Inspection on 12/01/06 for 10 Exmoor Crescent

This inspection was carried out on 12th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

10 Exmoor Crescent 02/10/07

10 Exmoor Crescent 24/07/06

Similar services:

Insight - Eastchurch

Southfields

Thorndene

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Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 10 Exmoor Crescent Durrington Worthing West Sussex BN13 2PL Lead Inspector Mrs S Rodgers Unannounced Inspection 12th January 2006 11:50 10 Exmoor Crescent DS0000064725.V272837.R01.S.doc Version 5.0 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 10 Exmoor Crescent DS0000064725.V272837.R01.S.doc Version 5.0 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. 10 Exmoor Crescent DS0000064725.V272837.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 10 Exmoor Crescent Address Durrington Worthing West Sussex BN13 2PL 01903 693050 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) Outreach 3 Way Mr Michael Paine Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 10 Exmoor Crescent DS0000064725.V272837.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Up to three (3) service users aged from 18-65 years in the category of Learning Disability may be admitted/accommodated. Not applicable Date of last inspection Brief Description of the Service: 10 Exmore Crescent is a care home registered to provide accommodation for up to three adults with a learning disability. The property is a detached 3 bedded bungalow situated in a residential area of Durrington. The garden is to the side of the property with an enclosed paved area to the rear. The establishment is close to some local shops and is approximately five miles from Worthing town centre. Outreach 3 Way owns the services. The registered manager responsible for the day-to-day running of the home is Mr Michael Paine. The responsible individual on behalf of the providers is Mrs Vanessa Keen. 10 Exmoor Crescent DS0000064725.V272837.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 4.30 hours. 10 Exmoor Crescent is a new service and as such has had no previous inspections. Planning for this inspection was based on reviewing records such as the Statement of Purpose, Service User Guide and general correspondence. During the course of the inspection the inspector toured the home and reviewed records. All residents were seen at the inspection. Residents have their own planned activities. Residents are taken the day centre, shopping or any other planned activity at various times of the day depending on their individual timetable. Due to the profound needs of the residents communication is difficult for people who do not have regular contact with them, therefore the inspector took the time to observe residents interact with staff. The inspector was able to ascertain that the interactions between staff and residents were relaxed and confident. The inspector observed that staff are able to communicate well with residents and staff understood each residents method of communication i.e. a special sound or look. Three staff members were on duty during the inspection, one support worker who is also the deputy to the manager was spoken with during the course of the inspection. Standard 39 (Quality monitoring and Quality assurance) of the National Minimum Standards was not assessed at this visit as the home has only been in operation for four months. However the manager was informed of the need to carry out an annual quality monitoring quality assurance audit. What the service does well: The service supports residents to develop and maintain an active lifestyle within their assessed capabilities. Residents are also offered the opportunity to attend day centres and access local amenities within the community. The care planning records are of a good quality and assist staff with understanding how to deliver the appropriate care to each resident. Staff treat all residents as individuals and planned activities are based on individual choice. 10 Exmoor Crescent DS0000064725.V272837.R01.S.doc Version 5.0 Page 6 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. 10 Exmoor Crescent DS0000064725.V272837.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection 10 Exmoor Crescent DS0000064725.V272837.R01.S.doc Version 5.0 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 the following standard(s): 2 The individual needs and aspirations of residents are assessed to ensure that the service can meet their needs. EVIDENCE: Pre admission reviews were undertaken on all three residents prior to them being admitted to the home. All three reviews were seen. Residents were unable to ‘test drive’ the service as the timing of the opening coincided with the closing of their previous placement however, Mr Paine confirmed that the homes admissions procedure does offer this option and should their be any future admission this would be offered. This service was specifically opened to provide a service for three residents who had previously been cared for with in the health service sector. Mr Paine advised the inspector that he was directly involved in the assessment process to ensure that each resident’s individual and collective needs could be met by this service. 