Inspection on 22/02/06 for 111 Eastbourne Road

This inspection was carried out on 22nd February 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

111 Eastbourne Road 23/05/07

111 Eastbourne Road 13/09/06

111 Eastbourne Road 08/11/05

111 Eastbourne Road 01/02/05

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

CARE HOME ADULTS 18-65 111 Eastbourne Road 111 Eastbourne Road Lower Willingdon Eastbourne East Sussex BN20 9NE Lead Inspector Lucy Green Unannounced Inspection 22nd February 2006 12:00 111 Eastbourne Road DS0000061489.V278599.R01.S.doc Version 5.1 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 111 Eastbourne Road DS0000061489.V278599.R01.S.doc Version 5.1 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. 111 Eastbourne Road DS0000061489.V278599.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 111 Eastbourne Road Address 111 Eastbourne Road Lower Willingdon Eastbourne East Sussex BN20 9NE 01323 482174 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) The Regard Partnership Limited Vacant Care Home 9 Category(ies) of Learning disability (9) registration, with number of places 111 Eastbourne Road DS0000061489.V278599.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is nine (9). Only service users diagnosed with a learning disability are to be accommodated. Service users will be aged between eighteen (18) and sixty-five (65) years on admission. 8th November 2005 Date of last inspection Brief Description of the Service: 111 Eastbourne Road is a large detached two storey property situated off the main road between Eastbourne and Polegate. The home is a short walk from the local amenities and a car journey from the main town of Eastbourne. The home is registered to provide residential care to nine younger adults with learning disabilities. Local shops and public transport links are a short walk away. Service user accommodation is provided by nine single bedrooms, all of which have en-suite facilities. An additional communal bathroom is situated on the first floor. Communal areas comprise of a large lounge, separate dining room and a games/activities room. A large and well-maintained garden is situated to the rear of the property. Parking is available at the front of the home. The registered providers of the service are The Regard Partnership. This organisation owns a large number of homes across England and Wales. 111 Eastbourne Road DS0000061489.V278599.R01.S.doc Version 5.1 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 Regulations 2001, uses the term ‘service user’ to describe those living in care home settings. For the purpose of this report, those living at 111 Eastbourne Road have requested to be referred to as ‘residents’. This unannounced inspection took place over three and a half hours on 22 February 2006. This is the second inspection of this financial year and therefore this report should be read in conjunction with the report from the unannounced inspection carried out on 08 November 2005. The purpose of this inspection was to assess compliance with the requirements of the previous inspection and to generally monitor care practices at the home. A tour of the premises took place, care, medication and staff records were inspected. The Inspector met with all nine residents and had longer conversations with three of them. The Acting Manager, Training Manager and staff members on duty were spoken with throughout the inspection and the Inspector joined residents and staff in the dining room for their lunchtime meal. The home does not currently have a Registered Manager. An Acting Manager has been in post now for seven months and it is a requirement from this inspection that a Manager for this service is put forward for registration. What the service does well: What has improved since the last inspection? 111 Eastbourne Road DS0000061489.V278599.R01.S.doc Version 5.1 Page 6 The training available to staff has improved since the last inspection and it was pleasing to find mandatory training was now up to date for all staff. The Inspector met the Training Manager who was present in the home for part of the inspection and it was encouraging to hear that specialist training such as Makaton and working with people with autism was now being planned. Medication procedures have also been updated and the evidence found at this inspection demonstrated that the home now has a safe system in place for managing medication. Communal fire doors have been fitted with appropriate hold open devices and thus the use of door wedges has now ceased, improving fire safety within the home. 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. 