Inspection on 23/04/07 for William House

This inspection was carried out on 23rd April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 24/11/05

William House 02/08/05

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 6HJ Lead Inspector Peter J McNeillie Unannounced Inspection 23rd April 2007 09:00 William House DS0000012073.V332504.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 William House DS0000012073.V332504.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. William House DS0000012073.V332504.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service William House Address MacCallum Road Enham Alamein Andover Hampshire SP11 6HJ 01264 345835 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) Enham Fiona Margaret Kelly Care Home 23 Category(ies) of Learning disability (1), Physical disability (23) registration, with number of places William House DS0000012073.V332504.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th November 2005 Brief Description of the Service: William House is part of The Enham Organisation, a charitable trust which is situated in the North Hampshire village of Enham Alamein close to the towns of Andover and Newbury in Berkshire. The establishment is one of three similar registered residential facilities all of which are sited close to each other in large extensive grounds. The home is registered to provide care and support for up to 23 service users with a physical disability, the majority of whom participate in work of their own choosing at the resource and development centre which is also on the same site. William House is a modern, purpose-built two-storey building fitted with a range of electrical and mechanical aids and equipment designed to assist residents maintain as independent life as possible. Prior to admission to William House potential residents undergo an assessment of needs and risk in a neighbouring sister home but if they wish spend time, including overnight stays at William house. During their stay residents are able to experience what living at William House is like and what care / support as well as work and social opportunities are available both in the home, nearby community and throughout the Enham Organisation. These assessment stays are also designed to allow staff to assess the needs of a potential resident and ensure the home can meet these needs. William House DS0000012073.V332504.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In formulating this report evidence from a number of sources including a site visit to the premises, previous reports examining residents /staff records, personal observations, talks with residents, staff, management, reading reports produced by the registered person as required by the regulations, responses to an internal annual satisfaction survey results from an in house quality survey, responses to a pre inspection user survey by C.S.C.I. and responses by the manager to a pre inspection questionnaire were taken into consideration. Following the last two inspections during which the key standards for younger adults were last inspected no requirements or recommendations were made. This key unannounced visit, which took place on 23/04/07 between the hours of 09.00am and 02.30pm, was the first inspection for the year 2006/07 and covered all of the designated key standards for younger adults. During the inspection the manager who had been registered since the last inspection assisted the inspector. The inspector was also able to discuss the service with the registered managers line manager and the registered person. The results and findings contained in this report will determine the frequency and type of future inspections. Current residential fees range from £574 to £596 per week. Three-week assessment: from £2598. What the service does well: What has improved since the last inspection? There were no requirements or recommendations made following the last inspection a situation that mirrored itself at this visit. William House DS0000012073.V332504.R01.S.doc Version 5.2 Page 6 The number of standards assessed as excellent has increased as demonstrates in the previous section of this report. 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. The summary of this inspection report can be made available in other formats on request. William House DS0000012073.V332504.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection William House DS0000012073.V332504.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has a system of assessing and identifying re needs in which the resident participates and ensures residents safety and that their assessed needs can be met. EVIDENCE: A sample of three residents files chosen at random by the inspector were viewed. All of the records seen confirmed that residents are only admitted following a detailed assessment of needs, risk and benefits being carried out. As part of the pre admission procedure following a referral from a care manager, which would include a care, management assessment prospective residents would be invited to stay at the home where a very comprehensive assessment of need over a period of approximately three weeks takes place. William House DS0000012073.V332504.R01.S.doc Version 5.2 Page 9 Prior to the commencement of the assessment, a pre-assessment meeting is held with the prospective resident. This allows all parties to identify any special requirements the person might have during the assessment as well as answering any worries and concerns. Other areas covered at this meeting would normally include a brief history of the individual and details of any identified risks, medication needs and personal and family contacts. During the three-week period the prospective residents who would live in an assessment flat located in a neighbouring unit is also invited to visit and stay in any of other two sister homes including William House to allow a comparison between the various facilities on site. At the end of the three-week period assessment and development reports are produced. The assessment report which includes information on social skills communication, personal care, benefits, emotional needs and physical health equipment /aids required also concludes whether or not the home can meet the person’s needs. The development report includes suggestions for personal development plans and activities, for example work experience, art, drama, life skills, numeric and literacy study. A report is also made by the Occupational Therapist. All of the managers of the homes on the site are consulted and contribute to the assessment process. If needs can be met and the prospective resident agrees plans are then made to admit, initially for a probationary period to a service of their choice. Following admission for the probationary period of usually three months a review is arranged following which a care plan is formulated from all the information collected and signed by all parties. William House DS0000012073.V332504.