Inspection on 14/02/06 for Timaru

This inspection was carried out on 14th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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 13/09/05

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 Unannounced Inspection 14th February 2006 09:30 Timaru DS0000063045.V281966.R01.S.doc Version 5.1 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.V281966.R01.S.doc Version 5.1 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.V281966.R01.S.doc Version 5.1 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.V281966.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th September 2005 Brief Description of the Service: Timaru is a large, detached modern property, set in large grounds within the service user area of Romsey, Hampshire. The property provides 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 activities of the home. Local community integration is another focus that the team is developing for service users. Timaru DS0000063045.V281966.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection of the home was undertaken on 14th February 2006 over a period of three hours. Four 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. Various administrative and service user records were viewed. The inspection was undertaken with the assistance of the deputy manager. No requirements were placed on the establishment. What the service does well: What has improved since the last inspection? With the exception of two bedrooms, all floor covering have been replaced with laminated surfaces. One new tumble dryer has been purchased. Developmental work currently includes the development of a medical ‘quick reference’ file for staff to refer to for emergency situations including hospital admissions and the team are also developing risk taking measures for service users currently. Timaru DS0000063045.V281966.R01.S.doc Version 5.1 Page 6 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.V281966.R01.S.doc Version 5.1 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.V281966.R01.S.doc Version 5.1 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): EVIDENCE: Standard 2 was assessed satisfactorily at the previous inspection, which took place on 13th September 2005. Timaru DS0000063045.V281966.R01.S.doc Version 5.1 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, 9, 10 Further developmental work has taken place for risk assessment procedures for off site service user visits. The new format will be beneficial towards the safety of both service users and the staff. Appropriate safeguards are undertaken to protect confidential information. EVIDENCE: Care plans viewed by the inspector at the previous inspection were well written, comprehensive and provided extensive information on services users. The information included a wide range of detail to ensure the well being of this vulnerable service user group. Information included personal care checks, 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. The inspector was informed that care plans are Timaru DS0000063045.V281966.R01.S.doc Version 5.1 Page 10 currently being further developed with the assistance of the Learning Support Development Manager for the group, and will continue to reflect person centred planning methods. General risk assessment procedures were viewed at the previous inspection and found to be of a high standard in quality and recording. Since the previous inspection, further work has been undertaken on risk assessments, which have to be completed by staff, prior to service user trips off site. Additional information has been included in the new paperwork, much of which is based on a safety reminder tick list towards ensuring that staff have taken all necessary precautions regarding specific service users. All confidential information for both service users and staff is kept either within locked filing cabinets or on a password protected computer. Passwords are changed regularly. Keys for the cabinet are kept in the safe and allocation of keys is limited to the manager, deputy manager and the administrative member of the team. Timaru DS0000063045.V281966.R01.S.doc Version 5.1 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): 15, 16 and 17 Service user home visits to family and general contact with family is encouraged and thoughtful preparation is undertaken towards home visits. Staff endeavour to ensure that the rights of service users are recognised and supported. The staff and chef work towards providing a healthy, balanced diet for service users. EVIDENCE: All parent and family contact is recorded in individual daily diaries for service users. The inspector discussed contact with family and procedures for home visits for all service users. For some service users, home visits have been undertaken. These involve planning as the home provides staff and transportation to and from family homes and travel involves distance. Risk assessments are part of this process. All service users receive regular visits from parents and occasional visits from siblings. Occasionally, service users join each other in watching a video in each other’s room. Timaru DS0000063045.V281966.R01.S.doc Version 5.1 Page 12 Staff endeavour to promote daily routines and practices towards independence by personal knowledge regarding methods of communication recognised by staff for individual service users. Staff are also able to identify choices by gestures and body language and known identified communication contact All bedroom doors and bathroom doors are lockable and entry available by the use of a master key should this be required. Mail is given directly to service users and assistance provided by staff to open mail and where arranged, to discuss contents. Should service users wish to spend time in their own company, staff are able to identify this need and respond and staff will sit directly outside service user doors or be in close proximity, to ensure privacy and acknowledge service user’ rights. There are no restricted areas within the home, with the exception of the kitchen when cooking is in progress, or if there is a wet floor area, in recognition of