Inspection on 28/10/06 for Zacchaeus

This inspection was carried out on 28th October 2006.

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

Zacchaeus 18/02/06

Zacchaeus 09/09/05

Zacchaeus 16/12/04

Zacchaeus 12/07/04

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Zacchaeus 37 Servite Close Bognor Regis West Sussex PO21 2DE Lead Inspector Mrs D Peel Unannounced Inspection 28 October 2006 10:15 th Zacchaeus DS0000014866.V307795.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 Zacchaeus DS0000014866.V307795.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. Zacchaeus DS0000014866.V307795.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Zacchaeus Address 37 Servite Close Bognor Regis West Sussex PO21 2DE 01243 828532 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) L`Arche (Registered Office) Mrs Hanna Lizakowska - Campkin Care Home 5 Category(ies) of Learning disability (5), Learning disability over registration, with number 65 years of age (0) of places Zacchaeus DS0000014866.V307795.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The total number of service users should not exceed five persons at any one time 18th February 2006 Date of last inspection Brief Description of the Service: Zacchaeus is a care home providing personal care and accommodation for five adults with learning difficulties. The home is one of three homes operated by the LArche organisation in West Sussex. The building is owned by The Servite Housing Association and consists of two adjoined semi-detached houses. There is a communal lounge, a dining room and a kitchen. Private accommodation for service users consists of five single bedrooms. The house is located in a cul-de-sac in a residential area of Bognor Regis, close to shops and other amenities. Zacchaeus was first registered with the previous registration authority in July 1989. The Responsible individual is Kathleen OGorman and the registered Manager is Mrs Hanna Lizakowska-Campkin. Zacchaeus DS0000014866.V307795.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by Mrs Diane Peel on Saturday the 28th October 2006, in order to meet residents who are usually out working or attending day services on weekdays. A return visit was carried out on Monday the 30th October to meet with the manager and look at staff records. During this visit the intended outcomes for 38 standards were assessed; these included the key standards for care homes providing a service to Young Adults aged 18-65. Prior to the visit to the home the inspector reviewed information provided in a pre inspection questionnaire completed at the request of the inspector some weeks prior to the visit and other information received from the provider and manager since the last visit to the home on the 18th February 2006. The inspector arrived at 10.15am on the Saturday and met three of the five residents who currently live at the home and the staff who were supporting them. One resident was away for the weekend staying with relatives and the other resident stayed in bed during the period of the visit. The Responsible Individual, Kathleen OGorman also visited Zacchaeus on the Saturday to carry out her monthly monitoring visit on behalf of the L’Arche organisation in West Sussex. During the visit all communal areas of the home were seen. Two people gave permission for the inspector to view their bedrooms and a third bedroom was viewed as the door had been left open. A case tracking exercise for three of the five residents was undertaken to see how the assessed needs had been used to form a care plans which residents were happy with and staff followed. Residents were encouraged to provide feedback about what it is like to live at the home by talking to the inspector during the visit and service user comment cards which were returned to the inspector by all the people living at the home prior to the visit. Staff were spoken with informally to find out what it is like to work at the home, what training had been provided and to find out to what extent they knew about the contents of residents care plans. The current scale of fees being charged at the home is from £451.94 to £821.00 per week. Zacchaeus DS0000014866.V307795.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The on going programme of refurbishment and renewal should continue. Zacchaeus DS0000014866.V307795.R01.S.doc Version 5.2 Page 7 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. Zacchaeus DS0000014866.V307795.R01.S.doc Version 5.2 Page 8 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 Zacchaeus DS0000014866.V307795.R01.S.doc Version 5.2 Page 9 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): 2,3,4, Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to the service. Residents are assessed prior to moving into the home to make sure that the home can meet their individual needs. Prospective residents and their families are provided with the information they need to make an informed choice about the home. They are invited to visit the home to meet other residents and staff and to see the facilities available at the home so that they can make a choice about moving in. EVIDENCE: One resident has moved into the home since the last visit in February 2006.This resident was not available during the visit because they had gone to stay with relatives for the weekend. When the inspector visited on the Monday residents were not at home. Staff spoken with explained that this person had been visited in Kent by the manager to carry out an assessment. The resident had then visited the home for a weekend stay followed by a week stay to find out if the home could meet their needs. Staff said that this person was still taking part in a three-month trial period at the home. Zacchaeus DS0000014866.V307795.R01.S.doc Version 5.2 Page 10 A report of a monthly visit to the home by the