Care Home: Starboard House

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What the care home does well From talking with residents and from the comments received it was clear that residents were happy living at the home and that staff and residents got on well together. Comments received from residents included "I am very happy here", "I have lived here for 8 years and am very happy" and "it`s very nice"" From talking to staff it was clear that they know the residents well and those staff spoken to were aware of residents needs and knew how individuals liked to be supported and residents told us that they received the support that they needed. The home provides care and support to enable residents to live fulfilling and meaningful lives. Residents are given choice in their day-to-day lives with appropriate support provided by staff at the home. There is an effective care planning system in place and each resident has a key worker who assists individuals to be involved as much as possible in this process. Residents are supported to access the local community and to undertake leisure pursuits of their choice. What has improved since the last inspection? Since the last inspection the home has developed its care planning process and care plans are now person centred and provide staff with the information they need to support residents effectively. Medication procedures have been improved and there is a clear policy and procedure in place for administering medication including "when required" medication. All but 1 of the resident`s bedrooms have been decorated and new flooring has been laid down in the main thoroughfare of the home. What the care home could do better: There was 1 requirements made as a result of this visit and other points, which need to be addressed to help improve the service provided for residents are contained within the main body of the report. General observations were: The home`s medication cabinet was checked and this was suitable for its current purpose, however should there be a need for any controlled drugs to be held at the home, they must be stored in a proper Controlled Drugs Cupboard. The homes procedure for paying residents personal allowance into there individual bank accounts needs to be changed so that money is paid into accounts as soon as practicable after it has been received by the Regard Partnership Ltd. CARE HOMES FOR OLDER PEOPLE Starboard House 105 Obelisk Road Woolston Southampton Hampshire SO19 9DN Lead Inspector Mick Gough Unannounced Inspection 17th June 2008 09:30 X10015.doc Version 1.40 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 Starboard House DS0000042317.V365581.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 Older People. 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. Starboard House DS0000042317.V365581.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Starboard House Address 105 Obelisk Road Woolston Southampton Hampshire SO19 9DN 02380 434317 02380 434317 starboard@regard.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) The Regard Partnership Ltd Manager post vacant Care Home 10 Category(ies) of Learning disability (10), Learning disability over registration, with number 65 years of age (10) of places Starboard House DS0000042317.V365581.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users in the LD category must be at least 45 years of age. Date of last inspection 31st July 2007 Brief Description of the Service: Starboard House is a unique detached home built over several floors including a basement (currently laundry and storage area) and has a separate selfcontained bungalow within the grounds of the home. Bedrooms are equipped with washbasins and are all single occupation. Communal space is appropriate for the number of service users. The garden is an adequate size for the number and needs of the people living at the home and provides a pleasant area to relax in, undertake hobbies and interests and provides shaded areas and a covered area for people who smoke. Starboard House is registered to accommodate up to ten service users from 45 years of age who have a learning disability. Starboard House is situated within a short walk of the shopping centre of Woolston and within a ten-minute drive from the city of Southampton, which has a range of shopping and leisure facilities. The home is owned by the Regard Partnership and at the time of the last visit fees at the home ranged from £700 – 950 per week, depending on the type and level of support required. An up to date scale of fees can be obtained by contacting the home. Starboard House DS0000042317.V365581.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 report details the evaluation of the quality of the service provided at Starboard House and takes into account the accumulated evidence of the activity at the home since the last inspection, which was carried out in July 2007. The inspection took into account; the previous key inspection report and information from what other people have told us about the service. Comment cards were sent out to residents and staff at the home, unfortunately at the time of writing this report no responses had been received back. Included in the inspection was an unannounced site visit to the home, which took place on the 17 June 2008. Evidence for this report was obtained from reading and inspecting records, touring the home and from observing the interaction between staff and users of the service. It was also possible to speak with 5 people who live in the home, 3 members of staff and the homes manager who assisted the inspector throughout the visit. The home is registered to