Care Home: 79 Silvester Road

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Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 79 Silvester Road 79 Silvester Road Cowplain Hampshire PO8 8TR     The quality rating for this care home is:   three star excellent 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: Kathryn Emmons     Date: 2 3 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 27 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.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: 79 Silvester Road 79 Silvester Road Cowplain Hampshire PO8 8TR 02392268922 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) : Mr Dawson Smith,Mrs Julie Smith care home 7 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 7 The maximum number of service users who can be accommodated is seven (7) The registered person may provide the following category of service only: Care Home only - Code PC To service users of the following gender: Either Whose primary care needs on admission the home are within the following category: Learning Disability Code LD Date of last inspection Brief description of the care home 79 Silvester Road is a care home accommodating six adult service users who have a learning disability. There is an active educational and activity plan arranged for service users throughout weekdays and as chosen by them. There is close contact maintained with the local community care team. The home is situated in a quiet residential area of Cowplain near Waterlooville, and blends in with all surrounding properties. The home is close to local shops and public transport is available within walking distance from the home. The accommodation comprises of an open plan kitchen, sitting room and conservatory, where service users are able to sit as a group for dining purposes. There are six single bedrooms, four of which are on ground floor level and a bathroom on both floors, fitted with shower facilities. Fees at the home range from #380 - #500 per Care Homes for Adults (18-65 years) Page 4 of 27 Brief description of the care home week and service users are responsible for purchasing their own toiletries and items of a personal or luxury nature. Care Homes for Adults (18-65 years) Page 5 of 27 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: three star excellent 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: The visit to the service was undertaken by one inspector who spent five hours at the home. The care received by three service users was looked at in detail. This is a method called case tracking. This included looking at their personal records a range of general records and staff details. This forms part of a key inspection and focused on the standards in the key areas that most effect the quality of life for the service users. Information already held such as a service history and the providers self -audit which is called an AQAA (Annual Quality Assessment Audit) were used to plan the visit. During the visit the inspector spoke to the registered manager who is also one of the providers, all of the service suers and one staff member. We also sent comment cards for staff and residents to complete and we also considered the comments these contained when writing the report. Care Homes for Adults (18-65 years) Page 6 of 27 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 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 9 of 27 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. Service users can be confident that their needs will be comprehensively assessed before an offer of placement is made. Contracts and a service user guide enables service users and their relatives to be confident about the services they can expect. Evidence: Since the last inspection a new service user has been admitted to the service. We could see information to evidence that the service user had been able to visit the home and stay for a few days before making a decision to live at the home for a trail period. We saw assessments in place to demonstrate the manager had met with a team of social care professionals to fully asses the service users needs. We saw that there is a statement of purpose and service user guide , which provide information about the house and service . The manager advised that this was reviewed regularly and updated when necessary. A copy of this is left in the lounge and the service users told us about the document and showed us the pictures and symbols that had been used to make it easier for them to understand., Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: We could see that contracts are in place and these had been signed by the service users and in one case the relative of service user. Care Homes for Adults (18-65 years) Page 11 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Written records provide residents with confidence that their needs are known and that they are able to be kept safe. The plans are in a format which enable service users to be central to the support they receive. . Risk assessments enable service users to learn new skill while remaining as safe as possible.Service users rights are upheld. Evidence: We saw care files for three service users. These included the newest service user to be admitted to the service. The files contained written assessments, care plans and risk assessments. It was clear what service users needs and what level of support they required. Comprehensive details were included on how to provide the support and guidance.The format of the care plans was called PATH (planning alternative tomorrows and hopes). This provides a plan which service user can contribute to and set their own goals for achieving skills.. We could see that reviews took place and that care plans were reviewed regularly and service users had been involved in the reviews with the manager. We could see that progress notes were completed on every shift Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: change over. This means that service users welfare needs are known and any changes are recorded. We spent time with all of the service users when they had returned from being away from the service for the day. Service users told us that they had different activities everyday and they could always chose