Inspection on 05/07/07 for Russets

This inspection was carried out on 5th July 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Russets 02/05/06

Russets 28/09/05

Russets 21/04/05

Russets 17/02/05

Russets 19/04/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Russets Russets Gatcombe Drive Hilsea Portsmouth Hampshire PO2 0TX Lead Inspector Nick Morrison Unannounced Inspection 5th July 2007 10:00 Russets DS0000029304.V338768.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 Russets DS0000029304.V338768.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. Russets DS0000029304.V338768.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Russets Address 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) Russets Gatcombe Drive Hilsea Portsmouth Hampshire PO2 0TX 023 9266 3780 www.portsmouthcc.gov.uk Portsmouth City Council Andrew Edward Cooper Care Home 15 Category(ies) of Learning disability (15) registration, with number of places Russets DS0000029304.V338768.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named service user over the age of 65 years may be accommodated. 20th October 2006 Date of last inspection Brief Description of the Service: Russets is a purpose built home run by Portsmouth County Council, which provides respite care for up to 15 adults with learning disabilities. Accommodation is split up into smaller living units and can support people with physical disabilities. Russets can provide daycare although most service users attend local day services. Russets DS0000029304.V338768.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report represents a review of all the evidence and information gathered about the service since the previous inspection. This included a site visit that occurred on 5th July2007 and lasted six hours. During this time the Inspector toured the premises, looked at six service users’ files and met with one service user. There was also written feedback provided by four service users and their families as well two Care Managers and on Community Nurse. All records and relevant documentation referred to in the report was seen on the day of inspection. The Inspector spoke with the Manager and three members of staff and also referred to the home’s own self-assessment. 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. The summary of this inspection report can be made available in other formats on request. Russets DS0000029304.V338768.R01.S.doc Version 5.2 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 Russets DS0000029304.V338768.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users benefit from having their needs assessed prior to moving into the home. EVIDENCE: Service users’ files showed that they had Care Management assessments that had been completed prior to them using the service for the first time. These were updated prior to subsequent visits to the home if necessary. Care Managers said there was good liaison with other professionals and that the home worked well with service users and their families prior to them using the service. They said that the home gained good knowledge and information regarding each service user and that this was well recorded. The Community Nurse said the home works in partnership with the Health Trust to ensure that information is produced in formats accessible to people who use the service and to ensure effective service user involvement in the running of the home. Russets DS0000029304.V338768.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users benefit from having clear individual plans in place and from support to take decisions and risks appropriate to their development. EVIDENCE: There had been a requirement from the previous inspection that the registered manager must ensure personal plans reflect how the service users wishes and needs to be supported using a person centred approach. 50 of the person centred plans must be developed and implemented by January 2007 and a further 50 by April 2007. The care planning system at the home had been re-designed within the framework of person centred planning. This had been a time consuming task and the home had employed additional staff in order to achieve it. Staff were in the process of receiving training in person centered approaches and most of the new plans had been written. The quality of the plans was good, with the Russets DS0000029304.V338768.R01.S.doc Version 5.2 Page 9 use of photographs and symbols to ensure they were accessible to the people they related to. People who use the service had been involved in devising the plans, along with relatives, care managers and other relevant professionals. The plans detailed exactly what support each person required and how the support needed to be delivered. A system was in place for staff to make themselves aware of the plans for people who were about to use the service. The plans were reviewed prior to each time the person began a stay in the home. A Community Nurse said that the comprehensive profiles enable people using the service to have their preferences included in their care plans. The plans emphasised the rights of service users and the importance of them being involved in decisions about their own care and their own lives. Plans contained information on how individual service users made and expressed decisions for themselves. Staff had good training in the various communication systems used by service users in the home and were able to communicate effectively with them. On the day of the inspection visit staff were observed communicating with service users over decisions about activities. The right of service users to make their own decisions was covered in staff induction training and was emphasised throughout the service including staff meetings, support and supervision and policies. Risk assessments were well written. They contained clear information about the identified risks and had appropriate control measures put in place to ensure that all risks were minimised as far as possible. These were also reviewed prior to, and during, each visit. Russets DS0000029304.V338768.R01.S.doc Version 5.2 Page 10 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): 12, 13, 15, 16 and 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users benefit from being part of the community and involved in varied activities. They also benefit from a healthy diet. EVIDENCE: The aim of the home is to ensure people enjoy the time they spend away from their usual home. Activities are planned and service users said they were offered opportunities to take part in them but could also choose not to. There was an activities board in the front entrance detailing what activities were planned for the week. Some activities took place outside of the home and people staying in the home were encouraged to