responsible individual on behalf of LArche organisation in West Sussex refers to a prospective resident coming to the home for a three month stay after having spent a week at the home. Zacchaeus DS0000014866.V307795.R01.S.doc Version 5.2 Page 11 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): 6,7,8,9 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to the service. Care planning systems give clear information so that staff can support residents with all aspects of health, personal and social care needs. Residents are included in decisions made about life in the home so that they have opportunities to exercise choice and have a fulfilling life style. EVIDENCE: All five people returning service users comment cards reported that they had a care plan. Residents have care plans, which have been developed from their needs assessment. The plans are written in plain language and are easy to understand. They consider all areas of individuals needs, including agreed goals and personal development. Zacchaeus DS0000014866.V307795.R01.S.doc Version 5.2 Page 12 Care has been taken to make sure that the plans reflect the abilities of residents so that residents are able to retain their individual levels of independence. The three care plans observed during this visit had been updated regularly to show the changing needs of residents. All five people returning comment cards reported that they have meetings in their home to talk about what’s good and what should be changed. Staff confirmed that house meetings take place on a Monday and everyone is encouraged to attend and discuss any issues, make suggestions or requests. Risk assessments were observed to be in place for the residents who’s care plans were seen. Zacchaeus DS0000014866.V307795.R01.S.doc Version 5.2 Page 13 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): 12,13,14,15,16,17 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to the service. The residents living at the home take part in a variety of activities and have opportunities for personal development so that they feel valued and have opportunities to develop skills. Staff support residents to maintain contact with their families and friends so that they can maintain and develop relationships outside the home. Residents are offered a varied diet and can have alternatives if they wish. EVIDENCE: All residents returning service user questionnaires reported that they had lots of things to do and that their family and friends can visit. Zacchaeus DS0000014866.V307795.R01.S.doc Version 5.2 Page 14 Care plans record what residents like to do in their leisure time, who their friends are and what contact they have with families. The detail was supported by what three residents spoken with, told the inspector about what they liked to do and who their friends were. Examples of social activities recorded are: visits to pubs, clubs, visiting friends, going to the cinema, eating out. One resident returning a questionnaire to the inspector when asked about “What’s good about living in the home?” responded, “ Trips out together, watching TV, going bowling and going to the cinema”. Residents spoken with during the visit thought that their rights were respected by staff. All residents have a lock on their door and four residents said in their questionnaire that they had a key to their room. The staff induction programme covers all aspects of living within the home including respecting the rights of residents. When the inspector arrived at 10.15 am on the Saturday morning two residents were having their breakfast at the kitchen table. One was having allbran and the other toast with chocolate spread. Both commented that this was what they liked to have for breakfast. Staff told the inspector that a different person chooses the menu each day for lunch time and teatime. On the Saturday lunch time the meal was to be minestrone soup followed by pizza. Records provided prior to this visit to the home show that there is a variety of fresh food available. Residents reported in questionnaires that they choose what to eat and sometimes go shopping for food. Zacchaeus DS0000014866.V307795.R01.S.doc Version 5.2 Page 15 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): 18,19,20 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to the service. Residents receive personal support in the way that they want so that they can maintain individual levels of independence. A variety of healthcare professionals are involved in maintaining the physical and emotional needs of residents. Zacchaeus has demonstrated satisfactory medication handling. EVIDENCE: A resident invited the inspector to accompany them to their bedroom along with a care assistant, to observe oral care and denture care taking place after breakfast. The detail in this persons care plan was exactly as the resident performed the task with minimum supervision and prompting from the assistant, showing that this resident was being provided with a level of personal care support in a way they wish it to be given. Zacchaeus DS0000014866.V307795.R01.S.doc Version 5.2 Page 16 All residents reported through service user questionnaires that they saw the doctor and the dentist and that they feel well cared for by staff. Records show that residents visit health care professionals and that the outcomes to these visits are recorded and any changes made in the individual persons care plan. The home uses a monitored dosage system and has an agreement with a local pharmacy for advice. Staff receive training in the handling of medication during their induction period and there is a list of medication handlers signatures on the front of the medication cabinet. Medication records seen on this visit were in good order and since the last visit to the home a system has been introduced which ensures that medication is signed for when