Inspection on 02/08/05 for William House

This inspection was carried out on 2nd August 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

William House 23/04/07

William House 24/11/05

William House 07/12/04

William House 20/04/04

William House 24/06/03

Similar services:

Flint House

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

The Cotswold Home

Fairways

Treloar College

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

CARE HOME ADULTS 18-65 William House MacCallum Road Enham Alamein Andover, Hampshire SP11 6HU Lead Inspector Laurie Stride Unannounced 02/08/05 10.30am 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 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 Stationary 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. William House H54 s12073 William House v236873 020805.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service William House Address MacCallum Road, Enham Alamein, Andover, Hants, SP11 6HJ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Enham To be confirmed CRH 23 Category(ies) of LD, Pd registration, with number of places William House H54 s12073 William House v236873 020805.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users must be at least 18 years of age. Date of last inspection 07/12/04 Brief Description of the Service: William House is part of The Enham organisation, a charitable trust, and is situated in the village of Enham Alamein, Andover in Hampshire. The establishment is one of four residential settings on the large site and is registered for 23 physically disabled service users. William House continues to support, care and provide facilities for service users with physical disabilities, the majority of whom continue to participate in personal choices for work programmes at the resource and development centre. William House itself is a modern, purpose-built establishment, which is both tastefully decorated and well maintained throughout. The establishment also incorporates an assessment process, where prospective residents stay in an assessment apartment for a period of time and are able to have a flavour of what care and support is available at William House and throughout the Enham establishment, and allows staff to assess the suitability of the candidates. William House H54 s12073 William House v236873 020805.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first of two annual unannounced inspections and lasted just over five hours. The inspector spoke with four residents and was assisted by the staff members on duty and the senior care home manager in the absence of the recently appointed home manager. A tour of the premises was undertaken and samples of the home’s records were inspected. A tour of the Resource and Development Centre was also undertaken with the manager of client development. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. William House H54 s12073 William House v236873 020805.doc Version 1.40 Page 6 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 Standards Statutory Requirements Identified During the Inspection William House H54 s12073 William House v236873 020805.doc Version 1.40 Page 7 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 standard(s) These standards were not assessed on this occasion. EVIDENCE: Two residents had moved from Weston Court, within the Enham establishment. The senior care home manager reported that in-house assessments had been carried out in order to ensure that the home’s equipment and facilities matched the resident’s needs. William House H54 s12073 William House v236873 020805.doc Version 1.40 Page 8 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 standard(s) 6 and 9 There are clear and consistent care planning and risk assessment systems in place to provide staff with the information they need to meet residents’ needs. EVIDENCE: A sample of three resident’s care plans was inspected. These contained details of professional, family and social contacts, physical and mental health information, personal support needs, behaviour management guidelines and risk assessments. Support guidelines include a section that states how each resident wishes the care and support to be carried out. Through talking with residents and viewing relevant files it was evident that matters of importance to them were recorded in their care plans. ‘Permission to share’ information forms were included and those seen had been signed by the resident. The home was in the process of updating the format of care plans. In-house reviews are held every six months and there is an annual review attended by the social service care managers and families. Reports of these showed that the effectiveness of care plans was assessed, along with aims and objectives, areas of successful achievement and goals to work towards. The review programme is also shared, where relevant, between the residential home and the development programme teams so that residents’ goals and William House H54 s12073 William House v236873 020805.doc Version 1.40 Page 9 needs are fully discussed and appropriate support is agreed. Residents or their representatives sign to say they agree with the outcomes of each review. Throughout the process it was apparent that resident’s independence, rights and responsibilities were being promoted and this was further confirmed through discussion and observation with residents and staff. The manager of client development reported that residents are always involved in discussing what is recorded on file about them and are encouraged to ‘write’ their own reviews. This further demonstrated a person-centred approach to care planning. Thorough and comprehensive risk assessments were on file for each resident. These indicated the level of risk identified for each activity, for example accessing the community or self-administering medication, and included risk management plans and guidelines for staff. There were records of monitoring and reviewing risks and assessments were agreed and signed by residents or their representatives. William House H54 s12073 William House v236873 020805.doc Version 1.40 Page 10 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 standard(s) 11, 12, 13 and 17 The arrangements and facilities for residents’ personal development and acquiring employment skills are of a high standard. The service enables residents to access the community and take part in a range of activities. The catering arrangements have improved and meals now offer greater choice and variety. EVIDENCE: Care plans contain individual development programmes and support guidelines. There are opportunities for residents to participate in structured programmes at the development resource centre and workshop, situated in close proximity to all the homes on the