Inspection on 15/12/08 for 1 Empire Road

This inspection was carried out on 15th December 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

1 Empire Road 25/01/07

1 Empire Road 26/01/06

1 Empire Road 14/09/05

1 Empire Road 12/01/05

1 Empire Road 07/07/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 12/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 1 Empire Road 1 Empire Road Torquay Devon TQ1 4LA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Michelle Finniear     Date: 1 5 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: 1 Empire Road 1 Empire Road Torquay Devon TQ1 4LA 01803326215 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Osbond Type of registration: Number of places registered: Parkview Society Limited care home 1 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home 1 Empire Road was initially registered, and continues to provide care for one resident with a learning disability. The service is tailored to meet the specific needs of this resident and there is no further admissions planned. The home is situated in a residential area of Torquay, within walking distance of some shops, and within driving distance of the town centre. There is a double bedroom, a staff office, sleep-in room, a shower room, bathroom, lounge, quiet lounge, and kitchen. Outside is a small garden to the rear. The Owners are a local registered charity the Parkview Society that runs several care homes in the Devon area. The Statement of Purpose for the Home is not up to date. The fees for the service provided are #2,873.94 1 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 26 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 peterchart Poor Adequate Good Excellent How we did our inspection: The homes manager sent us information about what it is like to live at the home and what people can do when they live there. This included information about how the home is run, such as how many staff work there and how they are trained. We looked round the building and looked at some of the records the home keeps like care plans and tests of the fire equipment. We spent time with the person who lives at the home and the staff on duty, talking about how they spend their time and how they decide what they want to do each day. Care Homes for Adults (18-65 years) Page 5 of 26 Care Homes for Adults (18-65 years) Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 26 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 8 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is specifically designed to meet the needs of one person, who was involved in setting it up. Staff are clear as to the support provided and no further people will be admitted. Evidence: 1 Empire Road is a small home set up specifically to provide care for one person. It is not intended that the service will take in any more people. 1 Empire Road has been providing a home for over 12 years catering for this one person, and has developed and changed over time to meet their needs. Full assessments were undertaken at the time of setting up the service to make sure the home could meet the persons needs and these have been reviewed regularly over time. Care Homes for Adults (18-65 years) Page 9 of 26 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. The person living at the home is enabled to make decisions about their life with support from staff. Risks are assessed and managed. Evidence: During the site visit time was spent with the staff member on duty and the person who lives at the home talking about the support the person needs and how their care is delivered. This was then compared to the individual plan of care and other records to see how well they reflect the needs and aspirations of the person accommodated. The plan of care was clear and set out a goal for each assessed need and how that need was to be met. This helped keep a positive focus for the person. There was also a person centred plan identifying clearly how the person likes to spend their time and how they communicate choices or distress. This plan had photographs and had been Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: drawn up as far as possible with the person involved. This helps to ensure that the persons views about their care form the basis of their care plan. Discussions showed that the service is tuned to meet the wishes of the individual and the staff could describe changes that have been made recently to reflect their changing ideas about how they want to spend their time during the day. The staff spoken to were clear about how the person expresses choice and discussion was held on training in the Mental Capacity Act which will help with further understanding of decision making. Personal risk assessments were available for some activities undertaken by the person. Risk assessments help with the identification and management of risk to ensure that these are minimised wherever possible but still ensuring the person has opportunities to develop new skills and enjoy new experiences. During time spent at the home it was clear the person who lives there had opportunities to make many choices in their lives. During the visit they were supported in choosing what they wanted to eat that evening, what they wanted to watch on television and where they spent their time. There are two lounges in the home so the person can spend time with staff or be on their own if they wish. Staff were clear about encouraging the person to direct their own routines and activities. Care Homes for Adults (18-65 years) Page 11 of 26 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. Opportunities are available to lead a full and active life based on individual needs and wishes. Evidence: On the site visit time was spent with the person living at the home and the staff looking at how the person is enabled to folow a full and active lifestyle. Records seen showed evidence of the activities and opportunities available and undertaken with staff support. This included attendance at local day centres, visits to local football clubs, pubs, shops and reataurants. Discussions indicate that the programmes followed are all flexible and based upon the needs and wishes of the person at the time. Opportunities are available to develop additional lifeskills and personal care skills with staff support. Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: Involvement with the local community is encouraged and evidence was seen and heard of increasing time being spent with family members, including being able to take them out and enjoy meals with them most weeks. Staff are also working on developing a life history book, with the support of family and friends, looking at the life the person has lived and people that have been important to them. Discussion was also held on the possible accessing of a video camera to enable a record to be kept of outings and enjoyed events that can be re-lived as well as shared with others. During the course of the visit the person was supported to make choices about the evening meal they wished to have, with several options available. Care Homes for Adults (18-65 years) Page 13 of 26 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. Healthcare needs are being addressed and medication is being managed safely. Evidence: Discussions on the visit and a review of records showed that medical care is well managed when problems arise with both input from local community practitioners such as dentists and GPs, through to input from specialist support services where needed. This included preventative healthcare wherever possible. The plans seen would benefit from a full healthcare assessment being undertaken in an accessible format , involving the person living at the home as far as possible in making decisions about their longer term health and preventative strategies. Medication systems were recently inspected by the supplying pharmacist, and the records seen were completed appropriately. Medication is supplied to the home in a series of blister packs, which helps staff to see that