use community facilities during their stay. There were also a lot of activities within the home and facilities that people could use as part of organised activities or that they could just go and use themselves when they wanted to. These included board games and snooker tables. There was also a multi sensory room for people who enjoyed Russets DS0000029304.V338768.R01.S.doc Version 5.2 Page 11 it. The home has recently purchased a new television for the main lounge. People staying at the home were also encouraged to be involved in maintaining the garden and developing their own gardening skills. Records were kept of all activities each person had taken part in during their stay. The Manager explained that there were plans to develop themed weeks in the home so that particular kinds of activities could be planned for different weeks and people could arrange their stays at the home based around the activities that were planned at particular times. The rights of service users were emphasised throughout the home. Care plans placed emphasis on this, as did the home’s policies. Staff observed during the visit were clearly aware of service users’ rights and of their own role in ensuring that rights were respected. Service users, parents and Care Managers said that the home respects the rights of people staying there. Care Managers also said that the home enables people to build and maintain social networks by planning stays so that they can be at the home at the same time as their friends. They also said that the mix of people staying at the home at any one time was managed well so that people would be there with people they get along with and consequently have a more enjoyable stay. The food in the home is provided by an external catering company. Menus showed that meals were varied and nutritious. Individual dietary requirements of people staying at the home were recorded and the catering company had that information. Staff and service users said the food provided by the company was very good and that there was always plenty of the food they liked. Food observed and the day of the site visit was healthy, nutritious and well presented. The caterers provided taster sessions so that people staying at the home could have the opportunity to try new and different foods. Snacks and drinks were available in the other kitchens around the building and people staying at the home were able to help themselves to these, subject to a risk assessment. Russets DS0000029304.V338768.R01.S.doc Version 5.2 Page 12 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 and 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users are protected by the home’s medication policy and practices and benefit from having their health and support needs met appropriately. EVIDENCE: There had been a requirement from the previous inspection that the registered manager must ensure service users receiving as required medications (PRN) have a care plan or intervention plan describing clearly when the medication is required. Evidence from individual service users’ files showed that they each, where necessary, had a plan in place to describe the circumstances within which PRN medication may be administered. The plans were clearly written and staff spoken with understood the plans and the process to be followed prior to administering PRN medication. This requirement has now been met. Russets DS0000029304.V338768.R01.S.doc Version 5.2 Page 13 There was also a recommendation from the previous inspection that the registered manager is advised to purchase a larger or another medication cupboard. This recommendation has now been met. The home has a dedicated room for medication, which can be locked. Inside the room there were two medicine cabinets fixed to the wall as well as a fridge for any medication that needed to be stored in that way. The home’s medication policy was suitable and was reviewed regularly. Staff spoken with were clear about the policy and had received appropriate training in administering medication. Medication was stored safely and good records were kept of all medication administered. There were also clear records of all the medication coming into and going out of the home. An effective system was in place for tracking all medication and for monitoring the administration of medication. The healthcare needs of service users were regularly monitored throughout their stay and records were kept. As a respite service the home liaised closely with relatives of people using the service about their healthcare needs. A Community Nurse also said that staff in the home were positive in seeking advice and responding to it. Service users’ plans were clear about how each person preferred to receive their care and relatives and service users were involved in compiling this information. Staff spoken with were clear about the need to support people in the way they preferred and this was emphasised through training and through the ethos of the service. Russets DS0000029304.V338768.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users benefit from a clear complaints policy and were protected by the home’s Safeguarding Adults policies and practices. EVIDENCE: There had been a requirement from the previous inspection that the registered manager must ensure all staff receive training in adult protection. The Manager explained that this requirement has now been achieved and staff training records confirmed this. The home had relevant policies and procedures in place regarding the protection of vulnerable adults. Good procedures were in place to ensure that service users’ finances were dealt with appropriately and clear records were kept of all transactions where staff supported service users to manage their money, or managed it on their behalf, while they stayed in the home. This was subject to external audits and the Manager explained how the system had been updated as a result of the auditors’ recommendations. There was a clear complaints procedure in place that was given to each service user prior to them using the service and was available throughout the home in an accessible format. Service users spoken knew how to complain if they needed to and knew where to direct complaints. The home also noted issues raised by service users or relatives that were not necessarily complaints. These were dealt with and records were kept. Russets DS0000029304.V338768.R01.S.doc Version 5.2 Page 15 All service users said they were aware of the complaints procedure and who to speak to if they were not happy and that they had been given relevant information prior to using the service. Russets DS0000029304.V338768.