Care Home: Christchurch Road (1)

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What the care home does well All five residents appeared happy and content. One resident commented, "I have no complaints. I am very happy here. I can go out whenever I want and the staff are very helpful." Another commented, "This is my home and I am very happy here. I am very lucky to have found this place." Both the manager and the staff team interact well with their residents. Their efforts in assisting and supporting the residents over time resulted in positive outcome for the residents who require less personal care as their mental health improves. The service provides a homely, safe and comfortable environment for the residents to live in. The premises are very well maintained. There is a rolling maintenance programme drawn up by residents and staff to ensure that the home remains safe and comfortable. What has improved since the last inspection? Since the last inspection, an additional support worker has been recruited. The communal areas were recently redecorated and refurbished. The lounge is now a non-smoking room. An alternative area for smokers was set up in the courtyard by the kitchen. The kitchen has been refitted and some bedrooms have been redecorated. What the care home could do better: Since July 2007, together with the Community Mental Health Team, the service provides a recovery programme, giving ongoing support to some of the residents who wish to move on to a more independent living environment in the near future. The management hopes to achieve that target, preferably within 2 years. The management hope to increase the number of senior care workers in the near future as part of their improvement plan for the service. CARE HOME ADULTS 18-65 Christchurch Road (1) 1 Christchurch Road Hemel Hempstead Hertfordshire HP2 5BX Lead Inspector Yoke-Lan Jackson Unannounced Inspection 2nd April 2008 11:00 Christchurch Road (1) DS0000019315.V361769.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 Christchurch Road (1) DS0000019315.V361769.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. Christchurch Road (1) DS0000019315.V361769.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Christchurch Road (1) Address 1 Christchurch Road Hemel Hempstead Hertfordshire HP2 5BX 01442 398384 01442 398384 cchurch@nildram.co.uk 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) Hightown Praetorian & Churches Housing Association Dumitrachi Mazilu Care Home 5 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (5), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (5) Christchurch Road (1) DS0000019315.V361769.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th September 2006 Brief Description of the Service: Number 1, Christchurch Road is a residential care home, provided by Hightown Praetorian & Churches Housing Association, a charitable organisation. The home is registered for 5 people with mental health conditions. It is situated in a residential area of Hemel Hempstead, a short distance away from the M1 motorway. Public transport is accessible nearby. The old style detached building provides accommodation on two floors. Four bedrooms, bathroom, toilet and the administrative office are on the first floor. There is an en suite bedroom on the ground floor. All the bedrooms are for single occupancy. The spacious lounge, dining room and kitchen are all on the on the ground floor. There is an additional toilet on the mezzanine landing. The garage is used as a utility space for laundry and some food storage. There is a small paved garden at the rear of the house, which is tended by staff and residents. The home charges £952.87 a week. Information about the home and the service it offers is contained in the Statement of Purpose and Service User Guide. A copy of these and the most recent CSCI inspection report are available in the home. Christchurch Road (1) DS0000019315.V361769.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 the service experience excellent quality outcomes. The unannounced inspection was carried out on 02/04/08. The registered manager was present. The home has 5 residents. The inspection included a tour of the premises. Time was spent observing how the staff interacted with the residents. Staff and residents were interviewed and documents were examined. Information received by us (the Commission for Social Care Inspection) since the last inspection was reviewed. This included the Annual Quality Assurance Assessment (AQAA) which providers of registered services are required to complete. The AQAA focuses on how well outcomes are being met for people using the service. What the service does well: What has improved since the last inspection? Since the last inspection, an additional support worker has been recruited. The communal areas were recently redecorated and refurbished. The lounge is now a non-smoking room. An alternative area for smokers was set up in the courtyard by the kitchen. The kitchen has been refitted and some bedrooms have been redecorated. Christchurch Road (1) DS0000019315.V361769.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. Christchurch Road (1) DS0000019315.V361769.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 Christchurch Road (1) DS0000019315.V361769.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 1, 2, 3 and 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents can be assured that they will have the information they need to make an informed decision about moving into the home. They will have the opportunity to visit and assess the facilities and suitability of the home and a pre-admission assessment will be completed before they are admitted to ensure that the home can meet all their care needs. EVIDENCE: The provider has revised the Statement of Purpose and each resident has a Service User Guide, which is revised regularly with residents’ input. A new resident moved into the home recently following a full assessment by the management team. Written evidence of the pre-admission assessment was seen in the care plan file. The manager said that the staff worked closely with the local Community Mental Health Team to ensure that the resident’s care needs would be well met. The resident appeared relaxed and seemed to have settled in well. Christchurch Road (1) DS0000019315.V361769.