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Inspection on 21/06/07 for Windsor House

Also see our care home review for Windsor House for more information

This inspection was carried out on 21st June 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The staff appear to have an excellent relationship with the service user who had several positive comments to make, such as, "I can always go over and find someone who will help me" and "Everyone is very kind and understanding". The care planning system continues to be further developed and will be fully operational before the next inspection takes place. The service user is supported within the Care Programme Approach framework and frequent reviews occur to ensure changing needs are continuously assessed and reviewed. The home operates a very "individual approach" which clearly benefits the person who lives at Windsor House and ensures that he has the opportunity to experience life within a supported environment but maintaining his independence. Staff from the project have developed excellent working relationships with the local mental health community services and visits from the community psychiatric nurses are consistent and supportive to both staff and service user.

What has improved since the last inspection?

The staff continue to work hard to improve and further develop the care plan within the home. Risk assessments are in place and have been refined and improved since the last inspection took place. The senior liaison officer has endeavoured to provide more specialists training in mental health in order for staff to carry out their role more effectively. The home has further developed and implemented a new system of assessment since the last inspection and this is proving to be effective in identifying service users developing needs.

What the care home could do better:

Fire records must be completed accurately and regularly. The manager must assist the service user living in the home in maintaining the garden area and clearing the debris from the area.

