Inspection on 30/01/06 for Stepping Out (38 Hawthorne Rd)

This inspection was carried out on 30th January 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Stepping Out (38 Hawthorne Rd) 13/09/05

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 Rd) 38 Hawthorne Road Gorleston Norfolk NR31 8ES Lead Inspector Linda Wells Unannounced Inspection 30th January 2006 2.30pm Stepping Out (38 Hawthorne Rd) DS0000035106.V276030.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 Stepping Out (38 Hawthorne Rd) DS0000035106.V276030.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. Stepping Out (38 Hawthorne Rd) DS0000035106.V276030.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Stepping Out (38 Hawthorne Rd) Address 38 Hawthorne Road Gorleston Norfolk NR31 8ES 01493 440325 01493 442531 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) Norfolk County Council 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 (38 Hawthorne Rd) DS0000035106.V276030.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Seven (7) Service Users who have a Mental Disorder, excluding learning disability and dementia, may be accommodated. 13th September 2005 Date of last inspection 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 washbasin 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 (38 Hawthorne Rd) DS0000035106.V276030.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken on the 30th January 2006 over three hours and was carried out as part of a routine inspection plan. The home has recently completed 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. On the day of inspection seven residents were living at the home and were seen to be sitting in the lounges listening to music, taking part in supervised contact, having a snack and a main meal that residents and staff members prepared and cooked. The inspection took the form of a tour of the premises, individual discussion with two residents, two staff members and the manager, group discussion with three residents, 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: What has improved since the last inspection? Residents enjoy an environment that is comfortable and to make the home more attractive the flooring in the bathroom and the curtains in both lounges have been replaced and new waste bins have been provided to ensure a more efficient system. Residents and staff have benefited from an additional staff member working in the home in the form of an Occupational Technician. She is available on four days each week to work with residents in preparing and supporting them to live independently in the home and to move into the community. Stepping Out (38 Hawthorne Rd) DS0000035106.V276030.R01.S.doc Version 5.1 Page 6 What they could do better: Residents said that the home was comfortable and that they liked living there but to make the home completely safe for residents and staff the following six requirements and two recommendations were made. • • • • A more effective extractor fan must be fitted in the ‘smoker’s lounge to protect residents and staff when the windows are closed. In the process of being discussed. Repeated requirement. The radiators must be covered to protect everyone in the home. In the process of being carried out in the near future. Repeated requirement. Washable flooring must be provided between the kitchen and the utility area to make this area more attractive. Any staff member who has not completed training to NVQ3 must do so to ensure all staff members are fully trained in the needs of residents and to promote continued good care practise. Staff due to commence in September 2006. Repeated requirement. The manager has started but must complete the Registered Managers NVQ4 award to ensure continued good practise is carried out in the home. Repeated requirement. Thermostatic Blender Valves must be fitted to the hot water system in the kitchen, washbasins and the bathroom to ensure the health and safety of residents is protected. It is recommended that the remaining staff members complete training in the prevention of Adult abuse to help them recognise, prevent and deal with any potential abuse. It is recommended that the fire drill records be maintained and up to date to ensure everyone in the home is aware of the fire procedure and to plan regular fire practise. • • • • 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 (38 Hawthorne Rd) DS0000035106.V276030.R01.S.doc Version 5.1 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 Stepping Out (38 Hawthorne Rd) DS0000035106.V276030.R01.S.doc Version 5.1 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 the following standard(s): 2, 4 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 moved into the home that day said that she had visited and stayed at 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 (38 Hawthorne Rd) DS0000035106.V276030.R01.S.doc Version 5.1 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 the following standard(s): 6, 8, 10 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. Two 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, a photograph, daily records, risk assessments, key information, clinical history, back ground, involvement with health care professionals, weight records, nutrition and reviews. Residents said that they were confident that the information held on them was safely stored and 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 (38 Hawthorne Rd) DS0000035106.V276030.R01.S.doc Version 5.1 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 the following standard(s): 11, 15, 17 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 and with family and friends. 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. The manager said that he and staff were in the process of making changes to the way the home ran to enable residents to care for themselves as individuals and the changes would be based on supported living. During the inspection it was observed that a supervised contact was taking place in the home and that the family were given the sole use of the non-smoking lounge. 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 (38 Hawthorne Rd) DS0000035106.V276030.R01.S.doc Version 5.1 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 the following standard(s): 18, 19, 21 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, confidence and self-care. 