Inspection on 07/10/05 for 1 Ewer Court

This inspection was carried out on 7th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

1 Ewer Court 31/10/08

1 Ewer Court 01/11/06

1 Ewer Court 07/03/06

1 Ewer Court 16/01/05

1 Ewer Court 15/09/04

1 Ewer Court 19/02/04

Similar services:

Claremont House

Sun Court Nursing Home

Bramley Avenue (73)

15 Bramble Close

Dolphin Court

Fen Road

Wakes Hall

165 Putnoe Lane

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 1 Ewer Court Fairfax Road Colchester Essex CO2 7ED Lead Inspector Gaynor Elvin Unannounced 7 October 2005 th 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 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 Stationary 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. 1 Ewer Court I56-I05 360221 Ewer Court V235666 071005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 1 Ewer Court Address Fairfax Road Colchester Essex CO2 7ED 01206 861189 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) SCOPE Mr Anthony Skalafouris Care Home (CRH) 3 Category(ies) of Physical disability (PD), 3 registration, with number of places 1 Ewer Court I56-I05 360221 Ewer Court V235666 071005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, under the age of 65 years, who require care by reason of a physcial disability (not to exceed 3 persons). Date of last inspection 16/01/2005 Brief Description of the Service: Ewer Court is a new two-storey building, which is divided into flats. The home consists of three, purpose built, individual ground floor flats, which accommodate one service user respectively, who have physical disabilities. The home also incorporates a staff office and sleeping accommodation for staff on night duty.The home is located in Colchester, close to the town centre. The three flats access a communal patio area, through double doors, leading from their lounge area. Each flat is fully equipped and adapted to meet the needs of the occupant. 1 Ewer Court I56-I05 360221 Ewer Court V235666 071005 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 7th October 2005, over three hours. The inspection process included an informal discussion with the Registered Manager, senior carer and a resident; examination of records, documentation and policies and procedures. What the service does well: What has improved since the last inspection? What they could do better: Recruitment of staff had improved however the home needs to look at the area of retention, to successfully establish reliable and appropriate staffing levels to provide continued and consistent care. The current staffing levels and arrangements do not always allow for quality time, particularly in terms of enabling community participation. The home needs to explore ways in which it can further develop opportunities for service users to expand their involvement in activities of their choice when they would like to do them. It is recognised that the manager is doing his best in terms of staffing the home but only by providing additional and consistent staff are these areas of need likely to be addressed. 1 Ewer Court I56-I05 360221 Ewer Court V235666 071005 Stage 4.doc Version 1.40 Page 6 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. 1 Ewer Court I56-I05 360221 Ewer Court V235666 071005 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection 1 Ewer Court I56-I05 360221 Ewer Court V235666 071005 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 The service operates a thorough and responsible pre admission process ensuring the home is able to meet the individual’s needs. EVIDENCE: The current service users have lived at Ewer Court since it opened and moved from another SCOPE provision. They each were involved in their assessments and were aware of the content and implications of their future care. The Statement of Purpose was currently being updated to reflect the new changes within the home. The Commission looks forward to receiving a copy of the revised version. 1 Ewer Court I56-I05 360221 Ewer Court V235666 071005 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9&10. Care plans were developed with the resident according to their needs and they were supported within an individualised risk management approach. Residents were given guidance and support to lead independent lives by staff and independent advocates. Residents and staff were fully aware of confidentiality issues and the homes confidentiality policy. EVIDENCE: Individual care plans were person centred and clearly detailed the care and support required, residents kept possession of their care plans within their flats. Those spoken with were aware of the contents of their care plan and risk assessments. The staff indicated that as the home was small regular consultation takes place on a daily basis with the residents in addition to arranged resident meetings. 