Inspection on 04/12/06 for Southernwood

This inspection was carried out on 4th December 2006.

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

Southernwood 13/03/09

Southernwood 20/02/08

Southernwood 20/06/05

Southernwood 12/04/05

Southernwood 30/09/04

Southernwood 20/04/04

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Hillview Farm

Dalewood Respite Care

Orchard,The

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Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

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

CARE HOME ADULTS 18-65 Southernwood 148 Plantation Road Amersham Bucks HP6 6JG Lead Inspector Julie Willis Unannounced Inspection 4th December 2006 10:55 Southernwood DS0000023022.V322869.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 Southernwood DS0000023022.V322869.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. Southernwood DS0000023022.V322869.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Southernwood Address 148 Plantation Road Amersham Bucks HP6 6JG 01494 721607 01494 721607 h3m069stringer@mencap.org.uk H4037@mencap.org.uk Royal Mencap Society 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) Mr David Stringer Care Home 6 Category(ies) of Learning disability (0), Physical disability (0) registration, with number of places Southernwood DS0000023022.V322869.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 6 residents with learning disabilities, physical disabilities Date of last inspection 20th June 2005 Brief Description of the Service: Southernwood is a purpose built home, registered to provide accommodation for up to six adults with learning and physical disabilities. Each person living at the home has considerable care needs. The home is staffed by Mencap and is within a mile or so of local shops, and the towns of Amersham and High Wycombe are a few miles away. The home is not directly accessible by public transport. The home provides single bedroom accommodation with rooms of a good size, personalised and decorated to individual tastes and interests. There are lounge and conservatory areas and a kitchen/dining room. The home has two bathrooms with all necessary adaptations and lifting equipment. There is an enclosed garden that can be accessed through patio doors leading from the conservatory. All of the service users facilities are on the ground floor with just the office and staff bathroom on the first floor. There is parking at the side of the building. The fees for this service range from £948.24 to £2094.97 per week. Southernwood DS0000023022.V322869.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 10:55 am and was in the service for four and a half hours. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s manager, and any information that CSCI has received about the service since the last inspection. The inspector toured the building, looked at service users’ and staff records and observed care practice. Residents of this home are in the main non-verbal and were unable to provide verbal feedback to the inspector about the quality of care. The inspector met three of the residents and spent time observing what was going on in the home and how staff cared for the residents. As part of the inspection process a number of questionnaires were sent out by the Commission to health and social care professionals to ask for their views about the service. Responses were favourable and complimentary about the quality of care provided by the home. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. There were no legal requirements made following this inspection. The CSCI are not aware of any complaints about the home in the past year. What the service does well: This home is very good at providing care to users with complex health needs and with behaviours that may at times challenge the service. Staff were observed to be kind, caring and attentive to the needs of residents. The staff team are highly skilled and have received the training they need to provide good quality care. The whole of the staff team work well together to provide a happy and cheerful home for residents. The staff are very good at encouraging residents to learn new skills. They work well with other health care workers to improve the quality of life for the residents and to enable users to be more independent. Southernwood DS0000023022.V322869.R01.S.doc Version 5.2 Page 6 Written records were well kept and up-to-date and provided enough information for staff to provide the right care to each resident. 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. Southernwood DS0000023022.V322869.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 Southernwood DS0000023022.V322869.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): 2 Quality in this outcome area is good. All service users were fully assessed prior to admission to ensure the home could effectively meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have been no new admissions to the home since 2003. At previous inspections this standard had been met. Most pre-admission documentation has since been archived. From discussion with management and examination of service user documentation it is clear that all users are fully assessed on an on-going basis. Southernwood DS0000023022.V322869.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. The care plans were sufficiently detailed to enable staff to effectively meet service user needs. Service users are encouraged and supported to make decisions in relation to their everyday lives. All risks to service users’ safety are fully assessed and guidelines are in place to reduce the risk identified. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Examination of 3 service user care plans evidenced that the records were upto-date and well documented. It was evident that the staff team have tried hard to involve users in the care plan process despite the majority of users being non-verbal. The home has developed Person Centred plans, which have Southernwood DS0000023022.V322869.R01.S.doc Version 5.2 Page 10 been completed by the key worker alongside the resident. This has involved knowing the needs of each user well and involving other key individuals such as friends and family where appropriate. The care plans were comprehensive and holistic in detail and provided sufficient information for staff to provide the appropriate care. There was evidence in the files that care plans are reviewed regularly. The home has been proactive in involving the day centre staff team, social workers and other professionals in the formal reviews. This joint working has reduced the duplication of work for all those involved and the impact on the service user of having a number of separate reviews. Previously, each team of professionals held their own review of services, which was onerous for the resident. From examination of documentation and discussion with staff it is clear that the home positively encourages users to develop new skills and to increase their level of independence. In the case of one user the rehabilitation provided by the home has enabled the user to return to continence and to be independently mobile in his wheelchair. This may ultimately lead to the user moving to ‘supported living’. In another case the user has been provided with the necessary support and equipment to enable the user to feed themselves. From examination of documentation and discussion with the manager it is evident that all risks to users have been fully assessed and guidelines have been put in place to minimise the risk as much as possible. The service is aware of current policy issues and good practice developments and endeavour to involve users in the day-to-day running of the home within the limits of their individual capabilities. . Southernwood DS0000023022.V322869.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, 15, 16, 17 Quality in this outcome area is good. Service users take part in activities that provide opportunity for personal, practical and emotional development. Service users are encouraged to be part of the local community and citizenship is encouraged and supported. Service users are provided with a menu that is nourishing, varied and meets their individual and cultural need. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All service users are provided with the opportunity to engage in activities that are stimulating and worthwhile. Most attend local day centres several times a week where they are encouraged to participate in a range of group activities. Southernwood DS0000023022.V322869.R01.S.doc Version 5.2 Page 12 At home users are supported to listen to music, watch DVDs, or to go for walks to local shops in their wheelchairs. One user has a box of sensory ‘toys’, and also takes part in ‘paper play,’ which he particularly enjoys. The home has recently acquired an adapted vehicle, which can accommodate all of the users and several staff. This is used to transport users to communal facilities including local restaurants, cinemas, sports facilities and public houses. The availability of accessible user-friendly transport has resulted in plans to introduce two users to swimming sessions at the ‘Aqua vale wet entertainment centre’ where they will be accompanied by staff. Users are positively encouraged to develop and maintain their personal relationships. At the time of inspection a friend was visiting a resident. They were watching a film together in the lounge. The user was observed to be laughing and smiling and seemed to be enjoying the visitor’s company. Most users have regular contact with their relatives. Several are provided with support and transportation to visit their relatives and friends at home. Service users are positively encouraged to communicate their needs. Staff were observed to be able to interpret users’ non-verbal gestures effectively and to be patient and encouraging. One user is currently being supported to use verbal communication rather than using ‘Makaton’. Staff are being provided with support by the Speech & Language therapist to improve the residents’ communication skills and their progress is monitored and recorded in the daily records. The home provides a nourishing menu, which meets the needs of users. For those residents that need support at mealtimes help is provided discreetly and sensitively. One user has a PEG feed which is maintained by the home. Staff have received certificated training in the management of the Peg feed. Guidelines are in place to identify when there is a need to seek advice from healthcare professionals and dieticians. One user has a liquid diet. A dietician and other medical personnel monitor the user’s nutrition and weight. The home has been working with the professionals to encourage the user to experience a variety of new tastes and textures and this was a well-recorded part of their care plan. Southernwood DS0000023022.V322869.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. Service users’ physical and personal support needs are well met and medication is dealt with safely and appropriately. This judgement has been made using available evidence including a visit to this service. EVIDENCE: From discussion with management and staff and observation of residents it was clear that a number of the users have complex health needs or behaviours that at times may challenge the service. The home has been pro-active in seeking the support and assistance of other health and social care professionals to ensure that the behaviour and health issues are managed effectively. Users have been provided with the technical aids and equipment they need to maximise their independence. Track hoists, manual handling equipment and other aids are available throughout the home to ensure the comfort, privacy and safety of users. Staff are knowledgeable and skilled at meeting the specific needs of users and adopt a uniform approach to managing incidents and behaviours. Incidents are recorded fully Southernwood DS0000023022.V322869.R01.S.doc Version 5.2 Page 14 and the triggers for certain types of behaviour analysed to reduce likelihood of recurrence. All users have regular health checks and routine screening and treatments including dentistry, podiatry and attention to their vision and hearing. All users are offered regular vaccinations against flu and other illnesses by their doctor and any treatment is well documented. Observation of staff and service user interaction demonstrated that care was provided in a manner, which maintained the users right to dignity, privacy, independence and choice. The system adopted for the administration of medication is the monitored dosage system. This system reduces the likelihood of medication error and provides an accurate record of administration. All staff have been fully trained in safe administration and have been assessed by the Organisation as part of their formal training. Southernwood DS0000023022.V322869.