Care Home: 17 Flaxfield Road

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Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 17 Flaxfield Road 17 Flaxfield Road Basingstoke Hampshire RG21 8SE     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: Geoffrey Senior     Date: 0 6 0 2 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 24 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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 24 Information about the care home Name of care home: Address: 17 Flaxfield Road 17 Flaxfield Road Basingstoke Hampshire RG21 8SE 01256328273 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) : Royal Mencap Society care home 5 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 5 The maximum number of service users to be accommodated is 5. 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: Learning disability (LD). Date of last inspection Brief description of the care home The home is a semi-detached property set in a cul-de sac-within Basingstoke. It is within easy reach of the town centre and the local college. The home offers all single rooms on the ground and first floor. There is a lounge/diner, kitchen and ample bath and shower facilities. There is a small quiet area at the top of the stairs, which contains a computer for service users to use. The home has kitchen and laundry facilities and garden to the rear. Care Homes for Adults (18-65 years) Page 4 of 24 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: We arrived at the home at 10.45am on 6th February 2009 and stayed until about 2.10 pm. There were two staff on duty when we arrived and we were joined shortly after by a third. We spoke with three of the service users, one of whom was pleased to show us and a staff member around the house and especially her bedroom. They all said that they were happy living in the home and get on well with everyone who lives and works there. We also spoke with the Manager and staff. The staff were busy with the service users but took time to answer questions and said that they enjoy working at the home, have developed good relationships with the service users and are encouraged to take up the many training opportunities that are offered. As well as viewing records and documents on the day we also considered information Care Homes for Adults (18-65 years) Page 5 of 24 sent to us in the Annual Quality Assurance Assessment (AQAA). This had been completed by the acting manager in September 2008. She did however update some information verbally and confirmed that Health and Safety tests were still up to date. The last key inspection on this service was completed on 2nd February 2007. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 24 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 24 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. People who are interested in living at the home may visit and are provided with information to help them make a decision about moving in. Assessments are undertaken to ensure that the staff in the Home can support the service users needs and wishes. Evidence: Most of the people who live at the home have been there a long time and there has been only one recent admission. Staff spoken to described the admission process and emphasised the importance of ensuring that the service users needs are fully assessed and can be appropriately supported by the home. Admissions, even if they are known to the service, are subject to a thorough introduction and assessment period. We were told that the most recent arrival was encouraged to visit the home before moving in so she could meet and spend time with the existing service users and staff, view the accommodation and find out about the routine and lifestyle she could expect to experience at the home. She said that she was very happy to have chosen the home and feels safe and very settled. We saw that assessments, undertaken prior to, and Care Homes for Adults (18-65 years) Page 9 of 24 Evidence: after admission contribute to the care planning process. Service users, families and relevant agencies and professionals are encouraged to have their say. Care Homes for Adults (18-65 years) Page 10 of 24 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. People can be confident that the manager and staff will support them to make their own decisions and have a say in the care planning process. Choices are offered in a meaningful way. Evidence: The care planning system is clear, consistent and provides staff with information and guidance when supporting residents. People are able to have their personal goals identified and considered within the planning and risk assessment process. Service user plans show the support needs of service users and the home ensures that healthcare needs are met. Residents are helped to make decisions affecting their daily lives. One service user was pleased to show her personal plan tree, a pictorial record of her goals together with photos showing things she wants to do and of her achievements. An individual daily activities planner and the menu is also displayed in pictorial form in the dining area. All the service users have active access to a local advocacy service to help them voice their hopes and opinions. Care Homes for Adults (18-65 years) Page 11 of 24 Care Homes for Adults (18-65 years) Page 12 of 24 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. Staff and management support individuals in the lifestyle they choose. There is an emphasis on personal development, expressing choice and making decisions. The management need to ensure that staffing levels in the evenings do not compromise choices made. Evidence: Staff in the home have worked very positively with residents to establish interests, likes and dislikes. They are supported by the organisation to provide a wide range of activities and events. Service users have regular opportunities to use local community facilities such as the cinema and local shops. We were told however that evening activities, unless planned well in advance , are sometimes limited by lack of staff to support the activity. Each service user has their own weekly planner set out using pictures preferable to the individual. The manager, with the support by the staff team, Care Homes for Adults (18-65 years) Page 13 of 24 Evidence: has fostered a positive and active culture within the home. The individuals are involved in the day to day running of the home, doing household chores as well as involvement in food shopping and meal preparation. There is an adequate food budget and the service users and staff commented positively on the quality, quantity and choice of meals while maintaining a focus on, and