health and safety practices. The home has a non-smoking policy and a restricted area is provided for this purpose, outside the home. The home has a four-week rolling menu. Friday nights are generally dedicated to a takeaway meal and staff are able to identify selections, by using picture symbol formats or by using toy make believe food replicas e.g. burgers, chips, hot dogs. All meals are identified by service user choice. Individual break boxes are provided for each service user and include a variety of snacks. Cultural tastes are also catered for and include staff having sought specific recipes from parents. Regular information is recorded on weight charts. Timaru DS0000063045.V281966.R01.S.doc Version 5.1 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): 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 have been extended to include additional information and to observe more stringently, the safety of service users. EVIDENCE: Documentation previously 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. Records are available which document that service users have been visited or have access to various health professionals. Professional advice was observed to have been sought, from various sources to provide for the needs of service users. A mini medical file has been developed since the previous inspection, for emergency use for hospital admission or visits to a service user G.P. Regularly updated information includes current medication, G.P. information, National Health Service number, a list of illness, health action plan i.e. targets and problems, relevant personal information including diagnoses, allergies, Timaru DS0000063045.V281966.R01.S.doc Version 5.1 Page 14 communication ability and dietary needs, and hospital admission information. Included is a visit form to be completed and signed by the treating medic. “Bum bags” are carried by staff at all times when assisting specifically named service users as part of risk assessments and contain relevant, immediate use medication assistance. The inspector viewed several recording systems including epilepsy seizure records and charts and general information regarding procedures, which are part of specific hospital programmes and also required procedures within the home. Information was detailed and recorded. No medication sample checks were undertaken by the inspector during the current inspection, but were accurate following a check at the previous inspection. Timaru DS0000063045.V281966.R01.S.doc Version 5.1 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 Complaint issues are dealt with in an appropriate manner. EVIDENCE: The complaint procedure was considered appropriate at the previous inspection. No complaints have been received by the home, nor has the Commission for Social Care Inspection (CSCI) received any complaints since the previous inspection. Timaru DS0000063045.V281966.R01.S.doc Version 5.1 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): 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: Those areas visited by the inspector during the course of the present inspection, were excellent in decorative order, clean and hygienic and no unpleasant odours were identified. With the exception of two bedrooms, all flooring has been replaced by laminate flooring for practical reasons. Service users and some parents have been involved in choosing specific surfaces in replica wood. Since the previous inspection, two new areas have been developed within the extremely large general lounge area to reduce the size and make the area cosier and less sparse. One of the areas has been organised as a communal television and seating area for service users. The other has provided an office for the manager, deputy manager and administrative staff member and also incorporates a large table and seating area, where staff meetings or reviews can be held. Timaru DS0000063045.V281966.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Standards 32, 33, 34, 35 and 36 were assessed satisfactorily at the previous inspection, which took place on 13th September 2005. Timaru DS0000063045.V281966.R01.S.doc Version 5.1 Page 18 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, 42 The registered manager meets the competency requirements necessary to run the home and is currently continuing developmental training. There is an appropriate quality assurance procedure. EVIDENCE: As part of the registration of the home in 2005, the manager satisfied CSCI that appropriate qualifications had been achieved relevant to the management of the home. Currently, the manager is undertaking the Registered Manager’s Award towards developing his current skills. The home has a quality assurance system and as part of the system, the inspector was informed that an audit was being undertaken of the home the following day by senior management of the group. The inspector viewed a questionnaire which has been developed for relatives and visitors and which is shortly being posted to identify views in support of the quality assurance system. This will be the first recorded information requested directly, since the Timaru DS0000063045.V281966.R01.S.doc Version 5.1 Page 19 home opened to provide feedback for planning and reviewing the running of the home. Various health and safety records were viewed by the inspector at the previous inspection and found to be satisfactory. On this occasion, fire procedures were again checked and found to be recorded and undertaken as required. Timaru DS0000063045.V281966.R01.S.doc Version 5.1 Page 20 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 X 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 x ENVIRONMENT Standard No Score 24 x 25 X 26 X 27 X 28 X 29 x 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 X 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 3 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 3 x 3 X 3 X X 3 x Timaru DS0000063045.V281966.R01.S.doc Version 5.1 Page 21 NO 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.V281966.R01.S.doc Version 5.1 Page 22 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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