site. These programmes and facilities enable people with disabilities to take part in developmental and valued activities including work development. Residents commented that they enjoyed working at the centre. A tour of the facilities was undertaken with the manager of client development. A fully equipped kitchen with adjustable work surfaces provides a facility for residents’ on structured programmes or simply choosing to cook something, William House H54 s12073 William House v236873 020805.doc Version 1.40 Page 11 for example a birthday cake for a relative. An educational development room is used by small groups learning maths and English or about other things such as mobile phones. In the business enterprise room residents make things to sell, such as key rings and necklaces, greetings cards and bookmarks, dried flowers and pots, coasters and silk paintings. Money raised in this way is used to buy more materials for further projects. During the summer there are also fishing and horse-care programmes and trips out to places of interest. The well-equipped computer room was used for a variety of interests, for example designing T-shirts and digital photography. Residents have exhibited and sold paintings and examples of artwork were seen around the building. In the horticulture section residents were preparing plants for sale and some had also entered competitions. The manager of client development said that all resident’s programmes are individual and changeable according to their needs. The development programme works towards encouraging outside employment. There are links with community work placements and colleges and plans for further links with community groups. Two drama groups composed of residents from all units perform at local schools and the leisure centre. Several forms of transport are available on the site and the village provides nearby shops, bus and taxi services. Information is available to residents and staff about the Disability Discrimination Act, and staff undertake disability awareness training that is updated periodically. Newsletters and notices provide details of local services and activities. Staff rotas were organised to provide flexible cover according to resident’s needs and activities. The inspector met residents in the dining area at William House at lunchtime. Staff were observed providing assistance as required and the atmosphere was relaxed. There is a four-weekly menu of varied and alternative meals and residents confirmed they could ask for different meals. A resident catering survey had recently been completed. Lunch is between 12:30 and 1:30 when most of the residents take a break from the resource and development centre before returning in the afternoon. The evening meal is served between 5pm and 6pm. Breakfast is served at anytime and can be taken into resident’s flats. Catering arrangements have recently been re-designed to incorporate food preparation in William House itself. Since the new financial year, the manager has been provided with a catering budget, which has enabled choice to be extended further for residents. William House H54 s12073 William House v236873 020805.doc Version 1.40 Page 12 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 standard(s) 19 The health needs of residents are well met with evidence of relevant professional consultation on a regular basis. EVIDENCE: As mentioned previously, individual care plans include a section that states how each resident wishes their care and support to be carried out. A keyworker system is in place that helps to promote relationships of trust between residents and staff and provides a point of contact with the home for relatives and external agencies. Staff are trained in the principles of care and moving and handling techniques. Residents have the technical aids and equipment they need for maximum independence, determined by professional assessment. A visual assessment had recently led to changes to markings around the premises to improve safety for all residents. The sample of care plans seen contained personal and general healthcare information, for example details of GP and other contacts, health action plans, allergies, and pressure sore risk assessments. Health appointments and visits are recorded and files contained evidence of appropriate referral to healthcare specialists. Records showed that four residents had been admitted to Accident and Emergency in the last twelve months. In each case the home had notified the Commission for Social Care Inspection that appropriate action had been taken. William House H54 s12073 William House v236873 020805.doc Version 1.40 Page 13 There was a discussion regarding proposed arrangements for the effective management of epilepsy. Doctors and the Primary Care Trust (PCT) had given permission for staff at the home to administer specific medication to residents in order to assist recovery times. Resident’s permission would be sought and the PCT would provide individual written guidelines and procedures and regular training to staff at the home. The senior care home manager said she would confirm when everything was in place. William House H54 s12073 William House v236873 020805.doc Version 1.40 Page 14 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 standard(s) 22 and 23 The home has a suitable complaints procedure with evidence that service users views are listened to and acted upon. Training, policies and procedures are in place to ensure a proper response to any suspicion or allegation of abuse. EVIDENCE: The home has a complaints policy and procedure that includes response timescales, details of who to complain to and the appeals procedure. A record is kept of any complaint received by the home, action taken and final outcome and is signed by the manager. Residents confirmed that they knew who to speak to if they were unhappy with their care. Policies and procedures for the protection of vulnerable adults were available and staff induction and training programmes included abuse awareness. In discussion with a member of staff it was evident that he/she knew and understood the reporting and recording procedure. Two of the organisation’s management team were undertaking training to be trainers regarding Protection of Vulnerable Adults (POVA). The manager reported in the preinspection questionnaire that the majority of current residents manage their own personal allowance and relevant records are kept. Residents invest in the bank of their choice or post office savings account. William House H54 s12073 William House v236873 020805.doc Version 1.40 Page 15 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 standard(s) 24 The provision of modern, purpose built accommodation ensures that service users live in a homely, safe