Inspection on 09/02/06 for Spout House Support Services

This inspection was carried out on 9th February 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

Spout House Support Services 08/02/07

Spout House Support Services 20/10/05

Spout House Support Services 14/03/05

Spout House Support Services 08/06/04

Spout House Support Services 09/03/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Spout House Support Services Spout House Bay Horse Lancaster Lancashire LA2 9DE Lead Inspector Mrs Joy Howson-Booth Announced Inspection 9th February 2006 2.00 Spout House Support Services DS0000010040.V271689.R01.S.doc Version 5.1 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 Spout House Support Services DS0000010040.V271689.R01.S.doc Version 5.1 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. Spout House Support Services DS0000010040.V271689.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Spout House Support Services Address Spout House Bay Horse Lancaster Lancashire LA2 9DE 01524 792261 01524 792261 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) Mrs Pamela Joyce Broxup Miss Joanne Helen Swindlehurst Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Spout House Support Services DS0000010040.V271689.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th October 2005 Brief Description of the Service: Spout House is a small residential care home registered to accommodate up to five people of either sex who have a learning disability and associated needs. The home’s aim is to provide a domestic environment, which consolidates existing skills and abilities and endeavours to develop the lifestyles and potential of each of its residents. Spout House Support Services DS0000010040.V271689.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and was carried out by the inspector for the home over four hours. The services provided by the home were inspected against the National Minimum Standards. There were 5 residents in the home who were spoken with. In addition, two staff on duty, the assistant manager and registered manager were spoken with. Two care files were examined, along with other documentation held by the home. Comment cards were received from the residents, along with a comment card from a relative. All the residents spoken with said they liked living at the home and felt they were well cared for and their needs met. What the service does well: Spout House is a small home, which continues to provide the residents with an individual, needs-led service, which respects the skills, abilities and needs of each of the residents accommodated. The five residents have all been at the home for a number of years and continue to have good relationships with each other and with members of staff. It was noted that residents asked staff to assist them in completing comment cards for this inspection which displays trust and confidence that their comments will be relayed. All but one comment card received indicated that the residents like living at the home and feel well cared for. Comments on the remaining card were discussed with the registered manager who provided further information and clarification over the comments made. Comment cards were also received from three GP’s who confirmed that the staff at the home work in partnership and communicate clearly with them and they are satisfied with the overall care provided by the home. Being small, the staff team are supportive and encouraging and there is a real commitment to making sure staff are provided with relevant training to meet the individual needs of each of the residents. Staff spoken with during this inspection commented on the good team working that they feel helps in the delivery of the care, particularly at times when residents are needing more indepth support. There has been a very low turnover of staff which means the Spout House Support Services DS0000010040.V271689.R01.S.doc Version 5.1 Page 6 residents are being cared for by familiar people who know their needs and are able to support them appropriately. Again, the registered manager continues to demonstrate openness and cooperation with the Commission for Social Care Inspection and it is hoped this can continue in the future. What has improved since the last inspection? What they could do better: It was disappointing to see that the planned redecoration and refurbishment work continues to be on hold due to the work required to the roof which continues to be delayed due to bad weather. It is hoped that this redecoration and refurbishment work can be commence and be completed as soon as possible so that the home can continue with its redecoration and refurbishment work thereby ensuring a comfortable and homely environment. The registered manager was advised that a development plan for the home should be organized as this would give a clear picture of areas for development and enable planning to take place. The registered manager was advised that incidents of restraint should also include the actual timing of the restraint. Please contact the provider for advice of actions taken in response to this Spout House Support Services DS0000010040.V271689.R01.S.doc Version 5.1 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Spout House Support Services DS0000010040.V271689.R01.S.doc Version 5.1 Page 8 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 Spout House Support Services DS0000010040.V271689.