1 Ewer Court I56-I05 360221 Ewer Court V235666 071005 Stage 4.doc Version 1.40 Page 10 From discussion it was evident that residents were empowered and supported in decisions and choice to lead their life as they wish to. A list of wishes and aspirations for the year 2005 was noted on the wall of one residents lounge and they confirmed they had either achieved or attempted to achieve most of them. 1 Ewer Court I56-I05 360221 Ewer Court V235666 071005 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14,15, 16 & 17. Residents had various opportunities to develop social, emotional and independent living skills and establish a purposeful lifestyle. The residents had limited opportunities for accessing the local community and engaging in leisure activities. Family, friends and partnership links were strongly supported. EVIDENCE: Residents managed their own housekeeping, food budgets and menu planning and were supported to access various courses in personal development. One resident was fairly advanced in computer skills and had personally produced a lot of the paperwork within their care file. All the residents have profound physical disabilities and are wheelchair dependent, opportunities for social activities within the local community are fairly limited due to the homes staffing levels. Resident questionnaires identified the need for more staffing hours to provide more flexibility in accompanying residents out on a one to one basis. 1 Ewer Court I56-I05 360221 Ewer Court V235666 071005 Stage 4.doc Version 1.40 Page 12 The residents have the freedom to receive friends and family at any time within the privacy of their own flats. From care plans and discussion it was evident staff supported personal relationships. Staff indicated that opportunities were being explored for one resident to move into independent living following their wedding. 1 Ewer Court I56-I05 360221 Ewer Court V235666 071005 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 & 20. Staff engaged positively with residents and demonstrated a good understanding of the resident’s they were supporting. Care was provided in a sensitive, respectful manner and healthcare needs were recognised and addressed promptly. EVIDENCE: One resident spoken with had recently changed their GP at their own request, and participated fully and equally in their healthcare, including using computer skills to communicate in writing with their doctor. Residents were fully aware of their medication requirements and maintained possession of them within locked facilities in their flat although they required assistance with administration. A policy and procedure for the safe receipt, recording, storage, handling, administration and disposal of medicines were in place for staff guidance and staff had received appropriate training in the administration of medicines. It was evident from the individual care plan and discussion with staff and residents and that physical healthcare needs of resident’s are assessed, recognised and addressed and personal support is provided in a manner they prefer and require. 1 Ewer Court I56-I05 360221 Ewer Court V235666 071005 Stage 4.doc Version 1.40 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 The views and concerns of residents were listened to and acted upon. EVIDENCE: The complaints procedure was clear and written in a format that the residents could understand and follow easily. Residents were observed to be in possession of the SCOPE brochure titled ‘ Complaining isn’t wrong – it is right’. Residents felt confident to raise any complaints or concerns with staff and that they would be addressed. 1 Ewer Court I56-I05 360221 Ewer Court V235666 071005 Stage 4.doc Version 1.40 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28, 29 & 30. The premises were in keeping with domestic style living arrangements and the needs of people with physical disabilities. The individual self-contained flats enabled the residents to express their individuality. EVIDENCE: The resident’s flats are purpose built, meeting National Minimum Standards with regard to private and communal space, bathroom and toilets. They incorporate equipment and adaptations to meet individual needs, furnished to a high standard and personalised to each individual. Premises viewed were clean and comfortable. 1 Ewer Court I56-I05 360221 Ewer Court V235666 071005 Stage 4.doc Version 1.40 Page 16 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35, & 36 Staff were aware of their roles and responsibilities and collectively the staff had the required skills to form an effective team. The home needs to ensure that all staff receive appropriate additional training to enable their skills and knowledge to be kept up to date, particularly as they are lone workers the majority of the time. Staffing levels need to be regularly reviewed to ensure they relate to the assessed needs of the residents. Residents are supported and protected, by the robust recruitment and induction policies and procedures. EVIDENCE: Discussion with staff and a resident and feedback from service user questionnaires indicated that the staffing levels of the home are adequate to meet the basic needs of the service users, but leave very little space for any quality time. The home has a high usage of agency staff, although the registered manager endeavours to ensure consistency. Staff indicated that the part time staff at Ewer Court and from the local sister home Beehive Court were deployed in the rotas across both homes. 