111 Eastbourne Road DS0000061489.V278599.R01.S.doc Version 5.1 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 111 Eastbourne Road DS0000061489.V278599.R01.S.doc Version 5.1 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): These Standards were not assesses at this inspection, please refer to the report from the unannounced inspection carried out on 08 November 2005. EVIDENCE: 111 Eastbourne Road DS0000061489.V278599.R01.S.doc Version 5.1 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 The care planning process provides an outline of care needs and individual preferences. Residents would be better protected if care plans provided more detailed and accessible guidance to staff about how care should be delivered. Residents influence and make choices about all aspects of their lives. The safety of residents would be improved if the identified risk assessments were in place. EVIDENCE: Three care plans were viewed as part of the inspection process. There was documentary evidence that the format of care planning is currently under review and thus information was found recorded in different places. It is required that the home ensure each resident has a plan of care that provides detailed and accessible information about how to support each resident appropriately. The Inspector joined five of the residents for their lunchtime meal; it was observed at this time that residents have the opportunity to make choices about their lives. Conversation with staff members confirmed that they 111 Eastbourne Road DS0000061489.V278599.R01.S.doc Version 5.1 Page 10 support residents to live the life they choose. One resident informed the Inspector that he liked to smoke, but had agreed with staff that they should be responsible for his lighter when in the house. It was evident throughout the inspection that this restriction was in place by mutual agreement. The home supports residents to manage their finances and system using cash tins and balance sheets is place. During the inspection, residents were observed freely approaching staff for access to their money. There are a range of risk assessments in place for each of the residents and there was evidence that these had been reviewed and updated since the last inspection. It was however identified that there was no risk assessment in place for the resident that smokes and this is the basis of a requirement of this inspection. 111 Eastbourne Road DS0000061489.V278599.R01.S.doc Version 5.1 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): 16 Residents benefit from support that reflects both their rights and responsibilities. EVIDENCE: It was observed during the inspection that the home provides choice within daily living routines. Three residents spoken with individually confirmed that they are enabled to make choices about their lives and how to spend their time. Residents have unrestricted access to all areas of the home, with the exception of other residents’ bedrooms. All bedroom doors are fitted with locks and at the time of the inspection several residents were noted to have utilised this facility and carried their own keys. The home has purchased a specialist key adapter for one resident who cannot use an ordinary key. Residents are encouraged to be involved in the general running of the home and participate in household activities. The activity timetables viewed illustrated that time is built in to schedules for residents to participate in the running of the home. Two residents informed the Inspector that they help to 111 Eastbourne Road DS0000061489.V278599.R01.S.doc Version 5.1 Page 12 with daily tasks, such as cleaning, washing and tidying their rooms. At the time of the inspection, one resident was assisting a staff member to prepare the evening meal. 111 Eastbourne Road DS0000061489.V278599.R01.S.doc Version 5.1 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 & 20 Residents receive appropriate personal support to meet their needs. Residents are protected by the systems in place to manage medication. EVIDENCE: Residents spoken with all confirmed that they receive the personal support they require and that they are treated with dignity and respect. Throughout the inspection, staff were observed supporting residents appropriately. As highlighted in the in the care planning section, it is required that personal care guidelines and support needs are reflected in the updated care plans to ensure all staff provide this support in a consistent way. It was evident in some care plans that residents’ weights were not being regularly recorded and it is required that this be addressed. Medication is stored, dispensed and administered appropriately. Staff spoken with confirmed that only those who had received training and supervision were permitted to administer medication. Certificates were shown as proof of training. 111 Eastbourne Road DS0000061489.V278599.R01.S.doc Version 5.1 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 the following standard(s): These Standards were not assesses at this inspection, please refer to the report from the unannounced inspection carried out on 08 November 2005. EVIDENCE: 111 Eastbourne Road DS0000061489.V278599.R01.S.doc Version 5.1 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 the following standard(s): 24 & 30 Residents benefit from a clean, comfortable and well maintained home. EVIDENCE: 111 Eastbourne Road is a two storey, detached property, which is well maintained and provides residents with sufficient private and communal space to meet their needs. Resident accommodation is provided in nine single bedrooms, with en-suite facilities. Bedrooms have been decorated and furnished to reflect individual tastes and preferences. Communal space comprises of a large lounge and separate dining room. There is an additional games/activity room on the first floor. A large and well-maintained garden is situated to the rear of the property. At the time of this unannounced inspection, the home was found to be clean and tidy throughout. Although it was identified, that one resident has an unpleasant odour in his bedroom. A maintenance referral has been made to the organisation, but the cause is yet to be identified. It is required that further investigations are conducted to resolve this issue. 