Care Home: Fivepenny House

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What the care home does well The home provides a spacious and welcoming environment that is generally well maintained. Staff members provide care in a respectful and dignified manner and have developed a good rapport with service users. Comments received from relatives in response to a survey by the Commission for Social Care Inspection were very positive. One relative said, "looks after the residents lovingly and bonds them as one big happy family" and another said "everything is spot on". A third person stated ` the staff at the home are a credit to all concerned`. What has improved since the last inspection? Service user plans of care have been developed to include more detail as to the assistance a person needs and how this is to be done. The new documentation was seen to be well organised with clear easy to follow information. What the care home could do better: Hand written entries on MAR charts should include the signature of the person making the entry and the signature of a second person confirming the accuracy of details to promote the safety and wellbeing of service users. Records of personal monies held by the home would benefit from the inclusion of a second signature for each transaction to promote the safety and wellbeing of service users. CARE HOME ADULTS 18-65 Fivepenny House 42 Westbourne Road Hartlepool TS25 5RE Lead Inspector Jane Bassett Key Unannounced Inspection 12th August 2008 09:30 Fivepenny House DS0000021734.V369877.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 Fivepenny House DS0000021734.V369877.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. Fivepenny House DS0000021734.V369877.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fivepenny House Address 42 Westbourne Road Hartlepool TS25 5RE 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) 01429 276087 01429 276087 Voyage.com Milbury Care Services Ltd Kelly Louise Nicholson Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Fivepenny House DS0000021734.V369877.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th August 2006 Brief Description of the Service: Fivepenny House is registered with the Commission for Social Care Inspection as a care home to provide care and accommodation for up to 6 adults who have a learning disability. The home is set in its own grounds in a quiet area of Hartlepool near to local amenities. The acting manager said fees are based on individual’s needs and assessments. Information can be obtained from the Area Operations Manager. Fivepenny House DS0000021734.V369877.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 2 star. This means the people who use this service experience good quality outcomes. This inspection was a key inspection. As a key inspection, all of the key standards were looked at or discussed. This was to check that the home meets the standards that the Commission for Social Care Inspection say are the most important for the people who use services, and that it does what the Care Standards regulations say it must. The unannounced inspection visit lasted four hours. On the day of inspection the inspector looked at documentation including service users plans of care, staff records, administration and maintenance records. The inspector walked around the building. As the inspector walked around the home she carried out indirect observation of interactions between service users and staff. Due to the nature of the service users’ disabilities, communication between service users and the Inspector was not always possible. However service users appeared happy and contented with life at Fivepenny House. The inspector spoke to one service user, three staff and the acting manager manager. Five relatives and three staff returned surveys to CSCI. The registered manager of the home completed an Annual Quality Assurance Assessment (AQAA). At the time of the inspection the home was providing services to six service users. What the service does well: What has improved since the last inspection? Service user plans of care have been developed to include more detail as to the assistance a person needs and how this is to be done. The new documentation was seen to be well organised with clear easy to follow information. Fivepenny House DS0000021734.V369877.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. Fivepenny House DS0000021734.V369877.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 Fivepenny House DS0000021734.V369877.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): Outcomes for standard 2 were looked at. People who use the service experience good quality outcomes in this area. Admissions to the home only take place if the service is confidant staff have the skills, ability and qualifications to meet the assessed needs of the prospective service user. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: During the inspection the acting manager described the process that the home follows whilst assessing a prospective service user. The inspector was told that each service user has a full needs assessment before being admitted to the home. Information is gathered from the persons care manager and other health professionals. People are encouraged to visit the home and stay overnight prior to being admitted. The home then continues to assess the individual’s needs once they move in. Fivepenny House DS0000021734.V369877.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): Outcomes for standards 6, 7, & 9 were looked at. People who use the service experience good quality outcomes in this area. Individuals are as involved as possible in decisions about their lives and play an active role in planning the care and support they receive. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: During the visit the inspector examined the records for two service users. The home has recently introduced new documentation to record the service users assessment, risk assessments, plans of care and reviews. One file examined included this documentation. Files seen were found to be well organised and contained detailed plans of care, risk assessments, monthly reviews and a two monthly key worker review meeting. Files also contained information on that person’s likes, dislikes, interests and hobbies. Due to the nature of the service users’ disabilities, communication between service users and the Inspector was not always possible. Fivepenny House DS0000021734.V369877.R01.S.doc Version 5.2 Page 10 Staff told the inspector a picture board has been arranged to show various activities and likes and dislikes enabling service users to express their wishes. Staff and service users are also developing individual communication books, which will further enhance individual’s choices. Responses in surveys returned to CSCI by representatives of service users indicated people are supported to make choices and needs are met. Fivepenny House DS0000021734.V369877.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): Outcomes for standards 12, 13, 15, 16, & 17 were looked at. People who use the service experience good quality outcomes in this area. People who use the service are enable to participate in choices about their lifestyles, and are supported to develop their life skills. Social, cultural and recreational activities meet individual’s expectations. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The home offers a range of in house activities as well as trips into the local community. Staff who spoke to the inspector told her there were a range of activities that take place including bowling, shopping, meals out, trips to a local community centre and holidays. Information contained in surveys returned to CSCI by representatives of service users indicated there were no restrictions on visiting and people were kept informed. One person commented the home ‘looks after the residents lovingly and bonds them as one big happy family’. Fivepenny House DS0000021734.V369877.R01.S.doc Version 5.2 Page 12 Staff support and encourage people to have regular contact with families where appropriate. Staff told the inspector family and friends are welcomed at the home at any time. It was seen that staff members treated service users with dignity and respect when providing personal and social care. In discussion, staff members were able to display good values and attitudes when providing personal care and staff were seen to speak with service users in a friendly and cheerful manner. One staff member commented in a survey returned to CSCI ‘we encourage our clients to achieve their full potential in their every day lives’. Staff told the inspector the home has a menu that is based on the service users likes and dislikes, people are offered choice and alternatives. One service users who spoke to the inspector told her she enjoyed the meals. Fivepenny House DS0000021734.V369877.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): Outcomes for standards 18, 19, & 20 were looked at. People who use the service experience good quality outcomes in this area. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Service user records seen by the inspector all included health care records, including details of any input from health professionals such as GP’s, Opticians, Dentists, Speech and language therapists. Knowledge of service users’ preferences had been gained by staff members working closely with the service user and developing an understanding of their likes and dislikes over the many years of caring for the client group. Staff members were seen to communicate effectively with service users. Staff who spent time with the inspector were able to demonstrate through response to questions a good knowledge of service users needs and a commitment to promoting peoples health and independence. Comments received in surveys returned to CSCI by staff members included ‘we promote independence, privacy, dignity, health and safety’. Fivepenny House DS0000021734.V369877.R01.S.doc Version 5.2 Page 14 Information contained in surveys returned to CSCI by representatives of service users indicated people were satisfied with the care provided and people’s needs are met. Comments included ‘ people are always looked after well’. Information in the AQAA returned to CSCI indicated the home has a policy and procedure in relation to safe handling of medication. A sample audit of medication found no major concerns regarding the ordering, storage, administration, and disposal of medications. The inspector was told staff who administer medication have all completed safe handling of medication training. A sample audit of Medication Administration Records (MAR) examined were seen to be completed with no gaps in entries. However one hand written entry of details of medication and method of administration did not contain the signature of the person making the entry or the signature of a second person confirming the accuracy of detail. Fivepenny House DS0000021734.V369877.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): Outcomes for standards 22 & 23 were looked at. People who use the service experience good quality outcomes in this area. People who use the service and their representatives are able to express their concerns and have access to a complaints procedure, are protected from abuse and have their rights protected. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Information in the AQAA returned to CSCI indicated the home has policies and procedures in relation to handling complaints and protecting vulnerable adults from abuse. Responses in surveys returned to CSCI indicated people knew how to raise any concerns should they have any. All said they were satisfied with the care received and had no concerns or complaints. One person commented ‘everything is spot on’. One service user who spoke to the inspector told her she was happy at Fivepenny House and had no concerns. Information in the AQAA completed indicated the home has received no complaints since the previous inspection. Staff who spoke to the inspector were able to describe the action they would take to report any areas of concern. Staff said any issues raised are always acted upon. During discussion with the acting manager she was able to demonstrate knowledge of the safe guarding ‘no secrets’ guidance. Fivepenny House DS0000021734.V369877.