10 Exmoor Crescent DS0000064725.V272837.R01.S.doc Version 5.0 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 the following standard(s): 6,7,9 Residents assessed needs and personal goals are reflected in care plans. Residents are encouraged to make decisions about their lives with assistance. Risk assessments are undertaken to enable residents undertake various activities. EVIDENCE: All three care plans were seen at this inspection. Care plans contain clear information on what care is required and how care should be delivered. Mr Paine confirmed that all care plans will be reviewed six monthly. Residents also have a ‘communications book’. The book contains a summary of needs and details guidelines on how to deliver care including triggers that may cause distress to residents and what action to take should the individual become distressed. Activity sheets evidence that residents are asked what they would like to do. For example activity programmes reflect daily activities however residents are still asked if they want to undertake that activity or not. Residents will have 10 Exmoor Crescent DS0000064725.V272837.R01.S.doc Version 5.0 Page 10 the opportunity to be present at reviews in order that they can have a choice regarding services provided. There response to new and old activities or situations or suggestions will be observed and services adapted accordingly. The current residents have high dependency needs and depend on staff to assist them with every day activities however should a new activity be undertaken risk assessments are carried out and action is taken to minimize risks and hazards. 10 Exmoor Crescent DS0000064725.V272837.R01.S.doc Version 5.0 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 the following standard(s): 12,13,15,16,17 Residents are offered and take part in appropriate leisure activities and access the local community. Residents are supported to maintain appropriate relationships. The rights of residents are respected. Residents are offered a varied diet. EVIDENCE: Each resident has a programme of activities appropriate to their needs and wishes. Programmes indicate that residents attend day centres, go to local shops and access other leisure activities within the community. Care records indicate key family and personal relationships. Mr Paine advised the inspector that although in principle residents can invite friends to the home because of the profound disabilities it is not a usual practice as disruption to daily routines can cause residents to become anxious. The inspector noted that staff are aware of residents rights. Staff were observed to knock on bedroom doors prior to entering their rooms. Residents mail is opened with residents present, and staff talk with residents and not just amongst themselves when residents are present. 10 Exmoor Crescent DS0000064725.V272837.R01.S.doc Version 5.0 Page 12 Menu’s seen at this inspection evidence that a varied diet is offered. Fresh fruit is readily available. Special dietary needs are addressed. 10 Exmoor Crescent DS0000064725.V272837.R01.S.doc Version 5.0 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 the following standard(s): 18,19,20 Every effort is undertaken to ensure that residents receive support in the ways they prefer. Residents physical and emotional health needs are met. Appropriate systems are in place for dealing with medicines. EVIDENCE: Care plans have information regarding individual’s personal likes/dislikes. The plans also provide some evidence to indicate how and when residents want their care to be provided. Records clearly demonstrate that residents are registered with a local doctor and that they have access to other health professionals such as dentists, chiropodists and opticians. The home has a pharmacy agreement with a local chemist. All staff that administer medication have received training in the administration of medication. It was confirmed that the pharmacist will also provide in house 10 Exmoor Crescent DS0000064725.V272837.R01.S.doc Version 5.0 Page 14 training. Records seen of the receipt, recording, storage, handling, administration and disposal of medication were in good order. 10 Exmoor Crescent DS0000064725.V272837.R01.S.doc Version 5.0 Page 15 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 the following standard(s): 22,23 A complaints procedure is in place. Systems are in place to protect residents form abuse, neglect and self–harm. EVIDENCE: The homes complaints procedure clearly advises residents and/or their relatives of their right to complain. The procedure states each stage of the complaint process and timescales in which the complaint will be dealt. There was no evidence to demonstrate that all staff have recently had Adult Protection Training, although some staff have had Adult Protection training with previous employers however in some cases this training was 3 – 5 years ago. All staff should receive updates in Adult Protection Procedures. Mr Paine and his deputy when asked gave a good account of what action to take should they suspect abuse of a resident. Their response was in line with the local authorities Adult Protection procedures. 