Inspection on 12/07/06 for The Bungalow

This inspection was carried out on 12th July 2006.

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 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

The Bungalow 25/01/06

The Bungalow 28/07/05

The Bungalow 19/01/05

The Bungalow 09/08/04

The Bungalow 18/08/03

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 The Bungalow Anglesey Lodge Anglesey Road Alverstoke Gosport Hampshire PO12 2DX Lead Inspector Mr Ian Craig Unannounced Inspection 12th July 2006 13:15 The Bungalow DS0000011674.V296901.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Bungalow DS0000011674.V296901.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Bungalow DS0000011674.V296901.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Bungalow Address 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) Anglesey Lodge Anglesey Road Alverstoke Gosport Hampshire PO12 2DX 023 9258 6311 Hampshire Autistic Society Mrs Joanne Frances Young Care Home 5 Category(ies) of Learning disability (5) registration, with number of places The Bungalow DS0000011674.V296901.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th January 2006 Brief Description of the Service: The Bungalow is situated in the grounds of Anglesey Lodge and is surrounded by pleasant grounds. The home is a large bungalow, which is registered with the Commission for Social Care Inspection to provide care and accommodation for 5 younger adults in the learning disability category. Placements at the home also involve contractual agreement to attend day service activities at the neighbouring day centre, also run by Hampshire Autistic Society. The service users at the Bungalow are accommodated in single rooms and the home is close to a local bus route, which gives access to the towns of Gosport and Fareham where there are a range of shops and facilities. There is a large fitted kitchen, with a large lounge/dining room, which provides communal space in excess of the National Minimum Standards (NMS). The fees for the home range from £1,328.78 to £1,853.95 per week and this includes day service. The Bungalow DS0000011674.V296901.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection consisted of a tour of the building, discussions with the manager and acting deputy manager, observation of staff and residents, examination of records and information recorded by the manager in the “Pre – Inspection Questionnaire.” What the service does well: What has improved since the last inspection? What they could do better: The Statement of Purpose needs to be reviewed as some of the information is unclear; details of the contractual placement agreement including attendance at the neighbouring day centre also needs to be specifically recorded. The Bungalow DS0000011674.V296901.R01.S.doc Version 5.2 Page 6 Although redecoration takes place on a regular basis, signs of wear and tear are beginning to show in certain areas. The front entrance hall could be made more homely. As already referred to, the assessment and care planning could be improved regarding social, educational and recreational needs and wishes. Training for staff and managers in the principles and policies of medication should be expanded to include external training input from an approved college course, or similar. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Bungalow DS0000011674.V296901.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Bungalow DS0000011674.V296901.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Whilst potential service users receive information about the home, clearer details need to be communicated about the service arrangements. The home ensures that it only accommodates those service users whose needs can be met and prospective service users have a chance to “test drive” the home. EVIDENCE: The Statement of Purpose and Service Users’ Guide were examined. These need to be reviewed and amended due to the following: • The Service User Guide refers to the document being a ‘Statement of Purpose’ in its text. • Incorrect information is included that reflects another service. • There is a lack of information that any placement also includes a contractual agreement to attend daily activities at the neighbouring day centre. The home has not admitted any new service users for some time. There is an admissions policy and the Service Users’ Guide refers to the process of assessment before admission is deemed suitable. This involves liaison with the referring social services’ care manager. Potential residents have opportunities to visit the home, have a meal with the other service users and a chance to stay overnight. The Bungalow DS0000011674.V296901.R01.S.doc Version 5.2 Page 9 The Bungalow DS0000011674.V296901.R01.S.doc Version 5.2 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 the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Whilst each service user has a care plan these need to be in greater detail to reflect personal goals regarding social and leisure needs. Residents are supported to take risks as part of an independent lifestyle. EVIDENCE: Each person has comprehensive written assessments and care plans. These documents are of a particularly good standard regarding staff intervention with challenging behaviour, when medication ‘as required’ should be given, and monitoring mood. Specific strategies are recorded for dealing with mood, aggression, and other behaviours based on nationally recognised models called, strategies for Crisis Intervention (SCIP). There is a document entitled, Individual Personal Programme, recording how residents are supported in maintaining independence. Care plans are reviewed each month, with further reviews at 6 months and annually. Risk assessments are recorded to a good standard showing how staff support individuals in certain activities such as going to the shops. The Bungalow DS0000011674.V296901.R01.S.doc Version 5.2 Page 11 Assessments and care plans are constructed in a way that helps service users understand them. Assessments and care