Inspection on 24/11/05 for William House

This inspection was carried out on 24th November 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 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 Laurie Stride Unannounced Inspection 24th November 2005 10:00a William House DS0000012073.V259098.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address William House DS0000012073.V259098.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. William House DS0000012073.V259098.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service William House Address MacCallum Road Enham Alamein Andover Hampshire SP11 6HJ 01264 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 Care Home 23 Category(ies) of Learning disability (1), Physical disability (23) registration, with number of places William House DS0000012073.V259098.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users must be at least 18 years of age Date of last inspection 02 August 2005 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 DS0000012073.V259098.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second of two annual unannounced inspections and lasted six hours, during which the inspector spoke with a resident, a member of staff and the home’s manager and viewed samples of the home’s records. The inspector looked mainly at the key standards not assessed at the last inspection and therefore this report should be read in conjunction with the previous report. There were no requirements made as a result of this visit. 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 DS0000012073.V259098.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection William House DS0000012073.V259098.R01.S.doc Version 5.0 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 the following standard(s): The arrangements for assessing prospective resident’s needs enable their full participation in the process and exceed the standard. EVIDENCE: Records were seen in relation to two prospective residents who were taking part in the assessment process to see if the home was a suitable place for them to live. These included reports from previous placements, relevant professionals and the home’s initial assessment. A very comprehensive assessment of need over a period of approximately three weeks is part of the introduction to the home. This process is undertaken in William House where an assessment flat is available for general admission to the site. The process consists of monitoring applicants’ needs and abilities and also incorporates an assessment within the resource and development centre. The comprehensive package is formulated with an aim towards the development of life skills in general and is undertaken by many of the professionals employed at Enham. Interim reviews are held and records are kept of these. A pre-assessment meeting is held with the prospective resident and their representatives prior to the three-week assessment being undertaken. This allows all parties to identify any requirements the person might have during the assessment. William House DS0000012073.V259098.R01.S.doc Version 5.0 Page 8 The pre-assessment information includes, for example, a brief history of the individual and details of any identified risks, medication needs and contacts. A strengths and needs assessment is also requested in relation to mobility, personal care, social skills and other areas. A residential report includes information such as social skills, communication, compatibility, personal care, emotional needs and physical health, and concludes whether or not the home can meet the person’s needs. The development programme report includes suggestions for personal development plans and activities, for example work experience, art, drama, life skills, numeracy and literacy study. A report is also made by the Occupational Therapist. The home arranges a three-monthly review for each new resident following their initial probationary periods. This is also seen as a settling-in period, during which the home continues to work with residents to establish their aims, strengths and needs. A care plan is formulated from all the information collected and signed by all parties. A care plan review is held every six months. William House DS0000012073.V259098.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 The home provides residents with opportunities and assistance to make decisions about their lives. EVIDENCE: In conversation a resident confirmed that staff respected and assisted their right to make decisions. Daily routines were in accordance with residents’ preferences and maintained their independence. Monthly residents meetings are held where residents can discuss activities and things to do in and outside the home. Staff thought it important to respect each resident’s individuality, for example supporting residents to make informed choices about holidays. Relevant risk assessments and any limitations on individual choices are recorded in care plans. Residents handle their own financial affairs in accordance with their assessed needs and abilities. Individual support and tuition regarding finances is detailed in service user’s personal files. Information about advocacy services is available. William House DS0000012073.V259098.R01.S.doc Version 5.0 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 the following standard(s): 15 and 16 The home promotes the maintenance of residents’ relationships and upholds residents’ rights and responsibilities in daily routines. EVIDENCE: Residents are supported to maintain family links and friendships inside and outside the home and relevant policies were in place. The visiting policy welcomes visitors at all reasonable times and a resident confirmed that they see visitors in private if they wish. An intercom system gives residents control over who visits them in their home. Staff reported that residents are well integrated within the local village and so have opportunities to meet people and make friends who do not have their disability. Significant relationships are recorded in individual care plans and relatives and representatives are involved in the review process according to resident’s choices. Information and advice are provided if required to help residents to make appropriate decisions regarding their relationships. The organisation was working on further developing its policy regarding intimate personal relationships, including the use of focus groups. William House DS0000012073.V259098.R01.S.doc Version 5.0 Page 11 Residents are assessed on their abilities to undertake household routines within their own accommodation and can choose whether or not to join in with activities. This was confirmed through conversation with one resident. Staff reported that they encourage residents to help each other and to inform staff if they are going to be out late. Opportunities exist 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, and residents’ taking part in the workshop are expected to show commitment such as working to deadlines. This