Inspection on 08/06/07 for St Andrew`s

This inspection was carried out on 8th June 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

St Andrew`s 19/09/06

St Andrew`s 01/03/06

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 St Andrew`s 114 Kiln Road Fareham Hampshire PO16 7UN Lead Inspector John Vaughan Key Unannounced Inspection 8th June 2007 10:30 St Andrew`s DS0000066327.V338697.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 St Andrew`s DS0000066327.V338697.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. St Andrew`s DS0000066327.V338697.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Andrew`s Address 114 Kiln Road Fareham Hampshire PO16 7UN 01329 827323 01329 827323 standrews@truecare.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Truecare Group Limited Mr Russell John Weeks Care Home 5 Category(ies) of Learning disability (5) registration, with number of places St Andrew`s DS0000066327.V338697.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th September 2006 Brief Description of the Service: St Andrew’s is registered to provide care and accommodation for five people with learning disabilities between the ages of 18 and 65. Information provided by the manager confirms the fees are currently £192.00 to £232.00 per day to live in this service. The home is situated on the outskirts of Fareham and on a main road. The home is on one level and all service users are provided with a single bedroom with en-suite facilities. Service users share the use of a lounge, kitchen / diner and a bathroom. The home has a large, split level garden to the rear. St Andrew`s DS0000066327.V338697.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector met with people using the service, staff members and the manager of the home during the visit to the service, which took place over one day. During the visit the inspector spoke to people about their experiences of the home, observed people and staff, sampled records, interviewed staff and looked and the facilities and environment provided for people who live in the home. The inspector also reviewed information held by the commission including previous reports, incident reports and the Annual Quality Assurance Assessment (AQAA) provided by the manager of the service. What the service does well: People benefit from a well managed and varied activity programme that has been put together based on their individual needs and interests which includes going to college, trips out, walks, shopping, gardening, dancing classes and an annual holiday. Detailed care plans support the people with their assessed needs and these are reviewed with the individual on a monthly basis. The home has a very comfortable and relaxed atmosphere and people who use the service and staff talked openly together. The inspector saw positive contact between the staff and people who live in the home. A menu plan has been developed to give multiple choices to individuals on a daily basis and people said they liked the choices being offered. The home is clean and tidy and free from any unpleasant smells. Rooms are light and bright and have been decorated to a good standard. People who use the service told the inspector that they felt very happy with their private rooms. The home provides a high staff level to meet the needs of people and these staff are supported to develop their skills through a good training and development programme. St Andrew`s DS0000066327.V338697.R01.S.doc Version 5.2 Page 6 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. St Andrew`s DS0000066327.V338697.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 St Andrew`s DS0000066327.V338697.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. This judgement has been made using available evidence including a visit to this service. People who wish to use this service are only admitted after a full assessment of their needs and this information is used to produce a care plan to meet these needs. EVIDENCE: The home has admitted one new person to the home since the last inspection of the service. The manager confirmed that this person was an emergency admission. The inspector examined the records for this individual and found a good level of information. This included a full assessment of the person’s needs carried out by the placement officer. Copies of assessments from the care manager and community nurse were also on file to support this assessment. The information seen in these assessments could also be seen in the person’s care plan demonstrating that the individual’s needs have been responded to. St Andrew`s DS0000066327.V338697.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 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service are supported by a care plan and risk assessment that responds to their needs, reflects the choices they make and keeps people safe. This is enhanced by the high level of understanding of these plans demonstrated by the staff team. EVIDENCE: The inspector looked at two of the plans at this visit. Each plan has a strategy to support areas of need associated with daily living. Communication, personal care, social and leisure needs are covered with clear instructions on how to support the person with these needs. The care plan is reviewed monthly with the person using the service and a signed record of this review is maintained on each of the files. These meetings help the person to look at what they have achieved and make decisions about what to do for the coming month. An annual review takes place involving other St Andrew`s DS0000066327.V338697.R01.S.doc Version 5.2 Page 10 people outside of the home such as family members, advocates and the person’s care manager. Strategies contained within the care plans linked to the assessed support needs of the individuals and recommendations of the specialist that are involved in the person’s care. Equipment has been provided by the home following specialist assessment to support an individual to develop independence and facilitate improvement in their self-help skills. Personal plans reflected the day to day lives of the individuals and included clear information of the individual likes and dislikes of people, what they like to do with their leisure time and areas of needs that are being