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. The home has a complaints procedure, which is clear and accessible. Service users are protected from abuse and exploitation by well-trained and competent staff that are able to demonstrate knowledge of the home’s abuse of vulnerable adults and whistle-blowing policies. This judgement has been made using available evidence including a visit to this service. EVIDENCE: From examination of the complaints record it is evident that there have been no complaints recorded by the home or reported to the CSCI in the past year. Service users have access to the complaints procedure, which is explicit in their copy of the Service User Guide and readily available on the home’s notice boards. There was evidence in staff files that all staff receive training in the abuse of vulnerable adults as part of their formal induction and NVQ training in which it is a core module. Refresher training courses are also offered regularly. Staff were able to confirm that they were aware of adult protection issues and their responsibility in relation to whistle-blowing. Southernwood DS0000023022.V322869.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, 30 Quality in this outcome area is good. Service users benefit from living in a comfortable, homely environment, which is clean and hygienic This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the home evidenced that the home was clean and hygienic throughout. The home provides a physical environment, which meets the specific needs of residents who live there. The bathrooms and toilets are fitted with appropriate aids and adaptations to meet the needs of residents. Communal areas were spacious, light and airy and pleasantly furnished and decorated. The staff team have tried to reflect the particular likes and dislikes of individual users in their choice of decoration and furnishings in the residents’ own bedrooms. All rooms were well equipped and highly personalised. Southernwood DS0000023022.V322869.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Quality in this outcome area is good. Service users at this home benefit from having a highly motivated, well trained and skilled staff team to meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussions with management and staff on duty confirmed that they knew, understood and supported the aims and objectives of the home and fully complied with organisational policies and procedures. Staff demonstrated an awareness of the individual needs of service users despite verbal communication difficulties. They were able to interpret nonverbal signals appropriately and to offer appropriate choices to the users. The staff rosters demonstrated continuity of care through a designated and well-developed key worker system. The key workers are responsible for ensuring that daily records and key worker reports are kept up-to-date. Daily records clearly validated the content of care plans. Southernwood DS0000023022.V322869.R01.S.doc Version 5.2 Page 18 The relationship between service users and staff was observed to be relaxed, informal and positive. The current staffing levels are effectively meeting the needs of users, some of whom have complex needs. The home has a stable staff team and infrequently relies on agency workers to cover gaps in the roster due to sickness or annual leave. Examination of the staff files indicated that the selection and recruitment procedures at this home are robust. All necessary checks are carried out on staff to ensure that staff possess the necessary attributes to care effectively and protect users from abuse and exploitation. The staff have been properly inducted and have received training in core skills such as fire safety, first aid, manual handling, food hygiene, health & safety and infection control. All staff have received training in POVA (Protection of Vulnerable Adults) as part of their induction and as a core module in NVQ training. All staff at this home are highly motivated and have either achieved or are working towards a National Vocational Qualification at level 3 or 4. Staff confirm that they feel well supported by management and have the opportunity to express their views in the regular team meetings and in formal supervision sessions. They say that they are provided with plenty of opportunity to express concerns, share information and to feel included and involved in the way the service is delivered Southernwood DS0000023022.V322869.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good. The home is well run for the benefit of users by a competent manager and professional staff team. The home reviews its performance on an on-going basis, which seeks and focuses on the views of its users. Service users live in a safe environment. Risks to users’ safety are assessed and managed effectively. This judgement has been made using available evidence including a visit to this service. Southernwood DS0000023022.V322869.R01.S.doc Version 5.2 Page 20 EVIDENCE: The Registered Manager is widely experienced and is a Registered Nurse for people with learning disabilities. In order to enhance his knowledge and skills he has acquired the Registered Managers Award and NVQ 4 in Management. The staff on duty at the time of inspection confirmed that the home is well run by a supportive and caring manager who leads by example. The Manager regularly works on the roster alongside the staff team guiding and training. The process of managing the home is open and transparent. The monthly proprietor visit reports demonstrate a consistently high standard of care is provided at this home. Examination of the minutes of staff meetings indicated that they are held regularly and are entirely user focused. Systems of work are regularly reviewed and updated and are based on experience and good practice. Examination of a number of health & safety records indicated that all necessary checks and servicing of equipment in relation to fire safety and the maintenance of the water system are routinely undertaken to safeguard the health and welfare of users. Unnecessary risks to users are identified using a comprehensive risk assessment. So far as possible the risks are reduced or eliminated by putting in place effective procedures. Southernwood DS0000023022.V322869.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME 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 4 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 4 x 3 x x 3 x Southernwood DS0000023022.V322869.R01.S.doc Version 5.2 Page 22 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 Southernwood DS0000023022.V322869.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 Southernwood DS0000023022.V322869.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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