Inspection on 14/12/06 for 128 Beech Hill

This inspection was carried out on 14th December 2006.

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

The inspector found 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

128 Beech Hill 05/01/06

128 Beech Hill 07/06/05

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Insight - Eastchurch

Southfields

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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 18-65 128 Beech Hill 128 Beech Hill Haywards Heath West Sussex RH16 3TT Lead Inspector Mrs K Allen Unannounced Inspection 14th December 2006 02:20 128 Beech Hill DS0000062353.V325111.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 128 Beech Hill DS0000062353.V325111.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. 128 Beech Hill DS0000062353.V325111.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 128 Beech Hill Address 128 Beech Hill Haywards Heath West Sussex RH16 3TT 01444 239123 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 Disabilities Trust Mrs Susan Caroline Stopa Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 128 Beech Hill DS0000062353.V325111.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Commission for Social Care Inspection has agreed that Mrs Susan Caroline Stopa can be the registered manager of this service as well as Hollyrood because it is a `satellite` of the home. Date of last inspection Brief Description of the Service: Beech Hill is a satellite home connected to Hollyrood care home, which offers a service specifically to meet the needs of people within the autistic spectrum. Beech Hill accommodates four people who are able to live a more independent life but need the support of a care home rather than supported living. The home is based in Haywards Heath in a residential area that has access to local shops and amenities. It is a detached house on two floors offering single bedroom accommodation to all residents. There is a garden, which is accessible to all. 128 Beech Hill DS0000062353.V325111.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Prior to the inspection a review was made of the contact between the home and the Commission for Social Care Inspection (CSCI) since the last inspection. This included an analysis of incident reports and those of other statutory bodies such as the fire service. The manager completed and returned a pre-inspection questionnaire.. The inspection took place from 2.20pm over four hours. During this time all of the residents were seen going about their daily lives. A discussion was held with three members of staff and a line manager to the home. In addition a number of records were seen. Residents said they liked living at the home and enjoyed the various activities, which were made available to them. The requirement from the last inspection remains outstanding. This is that visits and reports need to be undertaken monthly, in accordance with Regulations 26 of the Care Standard Act 2000. Recommendations made at the last inspection have been met. Two have been made following this visit. They are that the NVQ training programme should be made more widely available and the quality assurance system should be further developed. Fees for the home range from £1785 - £2300 per week. What the service does well: What has improved since the last inspection? What they could do better: Monitoring visits must be made to the home on a monthly basis and a report held at the home. The NVQ training programme should be extended and the quality assurance system developed. 128 Beech Hill DS0000062353.V325111.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 128 Beech Hill DS0000062353.V325111.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 128 Beech Hill DS0000062353.V325111.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&2 Quality in this outcome area is good. Prospective service users have the information they need to make an informed choice about where to live. Their individual needs are fully assessed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Whilst no new service users have come to live at the home there is a written Statement of Purpose and Service User Guide available. The Statement of Purpose needs to include the new address for CSCI, however. All residents had an assessment prior to moving into the home and these are kept on their file. 128 Beech Hill DS0000062353.V325111.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is excellent. Service users needs are reflected in their individual plan of care. They make decisions about their lives with assistance as needed and take risks as part of an independent lifestyle. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All residents have a care plan which gives comprehensive details about their needs. This information includes cultural needs as well as physical, social and health needs. For example, it is recorded that one person celebrates a Jewish festival and does not like Guy Fawkes night. Care plans are reviewed every six months in partnership with other interested parties such as parents and social worker. A member of staff acts as key worker and provides a report for this review as well as supporting the service user to participate. Residents are encouraged to make decisions about day-to-day matters such as activities, meals, social events and how to spend their own money. For example, one person had been to the cinema and chosen the film he wished to see. Another person has a regular meeting with a set of representatives, which 128 Beech Hill DS0000062353.V325111.R01.S.doc Version 5.2 Page 10 enables him to gain more confidence and therefore make his own decisions. Residents meetings have recently been started to enable everyone to have a voice in the running of the home. All service users manage their own finances although one person requires support with this. Residents lead an active and fulfilling life, which involves taking some risks. These are assessed and residents are supported in line with the outcome of the risk assessment. They include areas such as going swimming, horse riding, using the microwave and public transport. 128 Beech Hill DS0000062353.V325111.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. Service users take part in age appropriate activities and are part of the local community. They have appropriate personal and family relationships and their rights are respected. A healthy diet is offered and service users enjoy their meals. This judgement has been made using available evidence including a visit to this service. EVIDENCE: One person has a part-time catering job and received a very good report of their progress. Others attend college for a number of days each week which gives them the opportunity to mix with a range of people some of whom do not have a disability. Service users use all the usual local facilities for example, the cinema, swimming pool, library, pubs and leisure centre. They are kept informed of local events by the provision of leaflets etc. Some choose to attend the Gateway Club where they meet up with friends. 128 Beech Hill DS0000062353.V325111.R01.S.doc Version 5.2 Page 12 Everyone has contact with their own family who are welcome at the home at any time. Daily routines are flexible to take account of residents various activities. For example, mealtimes can be changed if people are going out. Service users have a key to their own room and staff only enter when invited. Staff engage residents in conversation and involve them in all aspects of the home. Service users have unrestricted access to all parts of the home although the front door is kept locked. The key is available to residents but they require supervision when they leave the premises. Residents take some responsibility for household tasks on a rota basis and they said that they were happy with this. Meals are cooked by staff with assistance from service users. Fresh food is always used and ample portions provided. The residents do not eat as a group but with a member of staff as they find a group setting uncomfortable. The menu is varied and reflects individual tastes and preferences. Each resident has their own menu for breakfast and lunch which is written up for their reference in the kitchen. 