Inspection on 13/09/05 for Timaru

This inspection was carried out on 13th September 2005.

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

Timaru 14/03/07

Timaru 14/02/06

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Pinta

Kestrel House, St Anne`s Opportunity Centre,

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

CARE HOME ADULTS 18-65 Timaru Great Bridge Road Romsey Hampshire SO51 0HB Lead Inspector Drew Gurney Announced Inspection 13 September 2005 09:30a Timaru DS0000063045.V250035.R01.S.doc Version 5.0 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 Timaru DS0000063045.V250035.R01.S.doc Version 5.0 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. Timaru DS0000063045.V250035.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Timaru Address Great Bridge Road Romsey Hampshire SO51 0HB 01256 316555 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) Liaise Loddon Limited Nigel Royston Webster Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Timaru DS0000063045.V250035.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Timaru is a large, detached modern property set in large grounds within the service userial area of Romsey, Hampshire. The property has been converted to provide a suitable home for five younger adults with learning disabilities. The home is spacious, well maintained with furnishings and décor of a high standard. A large conservatory to the rear of the property provides additional communal space. All bedrooms are en-suite and are suitably equipped for the current service users. The home has access to local transport and facilities. Adequate car parking is provided to the front of the property. The rear of the property consists of a large lawn area, complete with an attractive fishpond and patio. An equipped sensory room and music and drama therapy are part of the developing activities of the home. Local community integration is another focus that the team is rapidly developing for service users. Timaru DS0000063045.V250035.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The first announced inspection of this property since it was registered in 2005 was undertaken on 13th September 2005 over a period of five and a half hours. All of the five service users were present at some point during the inspection. The inspector was able to observe staff interacting well with service users during the course of the inspection and to have a brief chat with staff on duty. The music and drama therapist who provides activities for service users was present on her one-day weekly duty and explained to the inspector, her role and the progress being made with service users. Records were viewed for both service users and staff. The inspection was undertaken with the registered manager, Mr. Nigel Webster. No requirements were placed on the establishment. What the service does well: Despite the service’s short period of registration, systems and general day-today running are of a high standard and quality. Care plans and information for service users is based on person centred care plans, which are still being developed. Pre-admission assessment information is extensive/recording systems including risk assessments, are of a high standard. Daily diary recording for service users is particularly well designed and utilised. New admissions are vetted thoroughly prior to admission. The recruitment procedure is robust. The continuing services of the Music and Drama Therapist and her knowledge and perception of this service user group, shows benefit to service users. Integration with the local community is developing well. The University of Southampton has requested that the home accept third year student nurses as part of their placement experience in challenging behaviour, which reflects on the skills offered to service users. The registered manager has an extensive background as a trainer. The staff interact well as a team. Timaru DS0000063045.V250035.R01.S.doc Version 5.0 Page 6 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. Timaru DS0000063045.V250035.R01.S.doc Version 5.0 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 Timaru DS0000063045.V250035.R01.S.doc Version 5.0 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 The needs of prospective applicants are assessed in a favourable manner. EVIDENCE: The assessment information for one particular service user was viewed by the inspector and proved to be of an excellent standard. The content provided sufficient information to provide the management team to reach decisions about the suitability of the home for the person involved. Assessment information is extensive to address the requirements of this vulnerable service user group. The information documented was full both in design and content, and provides the reader with clear knowledge about the applicant. Timaru DS0000063045.V250035.R01.S.doc Version 5.0 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 All service users have well designed and detailed care plans. Staff assist service users in reaching decisions by incorporating various methods of communication. Service users are supported to take risks as part of an independent lifestyle and this is clearly documented. EVIDENCE: Care plans viewed by the inspector were well written, comprehensive and provided extensive information on services users. The information includes a wide range of detail to ensure the well being of this vulnerable service user group. Information includes personal care check charts relating to hygiene, nails, skin care, height, and weight. It also incorporates specific behaviour charts related to diet, toileting and various other aspects and many other aspects including a health action plan. Also included is the communication level of individual service users and systems of communication to counteract social difficulties and provides clear guidelines for reactive strategies. Additional information for each service user, is held in a separate medical file and was seen to contain detailed information about all aspects of health care and professional involvement. Timaru DS0000063045.V250035.R01.S.doc Version 5.0 Page 10 Staff are able to identify