Care Home: 31 Liphook Road

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What the care home does well The home provides care and support to enable residents to live meaningful lives and staff supports them in their day-to-day lives and they are treated equally as individuals and with dignity and respect. There is an effective care planning system in place and residents are supported to access the local community. Residents are given as much choice as possible in their day-to-day lives with appropriate support provided by staff at the home. The home has a dedicated and stable staff team and they receive appropriate training to enable them to provide effective support to residents and there is a robust recruitment procedure, which helps protect users of the service. What has improved since the last inspection? Since the last inspection the home has turned one of the rooms in the house into a sensory room where residents can relax. A trampoline has been purchased for the rear garden and tables and chairs have been provided to enable residents to make full use of the garden. What the care home could do better: There were no requirements or recommendations made as a result of this visit, however some other points, which need to be addressed to help improve the service provided for service users are contained within the main body of the report, general observations were: Care plans could be improved with more information for staff regarding the epilepsy plan of one resident and changes in how recording takes place would benefit residents and staff. Risk assessments could be improved by having a generic risk assessment for any risks, which are common for all activities, this would then allow individual risk assessments to concentrating on the specific risks involved in individual activities. The home is looking to turn the double garage at the home into an activities room and when this is completed it will provide additional recreation space. Although there is sufficient communal space in the home, the development of the garage into the activities room would greatly benefit the residents and provide an area where they could play pool, table tennis and other activities that require a larger space. CARE HOME ADULTS 18-65 31 Liphook Road Lindford Hampshire GU35 0PU Lead Inspector Michael Gough Unannounced Inspection 21st November 2007 10:15 31 Liphook Road DS0000068241.V349531.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 31 Liphook Road DS0000068241.V349531.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. 31 Liphook Road DS0000068241.V349531.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 31 Liphook Road Address Lindford Hampshire GU35 0PU 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) 01420 487309 liphook@robinia.co.uk Robinia Care Mr Norman Donovan Bent Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 31 Liphook Road DS0000068241.V349531.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Any young person aged 16 and 17 may be admitted to the home. Date of last inspection 21st March 2007 Brief Description of the Service: 31 Liphook Road is a care home for five younger adults with learning disabilities. The home opened in August 2006 and is owned and operated by Robinia Care Limited, an organisation that has been a care provider since 1995. The home is in a quiet road in Lindford, Hampshire and it is easy to walk to the local shops from the home. Everyone has their own room with a bathroom. There are two lounges and a kitchen/dining room. The home has a garden at the back of the house for everyone to use. It costs from £1,686.00 to £2,000.00 per week to live in the home. Service users also have to pay for the hairdresser, newspapers chiropody, toiletries and annual holidays over £500. 31 Liphook Road DS0000068241.V349531.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report details the evaluation of the quality of the service provided at 31 Liphook Road and takes into account the accumulated evidence of the activity at the home since the last inspection, which was carried out on the 21 March 2007. The inspection took into account the homes Annual Quality Assurance Assessment (AQAA); and comment cards received from 1 relative. Included in the inspection was an unannounced site visit to the home, which took place on the 21 November 2007 Evidence for this report was obtained from reading and inspecting records, touring the home and from observing the interaction between staff and users of the service. It was not possible to gain the views of people living at the home due to the nature of their learning disability, however the inspector had the opportunity to speak with 2 members of staff and by speaking with the homes manager, who assisted the inspector throughout the visit. The home is registered to provide support for 5 residents who have a learning disability and at the time of the inspection the home was full. What the service does well: What has improved since the last inspection? Since the last inspection the home has turned one of the rooms in the house into a sensory room where residents can relax. A trampoline has been purchased for the rear garden and tables and chairs have been provided to enable residents to make full use of the garden. 31 Liphook Road DS0000068241.V349531.R01.S.doc Version 5.2 Page 6 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. 31 Liphook Road DS0000068241.V349531.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 31 Liphook Road DS0000068241.V349531.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users aspirations and needs are assessed before they move into the home. EVIDENCE: The home has a policy and procedure in place with regard to admissions to the home and there has been one new sresident admitted since the last inspection. There were comprehensive social service assessments undertaken as well as the homes in house assessment, which covered personal hygiene, eating and drinking, continence, health, sleep patterns, medication, communication, sexuality, education, mental health and physical well being and leisure. There was also a transitional programme for the resident to ensure a smooth change to the new service. These assessments were kept on file at the home and formed the basis for the care plans that are in place. 31 Liphook Road DS0000068241.V349531.