Inspection on 29/08/07 for Touchwood

This inspection was carried out on 29th August 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Touchwood 16/03/07

Touchwood 19/01/06

Touchwood 18/11/05

Touchwood 10/01/05

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Touchwood 13 Somerset Road Christchurch Dorset BH23 2ED Lead Inspector Tracey Cockburn Key Unannounced Inspection 29th August 2007 9:55 Touchwood DS0000059217.V344642.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 Touchwood DS0000059217.V344642.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. Touchwood DS0000059217.V344642.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Touchwood Address 13 Somerset Road Christchurch Dorset BH23 2ED 01202 487575 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) touchwoodcare@aol.com Principle Care Ltd Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Touchwood DS0000059217.V344642.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named service user (as known to the Commission for Social Care Inspection) under the age of 18 may be accommodated. 19th January 2006 Date of last inspection Brief Description of the Service: Touchwood is a care home situated in a residential area close to the centre of Christchurch. The home was first registered in April 2004 and provides support, accommodation and personal care to a maximum of five people with learning disabilities. The registered provider is Principle Care Ltd who also owns two other care homes in the area. The house is domestic in size and is in-keeping with neighbouring properties. There is a large garden at the rear and some parking on the front driveway. The home provides five bedrooms, all with en-suite bathrooms. One bedroom is situated on the ground floor and the remaining four bedrooms are on the first floor. There is a lounge with dining area and a kitchen. There is also a fully equipped laundry/utility room, a staff sleep-in room and a small office. The home has its own vehicle to support people with accessing their community. The home is also close to a bus stop, which offers routes into Christchurch town centre, Boscombe and Bournemouth. The home is staffed on a 24-hour basis with one waking night member of staff and one sleep-in duty each night. The current weekly residential fees at Touchwood ranged from £1250 - £1733 per week inclusive of day care. Also included in the fee are basic toiletries and medical requisites, provision of transport by the home and holidays. Touchwood DS0000059217.V344642.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection, which took place over 3.5 hours. The purpose of the inspection was to assess the home’s progress in meeting the key National Minimum Standards. The inspection would also assess progress in meeting the requirements and recommendations made at the last inspection in March 2007. During the course of the inspection a short tour of the home took place. 2 people who live in the service were talked to about their experiences of living in the home. The registered provider and newly appointed manager were also talked to. Discussions also took place with 4 members of staff. Samples of records were looked at including medication administration records, staff files and care files for people living in the service. Survey forms were left for people who live in the service to complete and survey forms were left for relatives and friends. At the time of the inspection 5 people were living in the service. The registered provider submitted and Annual Quality Assurance Assessment ( AQAA) and this was used to inform the planning of the inspection. Also reviewed as part of the planning process were regulation 37 reports of any incidents in the home. What the service does well: People are only admitted to the home after assessment of their needs has been completed. This means that the provider is clear about whether or not someone’s needs will be met by the service. Care and support plans contain detailed information which enables care staff to undertake their role to meet individual needs. Risk assessments are in place enabling care staff to minimise risks to individuals whilst not compromising on independence. People living in the service are able lead the lifestyle they want. Activities are individualised and recorded. People are supported to lead ordinary lives in the community, having contact with their family and friends as they wish. People are encouraged to participate in the running of the service and are making choices about the meals they eat. People say they receive the personal care support they need and their privacy and dignity is maintained. The home is comfortable and spacious and people living in the service say they like their bedrooms. Touchwood DS0000059217.V344642.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: At the end of this inspection there is 1 requirement and 5 recommendations. The manager appointed in July 2007 must submit an application to be registered with the commission. Individual plans of care for the people living in the service should be in a format, which suits each individuals preferred method of communication. It is important that the provider continues to seek safeguarding adult training for all staff to ensure they understand how to spot abuse and the appropriate action to take to ensure that people using the service are protected. The service should continue to support and encourage care staff to undertaken National Vocational Qualifications ( NVQ) of level 2 and above. Touchwood DS0000059217.V344642.R01.S.doc Version 5.2 Page 7 To ensure that care staff receive the support and supervision they need to do the job well, they should receive supervision at least 6 times a year. To demonstrate that the service is run in the best interests of the people living there an annual development plan should be completed. 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. Touchwood DS0000059217.V344642.R01.S.doc Version 5.2 Page 8 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 Touchwood DS0000059217.V344642.R01.S.doc Version 5.2 Page 9 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 service assesses people’s needs and aspirations before they are considered for the service. This means people can be assured that the service is able to meet their needs before they move in. EVIDENCE: 2 files were reviewed as part of the inspection. Both files contained detailed information on the assessment of both people before they moved into the home. At the previous inspection in March 2007, there were 2 people who had moved into the home. There was a care management assessment on the file as well as the homes own assessment documentation. There was evidence in the files at this inspection that reviews had taken place. Touchwood DS0000059217.V344642.