CARE HOME ADULTS 18-65
13 Wilbury Gardens Hove East Sussex BN3 6HQ Lead Inspector
Merle Blakeley Unannounced 10 June 2005 10:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 13 Wilbury Gardens H59-H10 S14115 13 Wilbury Gardens V229147 100605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service 13 Wilbury Gardens Address 13 Wilbury Gardens Hove East Sussex BN3 6HQ 01273 205044 01273 778361 Sucoarn@tiscali.com Royal National Institute for Deaf People (Organisation) Susan Ann Arnold Care Home 8 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Category(ies) of Physical Disability (PD), Sensory Impairment registration, with number (SI), 8. of places 13 Wilbury Gardens H59-H10 S14115 13 Wilbury Gardens V229147 100605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1. All residents should be aged between 45-65 years on admission 2. A maximum number of 8 people to be accommodated 3. The registration is issued for the care of hearing impaired adults 4. The home is registered for 8 people with a physical disability and/or sensory impairment 5. To admit one named individual who is 41 years of age on admission Date of last inspection 9 November 2004 Brief Description of the Service: 13 Wilbury Gardens is registered to provide care, accommodation and support for up to eight adults aged 45 years and over with hearing impairments and physical disability. The home is run by the RNID (Royal National Institute for Deaf People). Another RNID home is located close by at 32 Ferndale Road, Hove which caters for younger adults with hearing impairments. The service is located in a three-storey detached house in a quiet residential area of Hove. The home is in close proximity to local transport, shops and other amenities. Accommodation is provided in single rooms, none of which have en suite facilities. There is a lift to all floors. There is a large garden and conservatory to the rear of the building, which residents enjoy during the warmer months. The home is well maintained and has a very welcoming atmosphere. 13 Wilbury Gardens H59-H10 S14115 13 Wilbury Gardens V229147 100605 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This Unannounced Inspection took place over a period of five and a half hours on 10th June 2005. The inspection process included speaking with six of the residents with the assistance of a sign language interpreter, document reading, tour of the premises and informal discussions with the manager and staff on duty. What the service does well: What has improved since the last inspection?
Permanent residents have now been consulted on how they feel about people in the community coming into their home for day care services. There are two older deaf people who come into the home for short periods of time; one attends two days a week and the other four hours a week. All of the residents appeared to be happy with this arrangement on the proviso that extra staff are on duty when these people attend. A ventilation system has now been provided for the shower room on the first floor and the vent axia fan has been repaired. Staff are progressing well with the completion of NVQ Level 3 training and a good level of core skills training has also been achieved. Staff recruitment information has improved, however the home still needs to produce proof of identity documents and recent photos for each staff member. Recent refurbishments to the home have included new carpets throughout, new light fittings and net curtains. 13 Wilbury Gardens H59-H10 S14115 13 Wilbury Gardens V229147 100605 Stage 4.doc Version 1.30 Page 6 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. 13 Wilbury Gardens H59-H10 S14115 13 Wilbury Gardens V229147 100605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection 13 Wilbury Gardens H59-H10 S14115 13 Wilbury Gardens V229147 100605 Stage 4.doc Version 1.30 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 & 5 The home has produced an informative statement of purpose and service users guide in widget format. The RNID have still to produce individual contracts for residents. EVIDENCE: The home has produced a very informative service users guide, which has been formatted into a style that makes it easier for residents to understand. It contains details about the aims and objectives of the home, the staff team; qualifications and training, activities, medication, fees, religion, fire safety, accommodation and care plans. Residents have license agreements, which tell them what services they will receive from the home, however formal contracts are still not in place. The RNID legal department have still to produce this document. The home also provides a day care service for two older people in the community who have hearing impairments. One attends the home two days a week and the other attends for approximately four hours a week. The residents who live permanently at 13 Wilbury Gardens have been consulted about this arrangement and those that can have given their consent to have additional people come into their home. This