choice by using a variety of mechanisms such as makaton, pic symbols, photographs, gestures, and body language. Person centred planning continues to be developed for service users and this planning will focus on goals towards which both service users and staff are aiming to achieve. Current service users have moved to the home from an educational establishment and have been provided with a curriculum vitae and this information indicates service users’ ability in achieving tasks using a variety of methods. Full and detailed risk assessments were available for service users to address all aspects of daily living and social activities. Risk assessments incorporated risk taking by service users that they encounter in various activities. Timaru DS0000063045.V250035.R01.S.doc Version 5.0 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, and 13 Activities are provided which encourage service users to take part in age and culturally appropriate activities. Service users are well accepted by the local community. EVIDENCE: The inspector was shown service user programmes that include independent living skills, communication and social skills. This information is recorded within care information. Communication is focused on makaton skills, picture symbols and various means relevant to specific service users. The manager expressed clear views concerning the importance of staff being aware that activities should reflect the specific ages of the current teenage service user group as well as recognising abilities. The inspector talked with a music and drama therapist who is employed at Timaru for one day per week to encourage participation of all varieties associated with listening to music and the use of instruments. The therapist has known all current service users from their former educational background and spent time explaining her delight in the progress being made by service users and the feedback that is received by staff based on this activity. A large sensory room has been provided on the upper floor of the home for various soothing activities. The home is still developing this particular area, Timaru DS0000063045.V250035.R01.S.doc Version 5.0 Page 12 but at the time of the inspection, much progress had been made. Information was available indicating activity schedule development for walks, ‘messy sensory’ sessions, drama, massage and relaxation, shopping, make up and beauty, cooking, karaoke and videos. The home is still within early days of developing relationships within the community but at the time of the inspection, information was available with regard to the home working towards developing contact with religious and ethnic connections to stimulate the interest of service users. The manager informed the inspector that the local community development is being created by visits to the hairdresser and information was available concerning an Open Day at which many of the local community enjoyed the food provided and the bouncy castle which was available for any age group willing to participate. Timaru DS0000063045.V250035.R01.S.doc Version 5.0 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 Personal support and health care is provided for service users, directly by staff. Physical and emotional health needs are met. Medication procedures are appropriate and well recorded. EVIDENCE: Documentation viewed by the inspector, contained manual handling assessments appropriate to the abilities of service users. Personal care is assessed and the gender of care staff providing care is part of the assessment procedure, for protective reasons for both service user and staff members. All service users make personal choices about their wishes in all aspects and these decisions are documented in care plans. The inspector was informed by care staff that service users are supported to choose their dress for the day by staff offering two outfits of clothing and being aware of each service user’s response that will indicate their decision. Records are available which document that service users have been visited or have access to various health professionals. Professional advice is sought from various sources as required to provide for the needs of service users. The inspector observed evidence that service users’ health is monitored by being shown various charts that staff use to record specific detailed Timaru DS0000063045.V250035.R01.S.doc Version 5.0 Page 14 information. This monitoring ensures that any problems or potential complications are identified and dealt with at an early stage. Medication is stored in two kitchen cupboards, each service user being allocated an independent shelf for personal medication. The inspector viewed medication administration and storage. Records of medication administration were viewed and found to be accurate. All staff receive training in the administration of medication. Medication administration is checked and normally administered by a team leader. No self-administration of medication takes place at Timaru. Timaru DS0000063045.V250035.R01.S.doc Version 5.0 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 Complaint and adult protection issues are dealt with in an appropriate manner. EVIDENCE: The complaint procedure was found appropriate as part of the recent registration process and is provided to relevant parties. Staff provide explanations to service users to the best of their ability in the format of makaton and relatives are provided with the prepared information for the purpose. No complaints have been received since Timaru has been registered. Information is available confirming that all staff receive training on adult protection issues, including SCIP (Strategic Crisis Intervention Prevention) training from the registered manager, who is a SCIP instructor. All staff have been registered also for L.D.A.F. training which includes an element on adult protection issues. Professional documentation on adult protection issues is held by the home. The home’s head office holds the responsibility of maintaining service user finances and each service user has a personal bank book. The inspector was shown bank statements for individual service