Inspection on 01/05/07 for The Stables

This inspection was carried out on 1st May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

The Stables 14/07/06

The Stables 25/10/05

The Stables 25/05/05

The Stables 27/09/04

The Stables 05/05/04

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 Stables The Stables Bisterne Ringwood Hampshire BH24 3BN Lead Inspector Peter J McNeillie Unannounced Inspection 1st May 2007 10:00 The Stables DS0000011981.V336472.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 Stables DS0000011981.V336472.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 Stables DS0000011981.V336472.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Stables Address The Stables Bisterne Ringwood Hampshire BH24 3BN 01425 478043 01425 461076 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) The Stable Family Home Trust Kevin Michael Forward Care Home 8 Category(ies) of Learning disability (8) registration, with number of places The Stables DS0000011981.V336472.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th July 2006 Brief Description of the Service: The Stables is a registered care home owned and managed by The Stable Family Home Trust. The home which is registered to provide care and accommodation for eight adults with a learning disabilities is located in four acres of agricultural land in Bisterne, three miles outside of the South Hampshire town of Ringwood. Accommodation is located on the first floor of a large two storey building which also hosts the Old Stables a service which provides a day, employment, training and leisure service for up to seventy service users each day. These services do not form part of this inspection. The Stables DS0000011981.V336472.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In compiling this report we considered information/evidence from a number of sources both external and internal to the home. Apart from a visit to the home and observations made during the site visit previous reports, examining residents /staff records, talks with residents, staff, management, reading reports produced by the registered person as required by the regulations and an annual Quality Assurance Assessment (A.Q.A.A.) self assessment by the registered person were taken into consideration. As a result of this key unannounced visit which was the first inspection for the year 2006/07 and took place on 01/05/07 between the hours of 09.00am and 02.00 pm no requirements or recommendations were made. The results and findings contained in this report will determine the frequency and type of future inspections. At the time of the inspection residential fees ranged from £1800 per month to £2000 per month. What the service does well: What has improved since the last inspection? What they could do better: There were no areas of concern noted during this visit. The development of a formal satisfaction survey that seeks the views of residents,residents representatives and external health and social care professionals and the development of action plans based on results would improve information about the quality of the service delivered. The Stables DS0000011981.V336472.R01.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. The summary of this inspection report can be made available in other formats on request. The Stables DS0000011981.V336472.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 Stables DS0000011981.V336472.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 in which the resident participates and ensures safety and assessed needs can be met. EVIDENCE: There have been no admissions since the last inspection. A sample of three residents files chosen at random by the inspector were viewed. All of the records seen confirmed that residents are only admitted following a detailed assessment of needs and risk being carried out by a member of the homes management team. Records also included an assessment by a local authority care manager and a confirmation that the resident was involved and contributed to the assessment process. The Stables DS0000011981.V336472.R01.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. 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. The home has a well-developed system of planning and reviewing care which takes into account the wishes and aspirations of residents and ensures resident’s needs are met within a risk management policy. EVIDENCE: Three residents records were viewed during the visit. The Stables DS0000011981.V336472.R01.S.doc Version 5.2 Page 10 All files viewed included comprehensive care plans based on detailed assessments of needs and risk. All of the of plans seen were dual formatted (written and pictorial) very comprehensive and included a personal history, personal profile and family history and reflected the residents choices wishes and personal aspirations. Confirmation that the resident or their representative were involved in the production of, and were consulted about the plan and also involved in any reviews when the plan was changed was also seen as was evidence confirming consultation with external health care professionals. Resident’s rights to take risks within a risk-taking framework are supported and are seen as a fundamental right. Any restrictions placed on individuals due to their high needs or physical abilities were clearly recorded in the care plans following consultation and agreement with the resident following a detailed risk assessment which is reviewed on a regular basis. Residents spoken to confirmed they were encouraged to make their own decisions and take responsibility for their own actions and lives. The Stables DS0000011981.V336472.R01.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. 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. Quality in this outcome area is good. The social activities family contacts and the provision of varied and nutritious meals were well managed and reflected service users interests and choices. EVIDENCE: The Stables DS0000011981.V336472.R01.S.doc Version 5.2 Page 12 Records viewed, comments from residents, staff and notices seen during the inspection confirmed a full programme of activities and social opportunities both in house and community based were available. Examples of activities on offer include day services, pottery, pubs, clubs, trips, outward bound, shopping; holidays and any other area that residents wish to participate. Residents confirmed they were encouraged and supported to participate and access the local community if they wished to do so but this is sometimes difficult due to the location of the home despite free transport being available both in the evenings and at weekends. Whilst support guidance and assistance is available, residents are also encouraged to be proactive in seeking out local facilities as part of them leading independent lives based on individual preferences. Residents are supported to maintain family contact by phone, mail e-mail and weekend visits, establish friendships and if they wished, develop safe sexual relationships. All residents had access to an in house telephones on which they can make and receive telephone calls in private. Many owned their own mobile phone. All of the residents spoken with expressed total satisfaction at the quality quantity and choice of food available as shown in the varied menu. We joined the students for their mid day meal and can confirm the availability of choices and the quality of his well presented meal. Residents are encouraged to prepare the evening and morning meal. Tea and coffe is available at all times. The Stables DS0000011981.V336472.R01.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. 