arrangement also includes an extra staff member being on duty. All the residents are aged 45 years and over with some now being in their 80’s. 13 Wilbury Gardens H59-H10 S14115 13 Wilbury Gardens V229147 100605 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 & 8 The care plans for residents are organised and informative. Staff provide residents with information to help them make informed choices. Residents were seen to participate in the daily running of the home. EVIDENCE: Random care plans were viewed and they all appeared to be providing important up to date information on residents. Reviews are held every two months with key workers and daily plans are discussed at handover periods. Major reviews that involve the residents social worker, the manager and staff are held annually and family members/friends are invited to attend. Additional notes and entries into resident’s care plans need to include the date of when they were written. Residents have been provided with information about how they can contact local advocacy services. Staff provide information, where possible to help residents make informed choices about their lives. 13 Wilbury Gardens H59-H10 S14115 13 Wilbury Gardens V229147 100605 Stage 4.doc Version 1.30 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 14, 15 & 17 Residents have the opportunity to be as independent as possible. They are able to be part of the local community and engage in social activities. Links with family and friends are maintained. Residents are encouraged to help with the planning of meals. EVIDENCE: Some residents are able to go out on their own without assistance. The other residents who are not so mobile or independent can go out with staff members. Residents have various activities/hobbies that they choose to pursue and several are very keen on artwork. Some residents are also supported and accompanied by staff to go on holiday. One resident is taking a holiday in London accompanied by two staff and three other residents and staff are spending a week in Spain. Local outings are arranged to deaf clubs, cinemas, pubs and parks. Resident’s are also able to discuss the types of activities they would like to be involved with during their regular house meetings and recent suggestions have included croquet, pottery and darts. 13 Wilbury Gardens H59-H10 S14115 13 Wilbury Gardens V229147 100605 Stage 4.doc Version 1.30 Page 11 Residents are encouraged to develop independent living skills and they are assisted to clean their rooms and help plan the daily meals. Residents are again encouraged and supported to maintain links with family and friends. Staff can help residents arrange visits to see family and friends or they can come to the home. Residents are also assisted to keep in touch by writing letters and using the minicom or fax machine. Residents make choices about the meals they would like to eat and some will go out with staff and assist with the ‘weekly shop’. Not all the residents enjoy the same meals so often there can be up to five different meals being cooked. Residents who were spoken to stated that they were happy with the meal arrangements. 13 Wilbury Gardens H59-H10 S14115 13 Wilbury Gardens V229147 100605 Stage 4.doc Version 1.30 Page 12 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 & 21 The healthcare needs of residents are met. The home has produced a policy on death and dying and this has been included in the service users guide in widget form. EVIDENCE: All residents are registered with their doctor and they have access to other local medical facilities. Staff can arrange visits to check resident’s hearing aids and spectacles. A chiropodist comes into the home on a regular basis. Some of the residents are also registered with local specialist care teams who come into the home to provide support and advice. The home has a written death and dying policy, which has been explained to residents in widget form. It outlines the care that all residents will receive and how their wishes will be carried out. 13 Wilbury Gardens H59-H10 S14115 13 Wilbury Gardens V229147 100605 Stage 4.doc Version 1.30 Page 13 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 The home has a complaints procedure and a policy and procedure on Adult Protection. EVIDENCE: The home has produced a complaints procedure in widget form, which clearly details how residents can make a complaint if they are not happy about any aspect of life at 13 Wilbury Gardens. The procedure also informs residents about how they can contact the CSCI. The RNID has produced an Adult Protection Policy and Procedure for all its homes. All but one staff member has attended training in adult protection. Resident’s finances were checked and were found to be in order. The home maintains well-documented records concerning resident’s finances. There were no complaints or Adult Protection concerns in the home. 13 Wilbury Gardens H59-H10 S14115 13 Wilbury Gardens V229147 100605 Stage 4.doc Version 1.30 Page 14 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 