provide support for 10 residents and at the time of the inspection there were 8 people living at the home. What the service does well: From talking with residents and from the comments received it was clear that residents were happy living at the home and that staff and residents got on well together. Comments received from residents included “I am very happy here”, “I have lived here for 8 years and am very happy” and “it’s very nice”” From talking to staff it was clear that they know the residents well and those staff spoken to were aware of residents needs and knew how individuals liked to be supported and residents told us that they received the support that they needed. The home provides care and support to enable residents to live fulfilling and meaningful lives. Residents are given choice in their day-to-day lives with appropriate support provided by staff at the home. There is an effective care planning system in place and each resident has a key worker who assists individuals to be involved as much as possible in this process. Residents are Starboard House DS0000042317.V365581.R01.S.doc Version 5.2 Page 6 supported to access the local community and to undertake leisure pursuits of their choice. What has improved since the last inspection? 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. Starboard House DS0000042317.V365581.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Starboard House DS0000042317.V365581.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. New residents have a needs assessment undertaken prior to moving into the home this allows both the home and the resident to ensure that the home can meet the resident’s needs. The home does not provide intermediate care. EVIDENCE: No new residents have moved into the home since the last inspection. We were informed by the manager that and initial assessment of any new resident is carried out by someone from the organisation and meetings are held with any potential new resident and also with social services if they are funding the placement. The manager carries out an individual needs assessment prior to service users moving into the home using an assessment form and any new residents are invited to visit the home for a meal followed by a short stay before a decision is made. Intermediate care is not provided by the home. Starboard House DS0000042317.V365581.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health, personal and social care needs of residents are set out in an individual plan of care and provide staff with the information they need, and there are clear risk assessments in place to protect residents. EVIDENCE: A care plan was seen for 1 resident and this was in a new format that the home is introducing for all residents. The plan gave good information for staff on the care needs of the individual and was person centred and was in pictorial format, which made them clear and easy to follow and gave staff information on how the service user would like their care to be given. All of the care plans at the home will be changed to this format in the next few weeks. Staff spoken with were aware of the residents care needs. Residents spoken with said that their care needs were met by the home and were aware that there was a plan of care in place. The recording of daily notes is carried out by staff at the end of each shift and this was clear and provided information on how the service user had been during the shift. All residents have a key worker and they carry out monthly reviews and these give information on how the care plan is working for them and also details any changes that may have Starboard House DS0000042317.V365581.R01.S.doc Version 5.2 Page 10 taken place. Care plans contained risk assessments and these gave details of the assumed risk, the level of risk and also details of the risk. They detailed control measures to minimise the risk and they gave staff good information on any support that was required. Residents at the home are registered with 3 local GP surgeries although they may have different GPs. The local health centre provides dental treatment and a visiting optician provides eye care. There is a visiting chiropodist who calls every 6 – 8 weeks and the home is supported by the local learning disability team and other health care professionals are accessed through GP referrals. Those residents spoken to on the day of the visit said that they were very happy with the care and support that they receive. The home uses a monitored dose system provided by a local pharmacist and all staff at the home that administer medication have received appropriate training. The home has a clear policy and procedure regarding medication and there is also a clear procedure for administering any “when required” medication. None of the residents currently self medicate. Medication administration record sheets were viewed and these were found to be up to date with no gaps. The home’s medication cabinet was checked and this was suitable for its current purpose and the home does not currently hold any controlled drugs. The law concerning the storage of controlled drugs has recently changed and the home was reminded that should there be a need for any controlled drugs to be held at the home, they must be stored in a proper Controlled Drugs Cupboard. A proper Controlled Drugs cupboard is one, which meets the standard set in the Misuse of Drugs (Safe Custody) Regulations 1973. Suppliers of CD cabinets can confirm that a cupboard meets the legal requirements. Starboard House DS0000042317.V365581.