Care Home: 102 London Road

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What the care home does well There are good systems to assess people`s needs before they move into the home. This reassures people that the home will be able to meet their needs. People are supported to set out their needs in clear care plans and to make decisions about their lives. The home provides excellent support for people to take part in a range of activities they have chosen and to maintain contact with family and friends. People`s personal and health care is well met by staff who know their needs. There is a good system to safely store people`s medication and help them take it when they need to. The home is well maintained and provides a clean, comfortable and safe environment for people. Staff are well trained and there are good systems to check staff before they work in the home. This helps to keep people safe and ensure staff can meet their needs. There are good systems to assess the quality of the service provided and plan improvements. What has improved since the last inspection? The manager has made the complaints procedure available in pictorial format. This helps people understand what to do if they want to make a complaint. What the care home could do better: The manager needs to submit an application for registration to us. CARE HOME ADULTS 18-65 102 London Road Widley Portsmouth Hampshire PO7 5AB Lead Inspector Craig Willis Unannounced Inspection 28th February 2008 10:30 102 London Road DS0000056837.V359916.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 102 London Road DS0000056837.V359916.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. 102 London Road DS0000056837.V359916.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 102 London Road Address Widley Portsmouth Hampshire PO7 5AB 023 9232 7220 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) Mr David Rodgers Mrs Anita Denise Rodgers Post vacant Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 102 London Road DS0000056837.V359916.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th December 2006 Brief Description of the Service: 102 London Road is a care home providing accommodation for 4 adults with learning disabilities. The home is located on the main Portsmouth to Waterlooville road with easy access to the local shops and public transport services. There are four single rooms, one with an en-suite bathroom. There is an additional bathroom and toilets that are shared. People also share the use of a lounge, dining room and kitchen. The manager reported that the current fees range from £748.30 to £917.28 per week. 102 London Road DS0000056837.V359916.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The evidence used to write this report was gained from a review of the information the provider sent to us since the last visit and the previous inspection report. This information included incident reports and an annual quality assurance assessment. A site visit to the home was made on 28 February 2008. During the visit we spoke with two people who live in the home and observed their interactions with staff. We received comments from four people who live in the home, three relatives and three staff. We also spoke with the manager and staff on duty. The communal areas of the building were viewed and documents relating to the running of the home were inspected during the visit. What the service does well: There are good systems to assess people’s needs before they move into the home. This reassures people that the home will be able to meet their needs. People are supported to set out their needs in clear care plans and to make decisions about their lives. The home provides excellent support for people to take part in a range of activities they have chosen and to maintain contact with family and friends. People’s personal and health care is well met by staff who know their needs. There is a good system to safely store people’s medication and help them take it when they need to. The home is well maintained and provides a clean, comfortable and safe environment for people. Staff are well trained and there are good systems to check staff before they work in the home. This helps to keep people safe and ensure staff can meet their needs. There are good systems to assess the quality of the service provided and plan improvements. 102 London Road DS0000056837.V359916.R01.S.doc Version 5.2 Page 6 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. 102 London Road DS0000056837.V359916.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 102 London Road DS0000056837.V359916.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): Standard 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good systems to assess people’s needs before they move into the home. This reassures people that the home will be able to meet their needs. EVIDENCE: The manager reported in the annual quality assurance assessment that a full assessment of people’s needs would be completed before anyone moved into the home. Potential residents are able to visit the home to meet with other people who live there and staff. All of the people currently living in the home have lived there since 2004 and there are no vacancies. Surveys were received from all four people who live in the home. All said they were asked whether they wanted to move into the home and said they received enough information about the home to decide whether it was the right place for them. 102 London Road DS0000056837.V359916.