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): 6,7,9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People living in the service have individual plans, which detail the care and support they need. This means that staff know the action they need to take to fully support each person living in the home. Work on tailoring the format of the plans to each persons individual communication needs would be of benefit. EVIDENCE: Two support and care plans were reviewed as part of the inspection both plans contained information on the care and support needs of the individuals. 1 person spoken to during the inspection was able to get his file from the office and look through it discussing information contained within it. This person also said that they are able to look at their file any time they want to. The registered provider confirmed that this is the case. The format of the care and support plans are not individual to each person who lives in the homes preferred method of communication. Touchwood DS0000059217.V344642.R01.S.doc Version 5.2 Page 11 People who live in the home are encouraged to participate in reviews and to contribute to house meetings. At present a member of staff chairs meetings. The home should consider a person who lives in the home chairing the meeting with support. House meetings are held on a weekly basis, minutes reflect that people who live in the service are able to make decisions about activities and menus. It was noted that the meeting starts with appointments taking place each week and includes information such as who might be attending healthcare appointments or visiting the psychologist. This is confidential information and should only be shared with the individual concerned. Observation and discussion with several people using the service suggest that they are able to make choices about what they want to do within the structure of individual needs. Risk assessments for 2 of the people living in the home covers areas such as risks of abuse, risks posed by outside activities and risks within the home. Touchwood DS0000059217.V344642.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): 12,13,15,16,17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who live in the service are supported to lead the lives they want to, taking part in activities, which interest them in the community. People are also supported to make decisions about their lives, relationships and the food they eat. EVIDENCE: Each person living in the home has an individual programme of activities such as attending college or home based activities. On the day of the inspection most of the people living in the home were off to play snooker. In 2 files there was evidence of activities in the local community, including going to the local shops, leisure centre, pubs and park. The home has a rota for household chores such as setting the table and loading the dishwasher. Touchwood DS0000059217.V344642.R01.S.doc Version 5.2 Page 13 1 person spoken to during the inspection said that they were able to see their family when they wanted to. People living in the service have access to all parts of the communal areas of the home. Restrictions are agreed with each individual and recorded in their care and support plans. This includes access to the community and how the individual should be supported. The home employs a part time cook who is responsible for the preparation of main meals. Lunchtime was observed on the day of the inspection. All the people living in the service ate together. The cook was observed serving the food and she was mindful of each persons individual preferences. Before lunch staff were observed supporting 1 person who they explained later becomes anxious when routines are altered or there is a new face in the home. Staff were noted to be kind and patient and they were also observed to be following the support plan, which detailed the action to be taken in this situation. The fridge and freezer was well stocked. Touchwood DS0000059217.V344642.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): 18,19,20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who live in the service are supported in the way they prefer. Their physical and emotional needs are identified and they are supported to seek help and advice. Improvements in the homes medication policy and practice mean that people living there are protected. EVIDENCE: The two individual plans seen detailed that personal support was based on their individual assessed needs. Staff were observed encouraging individuals to take responsibility for their care needs and develop their skills. Daily plans of personal care talk about encouragement. Plans also uses phrases such as “ don’t rush him but encourage him to move on to each step” Support plans also identify triggers for behaviour and how staff can take action to diffuse behaviour. The two files seen contained information on healthcare appointments and their outcomes. Daily records demonstrate the outcomes of visits to the GP and action to be taken such as follow up appointments. Touchwood DS0000059217.V344642.R01.S.doc Version 5.2 Page 15 The home has a policy and procedure in relation to medication administration. The policy was reviewed in April 2007. During the inspection the member of staff responsible for medication was spoken to and discussed the process followed within the home and in the other homes belonging to the provider. Each person living in the home is the second signatory for his or her own medication. This is recorded on the MAR chart. The home has a clear audit trail and the local pharmacy are involved in regular audits. Although the home does not follow the royal pharmaceutical society’s guidance they have very stringent procedures, which are clear and followed by staff. There is a clear record kept on the computer and no errors were found. The home is working towards staff receiving training in the safe handling of medication. 9 staff working across all 3 homes owned by the provider have not had medication training according to the training record seen at the inspection. Touchwood DS0000059217.V344642.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): 22,23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Development of the homes system for recording concerns means that people living in the service have their views listened to and acted upon. Active pursuit of external training for staff in safeguarding adults means the service recognises the importance of protecting the people who live there by training staff accordingly. EVIDENCE: People living in the service are encouraged to express their views and concerns through daily contact with their key worker and in weekly house meetings. The records seen demonstrate that issues raised by individuals are clearly recorded and any action taken. There have been no safeguarding adult referrals since the last inspection. The homes policy on adult protection has been reviewed. Although staff have received training in this area the registered provider stated that finding places on local authority courses is difficult as they are oversubscribed and they don’t get the places. The registered provider stated his commitment to seeking such training for staff. Touchwood DS0000059217.V344642.