Care Home: Southview

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What the care home does well People are supported to take part in lots of activities they enjoy. People choose whether or not they take part in the activities. People are supported to prepare and cook their meals. Staff treat people well and maintain their privacy and dignity. People are supported to take their medication when they need it. The medication is stored and recorded safely. The home is clean and well maintained. What has improved since the last inspection? People now have clear care and support plans. These help staff to provide support in way that people want it. People now see their doctor when they need to. This helps to make sure they receive the treatment they need. The home now tells us about incidents and accidents. This helps us to judge whether staff have provided the right support to people. There are now enough staff at the weekends. This means that people can take part in the activities they choose. Staff have now received more training. This helps them to provide the right support to people. The home now has a manager. This person is making sure the home is well run and meeting people`s needs. What the care home could do better: The manager has a plan of further improvements she would like to make. Key inspection report Care homes for adults (18-65 years) Name: Address: Southview 34 Yew Tree Close Fair Oak Eastleigh Hampshire SO50 7GP The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Craig Willis Date: 0 6 0 8 2 0 0 9 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should:  Be safe  Have the right outcomes, including clinical outcomes  Be a good experience for the people that use it  Help prevent illness, and promote healthy, independent living  Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 star – poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. They reflect the things that people have said are important to them: 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 Care Homes for Adults (18-65 years) Page 2 of 27 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 mission of the Care Quality Commission is to make care better for people by:  Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice  Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983  Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services.  Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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: Southview 34 Yew Tree Close Fair Oak Eastleigh Hampshire SO50 7GP 02380601805 02380695473 southviewhome@tiscali.co.uk www.milburycare.com Milbury Care Services Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Kathryn Amelia Bennett Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 6 0 care home 6 learning disability Additional conditions: The maximum number of service users to be accommodated is 6. 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 1 0 0 2 2 0 0 9 Care Homes for Adults (18-65 years) Page 4 of 27 A bit about the care home Southview is a two-stroey domestic detached home. It is located near the centre of Fair Oak, about half a mile from local shops and other amenities. There is a house car that people are able to use when there is a driver working. People have their own bedroom with their own bath or shower. 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: two star good 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 Care Homes for Adults (18-65 years) Page 6 of 27 How we did our inspection: This is what the inspector did when they were at the care home We visited the home on 6 August 2009. During the visit we spoke with one person who lives in the home and observed the way staff treated other people. We spoke to the manager and staff on duty during the visit. We looked at the rooms in the home that people share and records kept by the staff. What the care home does well People are supported to take part in lots of activities they enjoy. People choose whether or not they take part in the activities. People are supported to prepare and cook their meals. Staff treat people well and maintain their privacy and dignity. People are supported to take their medication when they need it. The medication is stored and recorded safely. The home is clean and well maintained. Care Homes for Adults (18-65 years) Page 7 of 27 What has got better from the last inspection What the care home could do better The manager has a plan of further improvements she would like to make. Care Homes for Adults (18-65 years) Page 8 of 27 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Craig Willis The Oast Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 01622724950 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 9 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 10 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. There are good systems in place to assess peoples needs before they move into the home. This helps to assure people that the home will be able to meet their needs. Evidence: We inspected the records of two people who live in the home during the visit. Each person had an assessment of their needs that had been reviewed since the last inspection. The needs assessment had been used to review the care and support plans and risk assessments. The manager reported that the home has comprehensive procedures to assess the needs of any potential service users, involving the person themselves, relatives where appropriate and other professionals involved in their care. If a person was offered a place they would be supported to develop a transition plan to help them settle in. This would include visits to the service and overnight stays. No-one has move into the home since the last inspection. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good care planning and risk assessment systems, with plans that set out the support people need to meet their assessed needs and keep them safe. Evidence: Following the last inspection we made requirements that peoples assessed needs must be set out in clear care and support plans and there must be systems to effectively assess and manage any risks that people face. Both of these requirements have been complied with. We inspected the records of two people who live in the home during the visit. Both people had a set of care and support plans that had been reviewed and re-written since the last inspection. The plans contain details of peoples assessed needs, the support they require to meet those needs and goals for future achievements. The plans now contained detailed information about the support people need to manage their behaviour and their health conditions, for example epilepsy. Where people need support to deal with frustrations and anger there are detailed behaviour