CARE HOME ADULTS 18-65 Windsor House 8 Windsor Close Stevenage Herts SG2 8UD Lead Inspector Julia Bradshaw Unannounced Inspection 21st June 2007 10:00 Windsor House DS0000062311.V343784.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 Windsor House DS0000062311.V343784.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. Windsor House DS0000062311.V343784.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Windsor House Address 8 Windsor Close Stevenage Herts SG2 8UD 01438 813915 01438 813915 winnett@psycare.co.uk 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) Psycare Hostels Russell Fletcher Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places Windsor House DS0000062311.V343784.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th October 2006 Brief Description of the Service: Psycare Hostels limited operates Windsor House. It is a Psychiatric Aftercare Hostel / Personal Care Home focusing on providing, psychological, emotional and practical support to 3 male persons with enduring mental health disorders. Windsor House (cluster home) is a three bed home situated within 100 metres from its sister home Winnett Cottage (core home). The primary function of the cluster home is to compliment the rehabilitation programme commenced in the core home, providing a stepping stone into the community whilst working on the final stages of independent living. All service users living within Windsor House are able to access staff resources and support 24 hours a day. The home consists of three bedrooms and a communal bathroom on the first floor, a communal lounge and dinning room, kitchen, and down stairs toilet facilities on the ground floor. The home has a 24-hour pager system linked to the main core home. Windsor House is situated down a lane with no through access to the public with ample parking facilities within a quite residential area. The home has a service user’s guide and statement of purpose that are provided to prospective service users. Copies of the latest report on the home from the Commission for Social Care Inspection (CSCI) are available in the home. The manager stated that the fees are from £1050 per week to £1200. Windsor House DS0000062311.V343784.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The atmosphere throughout the inspection was calm and friendly, promoting a good relationship between staff and service users. The ethos of working openly, honestly and with a transparent approach appears to be effective. The home has a stable staff team to promote continuity for the service users. This report draws on information obtained during this unannounced site visit carried out on the 7th October 2006. The inspection process included an opportunity to speak to the person living in the home, to staff and to inspect some key records, including those for medication, staff recruitment and care planning. The manager was present for the beginning of this inspection process and Kate Chalker-Wye conducted the remainder of the inspection in his absence. Staff and service user surveys will be a part of the ongoing inspection of this service and any issues arising from these will be assessed and will then inform further regulatory activity by the CSCI in respect of Windsor House. This report also draws on any information received by the CSCI about Windsor House since the last inspection report in October 2006. What the service does well: The staff appear to have an excellent relationship with the service user who had several positive comments to make, such as, “I can always go over and find someone who will help me” and “Everyone is very kind and understanding”. The care planning system continues to be further developed and will be fully operational before the next inspection takes place. The service user is supported within the Care Programme Approach framework and frequent reviews occur to ensure changing needs are continuously assessed and reviewed. The home operates a very “individual approach” which clearly benefits the person who lives at Windsor House and ensures that he has the opportunity to experience life within a supported environment but maintaining his independence. Staff from the project have developed excellent working relationships with the local mental health community services and visits from Windsor House DS0000062311.V343784.R01.S.doc Version 5.2 Page 6 the community psychiatric nurses are consistent and supportive to both staff and service user. 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. The summary of this inspection report can be made available in other formats on request. Windsor House DS0000062311.V343784.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 Windsor House DS0000062311.V343784.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): 1 –5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Information to people who may choose to use the service is available. Full assessments are carried out prior to the admission of an individual. EVIDENCE: The statement of purpose and service user guide were seen on the day of the inspection. The service users’ file was reviewed and evidence gained regarding the initial assessments that are carried out to access if the home could meet the needs of the service user. Detailed information is held regarding the service user’s history and current needs. Assessments of each service users’ needs and aspiration are made before the service user moves into the home. Qualified and competent people complete the assessments. The home also receives and seeks external specialist support to meet the individual service users needs. Whole life and CPA reviews take place to support the service users in achieving and reviewing individual needs, goals and aspirations. The assessment process includes the gathering of information from other professionals. Windsor Cottage has its own internal assessment forms and reflected fully the current service provided. The information provided for prospective service users is presented in a format that is both informative and interesting. This assessment process has been further Windsor House DS0000062311.V343784.R01.S.doc Version 5.2 Page 9 developed since the last inspection took place, to include both information received prior to moving into the home and the homes own assessment process in order to obtain a completed overview of the needs of the individual service user. This was evidenced on the day of the inspection. The admissions procedure to the home includes trial visits for the service users to make an informed choice about where to live. A contract is then drawn between the service provider and the service user. The contract includes the terms and conditions within the home and the rights of the service user. The Statement of Purpose contains information for the service user to make an informed choice about where to live. The content is suitable to meet individual needs. Windsor House DS0000062311.V343784.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 – 10. Quality in this outcome area is good This judgement has been made using available evidence including a visit to the service. Service users’ goals are identified and assessments detailed in their care plan. Risk have been identified and minimised where possible. Service user feel secure within the home and that staff treat them with respect and promote their privacy. EVIDENCE: The care plans inspected had improved since the last requirements were made in the key inspection carried out in October 2006. Detailed records of visits carried out by other professionals were recorded and up to date. The manager and staff have worked hard to fully implement the new care planning system. Individual notes and guidelines for the service users were viewed. The service user is supported within the Care Management Framework and frequent whole Windsor House DS0000062311.V343784.R01.S.doc Version 5.2 Page 11 life reviews and CPA’s occur to ensure changing needs are continuously assessed and reviewed. Ranges of risk assessments are completed in the home for necessary actions. Activities and outings enjoyed by the service users determine that service users are supported to take risks as part of an independent life style. Risk assessments have improved since the last inspection. Staff work with people to assist them to lead safe and enjoyable lives, consulting with them as appropriate, regarding decision making and offering guidance where needed. Positive interaction was observed between the staff and the service user living at Windsor House during this inspection, demonstrating a high level of respect and patience. Several positive comments were made during this inspection relating to the staff. “Everyone is great here, they let me be independent and don’t hassle me” Windsor House DS0000062311.V343784.