Inspection on 10/05/05 for Storrington

This inspection was carried out on 10th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 but made no statutory requirements on the home.

Other inspections for this house

Storrington 10/09/07

Storrington 29/06/06

Storrington 25/11/05

Storrington 21/10/04

Storrington 15/06/04

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

CARE HOME ADULTS 18-65 Storrington Hill Road Beacon Hill Hindhead Surrey, GU26 6BG Lead Inspector Mr D Griffiths Announced 10 May 2005 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. Storrington H58 S13804 Storrington V219057 100505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Storrington Address Hill Road, Beacon Hill, Hindhead, Surrey, GU26 6BG 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) 01428 607606 Robinia Care Limited Carriage Court, 25 Circus Mews, Bath, BA1 2PW Ms Lydia Bukowski Care Home (CRH) 5 Category(ies) of Learning disability (LD) 5 registration, with number of places Storrington H58 S13804 Storrington V219057 100505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age/age range of the persons to be accommodated will be: 18-50 YEARS Date of last inspection 21 October 2004 Brief Description of the Service: Storington is a detached home situated in the centre of Breacon Hill Village, with easy access to the local community and shopping area. There is good access to the home with plenty of parking spaces available outside the home and within a public parking area provided for shoping . The Home is owned and run by Robina Care Ltd . Accomodation is provided for five young adults between the ages of 18-50 years that have complex care needs . Each resident has there own bedroom and the home has a communal lounge and a large communal conservatory . Residents also have access to a well maintained garden and patio area Storrington H58 S13804 Storrington V219057 100505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection of two to be undertaken in the Commission for Social Care Inspection year April 2005 to April 2006. It was an unannounced visit and it took place over a period of 6 hours. Regulation Inspector Damian Griffiths accompanied the Lead Inspector Vera Bulbeck. The Registered Manager Lydia Bukowski who was present throughout the inspection visit represented the home. It is recommended that the reader should also look at the previous report that can be accessed by using the CSCI website details on the last page of this report. A tour of the premises took place and the inspectors were able to meet with two residents and two members of staff who were helpful, patient and cooperative throughout our visit. The inspectors would like to extend their thanks to the residents, management and staff at Storrington for their time and hospitality. What the service does well: What has improved since the last inspection? What they could do better: Storrington is an excellent home that is able to deliver sensitive care and quality of life for its residents who all have complex needs. The areas needing to be improved are the other two requirements yet to be completed from the previous inspection. These were, the provision of full and Storrington H58 S13804 Storrington V219057 100505 Stage 4.doc Version 1.30 Page 6 Individual Contracts for each of the five residents and lastly for Quality Assurance Audits and Residents Surveys to have a clear outcome and feedback to management, staff and residents as a result of this inspection there have been other requirements made. 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. Storrington H58 S13804 Storrington V219057 100505 Stage 4.doc Version 1.30 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 Storrington H58 S13804 Storrington V219057 100505 Stage 4.doc Version 1.30 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) 1,2,3,and 5 The homes Statement of Purpose and Service User Guide are very good in providing existing residents and prospective residents with details of the services the home provides. Staff will help them make an informed decision about residency at the home and information about the homes ability to meet their individual need. EVIDENCE: The Statement of Purpose is set out very clearly for prospective residents and their representatives. It provides a clear description of the homes policies, procedures, costs and local knowledge as set out within the National Minimum Standards. All written details are accompanied by picture symbols designed to present an alternative form of communication for residents including details about how to make a complaint. Resident’s care plans contain specific details of the care they need and It informs the staff member how best to give the care identified. The care plan details have been taken from a care manger and the homes manger. The residents, family and representatives are always consulted during this period and before residence is agreed. Care plans are updated on a regular basis and also contain many other details that will be identified in the next section of this report. Resident’s personal contracts were not available to be inspected. The Manager stated this is due to the funding arrangements of each of the residents Local Storrington H58 S13804 Storrington V219057 100505 Stage 4.doc Version 1.30 Page 9 Authorities and as such the contracts are very lengthy and impractical to keep on the premises. The residents Individual Service Users Guide does include a lot of this information, e.g., costs. The Manager was informed that this however does not meet the requirement under the Care Homes Regulations 2001, residents complete contracts must be provided. Storrington H58 S13804 Storrington V219057 100505 Stage 4.doc Version 1.30 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 standard(s) 6,7,8,9 and 10. All Residents at Storrington have a comprehensive care plan that reflects personal goals, individual needs and aspires to assist fully with their understanding of it. EVIDENCE: The inspectors saw two excellent samples of resident’s assessments and care plans. These were kept in the office adjacent to the main living area and afforded some ease of access by staff but also provides secure storage. They contained details of no less than ten areas of need ranging from Personal Care, Activities and Diet to Wheelchair Management and Sleep