10 Exmoor Crescent DS0000064725.V272837.R01.S.doc Version 5.0 Page 16 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 the following standard(s): 24, 30 Accommodation is appropriate to the needs of the residents. The home is clean and hygienic. EVIDENCE: From touring the home both inside and out the inspector was able to ascertain that the home appears to be well maintained. The home has recently undergone refurbishment. Ramps have been provided at the front and back entrances to ensure easy access via wheelchairs. The home appears bright cheerful and comfortable. The home has been fitted with fire warning system. Appropriate systems are in place for the collection of clinical waste. Laundry facilities are separate from the food preparation areas and appear suitable for the needs of the current residents. Appropriate protective clothing and hand washing facilities are provided. 10 Exmoor Crescent DS0000064725.V272837.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Staff were relaxed, confident and knowledgeable with regards the needs of residents. Recruitment procedures are in place. The staff-training programme needs to be developed. EVIDENCE: Duty rotas indicate that staff are on duty in sufficient numbers and with the appropriate skill mix i.e. inexperienced staff are not on duty together without the support of experienced staff. All new staff receive induction training. Staff are encouraged and supported to undertake NVQ Awards specific the needs of the current residents, (Learning Disability Award Framework). The management need to undertake an audit of training for individual staff and the staff team as a whole, and develop a training programme to ensure that 50 of care staff have an NVQ level 2 or equivalent. A recruitment process is in place however it was noted that only one reference is on file for one employee. Two written references must be obtained prior to an appointment being made. 10 Exmoor Crescent DS0000064725.V272837.R01.S.doc Version 5.0 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,42. The registered manager is experienced and is running the home in line with its aims and objectives. Systems are in place to maintain the health and safety of residents. EVIDENCE: Mr Paine has fifteen years experience in working with people with a learning disability. He is currently undertaking NVQ level 4 and the Registered Manager’s award. Although Mr Paine does not currently hold the NVQ level 4 and registered managers award a requirement has not been as he is in the process of gaining the qualification. Checks on the home’s physical environment i.e. boilers, maintenance of electrical equipment were carried out as part of the registration process so therefore records of maintenance checks were not reviewed at this inspection. 10 Exmoor Crescent DS0000064725.V272837.R01.S.doc Version 5.0 Page 19 Some safe working practice topics listed in this standard have not been undertaken by staff. The manager must ensure that staff receive fire safety instruction at regular intervals of 6 monthly day staff and 3 monthly night staff. All staff preparing and serving food must have basic food hygiene training and all staff should have training in infection control practices. Also see standard 35. Accident records were seen. Mr Paine confirmed that he is in the process of undertaking risk assessments for safe working practice topics covered in standard 42.2 and 42.3. 10 Exmoor Crescent DS0000064725.V272837.R01.S.doc Version 5.0 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 Score 3 1 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 2 X 2 1 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 10 Exmoor Crescent Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 2 X X X X 2 X DS0000064725.V272837.R01.S.doc Version 5.0 Page 21 NA 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 YA23 Regulation 13 (6) Requirement The registered person shall make arrangements, by training staff or by other methods to prevent residents being harmed or suffering abuse or being placed at risk of harm or abuse. The registered person shall not employ a person to work in a care home unless he has obtained in respect of that person the information and documents specified in paragraphs 1 – 7 Schedule 2 The registered person shall ensure that persons working at the care home receive training appropriate to the work they perform. The registered person shall make arrangements for persons working in the home are aware of the procedures to be followed in the event of a fire. Timescale for action 20/02/06 1 YA34 19 (1) (b) 20/02/06 2 YA32YA42YA35 18 20/02/06 3 YA42 23 (d) 20/02/06 10 Exmoor Crescent DS0000064725.V272837.R01.S.doc Version 5.0 Page 22 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 10 Exmoor Crescent DS0000064725.V272837.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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. 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