Inspection on 18/09/06 for Tall Oaks

This inspection was carried out on 18th September 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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Tall Oaks 17/02/09

Similar services:

Flint House

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

The Cotswold Home

Fairways

Treloar College

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

CARE HOME ADULTS 18-65 Pirbright Care Home 5 Pirbright Road Farnborough Hampshire GU14 7AB Lead Inspector Debbie Oliver Unannounced Inspection 18th September 2006 11:00 Pirbright Care Home DS0000066521.V308195.R02.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 Pirbright Care Home DS0000066521.V308195.R02.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. Pirbright Care Home DS0000066521.V308195.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Pirbright Care Home Address 5 Pirbright Road Farnborough Hampshire GU14 7AB TBA TBA 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) Downing (Acacia House) Limited Mrs Susan Daphne Squires Care Home 6 Category(ies) of Learning disability (6), Physical disability (4) registration, with number of places Pirbright Care Home DS0000066521.V308195.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection N/A Brief Description of the Service: Pirbright Care Home is a property situated in a residential area in Farnborough and is undistinguishable as a care home from other homes in the street. Downing (Acacia House) Limited oversees the service and the home is registered to accommodate six people under the age of 65 with a learning disability. Each service user has a single bedroom with en-suite facilities. Communal space includes a large lounge cum dining room and a kitchen. The average fee in the home is £1,500 per week per person. Information about the service provided at the home would be made available to potential service users by providing a copy of the home’s service users guide and a statement of purpose. Pirbright Care Home DS0000066521.V308195.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The visit was unannounced and took place over four hours. During the visit, records and documents were examined, an opportunity was taken to tour the premises and staff working practices were observed. The inspector met both service users, but due to their communication needs did not have direct conversations with them. Observation enabled the inspector to gain a better understanding of how the needs of service users were being met. There were no service users from ethnic minority groups. What the service does well: What has improved since the last inspection? What they could do better: To ensure clearer and more detailed care plans and risk assessments with regular reviews are available so staff are clear how to support individuals. Clear documentation showing medication received in should be available to ensure monitoring of medication. Training for staff in adult protection and relevant policies in adult protection must be available to ensure the protection of service users. Pirbright Care Home DS0000066521.V308195.R02.S.doc Version 5.2 Page 6 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. Pirbright Care Home DS0000066521.V308195.R02.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 Pirbright Care Home DS0000066521.V308195.R02.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 at least once during a 12 month period. 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 the service. The home’s systems and procedures ensure the needs of existing and prospective service users are identified. EVIDENCE: The home has been opened since July 2006 and there are currently two service users living there. Both these service users had a detailed assessment completed by the care manager and another completed by the manager of the home. They have also had a review within the first month of living at the home. There was information showing a positive transition process for both service users. The service users came to visit the home for the day, then overnight stays for the weekend and then for a week. On observation throughout the day it was evident staff can meet service users’ needs. Pirbright Care Home DS0000066521.V308195.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Care plans and risk assessments require more detail to ensure staff know how to meet service users’ needs. Staff support service users to make decisions about their lives on a daily basis. EVIDENCE: Two service users were case tracked and the plans showed daily routines, how the service user communicates, mobility and self care abilities. However the plans lacked detail such as stating one service user is unable to feed themselves but giving no detail on how to support that individual with their food. On another occasion the plan talks about a service user needing specialist equipment when assisting them with personal care but does not detail what that equipment is. It was discussed with the manager that the plans need to be more detailed giving clear instructions to staff on how to Pirbright Care Home DS0000066521.V308195.R02.S.doc Version 5.2 Page 10 support service users appropriately. These also need to be reviewed regularly to ensure they remain up to date. It was apparent throughout the visit that service users are supported to make decisions such as telling staff what they want for lunch, choosing to have breakfast in their bedroom and choosing when to come out of their bedroom. Service users also demonstrate their choices using particular noises and gestures. Staff stated many choices are offered and service users will then indicate what they want. This information is detailed in their plans. Evidence was seen within the files to support that some risk assessments are available but it was discussed with the manager that there needs to be more risk assessments showing service users are supported in all areas to take risks, this includes risk of choking and being left in the bath on their own, as detailed in the care plans. It was also discussed with the manager the need for regular reviews to be undertaken to ensure the assessments remain up to date. Pirbright Care Home DS0000066521.V308195.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users have opportunities to engage in suitable activities and are part of the local community, so promoting independence and choice. Contact with families is well supported, and nutritional needs of service users are well managed. EVIDENCE: It clearly states in the plans what service users do socially such as going shopping, attending church and enjoying arts and crafts. One service user also attends the local day service. Contact with families is very positive. All service users have regular contact with their families and this is documented in their plans. On the day of the visit the inspector spoke with the family of one service user who said they were Pirbright Care Home DS0000066521.V308195.R02.S.doc Version 5.2 Page 12 really happy with the care their relative was receiving and felt they were settling in well. It was evident rights are adhered to as one service user was just getting up when the inspector arrived as they had chosen to sleep in. There was positive interaction between service users and staff although it was discussed with the manager the language being used by one staff member could be seen as negative and she agreed to discuss this with them. The menu was seen and showed a varied and balanced diet. Staff confirmed alternatives are available and are recorded in the daily record. One service user during the visit went in to the kitchen and chose what they wanted for lunch. Pirbright Care Home DS0000066521.V308195.R02.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 at least once during a 12 month period. 