Inspection on 25/05/07 for 10 Harison Road

This inspection was carried out on 25th May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

10 Harison Road 19/10/05

10 Harison Road 10/05/05

10 Harison Road 16/11/04

10 Harison Road 01/06/04

10 Harison Road 08/12/03

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

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 Harison Road Seaford East Sussex BN25 3PN Lead Inspector Niki Palmer Key Unannounced Inspection 25th May 2007 12:30 10 Harison Road DS0000020990.V335934.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 10 Harison Road DS0000020990.V335934.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. 10 Harison Road DS0000020990.V335934.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 10 Harison Road Address Seaford East Sussex BN25 3PN 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) 01323 490511 harison@onetel.com Southdown Housing Association Limited Mrs Susan Gales Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 10 Harison Road DS0000020990.V335934.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is five (5). Service users must be aged between eighteen (18) and sixty five (65) years on admission. Only adults with a learning disability are to be accommodated. Date of last inspection 19th October 2005 Brief Description of the Service: 10 Harison Road is a care home, which provides personal care and accommodation for up to five residents with learning disabilities. The home is owned and run by Southdown Housing Association who are a large voluntary organisation that have been providing services to people with learning disabilities across East Sussex for over 16 years. The home is located in a quiet residential area of Seaford approximately ¾ mile from the town centre and main bus and rail connections, although the home does have access to it’s own vehicle. Free on-street car parking is available at the home. The home is a large detached property with five single bedrooms located over two floors. There is a spacious kitchen, dining room and large lounge, with an additional small lounge providing a quiet area, which was converted from the integral garage. There is a pleasant and well-maintained garden to the rear of the property. The home provides personal care and support to residents who are funded by Social Services. The home’s fees as of 27 March 2007 are £1400.00 per person per week. Additional costs are charged for hairdressing, clothing, chiropody, toiletries, papers, some activities, holidays and payment towards transport. Prospective residents and their relatives are provided with written and pictorial information regarding the services and facilities provided at the home prior to admission. A copy of the home’s most recent inspection report is available on request from the home. 10 Harison Road DS0000020990.V335934.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001, uses the term ‘service user’ to describe those living in care home settings. For the purpose of this report, those living at 10 Harison Road will be referred to as ‘residents’. This unannounced inspection took place on Friday 25 May 2007 and lasted five hours. Five residents were accommodated on the day of the inspection, all of which were male and aged between 58 and 60 years of age. The majority of the inspection was facilitated by the Registered Manager and one of the Deputy Manager’s of the home. In order to gather evidence on how the home is performing, individual discussions took place with all five residents and two members of staff. Two care records were examined in some detail for the purpose of monitoring care. Other records and documentation inspected included: the home’s Statement of Purpose and Service Users’ Guide, medication practices, the provision of activities, quality assurance systems, complaints procedure and the systems in place to safeguard residents from harm, staffing levels and the provision of relevant training. All communal areas and most individual rooms were seen with the kind permission of residents. A detailed pre-inspection questionnaire was received prior to the visit to the home. This provided the Inspector with information relating to the residents accommodated, premises, maintenance and associated records and details of the homes policies and procedures. What the service does well: 10 Harison Road is an excellently managed service, which places residents at the heart of the service. The home is effectively run by a skilled and experienced Manager, who supported by two Deputy Managers, provides a clear sense of direction and values. Most residents have lived at the home for a number of years and have developed close relationships with each other and staff. The team works well using strategic guidance that is in place to ensure that any concerns or issues that arise between residents are minimised. Residents’ individual needs and choices are clearly assessed and reviewed on a regular basis and are detailed within comprehensive plans of care. Staff support each individual well to undertake a wide range of activities in order to promote their independence and maintain very busy and active lifestyles in the community. 