1 Ewer Court I56-I05 360221 Ewer Court V235666 071005 Stage 4.doc Version 1.40 Page 17 Following recruitment difficulties the home had successfully recruited staff into vacant posts, however staff and service users indicated there was still a high usage of agency staff covering sickness and maternity leave. It was also indicated that vacancies were imminent due to staff leaving. Discussion took place with regard to exploring the issue of staff retention. One element highlighted was lone working. The staff rota indicated long shifts; one member of staff covering a late shift followed by a sleep in and then an early shift. Lone working is isolating for the individual and does not allow full promotion of choice, independence and social inclusion for the service users, particularly when supporting individuals with high physical needs. From the staff files examined it was evident that a robust recruitment procedure was carried out including obtaining two references, satisfactory Criminal Record Bureau Enhanced Disclosure and POVA list clearance, followed by an induction to help ensure the protection of the residents. Discussion with a resident indicated a trusting and comfortable relationship with the staff. One member of staff has completed NVQ 2 and has applied to commence level 3, three have completed NVQ 3 and two members of staff are working towards NVQ 3. Two new members of staff have just completed induction and foundation training. Job descriptions were clear and specific with regard to care and supportive roles and promoting optimal independence. Staff spoken with were aware of their own limitations and were also aware of lone working policies and procedures to follow. The staff team training and development matrix identified the areas of training each member of staff had completed, but did not inform of current status of training, when update had been received or when it was required. New staff had completed mandatory training requirements but it was not evident that the longer serving staff had the opportunities to keep their knowledge and skills up to date. Staff confirmed that supervisions had re-commenced since the new manager was in post and yearly appraisals were currently under way. 1 Ewer Court I56-I05 360221 Ewer Court V235666 071005 Stage 4.doc Version 1.40 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38, 39, 40, 41, 42. The home promotes an open and supportive atmosphere for the residents. Overall, the health, safety and welfare of residents and staff are promoted and protected. Records, policies and procedures were well maintained and up to date to safeguard residents. Systems are in place for resident consultation and quality monitoring but require further development. EVIDENCE: After a considerable period of uncertainty and lack of secure managerial support for the residents and staff, Mr Anthony Skalafouris took up the managerial position at Ewer Court and Beehive Court, the sister home. He successfully completed the Registration process with the Commission of Social Care Inspection and has secured a place to commence NVQ level four in Care & Management. Positive feedback was received from the staff and residents about the manager’s approach. 1 Ewer Court I56-I05 360221 Ewer Court V235666 071005 Stage 4.doc Version 1.40 Page 19 Feedback from resident questionnaires generally confirmed satisfaction with the home. The manager needs to develop a framework to demonstrate evaluation, action and review of questionnaire responses to measure and maintain delivery of care and quality outcomes for residents. Policies and procedures, risk assessment and management strategies were in place for staff to refer to ensuring awareness and understanding of safe working practice. 1 Ewer Court I56-I05 360221 Ewer Court V235666 071005 Stage 4.doc Version 1.40 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 4 4 4 4 4 4 4 Standard No 11 12 13 14 15 16 17 3 3 2 2 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 2 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 1 Ewer Court Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x 3 3 3 3 3 x I56-I05 360221 Ewer Court V235666 071005 Stage 4.doc Version 1.40 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 YA13 YA14 YA33 Regulation 18 Requirement The Responsible Person must review staffing levels of the home to ensure that they are adequate to meet all the assessed needs of the service users. Timescale for action 30th January 2006 2. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations 1 Ewer Court I56-I05 360221 Ewer Court V235666 071005 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: 0845 015 0120 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 1 Ewer Court I56-I05 360221 Ewer Court V235666 071005 Stage 4.doc Version 1.40 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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