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 and 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users benefit from staying in a comfortable, safe and clean home. EVIDENCE: There had been a recommendation from the previous inspection that the registered manager is advised to keep all cupboards tidy and equipment easily accessible to minimise the risk of staff injuring themselves. Those cupboards seen during the inspection visit were tidy and equipment was well stored. There had been no recorded instances of staff or service users injuring themselves as a result of untidy cupboards. This recommendation has now been met. The home was comfortable and planned around the physical needs of service users. The amount of living space within the home was adequate for the number of people staying there and the home benefited from good natural lighting and ventilation. All parts of the home were accessible to service users. Russets DS0000029304.V338768.R01.S.doc Version 5.2 Page 17 Furniture provided in the home was comfortable and of good quality. The home was clean throughout, although retained a homely and comfortable atmosphere. The building is owned and managed by an external company who have responsibility for all facilities and maintenance. The Manager explained that there were service level agreements with the company to ensure that all building issues were dealt with as required and that the service they received from the company was very good. Records showed that maintenance was monitored regularly and issues were responded to in good time. Infection control procedures were in place and followed by all staff. The procedures were currently being audited against Department of Health guidance. Service users and their parents said the home was always clean and fresh. Russets DS0000029304.V338768.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): 32, 34 and 35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users benefit from being supported by competent, trained staff and are protected by the home’s recruitment policies and practices. EVIDENCE: Rotas showed that sufficient numbers of staff were on duty at all times in the home. During the inspection visit the Inspector observed staff interacting with service users in a very relaxed and supportive manner. The approach of staff observed on the day was wholly positive. They demonstrated that they understood the needs of service users and were skilled in communicating effectively with service users and supporting their personal development. Staff training records were good and showed that staff are able to access a wide range of training opportunities. Good, clear records were kept of all staff training, including induction training. Staff spoken with said that the quality of training within the home was very good and that it was quite freely available. They felt that the organisation supported them well in having the skills to do their job. Service users and their parents said that staff in the home were very good at communicating with people staying in the home. Russets DS0000029304.V338768.R01.S.doc Version 5.2 Page 19 Support and supervision sessions in the home were regular and clearly concentrated on the needs and wishes of service users. Service users said that staff in the home always treated them well and listened to and acted upon what they said. Staffing in the home was organised around the needs of service users, with staff being required to be flexible in their hours according to those needs. Staff interaction with service users in the home was extremely good and demonstrated that staff receive very good training in communication and supporting service users to be in control of their own lives and encouraging personal development. Staff records showed that all necessary pre-employment checks were carried out on each member of staff prior to them beginning work in the home. Russets DS0000029304.V338768.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, 39 and 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users benefit from living in a well run home and they are protected by the home’s Health and Safety policies and practices. Services users’ views are included in the planning and monitoring of the service EVIDENCE: The Manager is registered and has demonstrated that he has the skills, knowledge and qualifications to manage the service. Since this Manager has been in post there have been significant improvements to the service. This was evidenced through the development plan, inspection reports and confirmed in discussion with members of staff. The Manager demonstrates a commitment to the needs and rights of people using the service and is focussing on ensuring that service users are actively Russets DS0000029304.V338768.R01.S.doc Version 5.2 Page 21 involved in the development of the service. The Manager has enlisted the services of a local service users’ forum to advise the home on improving service user involvement. The home is developing a quality assurance system with the aim of regularly monitoring how well the service is performing and what developments are necessary. This process will be focussed on input from people who use the service, as well as other stakeholders. Service users and their families are asked for comments at the end of each stay and these are recorded and used to improve the service the next time the person comes to stay. Service users and their parents said they felt they were involved in the running and the development of the home. All staff had received health and safety training and workplace risk assessments were in place and regularly reviewed. Staff spoken with said they knew about and understood these assessments. Records were kept to show that all equipment was regularly serviced. All fire records were up-to-date. All accident and incident records were clear and the manager regularly monitored and reviewed these in order to look for patterns and plan to decrease future occurrence of these. Regular health and safety checks were made as part of the provider’s monthly assessment of the home. In addition, the home had a regular health and safety inspection from within Portsmouth City Council and any necessary improvements were recorded in a health and safety action plan. Russets DS0000029304.V338768.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 X 2 3 3 X 4 X 5 X 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 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Russets DS0000029304.V338768.R01.S.doc Version 5.2 Page 23 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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. Refer to Standard Good Practice Recommendations Russets DS0000029304.V338768.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Russets DS0000029304.V338768.R01.S.doc Version 5.2 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. 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!