128 Beech Hill DS0000062353.V325111.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is excellent. Service users receive good personal support. Their health care needs are met and they are protected by the homes medication procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents are able to get around the house independently and the personal support they require consists of prompting and supervision, for example in washing their hair, shaving and personal hygiene. Everyone has their own bedroom and bathrooms and toilets have locks so that privacy is maintained. Each day residents follow a ‘planner’ which ensures that any help they need is identified and staff allocated to assist wherever necessary. This also provides consistency through a key worker system. In addition, parents are consulted about how residents like to be helped and this informs what approach is adopted. Staff ensure that residents have reminders and appointments with health professionals such as the dentist and optician as well as routine screening and monitoring of medical conditions. For example, one person had developed a problem with chewing and this was being followed up appropriately. Medication is administered on behalf of residents and an up to date record of current medication is kept for each person. Records are also kept of all 128 Beech Hill DS0000062353.V325111.R01.S.doc Version 5.2 Page 14 medication received, administered and disposed of at the home. Safe storage is provided and staff receive training in the administration of medication. 128 Beech Hill DS0000062353.V325111.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. Service users views are listened to and acted upon and they are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a written complaints procedure which is made available in an accessible format for residents. No formal complaints have been received at the home and opportunities are provided for residents to express their views informally, for example at residents meetings. There are clear written guidelines for staff to follow with regard to adult protection. They were able to describe what action they would take should they suspect that someone was acting improperly towards a resident. This included reporting staff members if they were implicated. The policies and practices regarding residents’ money ensures that they are not exploited in this area of their lives. For example, three people manage their own money independently. 128 Beech Hill DS0000062353.V325111.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. Service users live in a homely, comfortable and safe environment which is clean and hygienic. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is suitable for it’s stated purpose in that it is located in a residential area with access to all amenities. Everyone has their own room and there is sufficient communal space for the number of residents and staff. It meets the requirements of the local fire service and environmental health officer. Furniture and equipment are of a good standard and domestic in style thereby creating a warm and comfortable environment. Residents can access all areas of the home including the kitchen, laundry and garden. There were no odours present in the home which was clean throughout. The laundry is off the kitchen as it would be in an ordinary household. This gives access to residents which enables them to develop self help skills. However, the equipment is suitable for the volume of laundry and soiled linen. Hand washing facilities are provided nearby. 128 Beech Hill DS0000062353.V325111.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is adequate. Service users are supported by competent staff, some of whom are trained. They are protected by the homes recruitment procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff showed respect to residents and evidently had a good rapport with all those they were caring for. For example, household tasks were shared with good humour and residents felt they could return this in their own way. Staff were patient and keen to ascertain residents wishes wherever possible, for example, what board game they wished to play. Staff understood the needs of people with autism and had received training in this. They understood their means of communication and encouraged residents to speak up for themselves. New staff are given a thorough induction which they said set them up for the job. An ongoing training programme is in place covering areas such as fire safety, food hygiene, Makaton and adult protection. Three people plus the manager have a National Vocational Qualification (NVQ), however this does not equate to 50 of the staff, which is required to meet this standard. The recruitment procedure includes taking up of two references and a Criminal Records Bureau check. Work permits are also checked if this is necessary. Staff 128 Beech Hill DS0000062353.V325111.R01.S.doc Version 5.2 Page 18 confirmed that these checks were carried out although, written documentation was not checked on this occasion. 128 Beech Hill DS0000062353.V325111.R01.S.doc Version 5.2 Page 19 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, 39, 41 & 42 Quality in this outcome area is good. Service users benefit from a well run home and their views aid it’s development. They are not always protected by the homes record keeping due to the absence of Regulation 26 reports. The health and safety of residents and staff is protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is experienced and competent. She has an NVQ level 4 and the Registered Managers Award. Clear policies and procedures are in place and available to all staff from when they take up their employment. Quality assurance is carried out and consists of a weekly report from the manager to the quality assurance manager and a weekly meeting with all senior staff. This meeting focuses on the needs of resident and involves the assistant psychologist and activities co-ordinator. Parents are invited to contribute to six monthly reviews of residents and are provided with a 128 Beech Hill DS0000062353.V325111.R01.S.doc Version 5.2 Page 20 questionnaire to complete. Feedback is not routinely sought from others involved in the home such as health professionals, friends or advocates. Policies and procedures are reviewed at regular intervals. Monthly visits to the home under Regulation 26 of the Care Standard Act 2000 are not always conducted or a report made regarding such visits. This is an outstanding requirement from the previous inspection. There are written health and safety policies and procedures. Staff receive training which supports safe working practices such as fire safety, moving and handling, food hygiene and first aid. Safety checks are made on fire fighting equipment in line with intervals recommended by the fire service. Health and safety is further assured by regular servicing of boilers, kitchen and laundry equipment as well as safe storage of hazardous chemicals. All accidents are recorded and monitored. 128 Beech Hill DS0000062353.V325111.R01.S.doc Version 5.2 Page 21 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 x 3 X 3 X 2 3 x 128 Beech Hill DS0000062353.V325111.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 YA41 Regulation 26 Requirement Visits and reports must be undertaken monthly, in accordance with this Regulation, with a copy of the report held at the home (Previous timescale 05/04/06) Timescale for action 31/03/07 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 YA32 YA39 Good Practice Recommendations The NVQ training programme should be made more widely available The quality assurance system should be developed 128 Beech Hill DS0000062353.V325111.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 128 Beech Hill DS0000062353.V325111.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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