Care Home: Churchill House

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What the care home does well If new service users were to move into the home, their needs would be assessed first so the home could ensure their needs could be met. All service users have detailed support plans which cover all aspects of personal lives, both current and future. We saw that service users make decisions about how they spend their time, which includes going to work part time. Activities are decided on an individual basis. Service users meet regularly to discuss issues which affect them and they meet each week to choose their meals for the week. Service users` personal and healthcare needs are met in ways which suit them as individuals. There is a complaints procedure in place and service users feel able to complain. The home was clean. New staff only work in the home after the necessary recruitment checks are completed. Staff are well trained and qualified. The manager is also qualified and manages the home well. Service users` views are regularly sought and acted upon. The home is run with regard to health and safety issues. What has improved since the last inspection? The home has continued to be refurbished and redecorated. What the care home could do better: The AQAA showed that the manager has identified some areas where improvements could be made. However, this report does not identify any areas where improvement must be made. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Churchill House 23 Winifred Road Waterlooville Hampshire PO7 7TD     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: Beverley Rand     Date: 2 0 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 24 Information about the care home Name of care home: Address: Churchill House 23 Winifred Road Waterlooville Hampshire PO7 7TD 02392241483 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) : Care Management Group Ltd care home 3 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 3 The maximum number of service users who can be accommodated is 3. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home Churchill House is a semi-detached house within walking distance of the main shops in Waterlooville. The house has parking at the front and a large, well-kept garden to the rear. There are two bedrooms for service users on the first floor, along with a sleep-in room for staff and a bathroom. The other service users bedroom is on the ground floor at the front of the house. Also on the ground floor are the lounge, the conservatory/dining room and the kitchen. The current fees are based on individual need and are decided by the local authority which funds the service users. Care Homes for Adults (18-65 years) Page 4 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: This was an unannounced key inspection. Before we visited the home we looked at the last inspection report and Annual Service Review. We also looked at the Annual Quality Assurance Assessment, (AQAA) which had been completed and returned to us by the manager. During the inspection we met all the service users and spoke with one. We also spoke with a staff member briefly and the manager. We looked at records such as support plans and recruitment files. Care Homes for Adults (18-65 years) Page 5 of 24 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 6 of 24 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 7 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home ensures it can meet service users needs. Evidence: There have not been any new service users at the home since the last inspection. However, the manager has a procedure in place should the need arise. Any prospective service users would have their needs assessed to ensure their needs could be met at the home. This standard was met on previous inspections. Care Homes for Adults (18-65 years) Page 8 of 24 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users have support plans in place which address all areas of their lives both currently and for the future. Evidence: The AQAA stated that, The service users care plan is made up of four folders. The main care plan, risk assessment and guidelines folder, daily diary, health action plan and person centred plan.All guidelines, risk assessment and action plans are read and signed by staff. Each service user has a contract and service user guide, which includes pictures, photographs of key personnel in the organisation and a questionnaire seeking feedback about understanding the guide. Extra fees are clearly identified. The support plans cover all aspects of personal care and show individual preferences to such a degree that new staff members could support the individual as the service user wishes, with consistency. There are written procedures in place regarding activities, such as going to the bank, which detail the order things need to be done in to ensure consistency. Risk assessments cover all activities within the home Care Homes for Adults (18-65 years) Page 9 of 24 Evidence: and in the community and there are guidelines in place for dealing with challenging behaviour. The daily diaries are well written and give detailed information about how the person has spent their day. We spoke to a service user who said that staff spoke to him about his support plan. Files showed that service users had their own interests and that these were supported by staff. One service user has a new pet, and there were clear records and photographs which showed how the decision making process had been carried out, such as visiting the pet shop, identifying costs such as food and vets bills, and comparing these costs with income. There were clear proposals regarding service users going on holiday, which also showed good decision making processes. Evidence was also seen regarding individual projects, such as making a model. The manager told us that staff worked with service users in a person centered way: for example, in this context, taking opportunities to work on the project when the service user was ready to do so, and spending as little or as much time as the service user was able to attend to it. Support plans are reviewed monthly and the home uses the same format as the support plans which means that they are detailed and all aspects are reviewed. Care Homes for Adults (18-65 years) Page 10 of 24 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home ensures that service users lead a lifestyle which suits them. Evidence: On the day of the inspection all of the service users were out when we arrived. On the return of two of them we saw that one opened the front door with their own key. The AQAA stated that, all service users have an input to the planning of activities at Churchill and external activities. Activities are chosen by individual service users and include bowling, bingo, food shopping, swimming, going for drives, going to places such as Southsea and Staunton Country Park, having a meal in a pub and going to birthday parties and so on. One service user has been supported to use public transport to access part time work. Service users also go to social clubs. Service users are supported to maintain friendships and family relationships. One of Care Homes for Adults (18-65 years) Page 11 of 24 Evidence: the service users said that he had friends all over the place. The manager told us that family members are invited to service users birthday parties, where appropriate. All service users are encouraged to vote and are registered. During the day we saw that service users chose how they wanted to spend their time. We saw the manager being attentive to what was on the television and asking the service user if that was what they wanted, and another who spent time sat in the garden, and then in a shed which has been furnished for that service user to spend time when he wishes and where he can listen to music. A completed service user survey stated that they can choose how they spend their time and can make decisions. The home holds a service user meeting on a weekly basis to discuss the menus for the following week. Service users have input into the decisions and go shopping for the food with staff