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 and 9. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has a well-developed system of planning and reviewing care which takes into account the wishes and aspirations of residents and ensures resident’s needs are met within a risk management policy. EVIDENCE: Following a very detailed and comprehensive assessment process as described in the preceding section of in this report, a care plan that fully reflects residents needs wishes and aspirations is produced. Samples of three residents care plans selected at random by the inspector were viewed. William House DS0000012073.V332504.R01.S.doc Version 5.2 Page 11 All plans viewed included a written confirmation that the resident had been consulted and contributed to the assessment/care planning process this was also verbally confirmed by residents spoken with. Records indicated all plans are reviewed a minimum of three monthly and amended to reflect the changing high care needs as before, with the involvement of the resident. Residents rights to take risks is acknowledged and is seen as most important in assisting residents to achieve any independence. Themselves evidence this in the manner in which many residents access the community and travel, in one case by driving their own vehicle. Any restrictions placed on individuals due to their high needs or physical abilities are clearly recorded in the care plans. William House DS0000012073.V332504.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 and 17. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The social activities family contacts and the provision of varied and nutritious meals were well managed and reflected service users choices. EVIDENCE: Opportunities exist for residents to participate in structured programmes at the resource centre and workshops situated in close proximity to the home on the same campus. William House DS0000012073.V332504.R01.S.doc Version 5.2 Page 13 Residents’ taking part in the workshop programme are expected to demonstrate commitment such as working to deadlines and good time keeping. This expectation is designed to foster individual responsibility and help people develop skills for employment. Records viewed, comments from staff comments from residents and notices seen during the inspection confirmed a full programme of activities and social opportunities both in house and community based were available. Examples of activities available include, T.V.music, craft, I.T.holidays (£500 included in annual fees.), on site clubs, church, daily living skills classes, gardening. Resident’s management and staff confirmed participation in any activity was by choice and only undertaken following a risk assessment. Whilst support and assistance is available, residents are encouraged and supported to be proactive in seeking out local facilities, maintain family contact, establish friendships and if they wished, develop safe sexual relationships as part of them leading independent lives. The majority of residents rely on transport provided by the home to visit local towns and places of interest and home as in many instances the use of public transport was not an option due to the absence of hoists/lifts to assist wheelchair users. Residents confirmed any restrictions placed upon them that restricted choice were discussed with them and agreement reached based on the need for personal safety and the needs of others for others. Any restrictions were recorded in the care plan. All residents had access to in house public telephones that could be used in private. Many residents owned a mobile phone. All bedrooms are fitted with a lock under the resident’s control, as is the main door, which is fitted with an entry phone and an automatic electronic entry system, which allows residents to choose, who they permit to enter. A menu based on healthy eating guidelines, resident’s likes and dislikes was displayed. Residents spoken with said they were satisfied with the food and confirmed, if they did not like what was available an alternative of their choice was always provided. Guidelines for staff to assist residents who required assistance when eating was also available. William House DS0000012073.V332504.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 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Satisfactory arrangements are in place, ensuring the personal emotional, health care and medication needs of residents are met. EVIDENCE: A sample of three residents records were viewed. Residents, staff and managers confirmed residents were encouraged to exercise choice in all aspects of their lives including bedtimes, clothes, food, gender of carer, GP, dentist optician and key worker being quoted as examples. William House DS0000012073.V332504.R01.S.doc Version 5.2 Page 15 Following the assessment /care planning process any social or health care needs identified which are not available within the home are resourced and provided. These might include consultations/input from learning disability specialists, doctors, district nurses and care managers, consultants from a number of disciplines or access to the on site services of a physiotherapist or occupational therapist. Residents confirmed that they felt staff and management were fully aware of their individual needs and quick to respond should specialist external sources of support be indicated. All residents are encouraged to take responsibility for their own drugs and medicines if appropriate following a risk assessment. At the time of the inspection no residents had responsibility for their own drugs and medicatio which are all individually securely stored. William House DS0000012073.V332504.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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has clear policies and procedures in place which ensures residents are able to complain and are protected from abuse . EVIDENCE: A corporate whistle blowing and Adult Protection Policy and Procedure have been implemented to work in tandem with the procedure produced by Hampshire County Council. The whistle blowing policy last reviewed in February 2006 is currently under review. Both policies and procedures are included in the staff handbook. In the main all management and staff spoken to demonstrate they were aware of the procedure to follow should they witness or suspect the abuse of a resident, however in some instances appeared slightly confused and required prompting from the inspector. The managers immediate line manager who has a training lead for the organisation gave a verbal undertaking that all staff would receive refresher training as soon as possible. This matter will be evaluated further at a future visit to the home. William House DS0000012073.V332504.R01.S.doc Version 5.2 Page 17 The complaints procedure, which was part of the service users information pack also included information on how to contact The Commission for Social Care Inspection (C.S.C.I), was seen, as was record of complaints, which included time scales within which complaints must be dealt. The record and pre inspection documentation indicated that any complaints received had been dealt with promptly to the satisfaction of the complainant. William House DS0000012073.V332504.