users and these indicated the current total, including interest. Timaru DS0000063045.V250035.R01.S.doc Version 5.0 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 Those areas viewed were well presented, clean, hygienic and appropriate for the needs of service users living at Timaru. There were no unpleasant odours identified throughout the home, during the course of the inspection. EVIDENCE: A tour was conducted of reas in the building that were accessible and where it was convenient to the needs of service users. The condition of the home was excellent and service users’ bedrooms are acquiring a personalised touch and are tastefully furnished and decorated. Every endeavour has been made to provide service users with a comfortable, family and safe environment. All furnishings throughout are of a tasteful, high quality, including furniture, carpeting and curtaining. All service user bedrooms are provided with en-suite facilities, including a mix of baths or showers, according to the assessed needs and personal choice of service users. Adequate provision has been made to provide equipment to enable service users, as required by each individual. The conservatory area leads onto a patio overlooking a large fish pond, that has been covered with a stable, safety feature to protect service users from harm. Timaru DS0000063045.V250035.R01.S.doc Version 5.0 Page 17 Communal areas and bedrooms are appropriate in size for the requirements of the home. The home throughout, was excellent in decorative order and clean and hygienic, with no unpleasant odours detected on the date of the inspection. During the course of the inspection, a flooring consultant visited the home to discuss new flooring for three areas within the home, where carpeting has proved difficult to maintain to a standard acceptable to the management. The inspector was informed that it is intended that these areas will be provided shortly with an alternative floor covering that is easier for staff to maintain. Timaru DS0000063045.V250035.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 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): 33, 34, 35 and 36 The home has appropriate staffing levels, which will be able to better meet service users’ needs once recruitment is achieved for key vacant posts. has well structured recruitment practices and training procedures and all staff members receive regular supervision. EVIDENCE: The staffing structure consists of the registered manager, the positive support manager, two team leaders (currently one vacancy), one positive support coordinator (vacant post), a chef and 13 support workers (7 vacancies). Vacant support worker posts are being covered by agency support, most of which is allocated on a regular basis. Interviews have been arranged shortly after the inspection process, to fill these vacant posts. All day shifts are covered by six support workers, including the manager and positive support manager and night cover is maintained by three wake staff members and an on call person. At the time of the inspection, four service users were in residency, with one vacant place. Service users are supported by care staff on a one to one basis with a regular one-hour rotation pattern allocated to each individual service user. This ensures that service users relate to all members of the team and the change of service user is found to be a suitable work pattern for team members and provides relief. This pattern of work was observed during the inspection. Timaru DS0000063045.V250035.R01.S.doc Version 5.0 Page 19 Sound practices are followed for recruitment. The files of two support workers were viewed by the inspector and contained appropriate health checks, references, outside United Kingdom documentation and CRB/POVA clearance. Interviews are recorded. Contracts of employment were available. All current members of staff have been registered for L.D.A.F. training and this training will be provided for new members to the team. Induction training has included all core subjects and additional topics such as medication, epilepsy awareness and SCIP training. The manager informed that discussion is currently taking place with Totton College to discuss core training. Recorded supervision documentation was present on files viewed by the inspector and is recorded at regular intervals. Timaru DS0000063045.V250035.R01.S.doc Version 5.0 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 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): 41 and 42 Records are maintained to a high standard. Systems are in place to ensure the safety and well being of both service users and staff. EVIDENCE: All records viewed by the inspector for both service user and for the home’s safety purposes were recorded to a high standard. All service user information relating to health, safety and well-being is expansive and specific in many areas. The daily recorded information is updated by staff on seven occasions during the course of the day, is signed and dated. Since the home has been registered, regular Regulation 26 notices have been submitted to CSCI, indicating a monthly visit undertaken by the registered person. Recording practices viewed by the inspector, also include fire procedures and training, recorded temperatures for refrigerator, freezer and meal temperature probes, and accident and incident procedures. All were found to be appropriate. Health and safety notices were on display in the kitchen. Timaru DS0000063045.V250035.R01.S.doc Version 5.0 Page 21 Timaru DS0000063045.V250035.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “ ” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 4 x x x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 x 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score x x 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Timaru Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x 3 3 x DS0000063045.V250035.R01.S.doc Version 5.0 Page 23 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 Timaru DS0000063045.V250035.R01.S.doc Version 5.0 Page 24 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. 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