expectation fosters individual responsibility and helps people develop skills for employment. There is a privacy policy statement made within the Charter of Rights provided to all residents and which covers their rights and responsibilities with regard to privacy. Staff were observed to knock on resident’s doors and wait to be invited in. All residents are provided with keys to the home and to their accommodation and as previously mentioned there is an intercom system which gives residents choice about whether to see visitors or not. Residents receive their mail unopened and assistance is given where requested in relation to reading and responding to mail. Residents have unrestricted access to the communal areas of the home and grounds. There is a non-smoking policy in the communal areas which staff observe by smoking outside. William House DS0000012073.V259098.R01.S.doc Version 5.0 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 the following standard(s): 18 and 20 The personal support needs of residents are well met with evidence of relevant professional consultation on a regular basis. The systems for the administration of medication are good with clear and comprehensive arrangements being in place to ensure residents’ medication needs are met. EVIDENCE: A sample of two residents care plans was viewed in relation to personal support. Individual care plans include a section that states how each resident wishes their care and support to be carried out. A key-worker 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, including training in the use of equipment such as manual and overhead hoists. Residents have the technical aids and equipment they need for maximum independence, determined by professional assessment. There is an on-site occupational therapist and physiotherapist available. A resident confirmed that they were happy with the assistance they received from staff, and that staff talk to and treat residents with respect. Staff reported that new staff members shadow experienced staff for at least a month before giving personal support to residents under the supervision of a senior staff member. William House DS0000012073.V259098.R01.S.doc Version 5.0 Page 13 The home has policies and procedures for dealing with medication and residents are enabled to retain, administer and control their own medication where appropriate. This was confirmed in discussion with a resident. Each resident has their own locked medication cabinet in their accommodation and individual risk assessments for those who manage their own medication. There is also a suitable medication storage facility in the office and medication records include a photograph of the individual resident. Staff are trained in the safe handling of medications and two members of staff administering medication sign the records. The manager reported that the home was discussing standardising its medication recording procedures with the other homes. William House DS0000012073.V259098.R01.S.doc Version 5.0 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 the following standard(s): None of these standards were assessed on this occasion. EVIDENCE: William House DS0000012073.V259098.R01.S.doc Version 5.0 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 the following standard(s): 30 The home has effective systems and procedures in place to ensure the home is clean and hygienic. EVIDENCE: All relevant information with regard to health and safety, hygiene and control of infection is available within the establishment. Protective clothing and laundry bags are available to reduce cross infection. Staff confirmed they receive training in infection control as part of their core training programme. The laundry is modern and appropriately designed with all required facilities and is suitably sited so that laundry is not taken through areas where food is stored, prepared or eaten. Staff reported that residents are encouraged to undertake their own laundry wherever possible, following a risk assessment. All COSHH materials are locked away and a pump-fed detergent system is in place. There is a contract for the collection of clinical waste. William House DS0000012073.V259098.R01.S.doc Version 5.0 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 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): 32 and 34 Residents are supported and protected by qualified and competent staff and the home’s recruitment policies and practices. EVIDENCE: Through discussion with staff it was evident that they had the skills and qualities to meet residents’ needs. Staff were approachable and interested and demonstrated motivation, knowledge and understanding of resident’s conditions and different personalities. The manager reported that out of ten care staff, eight were currently undertaking NVQ training. Senior care workers had completed level 2 awards and were either starting or completing level 3 awards. New employees receive induction training that meets the Skills for Care standard before starting NVQ level 2 training. Staff records were viewed in relation to four members of staff and recruitment procedures had been appropriately undertaken and recorded. These records included proof of Criminal Records Bureau (CRB) and POVA (Protection of Vulnerable Adults) checks, two written references for each employee, completed application forms with employment histories, rehabilitation of offenders and health declarations. All staff received written terms and conditions of employment and job descriptions. William House DS0000012073.V259098.R01.S.doc Version 5.0 Page 17 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 Residents benefit from a well run home with a clear and effective management structure. EVIDENCE: The manager has been in her current post for a year and is applying for registration to the Commission for Social Care Inspection. Mrs Fiona Kelly has eighteen years experience working for the organisation, including five years in a senior support worker role. The manager is aware of the requirements of the Care Standards Act and Regulations, has completed NVQ levels 2 and 3 and will shortly be commencing level 4 training. This is in addition to taking part in the homes’ rolling programme of statutory and other relevant training in order to keep her knowledge and skills updated. There are clear lines of support and accountability within the organisations line management structure. Staff confirmed that the management at William House are accessible and supportive. William House DS0000012073.V259098.R01.S.doc Version 5.0 Page 18 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 4 X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 William House Score 3 X 3 X Standard No 37 38 39 40 41 42 43 Score 3 X X X X X X DS0000012073.V259098.R01.S.doc Version 5.0 Page 19 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 William House DS0000012073.V259098.R01.S.doc Version 5.0 Page 20 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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