Inspection on 03/03/09 for Saxon House

This inspection was carried out on 3rd March 2009.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Saxon House 05/03/07

Saxon House 10/02/06

Saxon House 14/07/05

Saxon House 10/02/05

Saxon House 29/09/04

Saxon House 11/06/03

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Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Saxon House 8 Saxon Close Warsash Southampton Hampshire SO31 9TS     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sue Kinch     Date: 0 3 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 23 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 23 Information about the care home Name of care home: Address: Saxon House 8 Saxon Close Warsash Southampton Hampshire SO31 9TS 01489601351 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): alangeorgegreen@ntlworld.com Mr Alan Green Name of registered manager (if applicable) Mr Alan Green Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Saxon House provides accommodation to one person a learning disabilities. There is a strong family emphasis as the person lives with the proprietor, his mother and his daughter. No additional staff are employed at the home. The person is included in every day activities and are integrated into the family. The home is situated in a small cul de sac in Warsash, and is within easy reach of the village of Warsash, Park Gate, and on a regular bus route to Fareham town centre. The person has their own room and free use of the communal rooms, the kitchen, lounge and dining room. Fees range from 320 - 350 pounds per week. Items not included in the fees are; chiropody, hairdressing and private tuition. 1 Over 65 0 care home 1 Care Homes for Adults (18-65 years) Page 4 of 23 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was the first unannounced inspection since 5th March 2007 although we carried out an annual service review in April 2007. For this inspection we took into account the information we already hold about the service and the information included in the Annual Quality Assurance assessment (AQAA) completed by a consultant for Mr Green. We received one survey from the person living in the home who was helped by the owner to complete the form. When we visited we spoke to the person receiving registered care and other members of the household. We visited for just over four hours. Care Homes for Adults (18-65 years) Page 5 of 23 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 6 of 23 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 7 of 23 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home would only offer a service to those whose needs had been assessed however the home is not planning to make any further admissions. Evidence: New people have not been admitted to the home for several years and since the last inspection the home has changed its registration from two to one. Mr Green as stated at the last inspection, is not planning to offer services to any other people in the future. The home does have an admissions procedure which was available but not reviewed at this visit as it had been assessed previously and it is not his intention to use it. A service users guide and statement of purpose is available in the front hall. Care Homes for Adults (18-65 years) Page 8 of 23 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Basic care plans and risk assessments are in place these need to be kept under regular review to ensure changing needs can be met. Evidence: Basic care plans are used at the home with information about the care to be provided. They include likes and dislikes, a weekly timetable and some brief risk assessments (referring to low and medium risks ) and statements about how some aspects of care should be provided. The care needed was discussed to some extent with the person living in the home and Mr Green and he showed that owing to the size of the home he was aware of the needs of the person accommodated. There was a written statement in the home stating that the care plans had been reviewed in 2008 and were planned to be reviewed again in March 2009. The person to which the care plan referred had been signed by them. It was advised that the support for aspects of personal care is described in more detail and to include the risks involved that Mr Green said he takes into account. Mr Green agreed to do this. Care Homes for Adults (18-65 years) Page 9 of 23 Evidence: From observation of interactions, and discussion with the people living in the home there was evidence that some activities out of the home are carried out jointly but individual interests were seen to be are supported in the home using various areas of the home. We told by the person living in the home that they liked it and could do the things they wanted to do. This was supported by another member of the household. Care Homes for Adults (18-65 years) Page 10 of 23 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are opportunities for the person living in the home to benefit from educational, social and community activities. Healthy and varied meals are provided based on choices. Evidence: Support is given to follow interests and examples of this included shopping and trips to Southampton, support to research on the internet and pursuing personal interests at home. A conversation was held with the person living in the home and Mr Green about one particular interest and the person had a large collection of items relating to this for personal use. A discussion was also held about support given to obtain other items of interest important to that person. There are weekly timetables of activity and the person said that they did the things in it and these were recorded as having taken Care Homes for Adults (18-65 years) Page 11 of 23 Evidence: place. This included trips out to favourite places and tutoring. All people in the home spoken with agreed that activities outside the home take place regularly and they had planned to go out that morning but it was postponed because of our visit with plans made for the next day. Most external activities and trips take place with other members of the household and this is what the person liked. Food was discussed and the person living in the home described favourite foods and confirmed that they were provided. They are also like being regularly involved in food shopping. Food provided is not recorded and Mr Green was advised and agreed to do so. Care Homes for Adults (18-65 years) Page 12 of 23 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Support is provided to ensure the person living in the home receives support to meet their health needs although checks are needed to ensure that it can be evidenced that medication is provided accurately. Evidence: In the AQAA we were told that there are regular health checks including visits to the dentist and opticians and that in the last twelve months record keeping has improved. Records in the home do indicate when recent health appointments to various health professionals have been attended and these indicated that these are regular and have taken place in the last eight months. We had verbal feedback from one person living in the home that support is provided for attending regular health checks. Personal care is provided and action needed is referred to in the section on individual needs and wishes. Medication is provided and is held securely. We looked at the records and one type of the medication held in detail. We and noted that a record is not made of the drugs Care Homes for Adults (18-65 years) Page 13 of 23 Evidence: coming into the home or of the number held. The record sheet did not match the dosage on the box and Mr Green was advised to correct this to demonstrate that the correct amount is given. Care Homes for Adults (18-65 years) Page 14 of 23 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The person in the home is supported to make their views known. Training has been undertaken to ensure the risks of abuse are considered. Evidence: No formal complaints have been received by Mr Green since the last inspection and during the visit the person receiving the service said they were happy at the home. A copy of the complaints procedure with service user guide is in front hall including advocate addresses. Mr Green said that an advocate was not involved at the time of our visit. In the survey received, which was supported to be completed by Mr Green, the person says that they are listened to and knows how to make a complaint , who to talk to and feels well treated. It was noted at the last inspection that Mr Green had undertaken training in Adult Protection training and the certificate was seen. Management of personal finances for the person in the home was discussed with Mr Green who is involved in organising them. Money is held for the person and this was checked against the records and a slight inaccuracy was found Mr Green agreed to check. It was noted that at the last inspection the system for recording payments was not clear and this had been amended in the book used for recording. It was noted that receipts are not held for all purchases and this as advised which Mr Green agreed to Care Homes for Adults (18-65 years) Page 15 of 23 Evidence: do. Care Homes for Adults (18-65 years) Page 16 of 23 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The person living in the home are provided with a clean, homely and safe environment. Evidence: The family environment provided is clean and homely. A small bedroom, full of personal possessions, is provided on the first floor within easy access of a toilet with a suitable lock. There is no lock on the bedroom door and Mr Green said that this had been discussed with the person previously and was advised to keep this under review. There is adequate communal space with use of the dining room and lounge and access to the kitchen. In the AQAA Mr Green said that a new three piece suite had been provided and that there were plans to provide a new large television. Records showed that Mr Green had previously completed infection control training. Information is held in the home for promoting health and safety. An example of this was a box labelled infection control which stores, disposable gloves and aprons and a DVD about the topic. Care Homes for Adults (18-65 years) Page 17 of 23 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The person living in the home has support from the manager who has the experience and skills to meet their needs. Evidence: The owner Mr Green is the main carer in the setting and this has been a long standing arrangement for eleven years. Some support is provided by his mother but the care in this home is provided in a family type environment where much activity takes place jointly. The person receiving care said they were happy there. Staff are not recruited to work in the home. Care Homes for Adults (18-65 years) Page 18 of 23 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager has the experience and skills to support the person living in the home. The person living in the home is involved in everyday decisions and their health and safety is supported. Evidence: The manager has over eleven years experience of running the home and since the last inspection sought a change in the condition of registration to be registered for one person and this was agreed. The service has continued to be provided mainly by Mr Green with support from family members. He has undertaken specific training during at times not since 2007 but is not planning to extend the service further and has not immediate training plans. He was advised to keep his training needs under review. The home continues to run on a family style basis and people are consulted about day to day decisions. Care Homes for Adults (18-65 years) Page 19 of 23 Evidence: At the last inspection it was noted that Mr Green was working in a quality audit for the home and was required to undertake a quality audit by July 2007. At this visit we note that this had been carried out by the use of an external consultant and a document in relation to this was in the home . Mr Green is aware that this needs to take place annually and said that he had carried out a further check in 2008 although a detailed record of this was not held. He was advised to record them to provide clear evidence. Aspects of health and safety were discussed and considered. We noted items for infection infection control in the kitchen. We noted evidence that testing of electrical equipment had taken place in January 2009. Mr Green said this had been completed and that he was waiting for the certificate. He said that he tested the hot water regularly although this was not risk assessed and was advised to be included in the personal care risk assessment for the person living in the home. We noted that fire drills and tests of the alarms are regular. Care Homes for Adults (18-65 years) Page 20 of 23 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 21 of 23 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 13 The registered person must 31/03/2009 ensure that prescribed drugs are provided and recorded accurately including a record of drugs coming into the home and of dosages. To ensure that it can be evidenced that drugs prescribed are administered in the right dosage at the right frequency. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 22 of 23 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 23 of 23 - 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!