10 Harison Road DS0000020990.V335934.R01.S.doc Version 5.2 Page 6 The health, safety and welfare of residents is ensured through the home’s robust systems for dealing with any concerns or complaints as they arise and the procedures and guidelines that are in place to protect individuals from potential, harm, neglect and abuse. Residents are supported by a skilled and dedicated staff team who continue to work hard to meet the needs of residents. The staff team are supported to provide a high standard of care to meet the needs of residents through regular staff training, supervision and staff meetings. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 10 Harison Road DS0000020990.V335934.R01.S.doc Version 5.2 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 Harison Road DS0000020990.V335934.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and others are provided with sufficient information prior to admission in order to support their decision of where to live. Good systems are in place to ensure that only residents whose needs can be met are admitted to the home. EVIDENCE: The home has a detailed Statement of Purpose and Service Users’ Guide in place, both of which have been updated since the last inspection. The Statement of Purpose provides the reader with an introduction to Southdown Housing Association, details of the Registered Manager, the number, relevant qualifications and experience of staff working in the care home and overall service provision including: the accommodation, the arrangements for residents to engage in social and leisure activities together with any therapeutic techniques, the arrangements for dealing with concerns or complaints and the systems for ensuring that residents’ needs are identified, met and reviewed in accordance with person centred planning. The Service Users’ Guide is presented in an easy to read and understand format, which incorporates the use of colour pictures and symbols including a photograph of the home. It gives an overview of the philosophy of care, 10 Harison Road DS0000020990.V335934.R01.S.doc Version 5.2 Page 9 purpose of the service, accommodation and outlines what support and care individuals can expect from the home including support and communication, personal space, individual planning, holidays, day service provision and terms of occupancy. Each of the residents currently accommodated have lived at 10 Harison Road, between 6 and 19 years. On occasions, conflict can arise between some of the residents, however the home works well using strategic guidance to ensure that a harmonious environment is maintained. Albeit that there have been no new admissions to the home for a considerable amount of time, the Manager was able to describe in detail the arrangements in place for assessing all prospective residents in order to ensure that the home could meet their needs. She explained that all new residents would be given the opportunity to visit the home prior to moving in; this could involve staying at the home for a day, overnight or several shorter visits. Details of the home’s pre-admission assessment procedures are clearly outlined within the home’s Statement of Purpose. 10 Harison Road DS0000020990.V335934.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, 8 and 9. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are supported well by the home’s comprehensive care planning procedures. Residents are consulted about all aspects of the home and are supported to make decisions in all aspects of their lives to the best of their abilities. Clearly assessed and managed risks enable residents to undertake a wide range of activities in order to promote their independence. EVIDENCE: Two plans of care, which the home refers to as ‘support plans’ were examined in some detail. Both were noted to be exceptionally detailed and person centred to individual needs. The personal profile gives an overview of the person’s background, their needs and likes and dislikes. There was clear evidence that the plans are reviewed and updated on a regular basis Clear guidelines are in place for staff to follow. These are aimed at supporting staff to meet individuals’ needs whilst helping to promote and maintain their independence. Examples of guidelines seen include: supporting a person with 10 Harison Road DS0000020990.V335934.R01.S.doc Version 5.2 Page 11 their preferred daily routines such as bathing, activities, meeting their healthcare needs and managing behaviour. Albeit that behaviour management guidelines were noted to be reasonably detailed, they were in one instance noted to be quite lengthy and difficult to follow. It is recommended that these be reviewed in order to make them more concise and easier for staff to read and follow. Person centred reviews take place on a six monthly basis. This gives the individual, their carers and relatives the opportunity to focus on the achievements of the last six months and to plan goals for the next six months based on the wishes of individuals. Residents confirmed that they are involved in the planning of these meetings and are asked whom they would like to invite to the meeting (or not). Most reviews take place at the home, but can be arranged elsewhere based on individuals’ personal choice and preference. Residents are supported to make decisions in all aspects of their lives and care staff encourage them as much as possible to participate in all aspects of life in the home. Residents are encouraged to help with meal preparation, undertake household tasks, make their own hot and cold drinks, go shopping and are consulted to the best of their abilities about how the home is run including the recruitment of staff. Residents commented that they are kept informed about any changes within the home that may affect them through regular house meetings. All of the residents are encouraged to take responsible risks where necessary in order to promote their independence. Detailed risk assessments and guidance are in place for all activities of daily living, based on the needs of individuals. Examples of those seen included using hot water, going to college, bathing and managing epilepsy. 