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): Outcomes for standards 24 & 30 were looked at. People who use the service experience good quality outcomes in this area. The physical design and layout of the home enables people who use the service to live in a safe, well maintained and comfortable environment, which encourages independence. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The home provides six single bedrooms, one of which has en-suite shower facilities. Bedrooms were seen to be decorated individually to reflect that persons taste and choice. The home provides comfortable lounge, dining and conservatory areas that are pleasant and relaxing giving a homely atmosphere. On the day of inspection the home was see to be well decorated, clean and odour free. Information in the AQAA indicated the home and equipment are maintained as required. Fivepenny House DS0000021734.V369877.R01.S.doc Version 5.2 Page 17 Information in surveys returned to CSCI by representatives of service users indicated people were satisfied with the environment and facilities provided. One person commented ‘the building is well maintained, beautifully decorated with superb grounds’. Fivepenny House DS0000021734.V369877.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): Outcomes for standards 32, 34, & 35 were looked at. People who use the service experience good quality outcomes in this area. Staff at the home are trained, skilled and in sufficient numbers to support the people who use the service. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: During the inspection four staff files were examined. One of these files was of a staff member recently recruited. During discussion with the acting manager she was able to describe the process that is followed whilst recruiting staff. She told the inspector employment checks such as the CRB (Criminal record bureau) check are carried out by staff in the companies HR department and they retain the original documents. Files seen by the inspector indicated CRB, and references had been obtained prior to the employment of staff. Records seen indicated staff have received training in relation to fire safety, moving & handling, food hygiene, medication awareness and protection of vulnerable adults from abuse. Staff who spoke to the inspector confirmed this. During the visit the inspector observed one staff member participating in training using a computer programme (EL box). Fivepenny House DS0000021734.V369877.R01.S.doc Version 5.2 Page 19 The acting manager told the inspector 40 of the staff have achieved NVQ at level 2 or above and a further two members of staff are currently undertaking the training. Information in surveys returned to CSCI and discussion with staff during the inspection visit indicated there are sufficient staff to meet the service users needs. One comment received by CSCI from a service users representative stated ‘the staff at the home are a credit to all concerned’. Fivepenny House DS0000021734.V369877.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): Outcomes for standards 37, 39, & 42 were looked at. People who use the service experience good quality outcomes in this area. The management and administration of the home is based on openness and respect, has quality assurance systems and monitors the service it gives. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: On the day of the visit the inspector was told the registered manager had recently commenced a period of secondment to another home owned by the same company. CSCI must be notified if this period is for 28 days or longer. The acting manager has been at Fivepenny House for a number of years and has previous experience managing a care home. Staff who spent time with the inspector told her there was good support from senior staff, and there was an open door policy where issues can be raised. Fivepenny House DS0000021734.V369877.R01.S.doc Version 5.2 Page 21 A senior manager carries out a monthly quality assurance audit, and surveys, to gain relatives opinions about how the home is run, had recently been sent out. The inspector was told that previous surveys had been carried out, however the home did not have a copy of the analysis. The local authority has recently carried out a contracts compliance visit, the report was made available to the inspector. Information in surveys returned to CSCI from service users representatives indicated people were satisfied with the care provided and the management of the home. One person commented ‘everything is spot on’. Records of service users personal monies held by the home included details of all transactions and receipts. However there was only one signature per entry. Records indicated a monthly audit of monies took place. A sample audit carried out by the inspector evidenced monies held corresponded with amounts recorded. Records seen on the day of inspection indicated the home carries out weekly fire alarm checks. The home has developed fire evacuation plans for each service user. Information in the AQAA indicated the home has a range of policies and procedure to promote the safety and welfare of service users; these were reviewed in February 2007. Fivepenny House DS0000021734.V369877.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 x X 3 x Fivepenny House DS0000021734.V369877.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. 1. Refer to Standard YA20 Good Practice Recommendations 2 YA42 Fivepenny House DS0000021734.V369877.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Fivepenny House DS0000021734.V369877.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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