developed with intervention strategies. The inspector sat with one of the people who use the service and a carer and had a coffee. They told the inspector about their plans to go out shortly and during their preparations for the trip the inspector observed the member of staff assisting the person to make choices about appropriate clothing and giving reassurances about were they were going and how they were getting there. The support was provided in a positive and valuing way. Another staff member was supporting one person on a one to one basis and in discussion with the inspector they demonstrated a detailed understanding of this person’s needs including the best way to support the individual to make decisions for themselves. People using the service looked comfortable with staff and interacted well with the people supporting them. Risk assessments are contained within the care plans providing guidelines for the staff team on how to keep the person safe when taking part in activities. The areas covered include community activity, supervision needs, bathing and personal care, medication, environment, diet, cooking, aggression and management of violence. The manager stated that the organisation is reviewing the use of restraint in all of its services. One of the actions is to stop the use of prone restraint. The manager told the inspector that staff have attended a workshop on person centred planning and a new template for an accessible plan has been set up. It is the intention of the manager and his team to work with people to produce these plans. St Andrew`s DS0000066327.V338697.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): 12, 13, 14, 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. People who use this service continue to benefit from a wide range of activities based on their assessed needs, interests and hobbies together with a balanced and varied menu offering choices and healthy options. EVIDENCE: The inspector spoke to two service people who live in the home during his visit. An activity plan was seen for each service user and these plans cover recreational, daily living and educational activities. People who use the service told the inspector about the activities that they are taking part in. These included trips on public transport to local shops and pubs. St Andrew`s DS0000066327.V338697.R01.S.doc Version 5.2 Page 12 On the day of the visit three people were at college. The two remaining people both went out of the home, one for a countryside walk which is a favourite activity and another person went to the local town to do some shopping and have something to eat while they were out. Information from care plans demonstrated that the activities organised are linked to the goals and objectives agreed with the individual. People who use the service are also supported to take an active part in the homes day-to-day routines including meal preparation, laundry and cleaning. People were observed talking to staff about their day and helped to plan activities. Staff supported service users in a positive manner helping each person to complete an activity or make choices about what to do in the afternoon. One person is actively encouraged to spend more time integrating with other people in the home and this is being done in a way that is sensitive to the needs and wishes of the individual. The keypad lock system fitted to the front door just before the last visit to the home is still in use however the manager reported that this will no longer be of benefit following the departure of a person who moves next week and he is looking to have it removed. During the visit the inspector looked at the menu plan that has been updated to a summer version. This continues to offer more choice and flexibility to people. Fresh fruit and vegetables were available and a staff member who has responsibility for food and provisions regularly shops for fresh ingredients to make the meals on the menu. People said they enjoyed the meals and the inspector noted that the favourite foods of one person were included on the menu. The team are supporting one person with some difficulty in eating and clear strategies have been put in place in conjunction with healthcare professionals to respond to these needs. St Andrew`s DS0000066327.V338697.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 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The physical and emotional needs of service users are well met and improvements to the medication practices demonstrate that people using this service are kept safe. EVIDENCE: The inspector saw evidence of contact with General Practitioners, dentists and specialist consultants and a record is maintained of contact with health professionals. One person had been supported to see the dentist on the morning of the visit. Details of health and emotional support needs are included within the individual’s care plans. None of the service user’s currently self administer medication. A monitored dosage system is being used and medication is stored in a secure cabinet. Staff complete medication training at a local college before they can administer medication. The manager has introduced a more detailed assessment of St Andrew`s DS0000066327.V338697.R01.S.doc Version 5.2 Page 14 competency that is carried out with staff following their training and prior to them being able to administer medication in the home. Medication records were accurate and no surplus items were found in the medication cabinet. St Andrew`s DS0000066327.V338697.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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home can demonstrate that the views and concerns of service users, their families and representatives are documented and acted upon. The practices within the home mean that service users are protected from abuse. EVIDENCE: A complaints log is in place and the manager reported that they had received one complaint since the last visit. A record of the complaint, statements from the person using the service and people involved were on file and the matter was dealt with promptly. A policy and procedure is in place for responding to complaints within the home. The inspector spoke to staff at his last visit about the actions they would take to raise concerns and they were all aware of how to make the manager and senior staff aware of concerns, complaints and allegations. Staff have had training in adult protection and information received by the commission confirmed that prompt action is taken by the service when any concerns are raised. St Andrew`s DS0000066327.V338697.