Care Home: The Bungalow

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What the care home does well There is a comprehensive assessment process undertaken before anyone moves into the home and residents can be confident that the home will have the information it needs to assess if the home can meet potential new residents needs before they move in. There is an effective care planning system in place and each service users has a key worker who assists individual service users to be involved as much as possible in this process. Service users are given choice in their day-to-day lives with appropriate support provided by staff at the home. The home has an effective training programme and staff said that the home provides training in all areas and this enables them to carry out their job effectively. What has improved since the last inspection? The homes Statement of purpose has been updated and care plans have been reviewed and these contain up to date information with regard to resident`s recreational needs and wishes. All required staff information was available in the home and regular servicing of the homes gas system has taken place. What the care home could do better: There were no requirements or recommendations made as a result of this visit, however 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 recording in residents care plans takes place at the end of each shift and currently there is a lot of duplicate recording taking place. We discussed this issue with the homes manager and it was agreed that it would be more beneficial to service users and staff to have all a simpler recording system. This includes the recording of monthly reviews by key workers. At present the reviews do not provide any evaluation of the care plan nor do they give any information on how the plan is working and it was agreed with the manager that reviews should give an evaluation on progress or lack of it made each month by service users. The manager has introduced an activities file to give staff information on what activities are available in the local area, currently the file does not contain any information on the preferences of service users and it would be of benefit to staff if the file contained information about what service users liked to do and if activities were recorded in this file it would provide evidence of what activities had taken place and provide information about who took part. Some areas of the home were in need of decoration and the home would benefit from some pictures etc to create a more homely environment. The organisation is planning to redevelop the home but this should not distract from the need for decoration of the home. CARE HOME ADULTS 18-65 The Bungalow Anglesey Lodge Anglesey Road Alverstoke Gosport Hampshire PO12 2DX Lead Inspector Michael Gough Unannounced Inspection 3 March 2008 09:30 The Bungalow DS0000011674.V359481.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 The Bungalow DS0000011674.V359481.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. The Bungalow DS0000011674.V359481.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Bungalow Address 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) Anglesey Lodge Anglesey Road Alverstoke Gosport Hampshire PO12 2DX 023 9258 6311 Hampshire Autistic Society vacant post Care Home 5 Category(ies) of Learning disability (5) registration, with number of places The Bungalow DS0000011674.V359481.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12 July 2006 Brief Description of the Service: The Bungalow is situated in the grounds of Anglesey Lodge and is surrounded by pleasant grounds. The home is a large bungalow, which is registered with the Commission for Social Care Inspection to provide care and accommodation for 5 younger adults in the learning disability category. Placements at the home also involve contractual agreement to attend day service activities at the neighbouring day centre, also run by Hampshire Autistic Society. The service users at the Bungalow are accommodated in single rooms and the home is close to a local bus route, which gives access to the towns of Gosport and Fareham where there are a range of shops and facilities. There is a large fitted kitchen, with a large lounge/dining room, which provides communal space in excess of the National Minimum Standards (NMS). The fees for the home range from £1,328.78 to £1,853.95 per week and this includes day service. The Bungalow DS0000011674.V359481.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 The Bungalow and takes into account the accumulated evidence of the activity at the home since the visit to the home in July 2006. The inspection took into account the homes Annual Quality Assurance Assessment (AQAA) which was sent to the CSCI as part of the inspection process and evidence for this report was obtained from reading and inspecting records, touring the home and from talking to 1 service user, 3 members of staff and the mother of one service user who was visiting the home. We were also able to observe the interaction between staff and service users. It was also possible to gain the views of the homes manager who assisted us throughout the visit. The home is registered to provide support for 5 service users and at the time of the inspection there were 5 service users living at the home. What the service does well: What has improved since the last inspection? The Bungalow DS0000011674.V359481.R01.S.doc Version 5.2 Page 6 The homes Statement of purpose has been updated and care plans have been reviewed and these contain up to date information with regard to resident’s recreational needs and wishes. All required staff information was available in the home and regular servicing of the homes gas system has taken place. 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 The Bungalow DS0000011674.V359481.R01.S.doc Version 5.2 Page 7 be made available in other formats on request. The Bungalow DS0000011674.V359481.R01.S.doc Version 5.2 Page 8 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 The Bungalow DS0000011674.V359481.R01.S.doc Version 5.2 Page 9 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users aspirations and needs are assessed before they move into the home. EVIDENCE: The home has not admitted any new service users for some time, however there is a policy and procedure in place with regard to admissions to the home. The assessments seen were comprehensive documents and there were also social service assessments on file as well as the homes in house assessments. The assessment process continues for the first 3 months that the service user is in the home and we were informed that this is an ongoing process. The assessments formed the basis for the care plans that are in place. The Bungalow DS0000011674.V359481.R01.S.doc Version 5.2 Page 