Patterns. These included symbols to assist residents understanding of the details of recorded. Storrington appreciates the importance of their residents’ safety but also importance of the residents to have every opportunity to be a part of their community. Staff are able to help residents to achieve this by following residents risk assessments that were in evidence complied. This information will include, e.g., “food to be mashed at all times”. This helps residents to regularly visit restaurants in the area supported by staff who are confident in their ability to support the residents. The risk assessments and care plans Storrington H58 S13804 Storrington V219057 100505 Stage 4.doc Version 1.30 Page 11 have been regularly reviewed and it was evident that this process was of significant help to the residents and staff. Storrington H58 S13804 Storrington V219057 100505 Stage 4.doc Version 1.30 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 standard(s) 12,13,14,15,16 and 17. The home has developed the means of communication with the residents by expression and movement. Staff motivate and stimulate residents in a respectful manner. Links with families, friends and the local community are good. EVIDENCE: On the day of inspection staff demonstrated their experience in occupational therapy and were stimulating residents in an appropriate manner. It was very clear from observation that residents and staff have a good rapport. The home has a minibus which transports residents to various day centres and activities in the community. For example one resident likes ice skating, and two residents went out for lunch at the pub. The residents have good family links and these links are encouraged by the staff. All bedrooms are personalised and some residents are able to decide with support from the staff of different bed covers. Storrington H58 S13804 Storrington V219057 100505 Stage 4.doc Version 1.30 Page 13 There is a variety of food served in the home as the staff mainly of different cultures do the cooking, the inspectors were informed this is very much enjoyed by the residents. All meat and vegetables are purchased daily. Storrington H58 S13804 Storrington V219057 100505 Stage 4.doc Version 1.30 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 standard(s) 18,19 and 20. Personal care and healthcare support and assistance is planned and was seen to be provided, where needed, in a respectful and sensitive manner. Policies and practices are in place for the administration and management of medications. EVIDENCE: Personal support is provided in private and staff were supportive and caring towards residents. Residents are able to indicate to staff when they want to do something by expression, body language and sounds. Healthcare was clearly documented and monitored in the care plans and staff are aware and ensure the residents health needs are met. Visits to the local G.P are arranged when necessary and for regular health checks, any follow up appointments are undertaken. As well as visits to the dentist, hospital, optician, chiropody and hairdressers. Medication was found to be well documented and administered by staff who were up to date with their training. The homes policies and procedures were in place and staff adhere to. Storrington H58 S13804 Storrington V219057 100505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 Procedures were in place at the home. Staff confirmed they had received the protection of vulnerable adults training. EVIDENCE: The organisation Robina Care Limited have its own adult protection policy and procedure and a copy of Surrey’s multi agency vulnerable adult procedure was available in the home. All staff except the night staff has received training in this area and all new staff cover the training as part of their induction. Staff on duty confirmed they are fully conversant with the policies and procedures. Storrington H58 S13804 Storrington V219057 100505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,29, and 30. The standard of the environment within this home is good providing residents with an attractive and homely place to live. There were however some minor health and safety concerns. The inspectors found it difficult to locate Storrington, as it does not have adequate signage to inform the visitor of its location. This may also cause delays for emergency services trying to locate the premises. EVIDENCE: Difficulty in locating the home once Hill Road has been entered as there are no signs to indicate that the home is tucked away and located opposite the public car park. A recommendation was made for the provision of a new sign to be prominently displayed to enable visitors to find the home. A complete tour of the premises was made including the garage and laundry room. All residents have their own rooms all are located upstairs and are assessable by chair lift if required. There is a gate at the top of the stairs to ensure safety Storrington H58 S13804 Storrington V219057 100505 Stage 4.doc Version 1.30 Page 17 of the residents however there is also a sign that request staff to ensure this is adequately used. This was considered to be institutional and not appropriate in promoting a homely atmosphere therefore it was recommended that the manager review as a measure of good practice. Staff assist and encourage residents to personalise their own rooms by helping to provide a choice colour and decoration to the room, family photos and pictures and posters where evident in all of the rooms. Each room has its own key and alarms available for residents if they are needed. The resident’s rooms also had televisions and audio equipment of choice that is well maintained. Residents have adequate storage in their rooms, each has a large pine wardrobe in their room. It was noted that one resident has to share a storage cupboard with the home containing a lot of general items for communal use. Two requirements were made to comply with regulations regarding storage. The manager is required to ensure the wardrobes are secured to the wall to ensure they do not tip and also the shared cupboard located in the residents room needs to be locked to reduce the possibility of accidents and to reduce any casual use. Resident’s toothbrushes and beakers were observed to be next to a rubbish bin. It is a requirement of Care Homes Regulations 2001 