Care Home: 21 High Street

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What the care home does well There are clear systems to assess people`s needs before they move into the home and to regularly review them. This helps to assure people that the home is able to meet their needs. People are supported to set out their needs in clear care plans. This helps to ensure people receive the support they need. People choose to take part in a wide range of educational and leisure activities and are supported to maintain contact with their family and friends. People are supported to plan, shop for and cook healthy meals. People receive the care they need in the way they want it and are supported to attend the health services they need. People are given support to express any concerns or complaints and staff know how to respond to allegations of abuse. This gives people confidence that any complaints will be taken seriously and investigated. The home is well maintained and provides a clean, comfortable and safe environment for people. Staff are well trained and checked before they work in the home. This helps to keep people safe and ensure staff can meet their needs. The home is well managed by a qualified and competent manager who plans improvements based on the views of people who live there. What has improved since the last inspection? Records are now kept of the times staff are working in the home. The manager has completed assessments to ensure risks from windows and radiators are identified and minimised. What the care home could do better: There are no areas identified in this report that the manager must improve. The manager has good systems to identify the improvements she wants to make to the service. CARE HOME ADULTS 18-65 21 High Street Fareham Hampshire PO16 7AE Lead Inspector Craig Willis Key Unannounced Inspection 17th April 2008 2:00 21 High Street DS0000011627.V360987.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 21 High Street DS0000011627.V360987.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. 21 High Street DS0000011627.V360987.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 21 High Street Address Fareham Hampshire PO16 7AE 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) 01329 232641 Mrs Sara Fullick Mr John Fullick Mrs Sara Fullick Care Home 3 Category(ies) of Learning disability (3), Mental disorder, registration, with number excluding learning disability or dementia (3) of places 21 High Street DS0000011627.V360987.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th April 2007 Brief Description of the Service: The home is a listed building in the High Street, Fareham. The providers accommodation is in the front of the home, with the service users having their accommodation in the extension at the back. Service users have two bedrooms and a bathroom on the first floor. The bathroom contains a shower, two washbasins and a toilet. On the ground floor there is a further bedroom together with a lounge and a kitchen containing the washing machine. The service users share a second large lounge with the providers and eat their meals in the communal kitchen/diner. There is a second toilet with hand basin by the front door. At the rear there is a courtyard that accesses onto the High Street and provides some parking space. There is also a large garden. Service users have their own entrance to the home that exits into the courtyard. The home’s fees range from £342.29 to £389.20 per week. 21 High Street DS0000011627.V360987.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 3 star. This means the people who use this service experience excellent 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 an annual quality assurance assessment. A site visit to the home was made on 17 April 2008. During the visit we spoke with all three people who live in the home, the manager and a member of staff. 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 clear systems to assess people’s needs before they move into the home and to regularly review them. This helps to assure people that the home is able to meet their needs. People are supported to set out their needs in clear care plans. This helps to ensure people receive the support they need. People choose to take part in a wide range of educational and leisure activities and are supported to maintain contact with their family and friends. People are supported to plan, shop for and cook healthy meals. People receive the care they need in the way they want it and are supported to attend the health services they need. People are given support to express any concerns or complaints and staff know how to respond to allegations of abuse. This gives people confidence that any complaints will be taken seriously and investigated. The home is well maintained and provides a clean, comfortable and safe environment for people. Staff are well trained and checked before they work in the home. This helps to keep people safe and ensure staff can meet their needs. The home is well managed by a qualified and competent manager who plans improvements based on the views of people who live there. 21 High Street DS0000011627.V360987.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. 21 High Street DS0000011627.V360987.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 21 High Street DS0000011627.V360987.