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): No standards were assessed from this section during this inspection. Standard 2 was assessed and met at the previous inspection EVIDENCE: Spout House Support Services DS0000010040.V271689.R01.S.doc Version 5.1 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 9 There are clear and very comprehensive care documents in place which mean staff know and understand areas of risk and how to meet residents needs. Residents to feel consulted and make decisions about their lifestyles and feel listened to. EVIDENCE: There have been no new admissions since the last inspection. Care plans examined were very comprehensive and provided a range of information over the needs of the residents and how these were to be met. Feedback comments from a relative confirmed that they are kept informed of important matters affecting their relative and they are consulted about their care. Comment cards received from three GP’s confirmed that the staff demonstrate a clear understanding of the residents needs, medication is appropriately managed and there is always a senior member of staff to confer with. Spout House Support Services DS0000010040.V271689.R01.S.doc Version 5.1 Page 11 Where appropriate, there are guidelines in place for support and areas of risk and include daily routines, community activities, etc. Where support may include breakaway or restraint practices there are clear instructions in place provided as a result of specialist input along with training for staff. Staff spoken with confirmed that care plans and other guidance are reviewed 6 monthly and changed as required. There was evidence on care files that residents are involved and have signed to confirm this. Residents are able to make decisions about their lives but, because of their individual needs, this is often with assistance and guidance of the staff. Each resident has their own key worker who takes a lead role in their care. Previously there were no formal residents meetings but discussions with the residents took place “around the table”, for example, at mealtimes. More recently, the home have begun to introduce more formal residents meetings which are being built up over time. Discussions with residents confirmed that generally they are happy with the staff and the care provided and feel they are consulted about what goes on in the home. Spout House Support Services DS0000010040.V271689.R01.S.doc Version 5.1 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15 and 16 Residents are supported to have a good quality of life which includes experiencing a range of social and leisure and activities which are age appropriate, positive and reflect their preferences and wishes. Residents rights are respected at all times. There are no restrictions for families to visit the home. Residents benefit from seeing their families when they want. EVIDENCE: Each resident has their own individual care plan which also sets out their daily routines and activities. Residents at this home do not wish to seek employment, although one resident does do some voluntary work. Spout House Support Services DS0000010040.V271689.R01.S.doc Version 5.1 Page 13 Given the location of this home, residents are reliant on staff support to access public transport or for staff to use their own cars. Outings, etc., are discussed with residents and organised by the home. These include College courses, trips to local shops and amenities, outings to local pubs and cafes. All residents are registered to vote, although some prefer not to do so. Staff are employed to work flexibly with the residents with additional staff being brought on duty for community activities. Comment cards received from residents indicated that generally the home does provide suitable activities, although one resident commented that the there are not many amenities in the location. Family and other contacts are welcomed. A feedback card received indicated that relatives feel welcome at the home. The registered manager confirmed that two residents visit their parents in another town and there are good arrangements in place to ensure risks are minimised. Residents spoken with felt they are happy with the activities to date but would welcome more community activities. Residents also felt their rights were respected by staff. It is noted that where there are any restrictions for residents these are decided within a multi-disciplinary setting and clearly recorded on the individual residents file Spout House Support Services DS0000010040.V271689.R01.S.doc Version 5.1 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 19 Personal and healthcare support is provided by a dedicated and experienced team of care staff and advice and guidance is incorporated into the care plans which enable staff to meet healthcare and personal needs in a professional, dignified and sensitive manner. EVIDENCE: Personal support needs and other healthcare needs, wishes and preferences are clearly recorded in each individual residents care plan. These are reviewed six monthly or sooner if required. Discussion with residents confirmed that staff respect their privacy and personal support is provided with dignity and respect. Guidance and support is provided according to individual needs. Only female staff provide personal care. All residents have their own key worker who take the lead and act as a point of personal contact and support for their named resident. Comment cards completed by residents indicated that generally they feel well cared for. Comments on one card were discussed with the registered manager who provided clarification over the comment made. Spout House Support Services DS0000010040.V271689.R01.S.doc Version 5.1 Page 15 No residents control their own medication at present. Access to a range of healthcare professionals is arranged and care plans examined evidenced that monitoring of healthcare takes place and, as needed, a range of other healthcare professionals are accessed. Practical and emotional support is provided to residents to attend clinics, etc. Spout House Support Services DS0000010040.V271689.R01.S.doc Version 5.1 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The