Inspection on 13/09/05 for Stepping Out (38 Hawthorne Rd)

This inspection was carried out on 13th September 2005.

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 found no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Stepping Out (38 Hawthorne Rd) 30/01/06

Stepping Out (38 Hawthorne Rd) 17/03/05

Stepping Out (38 Hawthorne Rd) 21/12/04

Stepping Out (38 Hawthorne Rd) 10/02/04

Stepping Out (38 Hawthorne Rd) 05/06/03

Similar services:

Chesham House

Argyll House

Dorset Lodge

Acacia House

Falcon House

Dial House Nursing Home

Cromwell Avenue (9)

Abbey Lodge

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

CARE HOME ADULTS 18-65 Stepping Out 38 Hawthorne Road Gorleston Norfolk NR31 8ES Lead Inspector Linda Wells Announced 13 September 2005, 09:30 th 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 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 Stationary 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. Stepping Out I55 s35106 Stepping Out v243159 AN 130905 (4).doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Stepping Out Address 38 Hawthorne Road, Gorleston, Norfolk. NR31 8ES. 01493 440325 01493 442531 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Norfolk County Council - Social Services Mr Mark Alexander Blunt Care Home 7 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (7) of places Stepping Out I55 s35106 Stepping Out v243159 AN 130905 (4).doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Seven (7) Service Users who have a Mental Disorder, excluding learning disability and dementia, may be accomodated. Date of last inspection 17th March 2005 Brief Description of the Service: 38 Hawthorne Road is a care home funded by a Norfolk Mental Health Trust but run by Norfolk County Council Social Services Department. The home provides short to medium term residential accommodation for a maximum of 7 people of either sex who are between the ages of 18 and 65 years and have experienced mental health problems. It is the aim of the care home to provide support and guidance within a comfortable residential setting, and to encourage the revival or development of skills and confidence with a view to the ultimate achievement of independent living. The care home is a large, detached house located on a quiet residential road within the Shrublands Housing estate in Gorleston on Sea. It has eight single bedrooms that all contain a wash basin and service users have communal use of a bathroom and toilets on each floor, a smoking and non smoking lounge, utility room and a kitchen/dining room. There is a large garden that surrounds the home, off street parking to the front of the property and a small number of local amenities that are accessible on foot and the main bus route into Great Yarmouth that passes nearby. Stepping Out I55 s35106 Stepping Out v243159 AN 130905 (4).doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection undertaken on the 13th September 2005 over five hours and was carried out as part of a routine inspection plan. The home has recently begun the process of integration with the Mental Health Trust Community Recovery team and is improving and forging close links with other local mental health resources. Prior to inspection, comment cards were received from four service users and one health and social care professional and all indicated that they were satisfied with the care provided, that staff treated residents well and that residents felt safe at the home. On the day of inspection five residents were living at the home and were seen to be sitting in the lounges, walking around the home, returning to the home, listening to music, having a snack and a main meal that one resident cooked. The inspection took the form of a tour of the premises, individual discussion with four residents, two staff members and the manager, observation of residents in the home, examination of care plans, records, certificates and compliance of requirements and recommendations from the last inspection. What the service does well: The home has a friendly, relaxed, inclusive atmosphere and the residents spoken to said that they liked living at the home, that staff were “supportive and helpful”, the routine of the home could be flexible and that they were encouraged to “do things for themselves and others in the home”. Residents are well looked after and staff members said that residents are supported and given the opportunity to “grow” by discovering or rediscovering their life skills. The two staff members spoken to said that they enjoyed working at the home, that they were encouraged to promote independence and that they put the needs of each resident first. Stepping Out I55 s35106 Stepping Out v243159 AN 130905 (4).doc Version 1.40 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. Stepping Out I55 s35106 Stepping Out v243159 AN 130905 (4).doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Stepping Out I55 s35106 Stepping Out v243159 AN 130905 (4).doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) The written information available about the home is complete and fully enables residents and staff to make a decision on whether the home will meet the needs of anyone wishing to live there. EVIDENCE: The Statement of Purpose and Service User Guide were seen and have been updated since the integration of the home with the Norfolk Health Partnership Community Recovery Team and the move to joint working with the Crisis and Respite House. Both documents reflect clearly the aims and objectives of the home and the services available and the copy of the Terms and Conditions contract that was seen in the individual plan of care of each resident demonstrated that residents were given the information they need about the home. Residents are admitted to the home following a stay in hospital. To ensure that the needs of residents are identified as being able to be met by the home, records showed that an assessment is completed prior to admission to the home that includes the views of residents, their family members and other professionals. Residents visit the home prior to admission and staff members have the opportunity to visit residents in hospital. One resident spoken to who had lived at the home for six weeks said that she had visited the home prior