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 the service. The personal, physical and health care needs of service users are generally well met but better recording is needed to ensure this continues. The procedure for the receiving and administering of medication is robust ensuring a safe system for service users. EVIDENCE: Care plans show some information on how service users like to be supported in regard to their personal care but more detail is needed to ensure staff have all the relevant information. Staff spoken to confirmed service users have positive input from opticians, dentists and chiropodists and there was evidence in the plans to show this happens. The two service users have recently been registered with local general practitioners. On the day of the visit one service user was visiting a dietician. Daily records show visits to health professionals and the outcomes of these visits. Pirbright Care Home DS0000066521.V308195.R02.S.doc Version 5.2 Page 14 The system for receiving, administering and disposal of medication is satisfactory and is currently being changed to a monitored dosage system. It was discussed with the manager that clear documentation needs to be in place to show medication that is received in with staff signatures. There is a list of staff that can medicate and have all received the training enabling them to do so. ‘As required’ medication is detailed with stock levels recorded. For the one service user with limited verbal communication there is a plan detailing how they show they are in pain. No one in the home is prescribed any controlled medication but there is a separate cupboard and this is also bolted to the wall as well as the main cupboard. There is documentation for disposal of medication and a medication policy is also available. Pirbright Care Home DS0000066521.V308195.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Arrangements for responding to concerns are satisfactory. However further work is needed in the area of adult protection to ensure service users remain protected. EVIDENCE: The complaints procedure is available in the hall and copies can also be made available to relatives as needed. Staff spoken to were clear on what to do if they received a complaint or had a complaint themselves. There have been no complaints made. The home has policies on whistle blowing but the home did not have a copy of the Hampshire Adult Protection policy, produced by the local social services. Additionally none of the staff have received training in adult protection and the manager agreed to obtain a number to book this but it was discussed this needs to be a priority. Pirbright Care Home DS0000066521.V308195.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. A comfortable, safe and hygienic standard of accommodation is provided for the service users, which meet their needs. EVIDENCE: The inspector toured the home and it is well maintained and suited to the service users’ needs. It is decorated to a standard that creates a comfortable and homely ambience. The home is well furnished with good quality domestic fixtures and fittings. The four unoccupied rooms are in various stages of completion. One is ready to be accommodated, one requires minor alterations and the other two need extensive decoration before anybody can be accommodated. The laundry facilities are suitable for purpose and although the washing machine wasn’t working someone was visiting the next day. Gloves and aprons were available. Pirbright Care Home DS0000066521.V308195.R02.S.doc Version 5.2 Page 17 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): 32, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home has procedures and systems in place that ensure staff are properly recruited and that there is always enough staff on duty. The training in place shows staff have the necessary skills and knowledge to meet the complex needs of service users accommodated in the home, although training in adult protection would further support this. Regular supervision for staff ensures they are well supported. EVIDENCE: From observation and discussion with staff members, they are starting to build good relationships with service users and are developing a good understanding of their needs. One staff member and the manager were spoken to and they indicated that they have generally received good training since starting in the home. The training received included moving and handling, first aid and medication; an induction was in place as well. Staff also had a list of all the policies and procedures they have signed to say they have read. Pirbright Care Home DS0000066521.V308195.R02.S.doc Version 5.2 Page 18 Staff spoken to confirmed they receive regular supervision and that the manager is approachable and easy to talk to. There was adequate staff on duty at the time of the visit and this was confirmed on the rota. The inspector sampled two staff files and they contained all the necessary information relating to recruitment. The manager’s file was not on the premises and it was discussed with the manager it should be made available. Pirbright Care Home DS0000066521.V308195.R02.S.doc Version 5.2 Page 19 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, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users benefit from a well organised home and the quality assurance system that is being developed will ensure service users and their families are able to contribute their views for the development of the home. The system for maintaining the health, safety and welfare of service users is satisfactory. EVIDENCE: The manager started her registered managers award in her previous job but will be recommencing this once she has settled in to her new role. She is also an NVQ assessor. Pirbright Care Home DS0000066521.V308195.R02.S.doc Version 5.2 Page 20 The home has only been opened for a few months but the manager is looking in to quality assurance systems to use within the home. A future plan is to send out questionnaires to doctors, relatives and care managers. Service user meetings are also going to happen once more individuals move in. Team meetings will also start in the near future but the home does have a communication book for all staff to use. Service users have regular key worker meetings to ensure the home continues to meet their needs. The home’s fire alarm system and extinguishers were checked and the records for this were seen. Fire safety training was completed as part of the induction and staff have read the relevant policies. The manager will also be sending staff to do training in fire safety. The gas and electrics have also been tested and again the paperwork was seen to show this. The manager is also to attend a course so she is qualified to do the portable appliance tests. The accident book was seen but it was discussed with the manager that in line with data protection this needs to be kept locked away, and this was done during the visit. The manager is to devise a risk assessment for the building and this will be available to view during the next visit. It was discussed with the manager to think about a risk assessment for when staff may undertake lone working. Pirbright Care Home DS0000066521.V308195.R02.S.doc Version 5.2 Page 21 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 2 ENVIRONMENT Standard No Score 24 3 25 X 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 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 3 X 3 X 3 X X 3 X Pirbright Care Home DS0000066521.V308195.R02.S.doc Version 5.2 Page 22 N/A 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 15 Requirement Timescale for action 18/03/07 2 YA23 13 (6) The registered person shall ensure each service user has a written plan as to how their needs are to be met in respect of their health and welfare. The registered person must 18/12/06 ensure all staff receive training in adult protection and the relevant policies and procedures are in place. 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 Pirbright Care Home DS0000066521.V308195.R02.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Pirbright Care Home DS0000066521.V308195.R02.S.doc Version 5.2 Page 24 - 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. 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