10 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): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users assessed needs and personal goals are reflected in an individual plan of care and they are supported to make decision about their lives with assistance given by staff. Service users are supported to take responsible risks and this allows service users to live an independent lifestyle as much as possible. EVIDENCE: Care plans were seen for 2 service users and these contained clear information for staff on the support needs of residents and also how support should be given, staff spoken with said that care plans gave them the information they needed and the manager said that she was looking to reduce the size of the service users files as it was not always easy to find information. Recording takes place at the end of each shift and currently there is a lot of duplicate recording taking place and this issue was discussed with the homes manager who is looking to make the recording process simpler. Care plans are reviewed monthly by key workers however the reviews do not provide any evaluation of the care plan nor do they give any information on how the plan is The Bungalow DS0000011674.V359481.R01.S.doc Version 5.2 Page 11 working. The manager said that she would be getting key workers to review care plans and write an evaluation on progress or lack of it made each month. Service users are supported to make decisions about their day to day lives and staff were observed interacting with service users and taking their views into account, there was evidence in care plans of service users preferences and there was information in care notes which showed that service users had been offered choices and also detailed the choices made. Both service users plans looked at contained risk assessments and these gave details of the risk and the support required and the action to be taken to minimise the risk. Risk assessments were also seen for generic risks around the home. The Bungalow DS0000011674.V359481.R01.S.doc Version 5.2 Page 12 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): 12,13, 15, 16, & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported to take part in age, peer and appropriate activities and they access the local community on a regular basis. The homes visiting policy supports service users to maintain family links and friendships both inside and outside the home and service users rights are respected. Service users are offered a healthy and varied diet and service users enjoy their meals at the home. EVIDENCE: None of the service users at the home are able to undertake any form of paid employment. 4 of the service users attend day service 5 days per week and they receive training in independent living skills as well as leisure activities. 1 service user attends a course in computer and literacy and all those who attend day service have a programme of activities. The one service user who does not attend day service has 2- 1 support to enable her to undertake activities out in the community. The Bungalow DS0000011674.V359481.R01.S.doc Version 5.2 Page 13 Due to the nature of service users disability all service users require staff support to go out into the local community. Service users regularly go shopping, visit local pubs and cafes and attend local fetes and community events in the local area. The manager has introduced an activities file to give staff information on what activities are available in the local area, currently the files does not contain any information on the preferences of service users and the file would benefit from information about what service users liked to do and should also have records of what activities had taken place and provide information about who took part. The home has a clear visiting policy and the inspector was informed that staff would respect service users wishes on who they wish or do not wish to see. On the day of the visit is was the birthday of one service user and she was visited by her mother who told us that staff at the home encouraged her daughter to keep in touch with family and said that they organised regular phone calls so that she could keep in touch with all of her family. Daily routines in the home promote service users independence as much as possible. Staff were observed interacting with service users and their preferred form of address was used. A service user who was at the home during the visit appeared very happy at the home and it was clear that service users and staff get on well together. Routines in the home respected service users rights to be involved as much or as little as they want. Mail is given to service users unopened and staff support them with their mail. Service users are able to access all areas of the home. Menus at the home are made up each week by the staff after a menu-planning meeting with service users. Staff use pictures to help service users choose what they would like to eat and staff provide support to ensure that the menu is balanced and meet service users nutritional needs. The menu is flexible and allows for change at short notice and this gives service users the opportunity to choose a take away if they wish. The Bungalow DS0000011674.V359481.R01.S.doc Version 5.2 Page 14 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): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive personal support in the way they prefer and their physical, emotional and health needs are met. The homes policies and procedures with regard to medication provide protection for users of the service. EVIDENCE: Personal support is given flexibly and service users plans give clear information to staff on how service users would like their personal support to be given and this allows for a consistent approach. There is a mix of both male and female staff and each service users has a key worker and service users have been involved as much as possible in their selection. Personal support is given in private and the preferences of service users on who they prefer to give them the support they need is respected. The home has a policy on cross gender care and if at all possible same sex care is offered and given. All of the service users at the home are registered with the same GP surgery, and service users have specialist input through GP referral as required. Dental The Bungalow DS0000011674.V359481.R01.S.doc Version 5.2 Page 15 checks and treatment are provided by the local health centre and service users visit local opticians for sight checks. The homes medication policy and procedures were examined and discussed with the homes manager. All staff have received training in the administration of medication. There was clear information for the receipt, storage, disposal and administration of medication and there was a