10 Harison Road DS0000020990.V335934.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): 11, 12, 13, 14, 15, 16 and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are supported to take part in a wide range of activities to lead fulfilling lives, meet their needs and ensure their personal development. Residents play an active and fulfilling role in their community and maintain positive relationships with family and friends. The ethos of the homes promotes the right of residents to make choices in all aspects of their lives to the best of their abilities. EVIDENCE: Residents are supported to maintain their own daily diaries of the activities they have undertaken. Residents were happy to share these with the Inspector. They are written in the first person and include photographs, pictures and drawings. Recent activities include going to college, ten pin bowling, visiting a country fair, working on a voluntary basis at a nearby farm, rambling, bike rides, participating in a local church group, going to Longleat wildlife park and going to watch an ‘Elvis’ impersonator followed by a meal out. 10 Harison Road DS0000020990.V335934.R01.S.doc Version 5.2 Page 13 Residents confirmed that they receive one to one support from care staff for a number of activities. Three of the residents celebrated their 60th birthdays last year. They decided that they would like a joint celebration party to which they could invite their friends and relatives. Residents spoke about how the staff helped them to arrange this including the hiring of suits, a limousine and a venue. A friend of theirs from a nearby care home provided the music. Residents are supported to play an active role in their local community. All make good use of public transport facilities, although the home does have it’s own saloon car. In addition to using community facilities one of the residents started up a punk music band in the mid 1990’s. The band is made up of people both with and without learning disabilities who play gigs around the country, but mostly in and around the Brighton area. One of the residents told the Inspector that the band started to notice that a high number of people would start to leave the gigs at around 9pm, namely because their care staff were finishing work at 10pm. The band decided to set up a ‘Stay up late’ campaign in order to highlight to people with learning disabilities, managers and care staff that because of the way some care homes were being managed, a high number of people with learning disabilities were missing out. Southdown Housing Association alongside other learning disability projects supported the band to secure funding from the National Lottery to support and promote their campaign. Band members have since been interviewed on local radio, taken their concerns to government and established their own website: www.stayuplate.org. Residents told the Inspector that they enjoy raising money for different charities. They have taken part in sponsored walks and indeed on the day of inspection, were preparing for a plant sale at the home in which the proceeds would be donated to a charity of their choice. Residents had invited their friends, relatives and neighbours. Residents confirmed that they each have regular holidays. They said that they are offered a choice about where they would like to go and with whom. One person said that they were looking forward to a forthcoming holiday, in which their sister had been invited. Residents confirmed that they are well supported by staff to keep in regular contact with their families and friends in person and via the telephone. Visitors are always made to feel welcome at the home at anytime. Details of friends, relatives and people that are important to the person are clearly documented within individual plans of care. 10 Harison Road DS0000020990.V335934.R01.S.doc Version 5.2 Page 14 Throughout the duration of the inspection all staff were observed to respect residents’ privacy and dignity. They always knock on residents’ bedroom doors prior to entering and address them by their preferred term as indicated within individual plans of care. Staff spoken with were very positive in their approach to working with the residents and were sensitive and supportive of individuals’ needs and preferences. All meals are prepared within the home by care staff and residents based on the choices and preferences of the individuals. Residents can choose whether or not to dine together alongside staff in the kitchen/dining area, go out for a meal or have their meal at a time to suit them (depending on their chosen activity of the day/evening). 