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: Guidelines seen staff comments, which were confirmed by residents indicated choice, was being exercised by the residents in respect of all aspects of their lives. Providers of personal services, bedtimes, clothes, food, gender of carer, GP (approximately thirty doctors from 4 local practices are available), dentist optician and key worker being quoted as examples. Records seen indicated that following individual assessments and regular reviews any special medical or health or social care needs would be provided following consultation with the appropriate professional, these would include The Stables DS0000011981.V336472.R01.S.doc Version 5.2 Page 14 learning disability specialists, doctors, district nurses, care managers, physiotherapists and psychiatrists. To encourage independence appointments are made with doctors, dentists, and opticians in the community. These appointments would include attendance for regular checks at well person’s clinics. Records/risk assessments seen confirmed consultation had taken place and agreement reached on who would assume responsibility for the administration of drugs and medicines. We noted that one resident had assumed responsibility for their own medication and staff just being required to prompt and monitor to ensure medication is taken. A drugs/medication policy and procedure covering the storage administrations and recording of drugs/medicines administered and disposed of was seen, as were records of administration of drugs, which were accurate and complete. All drugs, which are securely stored, are administered by trained staff (training records seen). The Stables DS0000011981.V336472.R01.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. 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: A whistle blowing and Adult Protection Policy and Procedure have been implemented to work in tandem with the procedure produced by Hampshire County Council. All management and staff spoken to demonstrated they were aware of the procedure to follow should they witness or suspect the abuse of a resident. The complaints procedure, which was also included in the service users guide 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 stated they felt comfortable in discussing any concerns they had with the homes management and confident any matters raised would be dealt with fairly and promptly but went to great lengths to assure us that everything was “cool”. The Stables DS0000011981.V336472.R01.S.doc Version 5.2 Page 16 The Stables DS0000011981.V336472.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 clean, homely, free from adverse odours and equipped with a large number of specific aids and adaptations designed to maximise the independence, comfort and safety of the residents. EVIDENCE: As mentioned earlier in this report the home is sited on the first floor of a large building that accommodates administration functions and a dining room serving the day services project. Residents spoken with stated the position of the accommodation presented them with no problems. The Stables DS0000011981.V336472.R01.S.doc Version 5.2 Page 18 During the tour of the home, which was tidy, clean and free from any adverse odours, no obvious hazards to health and safety were seen and fire safety arrangements were all being observed. An infection control policy and procedure was in place which requires all staff to have access to and use aprons, gloves and antiseptic soap, ensuring residents safety and protection from cross infection. All communal rooms were fully decorated and equipped with furniture, which met resident’s needs. The last report highlighted two areas of concern; 1) The temperature of the bath water and 2) a peeling ceiling in a shower room. Since the last inspection the water temperatures have been adjusted and are monitored on a regular basis and the ceiling has been repainted. The previous report also commented that plans had been drawn up to refurbish a shared bedroom into two single rooms. It is hoped this project will still go ahead but no date has yet been agreed The Stables DS0000011981.V336472.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 staffing rota indicated there was always a minimum of two care staff available. Residents who were very self-sufficient confirmed the level of staffing was adequate and met their needs. Staff were described as being “Kind”,” Helpful” “Cool” “A laugh” and “All ways willing to help”. A sample of three staff records chosen by the inspector was viewed. Records seen confirmed all staff who receive regular one to one supervision are recruited in accordance with the home’s selection and recruitment procedure. The Stables DS0000011981.V336472.R01.S.doc Version 5.2 Page 20 This includes the completion of an application form, an interview and satisfactory Criminal Records Bureau (C.R.B.), protection of Vulnerable Adults (P.O.V.A.) and reference checks. Not all of the records included a photograph of the staff. The manager gave a verbal undertaking photographs would be added to all files within twenty-eight days of the inspection. On commencing an initial probationary period of employment all staff who are issued with a comprehensive staff handbook and a copy of the general Council Of Social care code of conduct are subject to an In House and The Learning Disability Award Framework (L.D.A.F.) induction process. As part of their conditions of employment all staff are expected to participate in a National Vocational Qualification (N.V.Q.) programme at least up to N.V.Q. level 2 in care. At the time of the inspection 60 of care staff had completed or were in the process of completing a course. Apart from the above records indicated a number of other training initiatives had taken place or were planned covering a number of diverse subjects such as manual handling, medication, health and safety, fire, midas (driving), infection control makaton level 1, and control of substances hazardous to health (C.O.S.H.) The Stables DS0000011981.V336472.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 informally sought apart from at reviews. EVIDENCE: Since February 2007 the registered manager has been on an internal secondment covering maternity leave in another of the organisations services. The Stables DS0000011981.V336472.R01.S.doc Version 5.2 Page 22 Details and qualifications of the acting manager have been provided to C.S.C.I. Residents and staff spoken to confirmed the acting manager was approachable and accessible and had an open door policy which encourages them to share any concerns or ideas they have to better the service. As part of an internal management quality control procedure, detailed checklists based on the National Minimum Standards have recently been introduced. These follow a similar inspection routine to that employed by C.S.C.I. and highlight any areas that require attention. Residents confirmed they were consulted about the home and how it is run but apart from formal personal reviews no written quality monitoring system based on seeking the views of service users, service users representatives or external health care professionals was available. An undertaking was given as part of the internal management quality control this matter will be addressed. Progress will be evaluated at a future visit to the home. A health and safety policy and procedure was in place which protects staff and residents by ensuring the maintenance of a safe working environment including the regular maintenance and servicing of equipment/ machinery in use within the premises. During the visit no obvious hazards to health and safety were seen. Protective clothing, gloves, control of substances hazardous to health (COSHH) assessments, risk assessments, equipment servicing and accident records were available as was but training records to confirm all staff have receive training in the techniques of moving and handling first aid health and safety and the procedures to follow in the event of fire, including evacuation were not seen and have been referred to in the staffing section of this report. The Stables DS0000011981.V336472.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 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 X The Stables DS0000011981.V336472.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 The Stables DS0000011981.V336472.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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