protocol regarding “when required” medication. The home uses a monitored dose system from a local pharmacist. Medication administration records were inspected and found to be accurate and up to date. The Bungalow DS0000011674.V359481.R01.S.doc Version 5.2 Page 16 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): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a clear and accessible complaints procedure, which includes timescales for the process and service users can be confident that their views would be listened to and acted upon, any complaints are logged and responded to appropriately. The homes policies and procedures help to protect service users from any form of abuse. EVIDENCE: The home has a clear and accessible complaints procedure and this contains all of the required information and gave details of how to contact the CSCI, however residents are not fully aware due to their disability and copies of the complaints procedure are given to relatives. There have been no complaints made to the home since the last inspection and staff spoken to were aware of the complaints procedure and said that they would support any resident to make a complaint if they so wished. The home has a copy of the Hampshire Adult Protection procedure and has a whistle blowing policy and a copy of the department of health guideline “No Secrets” staff also receive training with regard to adult protection and POVA as part of their induction. The manager has just completed a training course with Hampshire County Council and was aware of her responsibilities in this area. The Bungalow DS0000011674.V359481.R01.S.doc Version 5.2 Page 17 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): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a comfortable home, which was clean and hygienic and free from offensive odours, however some areas of the home are in need of decoration to create a more homely environment. EVIDENCE: A tour of the home was conducted and the home is a single storey bungalow. There are 5 single bedrooms and 2 bathrooms and there is also a separate WC. There is a large kitchen and a large lounge/dining area. All areas of the home were clean and furniture and fittings were of reasonable quality, the service was clean and hygienic and there were no offensive odours. Some areas of the home were in need of decoration and the home would benefit from some pictures etc to create a more homely environment. The organisation is planning to redevelop the home but this should not detract from the need for decoration of the home. There is a separate laundry situated on the ground floor, which has washable floors and walls. There an industrial washing machine with sluice facility and this is able to wash clothing at appropriate temperatures. The home is The Bungalow DS0000011674.V359481.R01.S.doc Version 5.2 Page 18 awaiting delivery of a new tumble drier. Staff carry out laundry duties, however there is no information, which gives staff clear guidance for washing any soiled items. The home has an infection control policy and staff have received training in this area. The Bungalow DS0000011674.V359481.R01.S.doc Version 5.2 Page 19 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): 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Competent, qualified and appropriately trained staff supports service users and meet their needs. The homes recruitment policy and practice protect service users. EVIDENCE: There is a good staff mix at the home and all staff are encouraged and supported to undertake National Vocation al Training. Currently all of its permanent staff members have either completed or are undertaking NVQ training. The homes staff rota showed that there are a minimum of 2 members of staff on duty at all times and additional staff work to provide one to one support for residents. The completed AQAA and conversation with the manager indicated that there were sufficient numbers of staff on duty to meet resident’s needs. The home has the support of the human resources department of the organisation and they oversee all recruitment. Staff files were seen for 2 members of staff and files seen contained all of the required information including POVA, CRB, references x 2, application form, interview notes and copy of passport/birth certificate The Bungalow DS0000011674.V359481.R01.S.doc Version 5.2 Page 20 The home is part of Hampshire Autistic Society and there is a training coordinator who provides and organises training for all staff employed at the homes. Staff undertake induction training, which is linked to NVQ, and mandatory training is carried out in; moving and handling, fire safety, medication, first aid, health and safety, food hygiene, adult protection and infection control. Additional training is also carried out for managing challenging behaviour, autism, makaton, and care practices. Staff members spoken with confirmed that they had received a good induction and said that there were regular training sessions at the home. The Bungalow DS0000011674.V359481.R01.S.doc Version 5.2 Page 21 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): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a well run home and the views of service users and other interested parties are sought on how the home is meeting service users needs. The health, safety and welfare of residents and staff are protected. EVIDENCE: The Bungalow DS0000011674.V359481.R01.S.doc Version 5.2 Page 22 The manager has been in post for 5 months and is currently in the process of obtaining registration with the Commission for Social care Inspection. She has 3 years experience working in a care setting and has NVQ4 in care and is enrolled on the Registered Manager award. The home seeks the views of interested parties on how the home is meeting its aims and objectives, questionnaires are sent to service users, staff, relatives and care managers. There are regular service user reviews and regular staff meetings take place. A member of staff at the home is responsible for Health & Safety and they report directly to the manager. There is a risk assessment for the building and appropriate monitoring takes place. The fire logbook was inspected and all testing and checks have been recorded. Appropriate certificates were in date for gas safety, fire alarms systems and equipment, including private electrical equipment. The home has a new style accident book and appropriate recording takes place. The Bungalow DS0000011674.V359481.R01.S.doc Version 5.2 Page 23 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 The Bungalow DS0000011674.V359481.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Bungalow DS0000011674.V359481.R01.S.doc Version 5.2 Page 25 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. 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