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): 6,7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents assessed needs and personal goals are reflected in an individual plan of care, however more information in the epilepsy plan for 1 resident would be beneficial. Staff at the home respect resident’s rights to be involved and make decisions about their day-to-day lives and staff support them in this process. Residents are supported to take responsible risks and this allows them to live an independent lifestyle as much as possible. EVIDENCE: Care and support plans were seen for 2 residents and these were clear and easy to follow and gave clear information for staff on what support was needed and how and when this support should be given. One residents Epilepsy care plan gave information for staff on what action they should take if the resident had a seizure, however this could be improved with more information for staff. The care plan did not give information on how long a normal seizure lasted and there was no information for staff on what action they should take once the seizure had finished, this was discussed with the homes manager who said 31 Liphook Road DS0000068241.V349531.R01.S.doc Version 5.2 Page 10 that he would update the care plan to give staff as much information as possible. Care plans viewed contained recording sheets where staff commented on what support had been given and how the service users had been, there were also a number of tick boxes where staff indicated that care had been given such as personal care, but these did not always provide evidence on what support was given. The issue of recording was discussed with the homes manager who said that he would be reviewing the recording procedures in care plans to make them more informative and user friendly. All care plans are regularly reviewed and staff are made aware of any changes. Residents are supported to make decisions about their day-to-day lives and staff were observed interacting with them. The home has developed “Yes and No” cards for residents who are able to indicate to staff if they wish to be involved in certain activities and the home also uses picture symbols and items of reference to enable residents to have as much choice as possible. Staff at the home respect resident’s choices and wishes. Risk assessments are detailed in a separate file and these gave details of the assumed risk, and gave staff information on how the risk could be minimised. A lot of the information contained in each risk assessment was generic for the individual resident and therefore there was a lot of duplication of information. The inspector discussed risk assessments with the homes manager and he is currently updating risk assessments and will be making some changes in order to provide clear information for staff. Residents understanding of the risks involved were limited but they were involved as much as possible in the risk taking process. 31 Liphook Road DS0000068241.V349531.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): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged and supported to be part of the local community and to be involved in appropriate activities. Resident’s benefit from support to maintain family and social contacts and daily routines at the home respect their rights and responsibilities. Meals at the home are flexible and users of the service benefit from a healthy diet. EVIDENCE: None of the service users at the home are able to undertake any form of paid employment. Residents attend a day service and those who are able are supported to maintain their independent living skills and this is done through close liaison with the home. Activities include, bowling, pool, swimming, horse riding, relaxation, walking, trips into the local community, gardening, boating and disco’s. 1 resident is supported to maintain his literacy and numeracy skills. The home is looking to turn the double garage at the home into an activities room and when this is completed it will provide additional recreation 31 Liphook Road DS0000068241.V349531.R01.S.doc Version 5.2 Page 12 space. Although there is sufficient communal space in the home, the development of the garage into the activities room would greatly benefit the residents and provide an area where they could play pool, table tennis and other activities that require a larger space. Due to the natures of resident’s learning disability and autism they all require staff support to go out into the local community. Residents regularly go shopping, visit local pubs and cafes and attend local fete’s and community events in the local area and the home has a large mini bus which enables them to access the local community with staff support. There is a clear visiting policy and the inspector was informed that staff would respect residents wishes on who they wish or do not wish to see. The home contacts relatives each week to give them an update on how their relative has been and one relative is contacted on a daily basis. Staff support residents to maintain family contacts and families regularly visit the home and go out with their relatives, staff are on hand to provide additional support if this is required. Daily routines in the home promote residents independence as much as possible and staff were observed knocking on doors before entering and using their preferred form of address. Residents are able to access all areas of the home and are able to choose if they wish to be alone in their rooms or be in the company of others. Menu’s at the home are made up by the staff 2 weeks in advance and the likes and dislikes of residents are taken into account as is their nutritional needs, one resident is on a gluten free diet, one is a vegetarian and one is on a high fibre diet. The home records what each resident has had to eat and the menu is flexible and allows for change at short notice and this gives residents the opportunity to choose a take away if they wish. Food shopping normally takes place once a week and residents go out with staff to buy the weekly shopping. 31 Liphook Road DS0000068241.V349531.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): 18,19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive personal support in the way they prefer and their physical, emotional and health needs are met. The homes policies and procedures with regard to medication provide protection for users of the service. EVIDENCE: Care plans for individual residents gave information on personal care needs and this is offered in private. The home has a policy on cross gender care and the staff team are flexible around the times when residents need personal support and there are no set routines, however there is a daily routine in the mornings and evenings to help with consistency. All of the Residents at the home are registered with the same GP surgery, but may have different GP’s. Dental checks and treatment are provided by a local hospital and a visiting optician service calls once per year. Residents have specialist input from the local learning disability team and any other health care professionals are accessed through GP referral. 31 Liphook Road DS0000068241.V349531.R01.S.doc Version 5.2 Page 14 The home has a medication policy and procedure and the information for the receipt, storage, disposal and administration of medication was clear. The home uses a monitored dose system from a local pharmacist for medication and records were inspected and found to be accurate and up to date. All staff at the home has received training with regard to the administration of medication and no resident self medicates. 31 Liphook Road DS0000068241.V349531.