bath and a walk-in shower. This bathroom is due to be refurbished. The bath is to be replaced and the walls tiled form floor to ceiling and overhead hoist and tracking is to be installed. For security purposes the front door operates on a keypad entry system. Visitors are required to press the buzzer and wait for assistance. For additional security an internal door has been fitted in the corridor upstairs to prevent persons gaining access via the back stair well. This door has a button release, which is easy for service users to operate and does not restrict their movement around the home. All areas of the home were of good standard of cleanliness and hygiene, with no unpleasant odours. At the previous inspection it was noted that the kitchen cleaning rota did not correctly reflect the frequency at which kitchen equipment was cleaned. This was checked and evidence was seen that cleaning is being completed in accordance to the rota. The laundry room is sited off the corridor away from the kitchen and is accessible by service users so that they can do their own washing. There are two washing machines one of which has a sluice cycle for the thorough cleaning of soiled linen. Paper hand towels and liquid soap dispensers were available in all bathrooms, en-suites and toilets, where staff are required to provide assistance with personal care. Purplett House Residential Home DS0000067479.V331220.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36, Quality in this outcome area is good. Service users can expect to be protected by the home’s recruitment procedures and supported by staff that are trained, skilled and competent to do their job. However, staffing levels at night need to be addressed to ensure the needs of individual service users are met and their rights and choices respected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The duty roster was seen which reflected that the home is staffed by a minimum staffing level of three staff on the early and late shifts. This includes a team leader or senior and two support workers. The shifts are 7.30am – 3pm and 2.30 -10 pm. There is one waking night staff and a second on a “sleep-in” basis to support service users. The sleeping in member of staff is in case of emergencies during the night. Two issues were raised, one concerning two of the service users whom require two staff to assist them with transfers and personal care and the other around staff safety. The two service users have to be in bed by 10.30pm to fit in with the staffing arrangements and therefore have little choice over when they wish to go to bed. On occasions where they have gone out for the evening, the manager confirmed the sleep in staff have worked extra hours to be flexible to assist the service users on their return. Purplett House Residential Home DS0000067479.V331220.R01.S.doc Version 5.2 Page 19 This was discussed with the manager who confirmed the situation is not ideal, and stated the budget does not allow for two night staff. They also felt there was not enough work for two staff during the night shift. Altering staff hours has been considered but the staff raised concerns about their safety leaving the premises alone at midnight. Training statistics confirmed that the home are on line to meet the National Minimum Standards (NMS) recommended ratio of 50 of care staff with a recognised qualification. In total the home employ 18 staff, 3 staff are in the process of completing level 2 National Vocational Qualifications (NVQ), 4 staff already have level 2 and 1 has level 4. Staff files reflect that other training has taken place, including a team leader who has completed the train the trainer for people handling and risk assessments. Additionally staff have attended training for first aid, moving and handling, care of medicines, protection of vulnerable adults and food hygiene. All senior staff have attended supervision training to support them in their role. A team leader is scheduled at the end of March to attend a 4-day appointed person’s first aid training course. The manager is aware that all staff requires training on fire safety, they have been trying to arrange the training since October 2006. At a recent up date of the homes fire risk assessment carried about Sanctuary health and safety officer identified fire safety training as an urgent issue. The manager provided an email from the training department confirming that they have again requested the training. New employees are provided with the homes own induction pack covering a 3 day induction into the service which links into the homes policies and procedures, layout of the building, risk assessments and familiarisation with the service users. The files of two new employees confirmed they had been issued with an induction booklet produced by Sanctuary care in line with the Skills For care, Common Induction Standards (CIS). The workbook consists of 6 sections, which are assessed by the manager. Once these have been signed off by the manager they are sent to an assessor with in Sanctuary care who verifies the successful completion of the workbook. Staff files seen confirmed the home generally operates a thorough recruitment process, which includes obtaining all the appropriate paper work including Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks. All new staff have been issued with new contracts with Sanctuary Care. Staff that worked for Shaftesbury are currently involved in a period of consultation over some changes to their contract and terms and conditions of employment. The files confirmed that formal supervision takes place on a regular basis and covers work performance, relationships with service users and other staff, roles and responsibilities, health issues and personal development. Two staff spoken with during the inspection confirmed they received supervision and were clear about their roles and responsibilities. They felt they worked well as a team and were mutually supportive and appreciative of each other. Purplett House Residential Home DS0000067479.V331220.