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, 25 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service benefit from a well maintained and comfortable home enhanced by individually personalised private rooms. EVIDENCE: The inspector observed that the home was clean was clean, tidy and free from any unpleasant smells. Two people allowed the inspector to view their private rooms. These rooms were decorated to their personal tastes with pictures, posters and personal items. An individual who moved in recently indicated that they were very pleased with their room and had everything that they need. St Andrew`s DS0000066327.V338697.R01.S.doc Version 5.2 Page 17 The inspector saw a well maintained home and the furniture and fixtures in the communal areas were of good quality. The manager is looking to replace the lounge sofas, which are showing signs of wear. A new water heater has been installed in the kitchen in response to requests from people in the home and this means that making hot drinks has become easier. The home has a large garden set out in terraces and this is very well maintained. The large hole that appeared last year has been filled and the manager told the inspector that they have plans to put a hobby/activity building in the garden to give people an alterative place to go when at home. St Andrew`s DS0000066327.V338697.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. Well-trained and supervised staff members support people who use this service. Improvements to the recruitment practices demonstrate that a thorough recruitment procedure is now followed in the home. EVIDENCE: The inspector examined the staff recruitment and training records. The inspector also looked at the day-to-day staffing in the home and the supervision and support staff members receive to carry out their roles. The organisation has agreed with the commission to hold its staff records centrally and each person has a form held within the home that details all of the checks that have been completed. The inspector examined two of these forms, one for the staff member whose records were incomplete at the last visit and one for the only person who has been recruited since the last inspection. St Andrew`s DS0000066327.V338697.R01.S.doc Version 5.2 Page 19 The records were fully completed with information to confirm that all checks have been completed for both individuals. This included two written references, details of the individuals Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) register checks. Staff training records were examined this provided evidence to confirm that staff are undertaking training and development relevant to their work. Staff undertake an induction and foundation course in line with the Learning Disability Awards Framework (LDAF) and skills for care. Information provided by the manager in his Annual Quality Assurance Assessment (AQAA) indicated that seven staff have obtained a National Vocational Award (NVQ) and three staff are working towards their NVQ 2 award. Training records confirmed that staff undertake training in moving and handling, fire safety, food hygiene, health and safety, management of violence and a four-day first aid course. Additional training is provided in autism and epilepsy. The manager has a training matrix that assists with monitoring to ensure updates are arranged. The inspector spoke to two staff members who stated that they feel well supported by their colleagues and the manager. Staff confirmed that they have formal supervision and one member of staff confirmed that they are in the final stages of completing their safe handling of medication course and have just started their NVQ award. St Andrew`s DS0000066327.V338697.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. Improvements since the last inspection demonstrate that the service is managed in an effective and open manner, a system is in place to develop the service with views from service users and their families included in this process and the home’s equipment is maintained and serviced to keep people safe. EVIDENCE: The manager is now registered with the commission and has completed their registered manager’s award (RMA). The areas identified at the last inspection including the reporting of incidents and the recruitment of staff have been addressed to demonstrate that the home is well managed. St Andrew`s DS0000066327.V338697.R01.S.doc Version 5.2 Page 21 Staff were very complimentary about the manager and stated that the service has focus and direction and the team works well under the guidance of the manager. The manager undertook a review of his service recently to complete the annual service development programme. The manager stated that they are working on alternative means of obtaining the views of people who use the service and their representatives. The manager has set out a number of areas in the service development plan to improve the service which include training for staff, improving communication, developing the communal space, making sure people are supported to get to college on time, developing the involvement of people in the home and improving activities at the weekends. The inspector confirmed by examining the homes servicing records and in formation supplied by the manager in the AQAA that the alarm system has been serviced regularly. Weekly alarms tests are completed, a fire drills and staff training in fire safety take place regularly. A weekly inspection of all fire fighting equipment takes place. St Andrew`s DS0000066327.V338697.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 3 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 3 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X St Andrew`s DS0000066327.V338697.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 St Andrew`s DS0000066327.V338697.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. 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