Inspection on 13/01/09 for Winscombe Care Home

This inspection was carried out on 13th January 2009.

CSCI found this care home to be providing an Good service.

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

Similar services:

Flint House

The Cotswold Home

Fairways

Treloar College

Rush Court

The Maypole Nursing Centre

Fir Tree Lodge

Chilmington House

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Winscombe Care Home Southwick Road North Boarhunt Fareham Hampshire PO17 6JF     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Beverley Rand     Date: 1 3 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Winscombe Care Home Southwick Road North Boarhunt Fareham Hampshire PO17 6JF 01329834188 01329834708 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Bowenhill Ltd care home 28 Number of places (if applicable): Under 65 Over 65 0 physical disability Additional conditions: 28 The maximum number of service users to be accommodated is 28. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Physical disability (PD) Date of last inspection Brief description of the care home The home is situated in a rural position on the outskirts of a village. The home is all on one level and the majority of bedrooms are single with some shared rooms. The communal area is open plan and includes sitting and dining areas. The gardens are large and attractive. Care Homes for Adults (18-65 years) Page 4 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced key inspection and was the first following the service being registered after being bought by new providers. Before we visited the home we looked at the previous inspection report and the Annual Quality Assurance Assessment which was completed by the manager. During the visit we spoke with four service users, one staff member and the manager. We looked around the home and looked at records such as care plans and recruitment records. Service users are funded by local authorities and so the fees are decided on an individual basis. Care Homes for Adults (18-65 years) Page 5 of 26 Care Homes for Adults (18-65 years) Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home ensures that prospective service users have their needs met before they move into the home. Evidence: The home has processes in place which ensures that prospective service users have their needs assessed before they move into the home. The assessment involves the individual, their relatives and any professionals involved. Prospective service users are invited to spend a day and a night in the home before deciding if they would like to move in. We saw the assessments for the service users whose support plans we looked at and these covered all the necessary areas. Care Homes for Adults (18-65 years) Page 9 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home ensures that service users have written support plans in place which include risk assessments. Service users make their own decisions. Evidence: The manager told us that an individual plan of care is created with the full involvement of service users and significant others if appropriate. We looked at three such plans and found evidence that service users were involved. Plans included areas such as mobility, medication, healthcare, maintaining a safe environment, diabetes, challenging behaviour, finances, personal care, communication, eating and drinking, sleeping routines, activities and spiritual needs. Risk assessments were in place for moving and handling, water temperatures, dangerous substances and activities. Plans were detailed and reviewed regularly and the manager is currently working on improving them further. We saw throughout the day that service users were making choices and spoke with Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: three service users who said they could choose what they did during the day. Staff told us how they try to encourage service users to sit with other service users, but that if they wish to remain in their room, or be alone elsewhere, they can. Care Homes for Adults (18-65 years) Page 11 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users individual needs are met and they make their own choices. Evidence: Some service users attend day services and others have one to one support in the community. The home employs an activities co-coordinator who provides entertainment and supports individual service users into the community. Entertainment evenings also include relatives. General activities include visits to the theatre, the beach, pub and shopping trips. In house activities include board games, art and craft and playing on the computer console. A record is kept of service user participation in organised activities. The home does have its own minibus, which is used to take service users out. Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: However, we were told by the manager and staff that it is often out of action, due to maintenance issues and the difficulty in obtaining spare parts. The home promotes service users relationships with friends or family. A local vicar visits the home once a month to undertake communion for those who wish to attend. We were told that staff maintain service users privacy and dignity by knocking on bedrooms doors, providing screens in shared rooms and giving post to service users unopened. Service users can and do have keys to their bedroom doors. As we walked around the home we saw a service user going to their room because they were not feeling well. We also saw the staff and manager supporting them to do this, and saying that they would bring lunch to their room. Service users told us they liked the food and that there was a choice at mealtimes. The home also told us that following a quality assurance survey last year, service users told them they were happy with the food. The manager told us that service users sometimes ask for food they have not had in a while and this is accommodated, often at short notice. The home employs a cook for the main meal and the carers make tea. Tea is generally at a set time but some service users ask for tea earlier and this is usually managed and others have their tea later. The home has pictorial menus in place. Care Homes for Adults (18-65 years) Page 13 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users health and social care needs are met although staff may benefit from broader medication training. Evidence: We saw from the care plans that service users are supported with their personal care needs as they wish. The home is aware of the need to support service users in the way they prefer regarding cross gender care and the service users can choose who supports them with personal care. Staff told us that service users can get up and go to bed when they wish. Service users visit healthcare professionals in the community when necessary. The manager told us how she found a NHS dentist for ten service users who had been discharged from another dentist. Records and care plans showed that the home sought advice from healthcare professionals when individual needs changed. The manager also told us that they ensure wheelchairs are in good repair. We spoke with a senior staff member who told us the procedure for administring Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: medication. They said they took the medication to one service user at a time, always locking the trolley even if they were not gone for long. They were aware of