to admission and had decided to live there because staff were friendly, gave her enough information about the home and were encouraging. Stepping Out I55 s35106 Stepping Out v243159 AN 130905 (4).doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) The information held in the individual plans of care ensures that the health care needs of residents are identified and met, that residents are consulted and supported to take risks. EVIDENCE: Residents said that they were well supported by staff and that staff could be trusted to keep their confidences. Four individual plans of care were examined and found to demonstrate involvement, consultation and agreement of each resident on their plan of care. They contain relevant health, personal and social care information, daily records, risk assessments, key information, clinical history, back ground, involvement with health care professionals, weight records, nutrition and reviews. They did not contain a photograph of each resident and a requirement was made that a photograph be held in each plan of care to aid in the identification of each resident. Residents said that they are encouraged to be independent, make their own choices and that staff supported them in taking risks within their daily lives by maximising their potential around confidence, self-care and promoting life skills. Stepping Out I55 s35106 Stepping Out v243159 AN 130905 (4).doc Version 1.40 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Residents are supported in planning their own social activities, daily routine and meals and are offered opportunities for personal development. EVIDENCE: Residents said that they were encouraged to take part in activities that were of interest to them in the community, with family and friends and within the home. They said that they were assisted by staff in making decisions and could choose how to live their lives but were all working to be able to live in the community independently. All gave examples of having a set day that they cooked for themselves and other residents and of having responsibility for doing household tasks around the home. During the inspection it was observed that the home was busy with residents and visitors freely coming and going at the home and keeping the staff informed of their intentions. Staff members spoken to gave examples of how residents are supported in taking responsibility for their own lives by constantly being encouraged to make choices and how they offered advice to residents on life style and leisure activities whilst ensuring that the rights of each resident were promoted and protected. Stepping Out I55 s35106 Stepping Out v243159 AN 130905 (4).doc Version 1.40 Page 11 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 standard(s) Personal support is given to residents in the way they prefer, their needs are met and they are protected by the homes medication policies and procedures EVIDENCE: The information seen held in the plans of care informs staff and enables them to support residents in the manner they prefer whilst meeting their needs. The two staff spoken to said that it was an ongoing process of change that worked with residents to promote their independence and confidence. Residents said that they receive the personal and emotional support from staff that they needed and that staff were always willing to listen to them if “they were having a bad day”. All staff had undertaken medication training and records demonstrated that medication was stored, administered and recorded correctly. Records held on residents showed that residents had not been consulted on their wishes at death and a recommendation was made following a discussion with the manager that a risk assessment be carried out on each resident to identify if it was felt appropriate to discuss the wishes at death with each resident in light of the increased risk of suicidal thoughts and actions for some residents. Stepping Out I55 s35106 Stepping Out v243159 AN 130905 (4).doc Version 1.40 Page 12 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 standard(s) The home has an active procedure on the protection of vulnerable adults that protects residents and supports the investigation of any cause for concern. EVIDENCE: The home has not received any complaints and the residents spoken to said that if they were unhappy they would tell their key worker or the manager and all agreed that they would be listened to and the appropriate action taken to resolve the problem to the satisfaction of all concerned. Residents are protected from abuse, neglect and self-harm by the objectives, policies and procedures of the home and staff have undertaken training in Adult Abuse to help them recognise, prevent and deal with any potential abuse. Stepping Out I55 s35106 Stepping Out v243159 AN 130905 (4).doc Version 1.40 Page 13 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 standard(s) Recent improvements have been made to parts of the home but there are remaining areas that require attention to make the surroundings safe, attractive and comfortable for those living and working at the home EVIDENCE: Residents were not fully protected at the home and although the manager said that arrangements were being made for all radiators to be guarded and either an additional extractor fan or one that is more efficient to be fitted in the smoker’s lounge neither had taken place and therefore two requirements were made with one repeated. An additional requirement was also made that the step down into the floor space between the kitchen and the utility area be reduced and flooring provided to protect the health and safety of residents and staff members and to aid cleaning of this area. Residents had personalised their bedrooms and benefited from a home that was clean, tidy, odour free and comfortable. However it is showing some signs of wear in some areas and although a new carpet had been fitted in the smoker’s lounge a requirement was made that the hallways, bathroom and toilets be redecorated and a recommendation was made that the hallway carpets be deep cleaned or replaced to make the home more attractive for residents and staff members. Stepping Out I55 s35106 Stepping Out v243159 AN 130905 (4).doc Version 1.40 Page 14 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Staff