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 excellent. This judgement has been made using available evidence including a visit to this service. There are clear systems to assess people’s needs before they move into the home. This helps to reassure people that the home will be able to meet their needs. EVIDENCE: The manager reported in the annual quality assurance assessment for us that each person has a comprehensive needs assessment, which forms the basis of the care plans. People are provided with clear information about what the service can offer and the home endeavours to include people at all stages of the process. Each person has a copy of the service users’ guide, which has clear details of the services and facilities provided by the home. The manager also obtains a copy of people’s care management assessment. The assessments focus on the support that people need to develop their skills and ensure that their different needs are met. No one has moved into the service since the last inspection. People’s needs are regularly reviewed and people said they take part in this process. The assessments are easy to understand and each person has a copy of what is written about them. People spoken with said they were happy that the information about them in the assessments was accurate. 21 High Street DS0000011627.V360987.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 to ensure people receive the support that they need. EVIDENCE: The records of all three 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 contained detailed information about the support people need to meet their different needs and aspirations. People spoken with said they were involved in developing the plans. The manager reported in the annual quality assurance assessment for us that people’s “expressed needs form the central core of our care planning”. Plans are formally reviewed every six months and there was evidence that plans had been amended where people’s needs have changed. Part of the review is a self-assessment by the person using the service. This asks people to identify “things I have achieved, things I enjoy, things I find difficult and things I would like to do”. One person spoken with said he would talk to the manager if there was anything written in 21 High Street DS0000011627.V360987.R01.S.doc Version 5.2 Page 10 his plans that he didn’t agree with and was confident changes would be made. Plans include support that is needed to develop independent living skills, for example voluntary work, independent travel, shopping and household jobs. It was clear that people who live in the home are aware of their plans and involved in any changes that are made. 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 the manager and staff. 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 regularly and are amended where assessed as necessary. During the visit the manager demonstrated a positive approach to risk management, ensuring that people are supported to take managed risks as part of the process of developing their skills and independence. 21 High Street DS0000011627.V360987.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 have an individual programme of activities, which is based on their needs and wishes. These include college courses, work placements and leisure activities. One person spoke of the progress they had made in their job and two people are actively involved with the Special Olympics Organisation and regularly participate in competitions. One person said they know a lot of people in the local area and enjoy socialising in the pub. All three people spoken with said they keep very busy with activities they enjoy. People are supported to maintain contact with their friends and family, with support provided for people to visit family where necessary. One person’s relatives have recently moved abroad and the manager supported them to set 21 High Street DS0000011627.V360987.R01.S.doc Version 5.2 Page 12 up a webcam so they could keep in regular contact. Support is provided for people to develop and maintain relationships. People have a key to the main door of their part of the house. One person spoken with said they had a lot of freedom and were able to come and go as they pleased so long as the manager was aware of when they would be back. The manager and a staff member spoken with demonstrated a good understanding of people’s rights. People are encouraged to take part in meal preparation on two days a week, with support to plan, shop for and prepare meals. Other main meals are cooked by the manager, taking into account people’s likes, dislikes and dietary needs. People take responsibility for preparing their own breakfast and lunch and have a well-stocked kitchen. People are encouraged to monitor the need for additional daily supplies, for example milk and bread and to plan shopping lists. Mealtimes are flexible to fit round activities and snacks are available at any time. People spoken with said they liked the food. 21 High Street DS0000011627.V360987.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 in a manner that reflects their preferences and maintains their dignity. EVIDENCE: People are generally independent with their personal care, with any support that is required detailed in their care plans. All three people spoken with said staff treat them well and provide the support they need. People are supported to attend a range of health services, including GP, nurse, dentist and optician. Details of consultations are recorded, including any advice given by the practitioner. There are systems to support people to store and take medication safely if they are prescribed any. People only have medication on an occasional basis and records are maintained of any medicines administered to them. 21 High Street DS0000011627.V360987.R01.S.doc Version 5.2 Page 14 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 excellent. This judgement has been made using available evidence including a visit to this service. People are given excellent support to express any concerns or complaints and staff know how to respond to allegations of abuse. This gives people confidence that any complaints will be taken seriously and investigated. EVIDENCE: The home has a complaints procedure, which is provided to all people living at the home. There is an easy read format to make it more accessible. People spoken with during the visit said they would speak to the manager if they wanted to complain and were confident that any complaint would be taken seriously. A weekly meeting is held for people who use the service, with a section of it devoted to concerns or complaints that people may have. Each week people are offered a private meeting with the manager to discuss any concerns they have. People spoken with confirmed that these private meetings were available to them and they would use them if they needed to. 