plans should be developed to reflect the needs and wishes of individuals in relation to social, educational, occupational and leisure activities. Whilst programmes of daily activities are recorded, it was not possible to tell from the assessments and care plans what each person’s needs are in these areas, nor what their preferences are. The Bungalow DS0000011674.V296901.R01.S.doc Version 5.2 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 the following standard(s): 11, 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users have opportunities for personal development, accessing the community, and for engaging in various activities. Clearer recording is needed to show that leisure and social needs and preferences have been assessed and are being catered for. A nutritious diet is provided. EVIDENCE: Each service user has a Life Skills Assessment document in their personal records folder and there are Individual Personal Programmes detailing how people are supported to develop and maintain independence in daily routines such as personal care. Although it was clear that each resident has a full programme of activities, including attendance at the day centre for 5 days a week, it was difficult to tell from records how individual’s needs had been assessed for leisure, developing life skills, education and social activities as well as personal preferences. Records showed holiday and leisure pursuits such as an activity holiday at the Outward Bound, a week at Centre Parcs, holidays with family members, day trips to places such as the Isle of Wight, plus visit to pubs and restaurants. The Bungalow DS0000011674.V296901.R01.S.doc Version 5.2 Page 13 The service is flexible in meeting the demands and wishes of the residents. For instance, on the day of the inspection several residents expressed a wish to go to a local pub for a beer, which was arranged in a prompt way by the staff team. Menu plans are devised based around the preferences of the residents and on nutrition guidelines. Residents are able to help in preparing food with staff supervision. Food stocks were seen and found to be ample with fresh fruit and vegetables available. The Bungalow DS0000011674.V296901.R01.S.doc Version 5.2 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 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 home ensures that residents’ personal care, physical and emotional health needs are met. Policies and procedures ensure that medication needs are met, although the provision for staff training in this area could be improved. EVIDENCE: The service promotes individuals in maintaining and developing independent living skills regarding daily personal care routines. Comprehensive records and assessments detail how each person is supported with these tasks, and the level of staff support required to maintain and develop independence. Each individual resident’s case records show that health needs are addressed. These include a format for monitoring that each person’s health needs are checked by the following professionals: dentist, optician, general practitioner, chiropodist and psychologist as well as other relevant health professionals. Medication policies and procedures are satisfactory with the exception of training for staff. Each new staff member’s induction includes medication procedures and a record is made to acknowledge that this has taken place. Whilst there is no suggestion that the policies and procedures for medication The Bungalow DS0000011674.V296901.R01.S.doc Version 5.2 Page 15 are not adhering to pharmaceutical guidelines, additional staff training is needed. There is no input to this training from any outside agency aside from the supplying pharmacist. The standards refer to the provision of ‘accredited training’ and whilst this is not specific regarding the type and extent of training, the service should not be solely reliant on its own ‘in house’ training. Records showed that medication is administered as prescribed. Case records detail the circumstances when medication ‘as required’ should be administered. Regular checks are made to ensure the safe storage and administration of medication. The Bungalow DS0000011674.V296901.R01.S.doc Version 5.2 Page 16 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 good. This judgement has been made using available evidence including a visit to the service. The service ensures that residents are listened to and are protected from abuse. EVIDENCE: The service provides a complaints procedure in the Service Users’ Guide and a copy of this is also displayed in the home’s entrance hall. An abbreviated pictorial display of how a complaint can be made is on each resident’s bedroom wall. Staff acknowledged that residents have great difficulty in understanding any procedure even in a picture display format. There are policies and procedures for protecting vulnerable adults, including the local authority adult protection policy. Hampshire Autistic Society also provide a one day training course for staff in this area. Staff receive training in dealing with physical interventions from the organisation’s own staff who have received appropriate training qualifying them to instruct staff in procedures entitled Strategies for Crisis Intervention Prevention (SCIP) which is approved by the British Institute for Learning Disability. Procedures for staff to following when dealing with challenging and aggressive behaviour are recorded to a very good standard. Policies and procedures for the safekeeping and handling of service users’ monies and valuables were checked and found to be satisfactory with well maintained records, receipts, withdrawals, deposits and balances all recorded. The Bungalow DS0000011674.V296901.R01.S.doc Version 5.2 Page 17 The Bungalow DS0000011674.V296901.R01.S.doc Version 5.2 Page 18 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, 26 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents live in a homely, clean and generally well-maintained house although the décor is showing signs of wear and