that they be moved to a place that is safe and hygienic. A requirement was made relating to the possibility of infection. The upstairs bathroom was also noted to need some maintenance to its shower mixer tap, as this was missing leaving a metal post exposed. It is a requirement that the homes premises be safe and well maintained. A conservatory has been added to the living room area and provides a comfortable and tranquil place looking out into a well-maintained garden. The Laundry room is separate from the main building and provides a spacious, warm and safe environment for staff and maintains the standards required. Storrington H58 S13804 Storrington V219057 100505 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,34 and 35 Staff currently working in the home have a good understanding of the needs of the residents and are appropriately supported by the manager on a regular formal and informal basis. EVIDENCE: On the day of inspection there were two members of staff on duty, the staff cover a range of duties including the cooking and cleaning. Staff were observed to be interacting well with the residents. The training records observed that staff have undertaken a number of training courses and the training file indicated that more training has been arranged in the next couple of months. There are arrangements in place for all staff to have regular access to training and a commitment from the organisation to provide staff with NVQ training. It was good to note that training has been a high priority and the majority of staff have their training certificates on file. The records for training were found to be well maintained, each with their aims and goals recorded. It was noted that the manager needs to update her first aid training and night staff need to complete the protection of vulnerable adult procedure training. This is essential to endure the safety of the residents therefore a requirement has been made for this to be completed. Storrington H58 S13804 Storrington V219057 100505 Stage 4.doc Version 1.30 Page 19 The manager is involved in all aspects of staff recruitment. Records were observed to be of good practice according to The Care Homes Regulations 2001, Schedule 2. Storrington H58 S13804 Storrington V219057 100505 Stage 4.doc Version 1.30 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 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) 37-43 Resident’s views are sought but there is currently no evidence to show that the home is providing questionnaires and quality assurance with clear outcomes The home complies with the Health and Safety requirements. EVIDENCE: Storrington is aware of the difficulties it has in understanding residents’ needs and are in discussion with the local advocacy services to assist in achieving better resident participation with the running of the home. A requirement was made in respect of standard 39 at the last inspection and is still to be met. The inspectors appreciate the homes commitment to improvement in this particular area. The Home’s overall Health and Safety procedures was evidenced and showed that it had regular fire checks and drills and had a signed record of the fire officers’ inspection. Storrington H58 S13804 Storrington V219057 100505 Stage 4.doc Version 1.30 Page 21 There was also in evidence thermometers to ensure fridge, freezer and cooker used to ensure the correct and safe temperatures are achieved. Staff receive Safe manual handling training and this is considered an essential part of their ongoing NVQ qualification. Safety checks had been carried out on the chair lift and were also in place for COSH. The Environmental Health Officer has recently inspected the premises and there were no concerns recorded. Storrington H58 S13804 Storrington V219057 100505 Stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 x 1 Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 2 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 2 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 2 x 3 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Storrington Score 4 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 1 x x x 3 H58 S13804 Storrington V219057 100505 Stage 4.doc Version 1.30 Page 23 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 5 Regulation 5 (1)(b) (c). Requirement The Registered Person must ensure that the terms and conditions in respect of accomodation, fees and a standard form of contract for the provison of services and facilities is available and kept on the premises for the resident and their representitives. The Registered Person must ensure that adequate provison is made to consult with residents and their representitives about the quality of care and the opperation of the home resulting in clearly identified outcomes. The Registered Person must ensure suitable and safe storage is provided .Wardrobes to be fitted securely against the walls and for the provision of a lock to be fitted to the shared storage cupboard in one residents bedroom The Registered Person must ensure that suitable arrangements to prevent infection are made by moving a wast bin away from residents toothbrushes. Timescale for action 21/06/05 2. 39 24 (3) and Sch 1 (10) 08/07/05 3. 24 23(2)(m) 21/06/05 4. 30 13(3) 10/05/05 Storrington H58 S13804 Storrington V219057 100505 Stage 4.doc Version 1.30 Page 24 5. 35 18(1)(a) The Registered Person must ensure that all staff recieve First Aid and Vulnerable Adult Training 21/-5/05 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 33 Good Practice Recommendations The Registered Person will monitor the requirements of the residents care needs during the night to establish whether staff are required to be awake at nights as opposed to the current arrangements . It was suggested that this will be over a period of 6 months from the date of inspection The Registered Person is recommended to place a new sign with the name of the home in a prominent position The registered Person will review all signs within the home that are for the benefit of the staff and will concider whether these can be relocated or provided in a less obvious way . 2. 3. 24 24 Storrington H58 S13804 Storrington V219057 100505 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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. 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