and comfortable environment. EVIDENCE: A tour of the premises was undertaken assisted by a member of the staff team. The building is modern and purpose-built and able to accommodate wheelchair users with ease. William House is comfortable, bright, cheerful, airy, clean and free from offensive odours. All furnishings and fittings are of good quality and the décor is to a good standard. All rooms seen are personalised, have a good outlook and room measurements meet the requirements of the Commission for Social Care Inspection. En-suite facilities and Occupational Therapist assessed assisted baths are available. New bedroom overhead tracking hoists had recently been fitted. Local amenities and transport are available. There is a continual planned maintenance programme, which holds an annual budget. A maintenance team is employed by the organisation on a regular basis and are sited in the village. The fire safety officer visited the premises on 11/11/04. William House H54 s12073 William House v236873 020805.doc Version 1.40 Page 16 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35 and 36. Residents are supported and protected by suitable numbers of trained staff and the home’s supervision policies and practices. EVIDENCE: A four-week rota was in place showing the number and names of staff on duty at any given time. Staffing levels appeared suitable to meet resident’s needs. The work development programme’s team of staff provide additional support hours. The manager reported in the pre-inspection questionnaire that there were currently thirteen care staff and two ancillary staff employed. Staff are allocated specific tasks in line with their role and competencies. The domestic staff had recently come under the direct supervision of the manager of William House. Staff recruitment records included individual’s qualifications and photographs for identification purposes, but evidence of Criminal Records Bureau (CRB) checks and written references were not available due to the manager being on leave. This standard will therefore be further assessed at the next inspection. The senior care home manager confirmed that the organisation operates robust recruitment procedures, including additional checks for staff who are promoted to senior roles. William House H54 s12073 William House v236873 020805.doc Version 1.40 Page 17 New workers undergo a structured induction programme in line with the Skills for Care standards (formerly known as the Training Organisation for the Personal Social Services – TOPSS). A member of staff and the senior care home manager confirmed that this is cross-referenced to NVQ awards in care. Staff said that their induction included an introduction to residents and orientation to the premises including fire procedures. The home provides staff with a rolling programme of statutory and other relevant training including, for example, health and safety, epilepsy, care planning, disability awareness, professional boundaries, risk assessment, behaviour labelled as challenging and protection of vulnerable adults. The programme runs every 3 months, allowing for new staff and refresher training. Certificates of attendance are kept in staff member’s personal files. Staff spoken to said they found the training useful and that it clarifies expectations about the support worker role. Four staff were reported to have completed NVQ2 awards and another was nearing completion. A new training manager for the organisation had recently taken up post. Staff confirmed that they had regular supervisions that are recorded and annual appraisals. Supervisions are held once a month or every other month and included discussion of resident issues and the key worker role. The manager supervises the senior staff who supervise the support workers. A supervision contract is in place for each member of staff. Staff reported that the managers and senior staff were accessible and supportive. William House H54 s12073 William House v236873 020805.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 and 42 The home has well organised systems in place to obtain residents’ views and promote safe working practices. EVIDENCE: The home undertakes a quality assurance survey through resident and other stakeholder surveys that can be completed anonymously. A catering survey had just been completed with results, including residents’ suggestions for improving the variety and choice of meals. The home’s policy file includes a quality management policy, annual performance and quality audit reports, a business programme for 2004 – 09 and statements regarding departmental training and development. The senior home care manager reported that she would be taking over responsibility for a number of quality management matters. Residents confirmed that they had meetings with the manager approximately once a month. The new manager had written to residents explaining the management change. William House H54 s12073 William House v236873 020805.doc Version 1.40 Page 19 The home was able to demonstrate that safe working practices were promoted and maintained. All care staff had current first aid certificates. A health and safety policy file contained risk assessments for the premises including fire safety, waste disposal, the use of hoists, moving and handling and stress at work. The fire safety log book had been kept up-to-date with records of checks, emergency lighting tests, fire procedure training signed by staff with dates of when the next training was due, induction and drills. The manager’s completed pre-inspection questionnaire indicated that domestic and specialist systems and appliances were regularly checked and tested. A health and safety audit is held regularly plus spot checks and there is a maintenance team and manager for the site. An on-call management system had been developed and implemented. A rota had been drawn up for the year with written guidelines. This would be reviewed at subsequent management meetings. William House H54 s12073 William House v236873 020805.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x x Standard No 11 12 13 14 15 16 17 4 3 3 x x x 3 Standard No 31 32 33 34 35 36 Score x x 3 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 William House Score x 3 x x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x H54 s12073 William House v236873 020805.doc Version 1.40 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. 1. 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. 1. Refer to Standard Good Practice Recommendations William House H54 s12073 William House v236873 020805.doc Version 1.40 Page 22 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton, Hampshire 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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