Inspection on 13/07/07 for The Conifers

This inspection was carried out on 13th July 2007.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

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 Conifers 228 Kempshott Lane Basingstoke Hampshire RG22 5LR Lead Inspector Peter J McNeillie Unannounced Inspection 13th July 2007 08:45 Conifers DS0000069145.V341028.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 Conifers DS0000069145.V341028.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. Conifers DS0000069145.V341028.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Conifers Address 228 Kempshott Lane Basingstoke Hampshire RG22 5LR 01256 869949 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) rogergomes1@btopenworld.com Care Opportunities Ltd Roger Alan Paul Gomes Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Conifers DS0000069145.V341028.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection First inspection. New service. Brief Description of the Service: Conifers is a registered care home owned and managed by Care Opportunities a specialist independent provider who offer residential accommodation care and support to adults with learning disabilities. The home is located on the outskirts of the North Hampshire town of Basingstoke within a short walking distance of shops and other local amenities. A bus route passes near to the home making access to town centre facilities such as a modern shopping centre, cinemas, restaurants, theatres, and leisure centres etc easy and convenient. Accommodation is available in single rooms with ensuite facilities including a personal shower. Fees start at £1425 per week; any additional costs over this are dependent on an individual assessment of needs. Conifers DS0000069145.V341028.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced visit was the first inspection since the home was registered in January 2007 and took place on 13/07/07 between the hours of 8.45 am and 1.30 pm during which all of the key standards for care homes for younger adults were assessed. A number of sources of information/evidence were considered in producing this report including a visit to the home. Other sources included, notifications to the Commission for Social Care Inspection (C.S.C.I.) under regulation 37, examining service users assessments/care plans, staff recruitment/ training records, policies / procedures comments by management, staff, residents, original registration documentation, the service users guide and information provided by the manager in a statutory Annual Quality Assurance Assessment (A.Q.A.A). The results/findings contained in this report will determine the frequency and type of future inspections. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can Conifers DS0000069145.V341028.R01.S.doc Version 5.2 Page 6 be made available in other formats on request. Conifers DS0000069145.V341028.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 Conifers DS0000069145.V341028.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. 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 this service. The home has a system of assessing and identifying residents needs which ensures residents safety and that their assessed needs can be met. EVIDENCE: Only one person had been admitted since registration in January 2007. All of the records seen confirmed that residents are only admitted following a detailed assessment of needs, being carried out in accordance with the home’s admission policy and procedure. As part of the pre admission procedure following a referral usually from a care manager the prospective resident would be visited by the homes manager who would undertake a very comprehensive assessment of needs and risk. The initial assessment would be in a written format but should it be necessary converted into a format that the resident would understand e.g. pictures or symbols. Apart from care needs, the assessment would include a brief history of the individual, details of any identified risks, medication needs, family contacts, social skills, any communication issues, benefits, emotional needs and Conifers DS0000069145.V341028.R01.S.doc Version 5.2 Page 9 equipment /aids required also concludes whether or not the home can meet the person’s needs. If needs can be met and the prospective resident agrees plans are then made to admit. Following admission a care plan is formulated (section 6-10 of this report refers) from all the information collected and signed by all parties. From records seen and conversations with the manager it was clear that a great deal of care is currently being given to ensure that the views wishes and needs of existing residents are considered before any admissions are agreed. Conifers DS0000069145.V341028.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. 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 this service. The home has a well-developed system of planning and reviewing care which ensures residents needs are met within a risk management policy and involves residents /residents representatives or relatives in decisions that affect them. EVIDENCE: Following a very detailed and comprehensive assessment process as described in the preceding section of in this report, a care plan that fully reflects residents needs wishes and aspirations is produced in a written and alternative format if required that the resident can understand. The care plan of the only resident was viewed, it set out clear objectives for the resident, had been regularly reviewed, updated where necessary and included a written confirmation that the resident had been consulted and contributed to the assessment/care planning process. Conifers DS0000069145.V341028.R01.S.doc Version 5.2 Page 11 Resident’s rights to take risks are acknowledged and are seen as most important in assisting them to achieve any independence, e.g. cooking, preparing his own breakfast. Restrictions placed on individuals due to needs or physical abilities are clearly recorded in the care plans. Conifers DS0000069145.V341028.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. 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 this service. The social activities, family contacts and the provision of varied and nutritious meals were well managed and reflected residents interests and choices. EVIDENCE: Records sampled show a wide range of activities and social opportunities are made available to residents. These are tailored to individual needs and wishes and involve activities both in the home and the community. A wide range of activities is currently being undertaken including, food shopping cooking, bowling, the pub, horse care, social club, gym, educational college courses, and the resident’s favourite gardening where he has the opportunity to meet with persons of the same disposition as himself. Examples of tubs planted by the resident were seen in the garden. The records also showed activities tried and rejected. Conifers DS0000069145.V341028.R01.S.doc Version 5.2 Page 13 Friends and family are encouraged to visit anytime, if required assistance would be available for travel and to assist the resident to go home for weekends. The resident is able to receive and converse with friends and make telephone call in private. The one resident is encouraged to participate in the choosing, buying and preparation (with assistance) of the meals including his own breakfast unassisted it is intended this process will be expanded to include all residents in the future. He said he liked the food available and helping to choose it. Tea coffee and other drinks were available at all time. Conifers DS0000069145.V341028.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. 