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a range of activities for residents, which meet their expectations and the religious and recreational interests of residents at the home are provided for. Residents are able to maintain contact with family and friends and visitors are welcome at any time. Residents are supported to exercise choice and control over their lives as much as possible and they are provided with a balanced diet in pleasant surroundings at time convenient to them. EVIDENCE: Activities at the home are displayed on the notice board in the home and these include: Bingo, games and puzzles, videos, music, and watching TV. There was a good rapport between residents and staff and we observed staff spending time with residents and staff spoken with said that they spend as much time as possible chatting and playing games or supporting residents out in the community. Some residents are able to access the community independently and 3 residents attend a local church and use local social clubs. One resident told us “I go out whenever I want I use the bus but the home will give me a lift in the car if I need it” Other residents spoken to indicated that they were happy with the activities provided and we were informed that trips Starboard House DS0000042317.V365581.R01.S.doc Version 5.2 Page 12 out into the community are organised and residents are canvassed to see where they would like to go and what they would like to do. The home has a clear visitors policy and there are no set times, visitors sign in at the home and the visitor’s book is kept in the hallway. We observed staff supporting residents and they were consulted about day to day issues in the home, we heard staff discussing what residents wanted to do and were offering support, they were seen offering choices of drinks, and residents told us that they are able to make informed choices and are able to control their own lives as much as possible, they said that they were consulted regularly and that staff at the home respected their views and that if they wanted anything all they had to do was ask. Residents had bought some of their own possessions into the home and rooms had been personalised. Residents at the home take it in turn each week to plan the weekly menu and staff provide support to ensure that there is a balanced diet. Breakfast is the resident’s own choice of cereals and toast. The midday meal is a snack type meal, which residents choose themselves and the evening meal is the main meal of the day and residents sit down together to eat. One resident chooses to eat her meals in her room, she does however sit down to eat with the other residents from time to time. Residents go out with staff to buy the weekly shopping and are involved as much as possible in the preparation of meals and snacks. Residents told us that they were very happy with the food provided by the home. They stated that the food was plentiful and good. Starboard House DS0000042317.V365581.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a simple, clear and accessible complaints procedure, which includes timescales for the process and any complaints are logged and responded to appropriately. The homes policies and procedures protect residents from any form of abuse. EVIDENCE: The homes completed AQAA told us that there have been no complaints made since the last inspection. We saw that the home has a clear complaints procedure, which was in pictorial format and this contains all of the required information. Residents spoken to were confident about raising any concerns they may have and stated that they would address any complaint they may have to a member of staff. Staff members spoken to were aware of the complaints procedure and said that they would support any resident to make a complaint if they wished to do so. Staff receive training with regard to adult protection and POVA as part of their induction, there is also annual updates provided. The manager was aware of what action to take with regard to adult protection and safeguarding issues and staff members spoken to confirmed that they had received training and were aware of their responsibilities in this area. Starboard House DS0000042317.V365581.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe and well-maintained environment and have access to comfortable indoor and outdoor facilities and the home was clean, pleasant and hygienic and free from offensive odours. EVIDENCE: A tour of the building was undertaken and all areas of the home were clean and tidy and in a good state of repair. All bedrooms seen were well equipped with all the required furniture and fittings and residents had their rooms decorated to their own choice and all rooms had been personalised. Residents spoken with were very happy with their home and said that it was always very clean. One resident was keen to show us his room and told us that he kept his room clean himself and staff helped him to keep it tidy. The home has a laundry, which is situated in the basement and this provides a full laundry service for residents, this is a small room equipped with an industrial washing machine and a domestic tumble drier, staff carry out laundry duties due to the steep stairs down to the basement. Residents put Starboard House DS0000042317.V365581.R01.S.doc Version 5.2 Page 15 any dirty laundry into baskets in their room and bring their laundry down to staff. Staff receive training with regard to infection control and protective clothing is provided for staff. Starboard House DS0000042317.V365581.