tear. EVIDENCE: The home is purpose built and single storey. Whilst there is frequent redecoration there are areas of wear and tear, which the home’s management are aware of. The home is clean and there is much evidence of the décor and environment reflecting the preferences and lives of the service users. Generally, the décor is homely with the exception of the entrance hall where a large staff notice board gave the impression of an office environment. Bedrooms reflected the individual tastes and interests of each service user with pictures, books photographs, hi- fi etc being present. Each resident has his or her own bedroom. The home was clean. There is a separate laundry and the staff receive training from a local college in infection control. The Bungalow DS0000011674.V296901.R01.S.doc Version 5.2 Page 19 The Bungalow DS0000011674.V296901.R01.S.doc Version 5.2 Page 20 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, 33, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents are supported by sufficient numbers of trained and qualified staff. The home’s recruitment procedures protect residents. EVIDENCE: At the time of the inspection the manager and staff team were taking part in a one-day course on Person Centred Planning. Records of staff training show attendance at a number of courses including induction, first aid, manual handling, infection control, medication, food hygiene, responding to abuse, epilepsy and person centred planning. Staff training comprises of mandatory courses and optional training. An internal training courses programme is available for staff to choose which courses suit their needs. Training and support for staff is an area of good practice. The national minimum standard of 50 of staff trained at NVQ level 2 has not yet been achieved but the home is working towards this. Staffing levels are provided at between 2 and 4 staff to meet the needs of the service users. This was confirmed from examination of the rotas, discussion with the deputy manager and observation of the numbers of staff on duty at the time of the inspection. Recruitment procedures were examined for recently appointed staff and were found to be satisfactory with the exception that an employment history was not given on one person’s application form. The manager of the service The Bungalow DS0000011674.V296901.R01.S.doc Version 5.2 Page 21 explained that a CV had been supplied with the application but could not be located on the day of the inspection. Suitable checks are carried out on staff including 2 written references, one of which is from the most recent employer, and criminal record bureau (CRB) and Protection of Vulnerable Adults (POVA) checks. Records of staff interviews were held with staff records. Recruitment records were not available for one staff member employed in the home on an occasional basis from a ‘relief’ pool. These records are held centrally as relief staff work in various services for Hampshire Autistic Society, whereas the regulations state that specific records should be held in the home. The Bungalow DS0000011674.V296901.R01.S.doc Version 5.2 Page 22 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. The home is well managed, and run in the best interests of the residents, although there is a need for a more systematic method of ensuring that the views of residents and their representatives are incorporated into the home’s development plans. The health and safety of the service users is promoted. EVIDENCE: The home’s manager is qualified at NVQ level 4 in management. A quality assurance system is in the process of being devised and will be implemented before the end of the year. This will involve obtaining the views of service users and their relatives/representatives about the home. The manager explained how regular audits are made of the individual service user’s care plans. The Bungalow DS0000011674.V296901.R01.S.doc Version 5.2 Page 23 Health and safety is promoted in the home with staff receiving training in first aid, infection control and manual handling and lifting. Equipment and appliances are serviced by qualified persons at recommended intervals with the exception of the gas heating system, which was last serviced approximately 18 months ago according to the manager. The Bungalow DS0000011674.V296901.R01.S.doc Version 5.2 Page 24 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 2 2 3 3 X 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 2 X X 2 X The Bungalow DS0000011674.V296901.R01.S.doc Version 5.2 Page 25 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 YA34 Regulation 19 Requirement Timescale for action 01/09/06 2 YA42 23(2) Agreement must be sought in writing from the Commission regarding any proposals for staff records (including relief staff) being held in a central location. If any records are held in a central location details must be held in the service specifying details of the staff member, CRB, POVA, references etc. as set out in the Commission guidance for providers. The home must ensure that the 12/10/06 gas heating system is serviced by a qualified engineer. 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 YA1 Good Practice Recommendations The Statement of Purpose and Service Users’ guide should be reviewed to ensure that it is applicable to the correct home and its content clear. The documents should refer to the contractual DS0000011674.V296901.R01.S.doc Version 5.2 Page 26 The Bungalow 2 3 YA6 YA20 arrangements to attend the day service. Assessments and care plans should be developed to that individual’s social, educational, educational and leisure needs and wishes have been assessed and are catered for. External ‘accredited’ training should be provided in for the home’s management and staff in the principles and administration of medication. The Bungalow DS0000011674.V296901.R01.S.doc Version 5.2 Page 27 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 The Bungalow DS0000011674.V296901.R01.S.doc Version 5.2 Page 28 - 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!