10 Harison Road DS0000020990.V335934.R01.S.doc Version 5.2 Page 15 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 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff provide sensitive and dignified support to meet the individual needs and preferences of residents. Residents are supported to access a range of healthcare services to meet their physical and emotional well-being. Residents are mostly safeguarded by the homes policies and procedures for the safe administration of medicines. EVIDENCE: Both of the care plans that were seen clearly identified individuals’ preferences in relation to having their personal care needs met. All personal care is carried out in the privacy of residents’ own bedrooms or in one of the bathrooms. Residents said that they are supported well by staff. All residents are registered with a local GP and dentist and are supported to all healthcare appointments as necessary. The home has developed close working relationships with the local Community Learning Disability Team (CLDT). Recent requests for referrals have included support from a Community Nurse and Clinical Psychologist. 10 Harison Road DS0000020990.V335934.R01.S.doc Version 5.2 Page 16 Southdown Housing Association have provided each resident with a Health Booklet, which is aimed at keeping clear and accurate records of all healthcare appointments. Whilst those seen were found to be relatively up to date, it is recommended that in line with Valuing People, Health Action Plans be implemented. The home’s medication records and storage systems were inspected. The home currently uses a pre-packed blister pack issued by the local pharmacy, which is easy to use and monitor. All members of staff have received the appropriate training and have been assessed as competent in the administration of medicines. Whilst medication practices were noted to be good and there was a clear audit trail in place for all medicines that had been received from or returned to the pharmacy, two minor shortfalls were identified: Some of the medication administration records (MARS) contained details of medicines that were no longer prescribed. Albeit that care staff were aware of this and these were no longer being administered, no action had been taken by the home to have these removed from the MARS. It therefore appeared as though some prescribed medicines were not being given. The home has a system in place for one person’s medication that is prescribed on an as and when required basis (PRN). This system appeared fairly complicated to the Inspector, although it must be noted that all care staff spoken with understood this process clearly. It involves staff having to ensure that when they support one of the residents out into the community, that they either take a pink or yellow labelled bottle (depending on the dose required). Whilst this procedure was well known to staff and had been written in the staff communication book, the Manager is required to ensure that this procedure is clearly written and documented within the home’s policies and procedures for the safe handling of medicines. In light of the minor shortfalls that have been identified, the CSCI considers the overall outcome for this area to be good. 10 Harison Road DS0000020990.V335934.R01.S.doc Version 5.2 Page 17 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 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good systems in place to ensure that all complaints are dealt with appropriately. Residents are protected from potential harm, neglect and abuse through the home’s robust policies and procedures and through staff receiving appropriate training. Detailed policies and procedures ensure that residents’ finances are managed well. EVIDENCE: The home has a detailed complaints procedure in place, which is included within the home’s Statement of Purpose and Service Users’ Guide (in a pictorial format). It gives clear guidance with regards to how a complaint can be made and how the complainant can expect it to be dealt with. No complaints have been received by either the home or the CSCI since the last inspection. All of the residents and staff spoken with said that any concerns (no matter how minor) are usually raised at that time by one of the residents, or at one of the weekly residents’ meetings. The home has a detailed Adult Protection and whistle-blowing policy and procedure in place in accordance with local multi-agency guidelines. Staff spoken with confirmed that recent training has been provided by Southdown Housing Association and that they would feel confident in reporting any concerns of suspected abuse and poor practices within the home. Nine alerts have been appropriately raised by the home since the past year. The appropriate action has been taken by the home in order to safeguard the wellbeing of residents. 10 Harison Road DS0000020990.V335934.R01.S.doc Version 5.2 Page 18 The Manager acts as an appointee for three named residents. All residents are supported to manage their own finances. Residents keep their own money in locked tins within their bedrooms and are supported as much as possible by care staff to keep clear expenditure records. 10 Harison Road DS0000020990.V335934.R01.S.doc Version 5.2 Page 19 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, 25, 26, 28 and 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. 