management guidelines in place, completed by the companys Behavioural Therapist. The plans contain clear information about peoples communication needs and support needed to make decisions. Where there are Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: restrictions on people there is information about why it has been put in place, for example the front door is currently controlled by a keypad lock that people cannot use. The manager was aware of the Deprivation of Liberty Safeguards that have recently been introduced and has arranged a best interests meeting with staff from adult services. The purpose of these meetings is to assess any restrictions on people and determine whether they are necessary or whether other methods of support could be used. Each person has a set of risk assessments relating to their activities and environment. These assess any hazards people face, the risk of harm and what control measures are necessary to keep the person safe. The plans and risk assessments are reviewed each month with the person and have been updated where peoples needs have changed. We spoke with two staff members during the visit. Both demonstrated a good understanding of peoples needs and the support they need. Both said the care and support plans were now much clearer and confirmed that they were used on a daily basis as a working document. During the visit we observed staff supporting people to make decisions about the activities they took part in. 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. People are supported to take part in a range of activities they enjoy and to maintain contract with family and friends. Evidence: Each person has an individual programme of activities that has been developed with them, taking into account their known likes and dislikes. Activities include college courses, social clubs, cooking, using the sensory room and trips out. The activity plan is set out each week and shows the staff who are providing support. Since the last inspection the manager has supported people to be more involved in household jobs. Each person has a daily job and a dinner job, for example cleaning their room, preparing food or washing up. Details of the support people need to do these jobs is set out in their support plans. Staff spoken with said that changes to staffing levels since the last inspection meant it was now easier to support people with activities over the weekend. One person who lives in the home was spoken with during the visit. This person said staff treated them well and they were able to take part in activities they enjoyed, particularly going to college and playing computer games. Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: During the visit staff were observed interacting with people in a friendly and respectful way. We observed staff encouraging someone to take part in their planned household job of cleaning their room, but they were not forcing the person to do it. The home has a planned menu that is developed in a meeting of people who live there. Staff use pictures of meals to support people to make choices. The menu is displayed in picture format and mealtimes are flexible to fit round activities. People are supported to be involved in the preparation and cooking of meals. Alternative meals are available if people do not want what is on the menu. 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. There are good systems to safely manage peoples medication and ensure people receive the personal and health care support they need. Evidence: Following the last inspection we made a requirement that the manager must ensure people receive medical treatment where necessary. This requirement has been complied with. Incident records indicated that people had received medical treatment following incidents in which they may have been injured. Details of the personal care support people need were set out in the care and support plans we inspected. These included specific details about how people like their support provided and details of how staff should maintain peoples privacy and dignity. We spoke to one person who lives in the home during the visit. The person reported that staff treat them well and provide the support they need. During the visit staff were observed responding to requests for support from people who live in the home. We inspected the record of two people who live in the home during the visit. These records indicated that people have been supported to see a range of health professionals including GP, optician, dentist, learning disability nurse and neurologist. Records are kept of appointments people attend and include any advice from the practitioner. Medication is stored in a locked cabinet in a locked room and most tablets are supplied in blister packs to aid administration. A record is kept of medication coming into the home Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: and returned to the pharmacist for disposal. The medication administration records for the current month were inspected and had been fully completed. This gives a record of medication people had been supported to take and the staff member who provided the support. Each person has a medication profile that gives details of their medication, why it is taken and any possible side effects. Where people are prescribed medication to be taken as required there are plans in place setting out when the medication should be taken. Staff who support people to take their medication have received training. 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. The home has good systems to investigate complaints and respond to allegations of abuse. This helps to ensure that people using the service are protected. Evidence: Following the last inspection we made a requirement that incidents affecting peoples safety or wellbeing must be reported to us. This requirement has been complied with. The home has a complaints procedure, which is supplied to all people who live in the home and their relatives in the service users guide. This document has been produced in a pictorial format to make it easier for people to understand. A record of complaints is kept and showed that there had been one complaint received since the last inspection. This was from a neighbour of the home and concerned parking issues. The complaint is being dealt with by the local council and the manager was due to attend a meeting with the council in the week following the visit. During the visit we spoke with one person who lives in the home. This person said they would speak to the manager if they were not happy about something. The home has safeguarding and whistleblowing procedures in place. Since the last inspection staff have received additional training in these areas and in how to respond if people become aggressive. We spoke with two staff during the visit. Both demonstrated a good understanding of different types of abuse, signs that someone may be being abused and action to take if abuse is witnessed, reported or suspected. The guidelines for supporting people if they become physically aggressive have been rewritten and staff spoken with demonstrated a good understanding of the guidelines and support required. Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: There has been a reduction in the number of incidents in the home in the last six months. Where there have been incidents of aggression between people who live in the home we have been informed. The manager has also informed adult social services and the police where necessary. The manager and senior managers in the company have attended safeguarding meetings and have provided regular updates on the action they have taken to address the concerns highlighted in the last inspection report. Care Homes for Adults (18-65 years) Page 19 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. The home is well maintained and provides a clean, comfortable and safe environment for people. Evidence: All of the homes communal areas were viewed during the visit. The home is well maintained, with good quality domestic furniture and fittings. People living in the home have access to a lounge, dining room, kitchen, sensory room and garden. Each person has their own room with en-suite toilet and bath or shower. There is a seperate laundry room that is fitted with machines capable of washing soiled clothing. The home is clean throughout. Hand washing facilities are suitably situated in the kitchen, laundry and toilets. There are infection control procedures in place. 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. Staff are well trained, deployed in sufficient numbers and there are good systems to check staff before they work in the home. This helps to keep people safe and ensure staff can meet their needs. Evidence: Following the last inspection we made requirements that there must always be sufficient staff working to meet peoples needs and staff must receive suitable training to enable them to meet peoples needs. Both requirements have been complied with. The manager reported that five of the sixteen staff have completed the National Vocational Qualification in care at level 2 or above. The remaining eleven staff have been registered to complete the award. The homes rota showed that there were either 3 or 4 staff in the morning and evening. At night there is 1 staff member awake and 1 asleep. The rotas showed that staffing levels at the weekends were sufficient to enable people who live at the home to participate in activities alone if they wish. Staff spoken with during the visit said there were sufficient staff on all shifts to provide the support that people need. One person who lives in the home was spoken with during the visit. They reported that there were enough staff working to enable them to do what they want to. The records of three recently recruited staff members were inspected during the visit. These demonstrated that the home had obtained a criminal records bureau disclosure about them, written references from previous employers and confirmation of their Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: identity. Since the last inspection the manager has identified gaps in peoples training and provided additional training where necessary. The training records were inspected during the visit and demonstrated that staff had completed an induction and courses including fire safety, manual handling, first aid, food hygiene, health and safety, safeguarding people from abuse, non violent crisis intervention, infection control, medication administration, autism, mental health and risk assessment. The manager reported that she has systems in place to check the training that staff have completed and ensure refresher courses are booked when necessary. Staff spoken with said they thought the training was good, gave them the skills they need to support people and was relevant to their role. All three staff who completed a survey for us said they are given training that is relavent to their role, helps them understand and meet peoples individual needs and keeps them up to date with new ways of working. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good management and quality assurance systems, which help to ensure the home is run in the best interests of people who live there. The health and safety of people who live in the home and staff is well managed. Evidence: Following the last inspection we made a requirement that the registered person or their representative must visit the home each month to assess the standard of care provided. This requirement has been complied with. Since the last inspection a new manager has been employed by the provider. The manager has subsequently been registered by us following an assessment of her fitness to manage the home. The manager has been the registered manager of another care home for approximately five years. Staff spoken with during the visit said they found the manager to be open and approachable and that they felt they receive good support from her. Since the last inspection the operations manager for the provider has visited the home each month to assess the quality of the service being provided. Reports of these visits are made and sent to the manager. The reports contain details of any actions that are required and an update on any requirements from the previous visit. The home also Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: completes an annual review that includes obtaining the views of people who use the service, relatives, purchasers and external professionals. Following the last inspection the provider submitted an improvement plan to us. This addressed all of the requirements from the last inspection, who was responsible for completing the work and the time-scale for completion. Records of the servicing and testing of the fire and gas systems were inspected and demonstrated that equipment was being regularly serviced and tested to ensure it was safe. There were general risk assessments in place that included control measures that should be implemented to reduce the identified risks. A monthly health and safety inspection was completed by the home. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes  No  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 Description 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 Description 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 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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - 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!