members are competent, the procedure for the recruitment and training of staff were robust and provide adequate safeguards to protect people living at the home. EVIDENCE: Residents said that they were well supported and the staff spoken to said that there were enough staff on duty to meet the needs of each resident. A new ‘on-call’ system has now been introduced to ensure that staff have access to an additional member of staff should the need arise at night. The two staff members spoken to said that they were supported by the home leader and the manager, handover, staff meetings and supervision and demonstrated that they were aware of their role and responsibilities. Records showed that residents were fully protected because all staff recruitment checks had been carried out and CRB checks, references, personal details, proof of identity and a photograph of each staff member were held in each staff file. Records demonstrated that staff members had a mix of experience and skills, most staff had completed or were in the process of completing NVQ3 but one staff member had not commenced NVQ2 and a requirement was made that he complete the training to ensure he was competent when left in charge of the Stepping Out I55 s35106 Stepping Out v243159 AN 130905 (4).doc Version 1.40 Page 15 home. Certificates showed that induction, foundation and updated training programs were undertaken by all staff to enable them to gain the knowledge necessary for the range of needs of residents living at the home. Stepping Out I55 s35106 Stepping Out v243159 AN 130905 (4).doc Version 1.40 Page 16 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) The manager is supported by the senior staff member, in providing leadership, guidance and direction to staff to ensure that residents receive a good standard of care and support. EVIDENCE: Residents and staff members said that the home was well run, the manager approachable and records demonstrated that residents are protected by the management and administration procedures carried out in the home. The manager is a qualified social worker and is in the process of undertaking the NVQ4 Registered Manager award. On completion of this award this element of the standard will be met. Policies and procedures have been produced and were seen on all aspects of the home and service provided. The records held were found to promote and protect the rights and best interests of each service user. A Quality Assurance has just been completed at the home and the results demonstrated that the views of residents, visitors, other professionals and staff members were considered and although some improvements were highlighted, residents and Stepping Out I55 s35106 Stepping Out v243159 AN 130905 (4).doc Version 1.40 Page 17 staff had a high level of satisfaction of living and working at the home. The manager said that an exit questionnaire had been devised to give to every resident when they left the home which would supplement the twice yearly Quality Assurance system and take into account the views of all residents that had lived at the home. The handover, staff meeting minutes and staff review records demonstrated that staff members worked as a team and were supported and regularly supervised by the house leader or manager to ensure that their knowledge of the needs of each resident, their work practice, commitment and training needs were identified, clarified and reviewed. To ensure that the health and safety of residents is protected the servicing and testing of all equipment had been carried out and relevant and timely certificates were held and records were stored securely. The manager successfully monitored identified financial budgets for the home and there was no reason to doubt that the financial security of Norfolk and Waveney Mental Heath Partnership and Norfolk Social Services were not sound. Stepping Out I55 s35106 Stepping Out v243159 AN 130905 (4).doc Version 1.40 Page 18 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 x 3 x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x 3 x 3 N/A x Standard No 11 12 13 14 15 16 17 3 3 3 3 x 3 x Standard No 31 32 33 34 35 36 Score x 2 3 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Stepping Out Score 3 x 3 2 Standard No 37 38 39 40 41 42 43 Score 3 2 3 3 3 x 3 I55 s35106 Stepping Out v243159 AN 130905 (4).doc Version 1.40 Page 19 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. 1. Standard YA6 Regulation 17.1-3 schedule 3 13.4 Timescale for action The registered person must 31st ensure that a photograph of December each resident is held in their plan 2005 of care. The registered person must 31st ensure that a more effective December 2005 extractor fan is fitted in the ‘smoker’s lounge. The registered person must 31st ensure that all radiators are January covered. REPEATED 2006 REQUIREMENT. The registered person must 31st ensure that the step down into January the floor space between the 2006 kitchen and the utility area is reduced and flooring provided. The registered person must 31st produce a program of December redecoration for the bathroom, 2005 toilets and hallways. The registered person must 31st ensure that all staff complete December NVQ2 or 3 training. 2005 The registered person must Met on ensure that the manager holds completion the NVQ4 Registered Manager of the award. award. Requirement 2. YA24 3. YA24 13.4 4. YA24 13.4 5. YA24 23.2 6. 7. YA32 YA37 18.1 9.2 Stepping Out I55 s35106 Stepping Out v243159 AN 130905 (4).doc Version 1.40 Page 20 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 YA21 Good Practice Recommendations It is recommended that a risk assessment be completed to show if it is appropriate that the wishes at death be discussed with each resident and if so that it is recorded in their plan of care. It is recommended that the hall carpets are deep cleaned or replaced to make the home more attractive 2. YA24 Stepping Out I55 s35106 Stepping Out v243159 AN 130905 (4).doc Version 1.40 Page 21 Commission for Social Care Inspection 3rd Floor Cavell House St Crispins Road Norwich NR3 1YF 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 Stepping Out I55 s35106 Stepping Out v243159 AN 130905 (4).doc Version 1.40 Page 22 - 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!