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There are clear care planning and risk assessment systems, which involve people in making decisions about their lives and helps staff to provide the support that people need. EVIDENCE: The records of two people who live in the home were inspected during the visit. People had a care plan, which set out how their assessed needs should be met. The care plans seen contained detailed information about how staff should provide support to meet people’s different needs and aspirations. People spoken with said they were involved in developing the plans. Plans are formally reviewed every six months and there was evidence that plans had been amended where people’s needs have changed. Keyworkers meet with people every month to gain feedback about how the plans are working. Plans include support that is needed to develop independent living skills, for example voluntary work and household jobs. It was clear that people who live in the 102 London Road DS0000056837.V359916.R01.S.doc Version 5.2 Page 10 home are aware of their plans, with one person spending time with us to read through their information. Details of how people should be supported to make decisions are set out in the care plans. People spoken with said they were able to make decisions about their lives and felt well supported by staff. All four people who live in the home who completed a survey said they were able to do what they wanted to during the day, in the evening and at weekends. One person who completed a survey for relatives and friends said their friend “is really happy there. He is listened to and supported to make his own mind up about everything he wants to.” Risk assessments have been completed for all people living in the home and include clear information about how to minimise the identified hazards. These assessments are reviewed as part of the care planning meetings and had been amended where assessed as necessary. Staff spoken with demonstrated a good understanding of people’s needs and the importance of supporting people to make decisions about their lives. 102 London Road DS0000056837.V359916.R01.S.doc Version 5.2 Page 11 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): Standards 12, 13, 15, 16 and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home provides excellent support for people to take part in a range of activities they have chosen, to maintain contact with family and friends and to maintain a healthy diet. EVIDENCE: People are supported to take part in a wide range of activities, including college courses, visits to the local pub and shops, bowling and horse riding. People have an individual programme of activities, which is based on their needs and wishes. One person has recently been supported to obtain a voluntary job for a local charity shop. During the visit one person asked a staff member what activities were happening during the day. The staff member took time to explain what had been planned and what the person’s options were. One relative commented that staff “endeavour to give [their relative] opportunities for social and leisure activities appropriate to the limitations of her disability, for example college, swimming, cinema.” People spoken with said they keep very busy with activities they enjoy. 102 London Road DS0000056837.V359916.R01.S.doc Version 5.2 Page 12 People are supported to maintain contact with their friends and family, with staff providing support for people to visit family where necessary. Three relatives and friends completed a survey for us. All said they are always kept up to date with important issues affecting their relative. One person spoken with said they regularly visited their parents, and were looking forward to the next visit at the weekend. One relative commented, “the manager phones me regularly if there is anything to discuss of an important nature regarding my daughter”. People are able to lock their bedrooms and staff were observed asking permission to enter people’s bedrooms. Staff spoken with demonstrated a good understanding of people’s rights. People are supported to plan a weekly menu, with help from staff to provide a balanced diet. People are encouraged to take part in meal preparation. Mealtimes are flexible to fit round activities and snacks are available at any time. People spoken with said they liked the food. 102 London Road DS0000056837.V359916.R01.S.doc Version 5.2 Page 13 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): Standards 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s personal and health care is well met by staff who know their needs. There is a good system to safely store and administer people’s medication. EVIDENCE: Care plans contain details of the personal care support people need and how it should be provided. People spoken with said staff treat them well and provide the support they need. All four of the people who live in the home who completed a survey for us said staff treat them well and listen to them and act on what they say. People are supported to attend a range of health services, including GP, nurse, dentist, chiropodist and optician. Details of consultations are recorded, including any advice given by the practitioner. Medication is securely stored in a locked cabinet in the office and most tablets are supplied in a monitored dosage system. A record is kept of medication coming into the home and returned to the pharmacist for disposal. The medication administration record for the current month was inspected and had 102 London Road DS0000056837.V359916.R01.S.doc Version 5.2 Page 14 been fully completed. All staff administering medication have received training and the manager reported she is looking at a more advanced assessed course for staff to complete. None of the people who live in the home are currently able to administer their own medication. 102 London Road DS0000056837.V359916.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): Standards 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good systems for dealing with complaints and responding to allegations of abuse. This gives people confidence that any complaints will be taken seriously and responded to. EVIDENCE: The home has a complaints procedure, which is provided to all people living at the home. Since the last inspection the complaints procedure has been provided in a pictorial format to make it more accessible. People spoken with during the visit said they would speak to staff if they wanted to complain and were confident that any complaint would be taken seriously. Three of the four people who live in the home who completed a survey said they know who to talk to if they are not happy and how to make a complaint. The manager reported in the annual quality assurance assessment that the home has not received any complaints in the last year. We have not received any complaints about the home since the last inspection. Staff have completed training in safeguarding adults procedures. Staff spoken with demonstrated a good understanding of the action they should take if abuse is witnessed, reported or suspected. There is a policy and procedure on safeguarding adults and the prevention of abuse. 