initial side effects which could accompany new medication and had received training from the district nurse with regard to a specific task. We were told that only senior staff administer medication. The training includes being shown the system, shadowing other staff and administering medication under supervision. The manager observes their practice and confirms their competence. Staff also watch a video about the system and a video entitled, Medication in the Care Home. There are also handouts and exercises which are marked by the manager. The manager has completed external training regarding medication, but does not have a, Train the Trainer certificate in this area. Whilst we did not identify any medication errors the provider should look at accessing wider training for staff to ensure staff receive training from people trained to do so. The medication was stored appropriately. The home uses a trolley for the majority of storage and this is chained to the wall. A fridge is used to store medication which needs to be kept cooler and this is fitted with a lock. We noted that the fridge was not actually locked and discussed this with the manager. Only the senior staff keep the keys and had just given out medication. Further, the fridge was located out of the reach of service users. The manager addressed this straight away. Fridge temperatures were recorded. There were clear signs around the medication area about the managing of diabetes issues and monitoring records were well kept. One service user is supported to self administer their medication and we were told that the medication is securely stored. There is a risk assessment in place for this. We looked at the Medication Administration Record sheets for service users and found them to be complete. There was information about the use of individual drugs and side effects within each service users record which meant it could be seen by staff as they administered medication. Care Homes for Adults (18-65 years) Page 15 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users know how to complaint and procedures are in place to protect them. Evidence: The home has a complaints procedure in place and we saw how complaints are logged and addressed. Complaints are dealt with within the 28 day timescale and outcomes are recorded. Service users can access the complaints procedure in large print and audio. We spoke to three service users who said the manager was nice and that they could talk to her if they were unhappy about something. The manager was clear about the process she would follow if there was an allegation of abuse at the home. However, the homes written procedure needs to be clearer as to the role of the local authority in safeguarding adults with regard to allegations or suspicions so that staff can follow the procedure to protect service users if necessary. Staff told us what procedure they would follow if necessary and they were aware of the role of the local authority in any investigations. The home looks after money on behalf of some service users and keeps records of how service users spend their money. We looked at the records of three service users and these matched the money held. Care Homes for Adults (18-65 years) Page 16 of 26 Care Homes for Adults (18-65 years) Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users live in a clean and homely environment. Evidence: We looked around the home at the communal areas and some bedrooms. The manager told us that when new service users move in their rooms are painted neutral to allow time for the service user to choose their own colours. They can also bring their own furniture if they wish and we saw that bedrooms had been personalised with service users own possessions. Some service users have keys to their bedrooms and choose to lock their rooms. The communal lounge/dining area is open plan and this meets the needs of the service users, most of whom are wheelchair users. The manager told us that the lounge/dining area had been fully decorated and modernised and that service users were happy with the outcome. The corridors had also been decorated and new carpets were fitted. The home has a laundry which is located outside of the main house. Liquid soap, alcohol cleansing gel and protective gloves of different sizes are available. The manager has introduced a maintenance and cleaning plan to ensure the home is kept clean. Care Homes for Adults (18-65 years) Page 18 of 26 Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff have access to training. Service users are involved in the recruitment of new staff. Evidence: Service users have been involved in the recruitment of new staff by sitting in on interviews and asking questions of their own choosing. We looked at the recruitment files for two staff who had been employed since the new providers and manager had been involved in the recruitment process. Both files showed that the Protection of Vulnerable Adults check had been received before the person started work. One file had two references which were dated as being completed before the person started work. The other file only had one reference dated as written before the person started work. The other reference was dated after the person started work. The manager was unable to explain why this was but was aware of the importance of the issue. We spoke with the provider and the manager again at a later date and they confirmed that the staff member was already employed in the home using another type of contract. New staff undergo an appropriate induction, the content of which depends on whether they are qualified with National Vocational Qualifications, (NVQ) in care. Out of twelve care staff, six have already achieved NVQ 2 or above, one is currently working towards Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: it and two are starting in the near future. The manager maintains good records for staff training and the computer system she uses keeps a running record of when training is due. We looked at the records for training in adult protection, first aid, medication in a care home, health and safety, food hygiene, infection control, fire safety and manual handling and found that all staff had either completed training or were booked to do so in January and February. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users live in a home which is well run. Evidence: The manager has been employed as the manager since January 2008. She is qualified with the Registered Managers Award and NVQ level 4 in care. The manager demonstrated a thorough knowledge of the service users as individuals. The manager has good systems in place for seeking and acting upon the views of service users. Service user meetings are held every three months or sooner if requested by service users. Every six months service users are asked to complete quality assurance surveys and the manager creates an action plan from the results. Views are sought via an annual survey from relatives. Monthly visits are undertaken by the provider and detailed reports are sent to the manager, identifying any issues raised during the visit. The home is run with due regard to health and safety. Records are kept regarding the Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: maintenance of equipment such as lifts, emergency call system and the minibus tailgate and these checks are all completed in a timely fashion. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!