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): 11-17. Quality in this outcome area is good This judgement has been made using available evidence including a visit to the service. Individuals have the opportunity to take part in a variety of appropriate activities and are provided with staff support as needed. Service users are provided with a varied diet. EVIDENCE: The service user has opportunities personal development. The service user discussed with the inspector options available to him. Examples were given including development of independent living skills, socialising, working, voluntary placements, college and further education and training. People are encouraged to access services within the community and were able to confirm that they were received effectively and through professional channels. The service user currently living at Windsor House does voluntary work on a partWindsor House DS0000062311.V343784.R01.S.doc Version 5.2 Page 13 time basis. The opportunity for service users to receive paid employment through the completion of tasks such as gardening, cleaning and painting and decorating is provided. Service users are encouraged to become part of the local community and many access the local community independently on a regular basis. Service users are supported in gathering relevant information regarding employment, further education, employment skills and benefit advice if required. Staff also support service users in accessing a range of activities outside of the home, including day trips to the coast and holidays. The service use currently living at Windsor Houser stated that he would like to return to a job in catering. The home has a rota for daily tasks and routines in which each person takes responsibility. These include cooking, washing up and vacuuming. Meals are offered on a flexible basis. The service user determines the menu and chooses a weekly menu. Daily routines promote independence for all service users, using a person centred approach at all times. Staff were seen to interact with the service user living at Windsor House and it was clear that mutual respect was held within the home for both staff and service user. Windsor House DS0000062311.V343784.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 –20. Quality in this outcome area is good This judgement has been made using available evidence including a visit to the service. Service users emotional and physical needs are being met adequately. EVIDENCE: The service user living within the home is self-medicating and has a current risk assessment in place to reflect this. Files checked confirmed that the service user has regular health checks including, mental health out patient appointments and CPN visits. All personal and health care support is well maintained ensuring individual needs, choices and preferences are met at all times. All care provided is individual and tailored to each person, with the service users need, choices and preferences being promoted. Windsor House DS0000062311.V343784.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 23. Quality in this outcome area is good This judgement has been made using available evidence including a visit to the service. The complaints procedure within the home is sufficient and adequate for the service users to feel that their individual views are listened too. Robust policies, procedures and training are in place to ensure service users are protected and safe. EVIDENCE: The home has a detailed complaints procedure in place. A record is maintained within the home of all complaints made detailing actions and outcomes as necessary. No complaints have been received since the last inspection was carried out. The service user stated that he was aware of the complaints policy and had a copy available to him, within the home. A detailed procedure is in place to ensure that service users are protected from abuse and harm. Staff receive suitable and adequate Protection of Vulnerable Adults training. Staff employed within the home are all subject to enhanced Criminal Records Bureau disclosures. The senior liaison officer is responsible for providing the training calendar for the staff team. The standard of training currently provided in relation to safeguarding adults is good. Windsor House DS0000062311.V343784.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. 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 the service. Maintenance and housekeeping in this home are generally good. EVIDENCE: The premises are adequately maintained and some re-decoration has been carried out to two out of the three bedrooms of the home since the last inspection took place. The home is currently occupied by one service user who manages the domestic maintenance with support from the main staff team at Winnet Cottage. The garden area of the home requires some tidying up and removal of some old flooring. The inspector would like to thank the service user for taking the time and trouble to show her around. Windsor House DS0000062311.V343784.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31 –36. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Appropriate levels of suitably trained staff are provided to meet the needs of those who use the service. Supervisions are inconsistent EVIDENCE: Staff are clear about their individual roles and responsibilities. There is a loyal core staff team that appear to have a good understanding of the current service users needs and abilities. Staff from the sister home currently support the service user across the road at Winnet Cottage. Training records have improved and there is a now an up to date record of all training provided. The manager must ensure that all supervisions are carried out regularly, recorded and signed by both parties. Supervisor and supervisee must take equal responsibility for reviewing and updating their performance review forms to ensure that clear evidence is available of training panned, reviewed and refreshed Windsor House DS0000062311.V343784.R01.S.doc Version 5.2 Page 18 The majority of staff have been at the home for several years, which is a positive for service users and provides consistency and reliability. Two staff files were inspected and contained all the relevant and required information to meet the standard. Windsor House DS0000062311.V343784.R01.S.doc Version 5.2 Page 19 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 –43. Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to the service. The home is operated in an inclusive manner that enables staff to contribute ideas and the service user to have some control over their lives within a risk assessment framework. Health and safety is currently compromised. EVIDENCE: The service users spoken to during the inspection appeared to be happy with the home and appeared to be generally comfortable in his environment. The relationship between the service user and the staff is well balanced with interactions observed being appropriate and supportive. The management approach of the home endeavours to create an open and positive atmosphere, staff and the service user spoken to commented that he Windsor House DS0000062311.V343784.R01.S.doc Version 5.2 Page 20 feels supported and feels the home is well managed. A clear commitment is made to equal opportunities within the home, with staff and the service user expressing positive views with regards to this. “All the staff are like friends in a supportive way”. Adequate training is being provided to ensure all staff have the necessary underpinning knowledge to carry out their role effectively. Supervision records must improve. Quality assurance systems require further development to include the formal views of service users, relatives/carers and outside professionals in order to review and further improve the current service. Service user meetings occur jointly with both homes participating. All records are secure within the home and were up to date and held in accordance with the Data Protection Act 1998 ensuring that service users rights and best interests are safe guarded by the homes polices and procedures. Records regarding staff were inspected and found to contain all the necessary information to meet the standard. Fire checks and records must be carried out regularly and in line with current health and safety legislation. Windsor House DS0000062311.V343784.R01.S.doc Version 5.2 Page 21 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 3 2 3 3 3 4 3 5 3 CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 2 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score INDIVIDUAL NEEDS AND CHOICES Standard No Score 6 3 7 3 8 3 9 3 10 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 3 2 2 3 Windsor House DS0000062311.V343784.R01.S.doc Version 5.2 Page 22 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. 2. Standard YA27 YA41 Regulation 23 (2) (o) 23 (4) Timescale for action The roll of discarded lino must be 23/06/07 removed from the grounds of the home. The manager must ensure all fire 06/07/07 records are maintained in line with current health and safety legislation. Requirement 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 Windsor House DS0000062311.V343784.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Windsor House DS0000062311.V343784.R01.S.doc Version 5.2 Page 24 - 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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