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): Standard 6, 7, 8 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can be assured that they will have a written care plan so that staff are able to identify goals and care needs appropriately. This gives the people an opportunity to make everyday choice respecting their preferences and requests, enabling them to achieve independent lifestyles. EVIDENCE: All five residents appeared well cared for. They all gave very positive feedback about the care and service provided. The residents confirmed that they have the choice to stay indoors or to go out by themselves anytime they want throughout the day. They have access to local independent advocacy and support schemes. The manager and a member of staff present were observed to interact well with the residents. The manager confirmed that the residents are supported to develop their daily living skills and that they are encouraged to live more independent lifestyles. Christchurch Road (1) DS0000019315.V361769.R01.S.doc Version 5.2 Page 10 Each resident has a comprehensive written care plan. Each person-centred care-planning document included the resident’s signature and comments where appropriate. The care plan reflects the personal objectives and care needs of the resident identified by staff during review sessions. These sessions are held regularly and are on a one-to-one basis. All the care plans examined have been updated. A full assessment of care needs is carried out every six months. This involves all interested parties, including relatives, supporters, healthcare professionals, the social services and the management team. Christchurch Road (1) DS0000019315.V361769.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 11, 12, 13, 14, 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. People who use the service can expect that their rights will be respected and that they will be encouraged to maintain contact with their family and friends and encouraged so to lead an independent lifestyle and engage in communal activities. A healthy diet is promoted which meets their needs and expectations. EVIDENCE: The service provides a recovery programme to enable each resident to move on to independent supported living if they so wish. This project, supported by the Community Mental Health Team (CMHT), began in July 2007. A member of staff from CMHT visits the home once a week as part of the arrangement. Together with the staff in the home they encourage and support each resident to take an active role daily as part of the programme. The recovery Christchurch Road (1) DS0000019315.V361769.R01.S.doc Version 5.2 Page 12 programme may take up to two years. Two of the residents are hoping to move into their own flat one day. Residents are encouraged to participate in activities of their choice, and to make use of local leisure facilities. Some residents attend college and day centres. Within the home, members of staff assist each resident to take part in a variety of activities and projects. Cookery lessons are organised in-house for each resident on a one-to-one basis. They are taught how to plan a healthy meal. Residents who wish to use the computer are given training and support by staff. Residents use the computer to send e-mails to their friends and relatives. One resident has written a book, which is due for publication soon. In-house entertainment includes films, music and art sessions. Drawings and sketches by a resident were on display in the communal areas and in the bedroom. Outdoor activities include shopping and places of interest. Holidays are arranged by staff for interested residents who choose where they want to go. In the summer, all the residents and three members of staff will spend a week at a Butlins’ holiday resort of their choice. The provider funds this annual holiday. All the residents are encouraged and supported to maintain contact with their friends and family. One resident stayed with their family over the Christmas period. Another resident is looking forward to seeing members of the family coming from abroad this summer. Staff handle confidential information in accordance with the home’s policy and procedures and the Data Protection Act 1998. The home offers residents a nutritious and balanced diet. There is a bowl of fresh fruit on the kitchen table for the residents to help themselves. Residents confirmed that they have a menu to choose from and that they are very pleased with the meals provided. Each member of staff takes turns to cook the meals with voluntary help from residents who take an active part in kitchen chores. Christchurch Road (1) DS0000019315.V361769.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 who use the service are treated with dignity and receive personal care and support in the way they prefer and require, including a full range of healthcare facilities. They are protected by the home’s medication policies and procedures, which ensure that they are kept safe but aim towards independence. EVIDENCE: Members of staff seemed to have a good knowledge of the residents’ conditions and their likes and dislikes, and deliver care and support accordingly. The support plans regarding their physical and emotional health care are assessed every six months, or earlier if necessary. The home has the support of health care professionals such as the General Practitioner and the Community Mental Health Team and behavioural concerns are referred to them for immediate assessment. Currently the community team is supporting the home in caring for a new resident, admitted only a month ago. On the day of the inspection, the new resident seemed settled. Christchurch Road (1) DS0000019315.V361769.R01.S.doc Version 5.2 Page 14 As part of the recovery programme some residents are assisted to administer their own medicines, subject to a Risk Management Assessment involving the resident, the management team, the Community Mental Health team and other healthcare professionals, in accordance with the home’s medication policy and procedures for the receiving, recording, storage, handling, administration and disposal of spoiled or unused medication. Since the last inspection there have been no medication errors. The manager audits medication regularly. Only members of staff who have had medication training are allowed to administer medication. There are no controlled drugs in use at the present time. The Medication Administration Record charts seen were accurately recorded. Christchurch Road (1) DS0000019315.V361769.