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”. Records held on residents showed that a risk assessment had been carried out on each resident to identify if it was appropriate to discuss the wishes at death with the resident in light of the increased risk of suicidal thoughts and actions for some residents. Where assessed as appropriate residents had been consulted on their wishes at death. Stepping Out (38 Hawthorne Rd) DS0000035106.V276030.R01.S.doc Version 5.1 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 the following standard(s): 22, 23 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 records held demonstrated that two incidents had been reported to the APU and CSCI and that the manager and staff members had dealt with both incidents appropriately and sensitively. 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 most staff have undertaken training in Adult Abuse. However, a recommendation was made that the remaining staff that have not undertaken the training do so to ensure all staff can recognise, prevent and deal with any potential abuse. Stepping Out (38 Hawthorne Rd) DS0000035106.V276030.R01.S.doc Version 5.1 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 the following standard(s): 24, 25, 27, 29, 30 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 repeated. An additional requirement was also made that washable flooring be provided between the kitchen and utility room to aid cleaning of this area. Residents had personalised their bedrooms and benefited from a home that was clean, tidy, odour free and comfortable. The bath and shower facilities were domestic in nature and the temperature of the hot water was tested and found to be over 43C in the kitchen and bathroom. Warning notices and risk assessments had been completed but residents use both of these areas independently and therefore a requirement was made that thermostatic blender valves be fitted to the hot water system to ensure that the health and safety of residents is fully protected. Stepping Out (38 Hawthorne Rd) DS0000035106.V276030.R01.S.doc Version 5.1 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 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): 31, 32, 36 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: Records demonstrated that staff members had a mix of experience and skills, undertook induction, foundation and updated training and that most staff had completed or were in the process of completing NVQ3. The manager said that the remaining staff were about to commence NVQ3 training in September 2006 and a requirement was repeated that this training be completed by all staff who are left in charge of the home. Staff members said that they were supported by the home leader and manager, the information given at handover, staff meetings and supervision and demonstrated that they were aware of their roles and responsibilities. Residents said that staff members were aware of their needs, competent and that enough staff were on duty at all times. Stepping Out (38 Hawthorne Rd) DS0000035106.V276030.R01.S.doc Version 5.1 Page 15 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): 37, 38, 42, 43 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. A requirement was repeated and on completion of this award this element of the standard will be met. 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. Stepping Out (38 Hawthorne Rd) DS0000035106.V276030.R01.S.doc Version 5.1 Page 16 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. However, the fire drill records showed that a fire practise had not taken place since October 2005 and although the manager said that they had occurred, in light of the short stay at the home of most residents, a recommendation was made that the fire drill records be maintained and up to date to ensure everyone in the home is aware of the fire procedure and to plan regular fire practise. 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 (38 Hawthorne Rd) DS0000035106.V276030.R01.S.doc Version 5.1 Page 17 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 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 3 26 X 27 3 28 X 29 N/A 30 3 STAFFING Standard No Score 31 3 32 2 33 X 34 X 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X 3 X 3 LIFESTYLES Standard No Score 11 3 12 X 13 X 14 X 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X 3 3 2 X X X 2 3 Stepping Out (38 Hawthorne Rd) DS0000035106.V276030.R01.S.doc Version 5.1 Page 18 YES 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 YA24 Regulation 13(4) Requirement The registered person must ensure that a more effective extractor fan is fitted in the smokers lounge. (Previous timescale of 31st December 2005 has not been met) The registered person must ensure that all radiators are covered. (Previous timescale of 31st January has not been met). The registered person must ensure that washable flooring is provided between the kitchen and the utility area. The registered person must ensure that the hot water in the kitchen, washbasins and bath is regulated. The registered person must ensure that all staff commence NVQ2 or 3 training. (Previous timescale of 31st December 2005 has not been met) The registered person must ensure that the manager holds the NVQ4 Registered Manager award. (Previous timescale not set and requirement has not been met) Timescale for action 01/06/06 2. YA24 13(4) 30/06/06 3. YA24 13(4) 01/05/06 4. YA24 13(4) 30/06/06 5. YA32 18(1) 01/09/06 6. YA37 9(2) 31/08/06 Stepping Out (38 Hawthorne Rd) DS0000035106.V276030.R01.S.doc Version 5.1 Page 19 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 YA23 Good Practice Recommendations It is recommended that the remaining staff members complete training in the prevention of Adult abuse to help them recognise, prevent and deal with any potential abuse. It is recommended that the fire drill records be maintained and up to date to ensure everyone in the home is aware of the fire procedure and to plan regular fire practise. 2. YA42 Stepping Out (38 Hawthorne Rd) DS0000035106.V276030.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Norfolk Area Office 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 (38 Hawthorne Rd) DS0000035106.V276030.R01.S.doc Version 5.1 Page 21 - 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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