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from living in a purpose built environment which was clean, homely, free from adverse odours and equipped with a large number of specific aids and adaptations designed to maximise the independence, comfort and safety of the residents. EVIDENCE: The purpose build building has been designed to meet the needs of residents with a disability including residents using a wheelchair. A tour of the purpose built building indicated it was safe, well maintained, tidy, clean and free from any adverse odours. No obvious hazards to health and safety were seen. William House DS0000012073.V332504.R01.S.doc Version 5.2 Page 19 Apart from large wide corridors, wide doors, automatic lights and an electronic door entry system under the control of residents a number of other personal aids and adoptions have been fitted including, fitted overhead hoists in bedrooms, special beds, baths/ showers, grab rails and ramps. All communal rooms, which were light, and airy rooms were equipped with furniture designed to meet resident’s needs including the kitchen where worktops and storage cupboards could be raised and lowered. Not only have the needs of the residents been taken into account, so have the needs of the staff enabling then to deliver a good service in a pleasant safe environment. An infection control policy and procedure is in place. All staff have access to aprons, gloves and antiseptic soap, which ensures residents protection from cross infection. William House DS0000012073.V332504.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s needs are met by sufficient numbers of well trained and supported staff who are recruited and selected using a procedure designed to protect all residents. EVIDENCE: The pre inspection documentation indicated the planned deployment of staff would be a manager, 3 support/care staff and a housekeeper and a cook each shift. Residents spoken with said the staffing numbers were” O.K.” and they rarely had to wait for attention. Staff confirmed that staffing levels are closely monitored to reflect the assessed needs of residents and they had time to give one to one attention to individual residents. Thee staff files chosen by the inspector were viewed. William House DS0000012073.V332504.R01.S.doc Version 5.2 Page 21 Files indicated all staff is employed in accordance with a robust recruitment and selection procedure designed to protect residents. This procedure involves the completion of an application form, the signing of a rehabilitation of offenders declaration, an interview, satisfactory Criminal Record Bureau, (C.R.B.) Protection of Vulnerable Adults (P.O.V.A) and reference checks followed by the satisfactory completion of an in house induction training and probationary period of employment. On viewing application forms the inspector highlighted that in some cases there were minor gaps in employment histories. The manager gave a verbal undertaking the missing information would be added to files as a matter of urgency. This matter will be reviewed at a future visit to the home. Staff spoken to confirmed they were not permitted to commence employment until all checks had been completed. Staff training and supervision records were also viewed; these confirmed on commencement of employment all staff underwent very comprehensive induction training followed by National Vocational Qualification (N.V.Q.) training programme. The pre inspection questionnaire provided by the manager stated that 38.5 of staff had been trained to at least N.V.Q.level 2. With a further 15.45 due to complete training shortly. A number of other training initiatives that had taken place or were planned including, infection control, medication, epilepsy, health and safety, disability equality, diabetes awareness, protection of vulnerable adults food hygiene, lone working, I.T skills, and telephone aggression. Any individual training needs are fully assessed at regular supervision session’s records of which were also available. William House DS0000012073.V332504.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management of the home ensures the health, safety and welfare of residents and staff are promoted and the home is run in the best interests of the residents whose views about living in the home are formally sought. EVIDENCE: The Manager who has been in post for just over two years has been registered since the last inspection having worked at Enham for the previous seventeen William House DS0000012073.V332504.R01.S.doc Version 5.2 Page 23 years (now a total of nineteen years) is very experienced in working with the client group living in the home. Apart from her experience the manager had just completed her N.V.Q.qualification level four three weeks prior to this inspection. Staff spoken to used the term “open door “ to describe the management style. They confirmed they were encouraged to put forward ideas for the improvement of the service both at staff meetings and supervision. Resident’s views are sought through resident satisfaction surveys or at regular meetings. Residents at times are reluctant to complete forms, which are anonymous, and there fore the returns are sometimes low this effect was mirrored in other homes on the campus. At present the current system does not I include seeking the views of residents relatives/representatives and visiting social and health care professionals. The inspector was informed work is in hand to address this deficit. Progress will be evaluated at the next visit to the home. William House DS0000012073.V332504.R01.S.doc Version 5.2 Page 24 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 4 3 X 4 X 5 X X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 4 4 X 4 X 4 LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 3 17 STAFFING Standard No Score 31 X 3 X 3 3 X 3 X 3 3 X 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X X 3 X DS0000012073.V332504.R01.S.doc 3 X 3 X X 3 X Version 5.2 Page 25 William House 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 William House DS0000012073.V332504.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI William House DS0000012073.V332504.R01.S.doc Version 5.2 Page 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!