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can be assured that they will be protected from harm and will be listened to and that their legal rights will be protected. EVIDENCE: A residents’ meeting is held weekly and their views are listened to. Appropriate changes are made accordingly. All the residents sign a form to acknowledge they have received and read the Complaints Policy and Procedure. To date there have been no complaints received, only compliments. Staff have received training in adult protection and abuse recognition. They understand the significance of the home’s whistle-blowing procedure. There is a copy of the Hertfordshire County Council Adult Care Services Safeguarding manual in the home. The manager ensures that all members of staff are familiar with the procedure to follow. Christchurch Road (1) DS0000019315.V361769.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, 25, 26, 28 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service live in a homely, safe and comfortable environment that promotes independent living, with access to all communal facilities. EVIDENCE: On the day of the site visit, the premises appeared neat and clean. There is a rolling maintenance programme. Both residents and staff were involved in drawing up a project plan for the maintenance programme this year. The dining room has been redecorated and refurbished with a new dining table and chairs and a laminated floor. The kitchen has had a new kitchen unit fitted. The stairways have new carpet fitted. Recently the lounge was redecorated and refurbished with new furniture and a carpet. It is now a non-smoking lounge. An alternative smoking area was set up in the courtyard for those who wish to smoke. Some bedrooms were recently redecorated to suit individual tastes. There were personal items on display and pictures and posters on the walls. The remaining bedrooms will be redecorated in the summer months. Christchurch Road (1) DS0000019315.V361769.R01.S.doc Version 5.2 Page 17 The residents interviewed said that they were very pleased with their accommodation. The building complies with the local fire service regulations. A positive report was received from the Hertfordshire Fire Authority at their last visit. Servicing records are kept in the office for easy access to all parties. Christchurch Road (1) DS0000019315.V361769.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 32, 34, 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can be assured that the home has an effective staff team who will support them and can be confident that they are safeguarded by the home’s robust recruitment policy and procedures. EVIDENCE: The residents benefit from a stable and long-serving staff team. There has been only one new member since the last inspection. The new staff member confirmed that he started working only after the necessary security checks had been completed and clearance had been confirmed. He is currently undergoing a period of induction and mandatory training that includes Food and Hygiene, Fire Safety, Moving and Handling and First Aid. There is an annual training programme arranged for all members of staff and this included refresher courses. The manager ensures that appropriate courses on mental health issues and other relevant conditions are also on the agenda. Since the last inspection, staff have had training on Equality and Diversity issues. The residents are therefore well supported by trained members of staff. Christchurch Road (1) DS0000019315.V361769.R01.S.doc Version 5.2 Page 19 Each member of staff has an annual appraisal and a monthly supervision. The staff recruitment files examined included training certificates and supervision notes that were recently updated. Christchurch Road (1) DS0000019315.V361769.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 38, 39, 42 and 43. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The standards of administration and management of the home are well maintained and this benefits the residents. Peoples safety is promoted and protected by the home’s policies and procedures. EVIDENCE: The service is well maintained and all the five residents are very pleased with the management style and the quality of care provided by members of staff. The registered manager has achieved the Registered Manager Award and NVQ Level 4 in Social Care. He hopes to enrol for the A1 Assessor Award. All Christchurch Road (1) DS0000019315.V361769.R01.S.doc Version 5.2 Page 21 members of staff are trained to NVQ Level 2. The provider’s training office for staff is now registered as an NVQ assessment centre. There is an annual quality assurance survey by the provider and this includes written questionnaires feedback from residents, relatives and others. There is a monthly proprietor’s report in compliance with regulations. The audit documents were readily available for inspection. Records in relation to health and safety in the home are maintained and show in particular that fire safety procedures are tested regularly. The home holds some cash for two of the residents. Proper accounting records are kept for each resident. The Annual Quality Assurance Assessment (AQAA) forms issued by the Commission were received on time for this inspection. The information provided was included in this report. Christchurch Road (1) DS0000019315.V361769.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 3 2 3 3 3 4 3 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 3 26 3 27 X 28 3 29 x 30 3 STAFFING Standard No Score 31 3 32 3 33 x 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 3 x LIFESTYLES Standard No Score 11 4 12 4 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 4 3 3 X 3 3 x Christchurch Road (1) DS0000019315.V361769.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Christchurch Road (1) DS0000019315.V361769.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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. Extracts may not be used or reproduced without the express permission of CSCI Christchurch Road (1) DS0000019315.V361769.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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