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): 24,30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People live in a homely, comfortable and safe house. Policies and procedures have been reviewed to ensure that the home is clean and hygienic. EVIDENCE: This service is an ordinary home in an ordinary road. It provides single bedrooms with en suite bathroom facilities for 5 people. People living in the home say they are able to have their personal possessions in their room. The home is comfortable and bright. The furniture is homely, as you would expect in a small family style service. The furnishings and fittings were in good condition. There is planned maintenance for the fabric and decoration of the home. Local amenities such as shops are within easy access. The home transports people to various activities. Touchwood DS0000059217.V344642.R01.S.doc Version 5.2 Page 18 The home is accessible to all the people who live there. The home is clean and the homes policy on infection control was reviewed in April 2007. The home has ordinary domestic style laundry facilities. Touchwood DS0000059217.V344642.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): 32,34,35, 36 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Improvements in identifying training needs and provision of specialist training means that staff are receiving the training they need to do the job. Improvements to recruitment practice means that people living in the service are protected. EVIDENCE: The registered provider supplied a copy of the services training record. This record covers all staff working in all 3 services owned by the registered provider. People using the service said that staff are good at listening and are supportive. This was also observed during the inspection, when staff were seen to be motivated and interested in the people living in the home. Not all care staff hold a care NVQ level 2 or 3. 1 staff file was examined as part of the inspection. This showed evidence of a completed application form and an interview process. Touchwood DS0000059217.V344642.R01.S.doc Version 5.2 Page 20 Appropriate checks with the Criminal Records Bureau had been undertaken prior to the care worker starting in post. Proof of identity was also seen on the file. There were 2 references on file. All staff at the home undertake an in-house induction programme, which covers basic health and safety practices, personal care, record keeping, medication and safeguarding adults procedures. The registered provider continues to pursue specialist training for care workers that reflects the needs of the people living in the service. Since the last inspection the training and development plan has been improved and courses such as first aid, fire and food and hygiene have been organised for staff. The record also identifies those members of staff who need refresher training. The new manager has identified that supervision has not been taking place as regularly as it should and is in the process of assuring this will be corrected. Touchwood DS0000059217.V344642.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): 37,39,40,42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The appointment of a new manager means that there is clear accountability in the running of the home. EVIDENCE: The home has a new manager who was appointed in July 2007. At the time of the inspection the manager had not yet submitted an application to be the registered manager of the service. This person has both the Registered managers Award and the National Vocational Qualification (NVQ) at level 4. The manager also has the NVQ assessor’s award. During the inspection the manager discussed areas such as supervision, which were not happening as regularly as they should. Touchwood DS0000059217.V344642.R01.S.doc Version 5.2 Page 22 The registered provider was able to demonstrate that the questionnaire, which had not been sent out at the last inspection in March 2007, had been returned and that the new manager was in the process of collating the information received into the annual development plan. The homes policies and procedures are accessible to staff, they are kept in the office. All the policies and procedures were reviewed in April 2007. The AQAA submitted by the service demonstrated that the policies had been reviewed and this was evidenced during the site visit. The fire risk assessment has been reviewed and a risk assessment specific to 1 individual regarding evacuation has been completed. The service has a training record, which clearly shows were the training gaps are. Since the last inspection the provision of training for staff has improved and where there were shortfalls such a fire training, first aid, manual handling, physical intervention and food hygiene this has been improved. Please see standard 23 were there continue to be problems sourcing safeguarding adults training as there are limited places available on courses run by the local authority. The registered provider stated that they continue to seek training for staff in this area. Fire records were up to date. Touchwood DS0000059217.V344642.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 2 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 2 33 X 34 X 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 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 2 X 2 3 X 3 X Touchwood DS0000059217.V344642.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. 1. Standard YA37 Regulation CSA 11 Requirement The proposed manager of the home must submit an application for registration to the Commission for Social Care Inspection. Timescale for action 01/11/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard YA6 YA23 YA32 50 of all care staff in the home should obtain a Care NVQ Level 2 or above. 4. YA36 Staff working in the service should receive supervision at least 6 times a year. This should be recorded. Good Practice Recommendations Service user plans should be in a format that the service user can understand and be held by the service user. The provider should continue to source safeguarding adults training for all staff. Touchwood DS0000059217.V344642.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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. Extracts may not be used or reproduced without the express permission of CSCI Touchwood DS0000059217.V344642.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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