if they went to day services or college and if they ever felt they didnt want to go they would be supported by staff with making this choice. We saw risk assessment in place for various activities an example was learning how to prepare money and order a taxi for returning home after a night out and another for a service user who was in a relationship with someone from outside of the service. We saw evidence of service user being supported to have their rights upheld example of this was being assisted to write a letter to complaint about a missing parcel and supported to vote. Care Homes for Adults (18-65 years) Page 13 of 27 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. Service users live in an environment which enables them to learn new skills and increase their independence. Different gender needs are acknowledged and promoted. Dietary needs and preferences are catered for. Evidence: Service users told us about the recent holiday they had chosen and showed us photographs of the previous years holiday. Service users go on two holidays yearly and are involved in deciding where they go. Each week a house meeting is held which is led by the service users and they are able to raise any issues they have and discuss ways of improving the life they have at the service. There was a lot of written information about the lifestyle activities each service user enjoyed and details of day activities they were involved in. These included attending day services ,college and supported employment. A couple of service users worked in charity shops. Service Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: users told us they went out in the evening and this included theatre, pubs, clubs and discos and sport activities. We could see that service users were supported to form relationships and friendships and where necessary staff would support service users to visit partners and friends outside of th service. Service users said they had a good irelationship with neighbours in the local community and rthey invite them to attend events in the home such as BBQs. We looked at how the service threads equalities and diversity through support provided . Examples of this was male support for the male service user who wanted to attend different activities from the female service users. An understanding of empowering services users to be as independent as possible even though they have a disability was centra to the support provided. The age group differs in the home but all service users said they didnt mind this and Its like a proper family with the older ones and we dont think about that we all pretty much like the same things. Service users told us that they pick the menus on weekly basis as part of the weekly meeting they chose what they have in their lunch boxes daily and are supported to make healthy choices with staff support. Service users take it in turn to be supported to make the evening meal for the rest of the service users and again this participation is optional. Care Homes for Adults (18-65 years) Page 15 of 27 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 personal support is given in their preferred way. Staff are able to deliver good emotional and personal support to service users. Medication arrangements keep service users safe. Access to heath care professionals enable service users to stay well. Evidence: Service users told us I have a bit of help and Julie knows how i like help and I like the people here, Dawson and Julie is very nice to us all and if i need some help i will always get it everyone knows what help we all need, we do not need much sometimes. We asked service users how they were supported if something upset them and were told we can all sit down and talk about it, someone close to me passed away and I had lots of time to talk to everyone about it , and I dont get sad but if i do i can always speak to (staff) and Julie. We looked at the medication arrangements for the service users and found that all records were in good order. There was a clear record of all medication received into the service and records of returned medication. All service users had been assessed to Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: see if they could manage their own medication. Currently no service users can look after their own medication or store in their rooms however a regular review takes place as the ethos of the service is to enable service users to being as independent as possible. We could see from staff records that staff had received training in the administration of medication. We could see from service users files that a full medical history had been obtained and when needed service users accessed health care clinics at the local surgery, and were supported to attend hospital appointments.We could see that appointments had taken place with opticians and chiropodists and dentists. Care Homes for Adults (18-65 years) Page 17 of 27 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. Service users can be confident that their concerns will be listened to and acted upon. Staff are trained in safeguarding adult procedures . Evidence: We saw a copy of the services complaints procedure. This was in symbol format as well as words and was on display in the lounge copy of the service users guide. We were told by the manager that any concerns will be investigated and responded to. No complaints or concerns have been raised since the last inspection. Service users told us We dont need to complain but we are always asked if everything is OK, they are serious about stuff like that. Staff had received training in safeguarding adults and we saw certificates for this on staff files . A copy of the service policy on safeguarding adults procedures is regularly reviewed and refered to in staff supervision sessions. we saw a copy of the Portsmouth County Council policy on how to manager safeguarding adult issues. We advised the new revised edition should be obtained as there are some changes which may need to be put into the services policy. Staff had a good understanding of practices which could be seen as abusive and the manager was confident that staff are very clear on what action to take . Care Homes for Adults (18-65 years) Page 18 of 27 