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,42, Quality in this outcome area is good. People living in the home can expect have their health, safety and welfare protected and have the home run in their best interests by an effective and competent manager. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has a wealth of knowledge and experience of working with people with physical and learning disabilities and caring for the elderly. They have worked with the previous and existing company for approximately 18 years. They have achieved an NVQ level 4 in management of care services. There was a clear management ethos at the home that encourages service users to be independent. Service users spoken with confirmed they are encouraged to take control of their lives with the support of staff. The atmosphere during this inspection was relaxed with good interactions between staff and service users. Purplett House Residential Home DS0000067479.V331220.R01.S.doc Version 5.2 Page 21 Sanctuary Care has their own quality assurance department and has recently visited Purplett House to assess the homes risk assessments and care plans and their effectiveness. The home is awaiting the report of their findings. The manager confirmed a further full survey obtaining service users, relatives and other person(s) involved with the home is to be conducted at the end of the year. The manager agreed to forward a copy of the results of the surveys to the Commission for Social Care Inspection (CSCI). Previous surveys were seen on display in the entrance hall for service users and visitors to read. Additionally, a representative from sanctuary care visits the home on a monthly basis as required by Regulation 26 of the Care Homes Regulations 2001. A previous requirement had been made for the home to monitor the siting of fire fighting equipment on a monthly basis. The fire logbook seen confirmed that weekly testing of fire detection systems; fire fighting equipment and emergency lighting was taking place. Documentation was provided confirming that an independent company had serviced the fire alarm system and fire fighting equipment within the last 12 months. Sanctuary Care’ s health and safety officer has reviewed and revised the fire safety risk assessment and policies and procedures. They identified a number of issues and made a number of recommendations, which included, staff training, new signage, additional internal and external emergency lighting, replacement fire doors and for the home to implement a contingency plan in the event of an emergency. The manager provided evidence that they were working through the recommendations. They had already implemented some of the smaller items but had contacted the organisations surveyor regarding the lighting and replacement doors. Purplett House Residential Home DS0000067479.V331220.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 2 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 2 X 3 X LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 3 X 3 3 3 X X 3 X Purplett House Residential Home DS0000067479.V331220.R01.S.doc Version 5.2 Page 23 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. 1. Standard YA5 Regulation 5 (b)(c) Requirement The registered person must make sure a written and costed contract/statement of terms and conditions between Sanctuary Care and the service user must be provided. A copy of the contract must be signed, dated and agreed by the service user and the registered manager. The registered person must make sure where there are concerns over a service users capacity to consent to the use of personal equipment, which restrains their movement. The service users capacity needs to be determined in line with the Mental Capacity Act 2005 and if unable to understand and agree to the risks of not using the equipment they should have family or independent advocacy support to establish their best interests. The registered person must make sure that staffing levels at night are addressed to ensure the needs of individual service users are met and their rights and choices respected. DS0000067479.V331220.R01.S.doc Timescale for action 05/04/07 2. YA18 Sch 3 (3)(q) 05/04/07 3. YA33 18 (1) (a) 05/04/07 Purplett House Residential Home Version 5.2 Page 24 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 YA1 Good Practice Recommendations It is recommended that information provided about the home and which relate to service users, such as care plans and contracts are available in formats suitable for their needs. Where there are restrictions of freedom and choice imposed and/or agreed by a service user, which have the potential for the service user becoming verbally aggressive, consideration should be given to planned interventions, on how to manage this behaviour. For example, locking cupboard doors in the kitchen to restrict access to food due to a health related condition also creates restrictions of choices for other service users in the home. Further training should be considered for staff involved in the planning process, for example accredited training providers such as BILD. 2. YA7 Purplett House Residential Home DS0000067479.V331220.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Purplett House Residential Home DS0000067479.V331220.R01.S.doc Version 5.2 Page 26 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!