medication is taken away from the home. Zacchaeus DS0000014866.V307795.R01.S.doc Version 5.2 Page 17 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): 22,23 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to the service. The complaints procedure is clear and in an accessible version so that those using the service understand the process and have the confidence that their views will be listened to. The registered person has arrangements in place to protect residents from being placed at risk of harm or abuse. EVIDENCE: There is pictorial version of the complaints procedure on display on the notice board in the kitchen. No formal complaints had been received by the home since the last visit in February 2006. All five people returning service users comment cards reported that they knew who to tell if they were unhappy. The majority of people said that they would tell the staff but in particular the “house leader” (manager). All staff members have training in the protection of vulnerable adults during their induction period. The organisation has a policy and procedure for responding to suspected abuse, which is used alongside the West Sussex Multi Agency guideline for reporting abuse. Zacchaeus DS0000014866.V307795.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29,30 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to the service. Zacchaeus provides a comfortable clean home for residents to enjoy living in. EVIDENCE: Communal areas within the home are furnished in a homely manner. Décor is good and residents say that they like living at the home. Resident’s bedrooms have been personalised to reflect their interests and hobbies. People say that they are happy with their rooms and can choose the colours of the walls. Recent regulation 26 reports completed by the responsible individual who monitors the home on behalf of the company report that one resident had a new bed, which they “like very much” Information provided by the manager prior to the visit showed that there are ongoing improvements to the décor, with one bedroom and one toilet recently been redecorated. Information provided showed regular maintenance within the home with checks being carried out on services and equipment. Zacchaeus DS0000014866.V307795.R01.S.doc Version 5.2 Page 19 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): 31,32,33,34,35,36 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to the service. The staff are well trained and are aware of their roles and responsibilities within the staff team and receive the appropriate supervision. EVIDENCE: At a return visit on Monday 30th October 2006 the records of three staff who had recently started work at the home were viewed. All records seen included a job description, evidence of identity, two references and evidence that CRB and POVA clearance had been received or in the case of one person applied for. This person has recently started their induction at the home and the manager assured the inspector that they were being supervised and not left in charge of residents or living on the premises. The organisation has an ongoing training programme and two of the staff who had recently been employed had already attended courses on: Heath and Safety Awareness, Infection Control, Moving and Handling, Food Hygiene, and Basic First Aid in addition to taking part in the induction programme. Zacchaeus DS0000014866.V307795.R01.S.doc Version 5.2 Page 20 Further training provided since the last visit to the home in February 2006 includes: Makaton, Challenging Behaviour and Abuse Awareness. Recent regulation 26 reports completed by the responsible individual who monitors the home on behalf of the company report that the manager has met all care assistants in the last six weeks for supervision. Zacchaeus DS0000014866.V307795.R01.S.doc Version 5.2 Page 21 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): 37,38,39, 41,42, 43 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to the service. The home is well managed providing leadership and guidance for staff and residents benefit from an inclusive open management approach. EVIDENCE: The manager has more that two years experience of managing the home. She is currently undertaking the NVQ Level 4 Registered Managers Award and can demonstrate that she has undertaken further training and development to maintain and update her knowledge and competence. Residents say in the returned service user questionnaires, that they like living at the home, that staff treat them well and that staff listen to them. Zacchaeus DS0000014866.V307795.R01.S.doc Version 5.2 Page 22 Residents talked about having the chance to talk about what is good, what they don’t like and what could be better at the weekly house meeting, which staff confirmed took place on Mondays. The home is monitored on behalf of the organisation by the Responsible Individual, Kathleen OGorman, who provides reports of her visits. All records viewed at this visit were in good order and up to date. Records show that the environment and equipment at the home are regularly maintained. No heath and safety hazards came to the attention of the inspector at this visit. Zacchaeus DS0000014866.V307795.R01.S.doc Version 5.2 Page 23 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 3 3 3 4 3 5 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 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X 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 X 3 3 3 Zacchaeus DS0000014866.V307795.R01.S.doc Version 5.2 Page 24 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 Zacchaeus DS0000014866.V307795.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Southampton HO 4th Floor, Overline House Blechynden Terrace Southampton Hampshire SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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