10 Harison Road offers a friendly and relaxed environment that is kept in good decorative order. It presents as a clean, well-maintained and homely place to live. EVIDENCE: The Inspector was shown around all communal areas of the home by the Registered Manager. In addition, three residents kindly showed the Inspector their bedrooms. The home is a large detached property with five single bedrooms located over two floors. There is an office/sleep-in room for staff on the first floor. All areas seen were noted to be exceptionally clean, well-maintained and homely. It was evident that residents have been involved in choosing their own furniture, accessories and décor. All residents have their own TV, video and stereo equipment in their rooms. There are a number of photographs 10 Harison Road DS0000020990.V335934.R01.S.doc Version 5.2 Page 20 displayed throughout the home of each of the residents, all of which have been nicely framed and presented. Communal facilities include a large lounge and smaller sitting area, separate dining area and a well-maintained garden to the rear of the property. Residents commented that they enjoy helping with maintaining the garden and were looking forward to a barbecue for one person’s forthcoming birthday. Major adaptations are not currently required by any of the service users. The home was clean and tidy at the time of the announced inspection. 10 Harison Road DS0000020990.V335934.R01.S.doc Version 5.2 Page 21 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, 33, 34, 35 and 36. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are supported by a skilled and dedicated staff team who continue to work hard to meet the needs of residents. Residents are supported and protected by the home’s robust recruitment procedures. The staff team are supported to provide consistent care and meet the needs of residents through regular supervision and staff meetings. EVIDENCE: In addition to the Registered Manager, the home employs a total of nine care staff, six of which have obtained at least NVQ level 2 in Care. Regular relief staff are used to cover additional shifts as necessary e.g. to cover staff sickness or annual leave. Staff spoken with said that a number of care staff that leave the service choose to stay on and work as relief. One person commented that this was because they had developed such good relationships with residents, they wanted to continue to support them, but not on a daily basis due to other commitments. Many of the staff have worked at the home for number of years and have therefore developed positive relationships with each of the residents and each 10 Harison Road DS0000020990.V335934.R01.S.doc Version 5.2 Page 22 other. This was evident throughout the inspection. Comments received from care staff during the inspection included: ‘I love working here, the residents are so bubbly’ ‘I really feel valued by the organisation. Everything the organisation stands for and the commitment from staff is to benefit the residents’. ‘As a staff team we know what each others qualities are’ ‘I think the residents have a damn good life… all the staff are really dedicated’ Residents, staff and duty rotas confirmed that there is always a minimum of three members of staff on duty in the daytime. Staff working hours must be flexible in order support residents in their chosen daily activities. There is currently no need for a waking night person although a sleep-in member of staff is always allocated. The Manager confirmed that all job advertisements are advertised in local newspapers and on the Southdown Housing Association’s website. All initial information is coordinated by the association’s Human Resources department who are responsible for sending out application forms, alongside the required Criminal Record Bureau (CRB) and Protection of Vulnerable Adults First (PoVA) check, health declaration and Equal Opportunities Monitoring Form. Residents told the Inspector how they have recently been involved in interviewing two prospective members of staff alongside the Manager. They said that this involved deciding in advance what questions they would like to ask using different pictures and photographs as a reminder. All staff recruitment records are held at Southdown Housing Association’s head office. It had previously been agreed between the CSCI and the organisation, that this was considered to be suitable practice on the basis that there was evidence provided at the home of these checks being seen and agreed by the Registered Manager. A record of this was not available on the day of the inspection, but was forwarded to the CSCI shortly after the inspection. The CSCI does not have any major concerns regarding the employment processes of this organisation. The Human Resources Services Manager confirmed in writing following the inspection, that all members of staff (including relief staff) have the required police checks updated every three years. It was also confirmed that should a relief member of staff not work for the organisation for a period of six months their names are removed from the register. This helps to ensure the health, safety and welfare of the residents. The home has not needed to induct any new members of staff for some considerable time, as there has been no new staff employed. Once the newly 10 Harison Road DS0000020990.V335934.R01.S.doc Version 5.2 Page 23 recruited