102 London Road DS0000056837.V359916.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): Standards 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained and provides a clean, comfortable and safe environment for people. EVIDENCE: All of the home’s communal areas were viewed during the visit. The home is well maintained, with good quality, domestic furniture and fittings. People living in the home have access to a lounge, kitchen and dining room. There is a planned maintenance and renewal programme and staff reported that maintenance issues are resolved quickly. There is a bathroom on the ground floor and one of the rooms has an en-suite bathroom. There is a garden to the rear of the home, which people said they enjoy using in the summer. Since the last inspection people’s bedrooms have been redecorated, following consultation with them about colours. The manager reported there are plans to decorate the dining room and fit new flooring in the kitchen and hallway. The home has a domestic laundry that is situated in a utility room off the kitchen. There are procedures in place to prevent laundry being taken through 102 London Road DS0000056837.V359916.R01.S.doc Version 5.2 Page 17 the kitchen whilst food is being prepared. The home is clean throughout. Hand washing facilities are suitably situated in the kitchen, laundry, toilets and bathrooms. 102 London Road DS0000056837.V359916.R01.S.doc Version 5.2 Page 18 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): Standards 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are well trained and there are good systems to check staff before they work in the home. This helps to keep people safe and ensure staff can meet their needs. EVIDENCE: The manager reported in the annual quality assurance assessment that one of the six staff have achieved the National Vocational Qualification (NVQ) at level 2 or above and five are currently completing the award. Staff members were observed spending time listening to people who live in the home. Two relatives who completed a survey said staff usually had the right skills and experience, one said staff sometimes did. People who live in the home who were spoken with said they felt there were enough staff to provide the support they need. Staff spoken with said they felt there were sufficient staff on each shift to provide the support that people need. All three staff who completed a survey for us said there were always enough staff to meet the individual needs of people who live in the home. The manager reported in the annual quality assurance assessment that all staff who have worked in the home over the last twelve months have had 102 London Road DS0000056837.V359916.R01.S.doc Version 5.2 Page 19 satisfactory pre-employment checks. The files of four members of staff were inspected. All had written references on file and confirmation that a Criminal Records Bureau (CRB) disclosure had been obtained. The home has an on-going training programme and staff reported that they receive good training, which helps them meet people’s needs. Staff training records indicated people had completed an induction and courses including medication administration, first aid, safeguarding adults, food hygiene, moving and handling, challenging behaviour and fire safety. One person who completed a relatives survey said some staff would benefit from additional training. The manager has identified where there are gaps in people’s training and planned courses throughout the year. 102 London Road DS0000056837.V359916.R01.S.doc Version 5.2 Page 20 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): Standards 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed, which helps to keep people safe and there are good systems to make improvements to the service based on the views of people who live there. EVIDENCE: The manager has been in post since September 2007 and reported she is due to start the NVQ 4 in care and the registered manager’s award this year. Staff spoken with said they thought the manager was very supportive. During the visit the manager demonstrated her desire to learn more and update her skills so that the service could improve. The manager has not yet submitted an application for registration with us. This was discussed during the visit and the manager was informed that an application should be submitted as soon as possible. 102 London Road DS0000056837.V359916.R01.S.doc Version 5.2 Page 21 The provider visits the home every month to assess the quality of the service that is being provided. Reports of these visits are made and sent to the manager. The reports contain a list of any actions that are needed and an update of actions that were required in the previous report. The home completes an annual survey of people who live in the home, staff and other stakeholders. The responses to these surveys are collated and used to plan improvements to the service. The manager reported in the annual quality assurance assessment that the electrical system, fire detection and fighting equipment and gas system are regularly serviced and maintained. These records were sampled during the visit and confirmed the manager’s report. 102 London Road DS0000056837.V359916.R01.S.doc Version 5.2 Page 22 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 X 4 X 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 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X 102 London Road DS0000056837.V359916.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 102 London Road DS0000056837.V359916.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. 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