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. Service users live in safe, clean and comfortable surroundings which they have been able to personalise. Evidence: The house is similar to other residential houses in the area. There is off road parking for a couple of cars and ample parking on the road side. The house was clean and tidy and well decorated and smelt fresh. Each service user had their own room and these have been personalised with their chosen colour scheme and furniture. We briefly looked at the rooms with service users permission . The communal areas were homely and comfortable and service users could move freely around the home. The kitchen was clean and tidy and we could see that good infection control measures were in place. Since the last insepction the service has gained an award called Better Food Better Business which means that the standard of kitchen hygiene is very good. Service users are supported to keep their rooms clean tidy and to do their laundry. A record is in place which is signed at each hand over to evidence that staff have left the service in a safe and tidy manner.There is a large garden at the back of the house and service users use this in warmer weather. Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: Bathrooms were clean and tidy and since the last inspection a new bathroom has been installed.We saw gloves and aprons were available if needed to be used by care staff. Service users are kept safe by staff monitoring who is entering the house. Security for the home was good and the provider has a maintainace plan in place and carries out most of the homes repairs. Care Homes for Adults (18-65 years) Page 20 of 27 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. Service users needs are met by a well trained and competent team. Robust recruitment procedures including interview systems ensure the right people are employed to support service users. Staff receive supervision sessions which enable them to identify any training needs and to discuss ways to improve how they work to improve the service they provide. Evidence: We looked at the recruitment records for the two staff who are employed at the service. We saw that all the necessary paperwork was in place including references and criminal record bureau checks.The manager confirmed that CRB checks are renewed every three years to ensure the care staff are still the right people to work with vulnerable people. This means that service users can be confident that the right people are supporting them. We were told by the service users and the manager that the service users are involved with the interview process and were able to ask questions to the prospective care staff member. This means that the providers understand that service users should be making as many decisions as possible regarding how their care is delivered. We looked at training records and saw that staff received an in depth induction programme and were also required to attend ongoing training sessions which were Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: relevant to the support they provided. An example of this was recent trainig in effective communication. The training matrix which is updated by the manager needs to include all of the mandatory training that is provided so that it is easier to see what training is outstanding. All staff work to wards the NVQ (National Vocational Qualification) in Health and social care. This means that they may have more skills and knowledge and may be able to provide an improved quality of support. We could see that regular supervision seasons take place and staff are able to raise any issues they have and discuss training and development needs. Service users made positive comments about the staff and providers such as there are only a few of them but they are brilliant and yes i like all of them they have been here as long as me. Care Homes for Adults (18-65 years) Page 22 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is managed and operated by competent, trained and experienced providers. Service users benefit from the quality assurance systems which are in place and are kept safe by the updated polices and procedures and heath and safety arrangements Evidence: The service is operated by Mr Dawson and Mrs Julie Smith with Mrs Smith also being the Registered Manager. They have been operating the service for 14 years.Both of the providers work in the home on a whole time basis and undertake many of the sleeping shifts and weekends. Staff we spoke with said they had a good relationship with Mr and Mrs Smith. Since the last inspection a fire risk assessment has been undertaken to ensure all people at the service remain safe at all times. Quality assurance systems are in place and these include questionnaires for service users , their families relatives and other relevant stakeholders such as day service staff and supported employment.The AQAA records that all polices and procedures have been recently updated. This means that staff are working to current care practices and Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: service users benefit from this. Health and safety arrangements were good and the manager was able to show records of internal monthly audits.Tthere was a business plan in place and this links to action plans from resident house meetings, staff meetings and any comment received from sending out quality assurance questionnaires. The manager said that both her and Mr smith are always working to improving the service they offer, and to make sure that service users are involved as much as possible. Service users were asked how they felt about the service and how it was managed so we could assess if service users felt they were in control of the home. ww were told I wouldnt want to live anywhere else, we are all friends and Dawson and Julie look after all of us really well and I will always stay here because i like it and i can do what i want really , it is really good here. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 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 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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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