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): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a clear and accessible complaints procedure, which includes timescales for the process and residents can be confident that their views would be listened to and acted upon. The homes policies and procedures help to protect service users from any form of abuse. EVIDENCE: The home has a clear and accessible complaints procedure and this contains all of the required information and gave details of how to contact the CSCI, however residents are not fully aware due to their learning disability and copies of the complaints procedure are given to relatives. There have been no complaints made to the home since the last inspection and staff spoken to were aware of the complaints procedure and said that they would support any resident to make a complaint if they so wished. The home has a copy of the Hampshire Adult Protection procedure and has a whistle blowing policy and a copy of the department of health guidelines “No Secrets” staff also receive training with regard to adult protection and POVA as part of their induction. The manager and staff members spoken to confirmed that they had received training and were aware of their responsibilities in this area. 31 Liphook Road DS0000068241.V349531.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): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a well-maintained environment and have access to comfortable indoor and outdoor facilities and the home was clean, pleasant and hygienic and free from offensive odours and this provided a pleasant environment for residents and staff. EVIDENCE: A tour of the home was conducted and the home is laid out over 2 stories, the upper floor has 4 bedrooms, all of which are ensuite and downstairs there is one bedroom, 2 lounges, a kitchen diner and an additional room which has been turned into a sensory area. Furniture and fittings were of good quality and the home was in a good state of repair. The home has a large enclosed rear garden and there are 3 garages, one is used for storage and there is also a double garage. The homes completed AQAA stated that the double garage is going to be converted into an activities room, however the manager said that this had been planned for some time, but to date no work has started. The fire authority has made some requirements, which must be carried out before the garage can be used for activities. 31 Liphook Road DS0000068241.V349531.R01.S.doc Version 5.2 Page 17 There is a separate laundry area fitted out with an industrial washing machine that can wash clothing at appropriate temperatures and also an industrial tumble drier. Residents are encouraged to bring their own laundry down to the laundry room and staff support them to do their own laundry. Staff has received training in infection control procedures and the home provides protective clothing for staff. 31 Liphook Road DS0000068241.V349531.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): 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home supports and encourages staff to undertake relevant care qualifications. Residents are supported by trained staff and are protected by the home’s staff recruitment procedures. EVIDENCE: Currently the home has 9 permanent staff members and 5 have completed NVQ training and 1 member of staff is due to commence NVQ training shortly. The homes staff rota showed that there are a minimum of 2 members of staff on duty at all times and additional staff work to provide one to one support for residents. The completed AQAA and conversation with the manager indicated that there were sufficient numbers of staff on duty to meet resident’s needs. There are a number of overseas staff employed at the home and all staff are treated equally and the recruitment records seen for 2 members of staff contained, application form, interview notes, passport, birth certificate, POVA & CRB check, references x 2, work permit, police check from Poland and health declarations. Robina Care Limited has a training co-ordinator who provides a 3 month training plan for all staff employed in the organisation and the manager, 31 Liphook Road DS0000068241.V349531.R01.S.doc Version 5.2 Page 19 discusses training needs with staff at supervision and he can then access any training for his staff. Specific training can also be arranged. Staff undertake induction training, which includes mandatory training in fire safety, 1st aid, moving and handling, food hygiene, medication, adult protection, infection control, learning disability awareness and equality and diversity. Additional training is provided in care planning, autism, managing challenging behaviour, communication and epilepsy. Staff members spoken with confirmed that they had received a good induction and said that the training provided was good with regular refresher courses. 31 Liphook Road DS0000068241.V349531.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): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are suitable management arrangements in place at the home and residents can be confident that their views are taken into account when developing the home. The homes policies and procedures promote and protect the health, safety and welfare of service users and staff. EVIDENCE: The manger of the home has been in post since the home opened last year and he has completed NVQ4 in care and is currently undertaking the Registered Managers Award. He has the skills and experience to manage the home effectively and has received training appropriate to his role. The home has an effective quality assurance system in place and satisfaction surveys are sent to residents who are supported by staff to complete them. Satisfaction surveys are also sent to relatives and care managers. There are 31 Liphook Road DS0000068241.V349531.R01.S.doc Version 5.2 Page 21 monthly resident meetings and staff meetings are also held monthly. Residents, relatives and care managers are included in yearly care reviews and these reviews are used to monitor how the home is meeting its aims and objectives. Regular monthly regulation 26 visits are carried out and this is another opportunity to monitor the quality of the service provided. Health and safety issue are dealt with promptly and staff understood the importance of highlighting issues to the management. Staff had received training in health and safety and policies were in place to support good practice. The homes fire logbook was up to date and the home has a new style accident book. Certificates were available for the annual testing of equipment and services. Fire equipment was last tested in August 2007, Gas equipment tested in August 2007 and private electrical equipment in July 2007. 31 Liphook Road DS0000068241.V349531.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 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 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 31 Liphook Road DS0000068241.V349531.R01.S.doc Version 5.2 Page 23 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 31 Liphook Road DS0000068241.V349531.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection 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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