medication has been given and helps to reduce the risk of errors. Medication was seen being given out during the visit and this was done appropriately. Care Homes for Adults (18-65 years) Page 14 of 26 Care Homes for Adults (18-65 years) Page 15 of 26 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. Staff working at the home need up to date training in how to protect people and legal frameworks that govern decision making and capacity assessments. Evidence: The home has a complaints procedure which is in the service user guide. No complaints have been received about the service since the last inspection. Information about the local Authority safeguarding processes were available at the home, and this included information about what to do if abuse is suspected. Some staff have attended training in the protection of Adults and safeguarding, but this was not recorded on training profiles. The staff have also not yet received training in the Mental capacity Act, which could have an impact on the way they assess capacity and support people in making decisions. Care Homes for Adults (18-65 years) Page 16 of 26 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. Evidence: 1 Empire Road is a semi detached two storey period property, situated in a residential area in Torquay. It is near to local services and facilities and provides a homely and personalised environment where the person living at the home can choose to mix with staff or have some private time in a separate lounge. Bathroom and toilet facilities provide for a bath or separate shower. The building was well decorated and clean in all the areas seen, but some areas did smell of cigarette smoke, when the person living at the home is a non smoker. This was discussed with staff who explained the homes policy of staff not smoking within the home. Some attention to maintenance and decor issues are planned after Christmas, and these were also discussed. The home was seasonally decorated, warm and comfortable. A new bed has recently been purchased for the person living at the home Care Homes for Adults (18-65 years) Page 17 of 26 Evidence: to support their healthcare needs and redecoration is planned to their room in the near future. The kitchen area is also to be altered to provid more comfortable dining arrangements, so that staff can sit and eat with the person who lives at the home in comfort. Evidence was seen of risk assessments and maintenance documents in relation to some aspects of he environment for example the maintenance of the fire equipment and regular tests and fire drills. Care Homes for Adults (18-65 years) Page 18 of 26 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. Staffing arrangements ensure consistency for the person living at the home, and ensure staff are well supported. Some training updates are required. Evidence: During the site visit time was spent talking about staff training, supervision and work roles. The person living at the home was clearly very comfortable with the staff on duty and evidence was seen and heard of the relationships built up and the qualities each member of the staff team brings to the home. For example a staff member and the person living at the home enjoy walking so take long walks together whilst another staff member regularly takes the person to visit their family and has built up good relationships with them. No new staff have been appointed to the service since the last inspection. On that occasion staff files were seen to be generally complete, but needed information on Induction and foundation procedures followed. On this visit the home had a copy of the Skills for care induction programme which provides information for new staff on the home and good practice in caring for people with learning disabilities. Care Homes for Adults (18-65 years) Page 19 of 26 Evidence: The home has information available for Agency workers who may come to the home, and this includes a plan of general routines and information on communication needs. Any agency staff used are generally the same people who know the person who lives at the home and their needs well. Staff records are now being kept at the home. Supervision and appraisal records were seen and these showed that staff recieve regular support, assesment and training. Staff still require training and updates in some core and service user specific training, such as person centred planning and healthcare needs, and on changes in legislation. Records of training recieved by staff were seen. The staff member on duty confirmed that management support was always available via the telephone in case of emergency or advice. This is important when staff work in isolation. It was also confirmed that there are lengthy handovers and a communication book, which helps ensure that information is passed on between shifts. Staff work a pattern of hours that means they live at the home for about a 24 hour period. This helps to ensure that the person can be supported flexibly when they wish to go out and are not reliant on getting back for sfaff shift changes in the evening. Care Homes for Adults (18-65 years) Page 20 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is a safe place to work and live in. Quality assurance systems are in place but would benefit from development. Evidence: Time on the site visit was spent looking at the management arrangements and support for the home. The manager of the home is based at another home owned by The Parkview Society in Newton Abbot. Distance support is available at all times for the staff at 1 Empire Road. The staff member on duty said that the management arrangements were satisfactory and that the staff at the home felt they were well supported by the organisation. Arrangements for the management of health and safety seen were satisfactory. The staff on duty could show logs of regular fire tests and drills, and some risk assessments were available for the environment and safe working practices. Some of these needed reeviewing. Care Homes for Adults (18-65 years) Page 21 of 26 Evidence: Discussion was also held on the homes arrangements for lone working when out of the building and the homes telephone system, which currently has an answerphone on when staff and the person living at the home are out. The organisation has a quality audit system and discussion was held on ways of increasing the input of the person living at the home in improving the quality of the service provided. Relatives are consulted via a questionnaire about their views on the service, but informal feedback is also gathered. The information available from the internal and external audits needs to be combined with feedback and other assessments to provide a quality assurance and annual development plan for the service. Care Homes for Adults (18-65 years) Page 22 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 23 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 23 13 The registered person must make arrangements for all staff to recieve up to date training in safeguarding and protecting Adults from abuse. This should also include training in the Mental capacity Act. This is to ensure that staff are aware of what to do in case abuse is suspected and are also aware of legislation that supports choices about capacity and decision making. 13/03/2009 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 1 19 Care plans may benefit from the addition of an accessible healthcare assessment such as My life my plan, which can be used to support the person with a learning disability in making decisions about their healthcare. Staff need to recieve updated training in core and person centred areas. Page 24 of 26 2 35 Care Homes for Adults (18-65 years) 3 39 The quality assurance sytem in place would benefit from development to include additional input from the person living at the home. Risk assessments should be updated to ensure they are regularly reviewed and still current. 4 42 Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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