if they wish. Individual records are kept regarding what each service user eats. There is a menu displayed in the lounge for that day. The home has looked at how it might communicate the information on the menu to a service user who needs additional support and borrowed a piece of equipment which was successful. We spoke with a service user who told us the food was, alright, I like the takeaways!. Service users usually choose a takeaway meal once a week. Care Homes for Adults (18-65 years) Page 12 of 24 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users health and social care needs are met in individual ways. Evidence: Records, support plans and observations during the day showed that service users received personal support in ways they prefer, as detailed earlier in this report. The service users are male and the majority of staff are female. We spoke to the manager about this and he confirmed that this had been considered with regard to personal support but that the current service users did not have any issue with being supported by female staff. A completed service user survey showed that staff always treat him well and listen to what he has to say. Each service user has a health action plan in place which was very detailed. They showed that service users visited healthcare professionals such as doctors, dentists, opticians and so on, as necessary. Records ensured that healthcare issues were monitored and referrals made where needed. Individuals weight was monitored. One of the service users prefers not to take tablets and the home liaised with the relevant professionals so that liquid medication is now prescribed. Care Homes for Adults (18-65 years) Page 13 of 24 Evidence: The home maintains good records regarding medication. We looked at the Medication Administration Records for all three service users and found there were no gaps. Medication was stored securely. The manager told us about the training provided to staff. New staff do not administer medication until they have been assessed as competent. Further, on the rare occasion that agency staff are working in the home, another staff member will go to the home to administer the medication. The organisation has a Medication Competence Test, which is supervised by a member of the management team, whereby staff have to find the answers to medication questions. Staff also undertake a half day course in the administration, disposal and refusal of medication, which also includes side effects. Some staff have had a days training provided by the local pharmacist. Senior staff are due to begin a National Vocational Qualification in Medication in March. Care Homes for Adults (18-65 years) Page 14 of 24 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users feel able to complain and procedures are in place to protect service users. Evidence: We spoke with a service user who felt able to speak with the manager or senior support worker if he was unhappy about something. The home has a complaints procedure in place, in various formats. Each service user has a copy and there is one displayed in the hall which has photographs of the relevant company personnel. The home has not received any complaints and neither have we. The home has safeguarding adults procedures in place. The manager told us the procedure he would follow should there be an allegation or suspicion of abuse and this involved reporting to the local authority safeguarding adults team straight away. Care Homes for Adults (18-65 years) Page 15 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users live in a clean and homely environment. Evidence: The AQAA stated that, the service users all have input with regard to the homes environment, i.e. the colours, carpets and decor etc. Each service user has their own choice of colour in their bedroom and what they have in there, i.e. bedding, curtains. A central heating system has recently been fitted in the home and some carpet has been replaced downstairs as well as the lounge being painted. New flooring has been requested for two bedrooms and the bathroom. We noticed that some of the rendering was missing off the back wall of the house and the manager told us that this had been noted and was included in the maintenance plans. The home has a small laundry area outside. The manager showed us the daily duties records which detail what needs to be done on a daily basis, which includes cleaning duties. The home was clean when we visited. Care Homes for Adults (18-65 years) Page 16 of 24 Care Homes for Adults (18-65 years) Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are supported by well trained and qualified staff. Robust recruitment procedures protect service users. Evidence: We looked at the recruitment files for three new staff. Criminal Record Bureau checks were in place before the staff began work and there were letters on file from head office, stating that the people were suitable to begin work with the company. All the files included two references and these were dated as being written before the person started work. However, the references were not dated as when received but this may have been implied by the letter from head office detailed above. Staff files also included contracts and induction records. The manager told us that potential new staff visit the home and meet service users. Service users have the opportunity to sit in on interviews and have composed a list of questions to ask candidates. The manager has a training matrix in place and shows that staff have received core training in first aid, food hygiene, moving and handling, protection of vulnerable adults, health and safety, fire safety, infection control and care of medication. Other training has included Makaton, supervision and normalisation and person centered planning. Care Homes for Adults (18-65 years) Page 18 of 24 Evidence: The provider is committed to staff achieving qualifications. Out of seven staff who work at the home, five have achieved the National Vocational Qualification in care, level 2 or above, and one is going to start the course. Care Homes for Adults (18-65 years) Page 19 of 24 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well run. Evidence: The manager is registered and has completed the Registered Managers Award and National Vocational Qualification in care, level 4. The manager continues to update his mandatory training as well as undertaking training in relevant subjects such as management and active support. The manager has good systems in place for managing the homes and records were all easily located. The manager is committed to seeking the views of service users and acting upon them. Service users meet on a weekly basis to discuss meals and anything else relevant to the week ahead. Monthly meetings are also held for more long term issues. The manager said that at the monthly meetings issues are discussed such as what to do in a fire and so on. Service users received questionnaires and the completed ones are sent to head office where the information is analysed. Surveys are also sent to other interested parties. The home has a book where people can write compliments Care Homes for Adults (18-65 years) Page 20 of 24 Evidence: and positive feedback. Monthly visits are undertaken either by the regional director, or managers of other homes in the company and a report is sent to the home. We looked at some of these reports and found they identified areas for improvement and noted when work such as training had been completed. The home has a fire risk assessment and procedure in place which includes a pictorial house map which shows who is in and who is out. Fire equipment within the home is checked at regular intervals. Potentially hazardous cleaning fluids are locked away. Records showed that temperatures were recorded for hot water and equipment in the home was regularly maintained. The first aid box within the house and the car were regularly checked. Care Homes for Adults (18-65 years) Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 23 of 24 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 24 of 24 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!