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 this service. Satisfactory arrangements are in place, ensuring the personal emotional, health care and medication needs of residents are met. EVIDENCE: The resident, staff and managers confirmed the resident was encouraged to exercise choice in all aspects of their lives including bedtimes, clothes, food, gender of carer, GP, dentist optician, and key worker being quoted as examples. Following the assessment and care planning process consultations/input with a wide range of external health /social care professionals including learning disability specialists, doctors, district nurses, care managers, physiotherapist and occupational therapists ensure that identified health and social care needs will be met. Conifers DS0000069145.V341028.R01.S.doc Version 5.2 Page 15 The resident confirmed he felt staff and management were fully aware of their individual needs and quick to respond should specialist external sources of support be indicated. It is policy that all residents will be are encouraged to take responsibility for their own drugs and medicines if appropriate following a risk assessment. At the time of the inspection the only resident did not have responsibility for his own securely stored medication. Records were seen to confirm all staff had received training in the administration and recoding all drugs and medicines; records of medication administered were complete and accurate. Conifers DS0000069145.V341028.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. 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 this service. The home has clear policies and procedures in place which ensures residents are able to complain and are protected from abuse . EVIDENCE: An in house Adult Protection policy/procedure that operates in tandem with the policy and procedure produced by Hampshire County Council designed to protect vulnerable residents from abuse was available as were records to confirm all staff had received training. Records viewed and staff spoken with confirmed they had received training in recognising abuse. All were able to demonstrate they knew what to do should they witness or suspect the abuse of any resident. The homes complaints procedure which was also included in the service users guide and the brochure given to all residents on admission included information on how to contact The Commission for Social Care Inspection (C.S.C.I) was seen as was a record of complaints. Residents spoken to said felt comfortable in raising any concerns they had with the homes management and confident any matters raised would be dealt with fairly and promptly. Conifers DS0000069145.V341028.R01.S.doc Version 5.2 Page 17 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. 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 this service. Resident’s benefit from living in an environment which was well maintained, furnished, clean, homely and free from adverse odours. EVIDENCE: The home is located in a residential area in a large house, which has been completely rebuilt internally to a very high standard creating a purpose built environment. The home was spotlessly clean clean, hygienic, free from adverse odours, safe and maintained to a very high standard. All communal areas are accessible by residents including the garden. Furniture, which met resident’s individual and collective needs, was comfortable, new, and homely in keeping with the décor. Conifers DS0000069145.V341028.R01.S.doc Version 5.2 Page 18 Only one resident has been resident in the home for a few months it is therefore not surprising, wear and tear to the fabric of the building and furniture is non-existent and the general condition of the property immaculate. Conifers DS0000069145.V341028.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s needs are met by sufficient numbers of well trained and supported staff who are recruited and selected using a procedure designed to protect all residents. EVIDENCE: The staff rota indicated the usual deployment of care staff would be two in the morning, two in the afternoon /evening and one overnight plus one sleeping in. These numbers do not include the registered manager. As the home becomes fully operational and all beds are filled the deployment of staff will be reassessed to ensure residents needs are met. The inspector viewed three staff employment/training files which indicated all staff are recruited and employed in accordance with the homes recruitment/ selection policy and procedure which involves the completion of an application form, the signing of a rehabilitation of offenders declaration, an interview, satisfactory Criminal Record Bureau and Protection of Vulnerable Adults and reference checks prior to commencing employment. Conifers DS0000069145.V341028.R01.S.doc Version 5.2 Page 20 On commencement of employment all new staff undergo detailed induction training during a probationary period of employment. The training of staff and achieving qualifications is given a high priority within the home. All care staff undertake National Vocational Training in care to at least level two. Records seen indicated of the staff group of four persons one has N.V.Q. level 3 and is taking level 4,one is taking level 2 and of the remainder one commences 2 and the other level 3 in September. Apart from the above training we saw evidence of additional training that is planned, these included courses on, crisis intervention, behaviour awareness, mental health needs, communication, epilepsy, autism, and protection of vulnerable adults, risk assessments, personal centred planning, and risk assessments, these are in addition to fire training, food hygiene, handling and health and safety training. Conifers DS0000069145.V341028.R01.S.doc Version 5.2 Page 21 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. 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 this service. The management of the home ensures the health, safety and welfare of residents and staff are promoted and the home is run in the best interests of the residents whose views about living in the home are formally sought. EVIDENCE: The manager who was registered in January 2007 is a very experienced learning disability manager and is a qualified learning disability nurse who is commencing an NVQ level 4 course in September 2007. Staff described the homes management as supportive, available and approachable who encourage them to come forward with ideas to improve the service. Conifers DS0000069145.V341028.R01.S.doc Version 5.2 Page 22 A system for seeking the views of residents, residents representatives and visiting health/social care professionals has been developed but has not yet been implemented and will form part of an annual quality audit. Apart from the above residents can express their views on the service at residents meetings and personal reviews. A health and safety policy and procedure designed to protect and keep both residents and staff safe was in place. Staff were observed to practice good infection control methods by using disinfectant soap/hand gel, disposal aprons and gloves. During the visit, we observed no immediate obvious hazards to health and safety. Cleaning materials and chemicals were securely stored, all of the hot water supplies to baths were fitted with thermostatic controls set at 43 degrees centigrade, and all radiators and hot pipes were covered. Control of substances hazardous to health (COSHH) assessments, fire safety assessments, equipment servicing and accident records were all available as were records to confirm all staff have receive training in the techniques of moving and handling first aid, food hygiene health and safety and safety and the procedures to follow in the event of fire, including evacuation. Conifers DS0000069145.V341028.R01.S.doc Version 5.2 Page 23 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 3 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 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 X Conifers DS0000069145.V341028.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action 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 Conifers DS0000069145.V341028.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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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