person’s employment checks are received by the organisation, the Registered Manager and Training Manager confirmed the processes that are in place and will be followed: The organisation has three major components to their induction programme, which is accredited by the Learning Disability Awards Framework (LDAF) and verified by East Sussex County Council. This includes: • • • A structured in-service induction A programme of formal training Completion of a portfolio - using information/knowledge gathered inservice and on training. This requires staff to demonstrate their knowledge in writing. The Training Manager confirmed that the organisation is awaiting further guidance from Skills for Care Learning Disability Qualification, which is due summer 2007. The Training Manager is responsible for organising and arranging all training dates and venues. Training courses are sought both internally and externally. All staff are expected to undertake specific training to their roles. Evidence was provided of recent training, which included moving and handling, safeguarding adults, first aid, person centred support, autism and active support. Future planned training includes: team building, challenging behaviour, medication, infection control and hazardous substances. All staff spoken with confirmed that they receive regular supervision and support from either the Registered Manager or one of the Deputy Managers. Supervision contracts are agreed and signed. Individual records are stored securely within the office. 10 Harison Road DS0000020990.V335934.R01.S.doc Version 5.2 Page 24 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, 38, 39 and 42. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. A skilled and experienced Manager provides clear direction and support to enable the staff to provide a high standard of care to residents. Both residents and staff benefit from an excellently managed and organised home. The views and rights of residents underpin the ethos and development in the home. EVIDENCE: The current Manager has been working for Southdown Housing Association for over 16 years. She has worked at 10 Harison Road for 13 of these and has been the Registered Manager of the home for the past 10 years. She has achieved NVQ level 4 in Management and a Registered Manager’s Award (RMA). The Manager is supported in her role by two Deputy Manager’s who work on a job share basis. Without exception, all of the staff spoken with, comments received from residents and the excellent outcomes for residents, 10 Harison Road DS0000020990.V335934.R01.S.doc Version 5.2 Page 25 which have been noted during this inspection, indicate that the home is managed exceptionally well. A new Quality Assurance Manual has been produced by Southdown Housing Association for all individual homes in the past six months. The Manager showed this to the Inspector, which was noted to be comprehensively detailed and well organised. There was clear evidence that feedback from residents, their relatives, staff and other stakeholders had been sought. It must be noted that the overall outcomes for the home was exceptionally positive. In addition, Southdown Housing Association has a two weekly residents’ advocacy/consultation group. This enables residents to share their experiences of living within individual homes and offers them the opportunity to feedback to senior management about any concerns or complaints they may have. These meetings are held at head office and are regularly attended by all of the residents living at 10 Harison Road. Evidence provided within the home’s returned pre-inspection questionnaire identified that all equipment is well-maintained and regularly serviced including fire equipment and alarms, the central heating and hot water system, environmental health issues and electrical appliances. 10 Harison Road DS0000020990.V335934.R01.S.doc Version 5.2 Page 26 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 3 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 4 25 4 26 4 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 4 34 2 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 4 3 X LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 3 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 4 4 4 X X 3 X 10 Harison Road DS0000020990.V335934.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? NO 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 YA20 Regulation 13(2) 17(1)(a) Requirement That all medicines that are no longer prescribed are removed from the medication administration records – in consultation with the GP. That the procedures for administering one person’s PRN medication are clearly written and documented within the home’s policies and procedures for the safe handling of medicines. Timescale for action 31/08/07 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. 2. Refer to Standard YA6 YA19 Good Practice Recommendations That behaviour management guidelines are reviewed in order to make them more concise and easier for staff to read and follow. That in line with Valuing People, Health Action Plans are implemented. 10 Harison Road DS0000020990.V335934.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 10 Harison Road DS0000020990.V335934.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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