encouraging, a healthy balance. Family and friends are welcomed into the home to visit service users . The staff keep in good contact with significant others to update them on progress and changes. Care Homes for Adults (18-65 years) Page 14 of 24 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 are treated with respect and their privacy is respected. Healthcare needs are appropriately addressed. Medication systems and procedures are adequate for the needs of the home. Evidence: There is clear documentation demonstrating that health issues are identified and acted upon with advice from professionals. Additional facilities are assessed and provided where residents have had changing levels of need. People are treated with dignity and respect and levels of privacy are maintained. All of the service users require assistance or encouragement with aspects of personal hygiene and care. The manager ensures that staff are instructed and supervised to provide this thoughtfully and sensitively. The medication records and storage facilities were viewed as adequate for the needs of the home. Medication Administration records were clear, accurate and up to date. The home has good policies and procedures in place and staff administering medication are provided with appropriate training. The potential for individual storage and management of medication was discussed. Care Homes for Adults (18-65 years) Page 15 of 24 Care Homes for Adults (18-65 years) Page 16 of 24 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. Systems are in place to protect and safeguard vulnerable adults from the risk of harm. Service users know they will be listened to if they are worried or concerned about anything Evidence: Staff are well aware of their responsibilities regarding the protection of vulnerable adults. There is clear written information and guidance available to all interested parties. Service users are encouraged to communicate any thing that is worrying them to the manager or staff member straight away so it can be dealt with and lessen any anxieties. They can also talk at the monthly meeting with their keyworker about any worries or concerns they may have. They are also encouraged to raise issues at the regular house meetings. The organisation has a robust recruitment procedure that undertakes checks and references on prospective staff members prior to commencement of duties. Care Homes for Adults (18-65 years) Page 17 of 24 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. The house offers a clean, well decorated, comfortable and homely environment in which to live and work. The few restrictions on access are in the interest of safety and security and do not compromise individuals lifestyle. Evidence: The house is well decorated, comfortably furnished and presents a pleasant and varied environment in which to live and work. Each service user has ther own favourite but not exlusive spot where they prefer to spend their time or take their meals. One service user was proud and keen to show us her private room which was painted in the colour of her choice and full of personal belongings and ornament. She said she liked very much living in the house and didnt want to be anywhere else. Everyone is free to move about the house without restriction although there are measures in place to safeguard people in the kitchen. Bathrooms and toilets are accessible and in good condition. People may also have access and free or supported use of the laundry. There is an enclosed rear garden which is well used in the good weather. A maintenance team is available for repairs and quick response to problems. Care Homes for Adults (18-65 years) Page 18 of 24 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. There are generally sufficient numbers of staff on duty, however, as noted earlier there are times on the rota when numbers on duty may lessen the opportunity for service user choice of activity in the evenings. There is a good staff training and development programme designed to meet the service users needs. Evidence: The home offers staff a good development programme. There is a comprehensive induction process that all staff are supported to work through. Mandatory training is provided and staff receive updates and refresher courses as required. Following induction, staff are encouraged to enrol on NVQ programmes. We were told that 5 out of 6 members of staff hold NVQ 3. All staff have thorough reference and criminal record bureau checks before commencing duties at the home. Staff spoken with were conversant with the needs of the service users and confident that they can provide appropriate support. We observed friendly and relaxed interactions between service users and staff throughout our visit. As noted earlier there are times on the rota when numbers on duty may lessen the opportunity for service user choice of activity in the evenings. Care Homes for Adults (18-65 years) Page 19 of 24 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. This is a well managed home that is run in the best interests of the service users. The health, safety and welfare of all is promoted and protected. Evidence: The manager has worked at the home for 9 years and has been in control of the day to day running since September 2008. She has a good range of experience and training. She has attained NVQ level 3 and hopes to enrol on NVQ 4 and the Registered Managers Award in the near future. She is also making application for CSCI registration. She has fostered an open and positive ethos in the home enabling staff, relatives and service users, where possible, to freely feedback about the service. Monthly monitoring visits are carried out by representatives of the organisation ensuring that the standard of care and relevant documentation is maintained and that the premises are in good order. They use the opportunity to discuss life in the home with both service users and staff and report accordingly. We were told that health and safety checks are undertaken, equipment service is up to date and the welfare of staff and service users in the home is promoted. Care Homes for Adults (18-65 years) Page 20 of 24 Care Homes for Adults (18-65 years) Page 21 of 24 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 22 of 24 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 1 12 The homes needs to respond to information from service users that the opportunities for evening activities are sometimes compromised by low staffing levels. Care Homes for Adults (18-65 years) Page 23 of 24 Helpline: 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 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. 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