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a mix of staff that has a range of skills and there are sufficient numbers of staff on duty to meet the needs of residents. The homes recruitment policy and practice supports and protects residents and they benefit from a staff team that has had sufficient training to meet their needs. EVIDENCE: There was a good rapport between residents and staff. The homes staff rota was examined and this showed that the home provides a minimum of 2 members of staff on duty between 0800 – 2000. Between 2000 – 0800 there is one staff member on duty throughout the night. In addition to these staff the manager told us that additional staff are made available to support residents out in the community or to attend appointments. The manager is also available in addition to the care staff rota. From speaking with the residents and staff at the home they told us that they felt that staffing numbers were sufficient to meet residents needs. The home employs a total of 8 full time care staff and all of the staff team hold a minimum of NVQ2, there are 4 staff undertaking NVQ3 and the deputy manager is working to achieve NVQ4. Recruitment records were seen for 2 members of staff and these contained application form, refs x 2, CRB/POVA, Passport, birth certificate, photo and Starboard House DS0000042317.V365581.R01.S.doc Version 5.2 Page 17 details of qualifications. Staff spoken with told us that their recruitment was thorough. We were informed by the manager that he has 2 new members of staff that he hope to employ shortly but is currently awaiting criminal record bureau (CRB) checks to come through, this demonstrates that the manager undertakes a good recruitment process and ensures records are in place before staff commence working with the residents. Staff undertake induction training when they start work at the home and this training includes an induction workbook, which is based on “skills for Care” and must be completed within the 6 month probationary period. Mandatory training is carried out in; moving and handling, fire safety, adult protection, medication, first aid, health and safety, food hygiene and infection control. Additional training is also made available to meet the needs of residents and this includes autism, learning disability and dementia. Staff members spoken with confirmed that they had received a good induction and said that there was regular training provided at the home. Starboard House DS0000042317.V365581.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Management arrangements at the home are satisfactory and residents, relatives and other interested parties are consulted about the running of the home. The financial interests of residents are generally safeguarded, however residents personal allowance should be paid into their bank account on a monthly basis. The health safety and welfare of service users and staff are promoted and protected. EVIDENCE: The manager of the service has been working at the home for over 3 years, he was originally the deputy manager and was appointed manager in March 2008. He is currently undertaking the registered managers award(RMA) and is waiting for the return of his CRB before submitting his application for registration with the CSCI. Starboard House DS0000042317.V365581.R01.S.doc Version 5.2 Page 19 The home has a quality assurance system in place and the organisation carries out regular regulation 26 visits to the home. Surveys are sent to relatives of residents and there are regular resident meetings, staff meetings and staff supervision and this gives the opportunity to monitor the quality of service provided for residents. 5 of the residents at the home manage their own personal finances and the home keeps money for 3 residents. Benefits are paid directly to the “The Regard Partnership Limited” and the homes manager writes a cheque to individual residents to pay their personal allowance into their own bank accounts. Currently this money is paid to residents at 3 monthly intervals and this means that their residents are being denied the opportunity to earn interest on this money until it is paid into their accounts. This was discussed with the manager at the home and he informed us that in future he would ensure that this money would be paid into resident’s accounts on a monthly basis. Where the home keeps money on behalf of residents, a clear record is kept of all transactions and this provides a clear audit trail. We checked the balance of one resident and this was found to be correct. The fire logbook was inspected and all appropriate testing and checks have been recorded. Appropriate certificates were in date for gas safety, fire alarms systems and equipment, private electrical equipment and fixed wiring. There is an in date fire risk assessment for the building and regular health and safety monitoring takes place. Starboard House DS0000042317.V365581.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Starboard House DS0000042317.V365581.R01.S.doc Version 5.2 Page 21 No Are there any outstanding requirements from the last inspection? 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. 1 Standard OP35 Regulation 20 Requirement To ensure that residents are able to receive interest on any monies they entitled to the registered provider must ensure that residents have their personal allowance paid into their individual bank accounts as soon as practicable after it has been received by The Regard Partnership Ltd. Timescale for action 30/07/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Starboard House DS0000042317.V365581.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Starboard House DS0000042317.V365581.R01.S.doc Version 5.2 Page 23 - 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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