111 Eastbourne Road DS0000061489.V278599.R01.S.doc Version 5.1 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 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 Residents will benefit from the increased training opportunities available to staff. EVIDENCE: The Regard Partnership has recently changed the way in which training is accessed. Internal trainers have now been appointed and staff confirmed that access to training has improved. All staff at 111 Eastbourne Road have either achieved National Vocational Qualifications (NVQ’s) or are currently working towards this qualification. The Acting Manager reported that staff were now up to date on all mandatory training and that they were now looking to access specialist training, such as Makaton and supporting people with autism. The Training Manager for The Regard Partnership was in the home for part of the inspection and confirmed that the requested training was in the process of being set up. Certificates of attendance for some staff were viewed which reflected the recent increase in training. 111 Eastbourne Road DS0000061489.V278599.R01.S.doc Version 5.1 Page 17 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 & 39 Residents benefit from an inclusive and well-managed home, but would be further protected if a Manager were registered. The home needs to introduce formal systems of gaining feedback from all stakeholders to develop and shape the running of the home. EVIDENCE: 111 Eastbourne Road does not currently have a Registered Manager in post. A Senior Carer has been the Acting Manager for the past seven months and there was evidence that the home is being effectively managed and that the service is continuing to improve. The home has now achieved some stability in respect of management, but a deputy manager cannot be appointed until the manager’s post has been confirmed. It is therefore required that the Registered Provider formalise the managements arrangements at 111 Eastbourne Road and put forward an application for the registration of a manager. 111 Eastbourne Road DS0000061489.V278599.R01.S.doc Version 5.1 Page 18 The home has a number of systems in place to gain feedback about the service and include all stakeholders in the running of the home. Regular residents’ meetings are held and minutes of these meetings were viewed. Satisfaction questionnaires were carried out in November 2005 with each resident and these provided positive feedback for the home. Residents also have monthly 1-1 meetings with their keyworker and those residents spoken with confirmed that this individual time was useful to them. Monthly monitoring visits are carried out on behalf of the Registered Provider and copies of the reports are forwarded to the CSCI each month. The Acting Manager informed the Inspector that these visits were now conducted on an unannounced basis. It was evident during the inspection that the home has regular contact with residents’ families and that informal feedback is given to staff. It has however been required that the home develop a formal system of gaining feedback from all external stakeholders. 111 Eastbourne Road DS0000061489.V278599.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 X 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 X 23 X ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X 3 X 2 X 2 X X X X 111 Eastbourne Road DS0000061489.V278599.R01.S.doc Version 5.1 Page 20 YES 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 YA6 Regulation 15 Requirement That the homes care planning system provides comprehensive support guidelines which outline how care and support should be given. (Previous timescale of 01/02/06 not met) Risk assessments are developed in respect of the service user who smokes. Home to maintain a record of service user weights. Action to be taken to rectify the unpleasant odour identified in one bedroom. The CSCI to receive an application for the registration of a Manager. A system of obtaining formal feedback from all external stakeholders be developed. Timescale for action 01/04/06 2 YA9 13(4) 01/03/06 3 4 5 6 YA19 YA30 YA37 YA39 17(1)(a) 16(2)(k) 8(1)(a) 24 01/03/06 10/03/06 01/04/06 01/05/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. 111 Eastbourne Road DS0000061489.V278599.R01.S.doc Version 5.1 Page 21 No. Refer to Standard Good Practice Recommendations 111 Eastbourne Road DS0000061489.V278599.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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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