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. There are systems in place to record any complaints that are received. Staff have completed training in safeguarding adults procedures. The manager and a staff member 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. 21 High Street DS0000011627.V360987.R01.S.doc Version 5.2 Page 15 Systems are in place to safely hold people’s money for them to help in budgeting. Money is securely stored in a safe and a record is kept of all money held. The manager or staff do not act as appointees or signatories and do not have access to anyone’s bank account. 21 High Street DS0000011627.V360987.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: Both the owners and their family and residents live the home. The residents’ accommodation is to the rear of the house, with its own entrance, kitchen, lounge and bathroom. There is a domestic washing machine in the kitchen. All of the communal areas used by residents were viewed during the visit. The home is well maintained, with good quality, domestic furniture and fittings. There is a large courtyard garden to the rear of the home, which people are able to use. Since the last inspection one of the bedrooms has been recarpeted and there are plans to change the layout of the lounge, following consultation with people. All areas of the home were cleaned to a high standard. 21 High Street DS0000011627.V360987.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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 lives in the home and provides the majority of the support, with additional help from two staff and a cleaner. One of the staff members has completed the National Vocational Qualification in care at level 2. All three people who live in the home said there was always someone available if they needed support and that the manager and staff provide support in the right way. Since the last inspection the manager has kept a record of the times staff are working in the home. The manager reported in the annual quality assurance assessment for us that all staff working in the home have had suitable pre-employment checks. The last inspection judged recruitment procedures to be good, with the manager obtaining references and criminal Records Bureau disclosures for staff. No new 21 High Street DS0000011627.V360987.R01.S.doc Version 5.2 Page 18 staff have been employed since the last inspection so no staff records were inspected during this visit. The manager has arranged a number of training sessions for herself and staff, following an assessment of what people’s training needs were. Courses have included adult abuse awareness, fire safety, first aid, food hygiene, managing boundaries, risk assessment, support planning and keyworking skills, diversity, dealing with complaints, lone working, managing stress, user involvement and assertiveness. The staff member spoken with said the courses were relevant to their role and helped them meet people’s needs. The manager reported that she was looking to introduce additional training in anger management and the Mental Capacity Act. 21 High Street DS0000011627.V360987.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 and 42. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well managed by a qualified and competent manager who plans improvements based on the views of people who live there. EVIDENCE: The manager has completed the Registered Manager’s Award and regularly attends training to update and maintain her knowledge and skills. Throughout the visit the manager demonstrated her commitment to ensure that the home in run in the best interests of people who live there and people are given the support they need to maximise their independence. The staff member spoken with said the manager was very good at her job and demonstrated clear leadership. 21 High Street DS0000011627.V360987.R01.S.doc Version 5.2 Page 20 The manager completes an annual survey of people who use the service and their relatives, to gain feedback on the quality of the service that is being provided. Feedback is also received during the weekly meetings with people who use the service. As the manager also lives in the home, she has daily contact with people and can assess how the service is running. The manager completed an annual quality assurance assessment for us, which assesses the service against the key national minimum standards. In completing this document the manager identified improvements to the service that she would like to make over the next year. The assessment also demonstrates that the manager listens to and responds to the views of people using the service. The manager employs external accountants to oversee the financial affairs of the home. 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. Since the last inspection the manager has completed risk assessments of the radiators and windows, to ensure any hazards are identified and reduced where necessary. 21 High Street DS0000011627.V360987.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 4 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 4 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 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 3 X X 3 X 21 High Street DS0000011627.V360987.R01.S.doc Version 5.2 Page 22 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 21 High Street DS0000011627.V360987.R01.S.doc Version 5.2 Page 23 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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