arrangements for dealing with complaints are good. Residents can speak up and feel that they are listened to. Residents are protected from abuse by trained staff who are supervised by a competent manager EVIDENCE: Discussions with residents indicated that they feel listened to and their views acted on. Residents indicated that the management team will listen to them and provide advice and help. All the comment cards received from residents indicated that they knew who to talk to if they were unhappy about their care. The home has a formal complaints procedure and residents are informed of this in their ‘resident information pack’/service user guide. Feedback from a relative confirmed they are aware of the home’s complaints procedure. Residents have their own key worker who can be accessed for one to one discussion and support. No complaints have been received either at the home or by the Commission regarding this home. Discussion with staff confirmed that all have received training in abuse awareness and have access to the homes policy and procedure. If there were any concern in this area, staff would seek advice of the senior member of staff on duty. Spout House Support Services DS0000010040.V271689.R01.S.doc Version 5.1 Page 17 There are instances where staff may have to employ the agreed restraint procedure on named residents. These procedures have been agreed within a multi-disciplinary setting and are formalised. Only staff trained in these practices are allowed to undertake them. An incident log is completed for any instance when restraint has had to be used. It was advised that this record should also include the timing of any restraint. The registered manager is aware of her responsibilities where an instance of abuse allegation is reported. The home provides staff with a Code of Conduct which gives clear guidance for staff regarding residents monies and financial affairs. Spout House Support Services DS0000010040.V271689.R01.S.doc Version 5.1 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): No standards within this section were assessed. Standards 24 and 30 were assessed at the previous inspection with a recommendation that once the major roof repairs have been completed the redecoration programme of the home should continue. EVIDENCE: Spout House Support Services DS0000010040.V271689.R01.S.doc Version 5.1 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): No standards were assessed during this inspection. Standards 32, 34, 35 and 36 were assessed and met at the previous inspection. EVIDENCE: Spout House Support Services DS0000010040.V271689.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 and 42 The manager has a good understanding of the areas in which the home needs to improve. The manager provides good support to the staff and residents at the home who feel confident their rights and interests are safeguarded. EVIDENCE: There is no annual development plan for the home and the registered manager was advised this would be useful to identify development of the service for the future. As mentioned in previously report, a formal external quality assurance system may something that would not be used in such a small home. However, feedback is obtained directly from residents. Staff meetings, house meetings and key worker feedback is also provided. External feedback is sought from from other professionals, visitors, relatives, at the annual review for individual residents. Spout House Support Services DS0000010040.V271689.R01.S.doc Version 5.1 Page 21 Residents were provided with copies of comment cards which staff helped them to complete. Most indicated they were satisfied and happy at the home. Individual comments in the comment cards were discussed with the registered manager who provided further clarification. The pre-inspection questionnaire confirmed that all the home’s policies and procedures are reviewed on an ongoing basis. The pre-inspection questionnaire submitted by the home’s registered manager confirmed that maintenance of equipment and facilities takes place, along with regular fire drills and testing of equipment. It was also confirmed in the pre-inspection questionnaire that staff training has included First Aid, Fire Safety, Food Hygiene, Moving and Handling, Health and Safety, Infection Control. Only staff who have had training administer the medication to residents. Staff also received induction and other training to meet the Skills for Care requirements. Risk assessments are carried out and samples of these were seen on file. The accident book was examined and found to be accurately kept. Spout House Support Services DS0000010040.V271689.R01.S.doc Version 5.1 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 X 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 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 X 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 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X X X 2 x X 3 x Spout House Support Services DS0000010040.V271689.R01.S.doc Version 5.1 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. 1 Refer to Standard YA24 Good Practice Recommendations The redecoration and refurbishment programme for the home should continue once the roof repairs have been completed – confirmation of this should be sent to the Commission. A business plan for the home to be developed to identify areas for development in the future. When physical restraint takes place the incident record should show the timing of the actual restraint 1 2 YA39 YA23 Spout House Support Services DS0000010040.V271689.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Spout House Support Services DS0000010040.V271689.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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