25, 27, 28 & 30 The home provides accommodation in single bedrooms. Adequate bathing and toilet facilities are available. Pleasant communal areas are provided for residents and the home is maintained to a good standard. EVIDENCE: All residents are provided with single bedrooms, which are comfortable and homely. Bedrooms have hand washbasins only and are therefore not en suite. There are five bedrooms located on the first floor and three bedrooms on the second floor. A lift is available to all floors. The home has installed a parker bath for residents who need some assistance with bathing; there is also a separate shower room and another bathroom. Communal areas within the home include two resident’s lounges, a very pleasant conservatory, large dining room and separate kitchen. Resident’s also have access to a large rear garden. Recently one of the residents has started showing an interest in gardening and was weeding the path on the day of the inspection, he appeared to be enjoying this activity. Overall the home is maintained to a good standard and was found to be clean and hygienic. Recent refurbishments to the home include new carpets throughout, new light fittings and curtains. 13 Wilbury Gardens H59-H10 S14115 13 Wilbury Gardens V229147 100605 Stage 4.doc Version 1.30 Page 15 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34, 35 & 36 Several staff have completed their NVQ qualifications. The home is experiencing some staff shortages. Recruitment documentation has improved but proof of identity is still required. A good level of staff training is being provided. Staff are supervised on a regular basis. EVIDENCE: The manager stated that to date two staff members have obtained their NVQ Level 3 qualification with another two staff due to complete Level 3 in November this year. Funding has been received for two more staff to commence training in August 2005, so by next year at least six staff members will have completed their NVQ qualification, which is excellent. The home currently employs six full time staff and one part-timer; there are three staffing vacancies at present. One staff member is due to leave soon and another is on sick leave, therefore the home is experiencing some staff shortages and agency staff are being used. The manager felt this would hopefully only be on a short-term basis because a staff member from another RNID home was hoping to transfer to 13 Wilbury Road. Staff recruitment information has improved and the home is now able to maintain all information pertaining to staff employment. All staff have CRB checks and references. Proof of identification is still required for each staff members file. Once new staff have been appointed they undergo a three-day induction period during the first week; this is then followed by the RNID induction-training programme.
13 Wilbury Gardens H59-H10 S14115 13 Wilbury Gardens V229147 100605 Stage 4.doc Version 1.30 Page 16 Recent training staff have attended includes infection control, manual handling, basic food hygiene, health & safety, fire safety and adult protection. Some staff have also attended a two-day course in challenging behaviour. Staff meetings are held on a fortnightly basis and supervision is carried out and recorded sixweekly. Senior staff members supervise support workers and the manager is responsible for supervising the senior staff members. 13 Wilbury Gardens H59-H10 S14115 13 Wilbury Gardens V229147 100605 Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39, 41 The home needs to ensure that more regular resident’s satisfaction surveys are carried out. The required records are maintained by the home. EVIDENCE: The home has a Quality Assurance Programme, however it was noted that a resident’s feedback survey had not been carried out for quite some time and this was highlighted during the last inspection in November 2004. Also, there was no evidence to show that the home had carried out the intended survey for relatives/friends/social workers. Records were viewed and appeared up to date. It was discussed with the manager about the use of Regulation 37 Forms, which are used to record any adverse events involving residents or staff. It appears the home has not been aware of these forms. 13 Wilbury Gardens H59-H10 S14115 13 Wilbury Gardens V229147 100605 Stage 4.doc Version 1.30 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 x x x 2 Standard No 22 23
ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 3 x x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score x 3 x 3 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 x 3 3 x 3 Standard No 31 32 33 34 35 36 Score x 3 3 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
13 Wilbury Gardens Score x 3 x 3 Standard No 37 38 39 40 41 42 43 Score x x 2 x 2 x x H59-H10 S14115 13 Wilbury Gardens V229147 100605 Stage 4.doc Version 1.30 Page 19 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 YA39 Regulation 12(1)(a)( b) Schedule 2 5c 37 Requirement That a service user feedback survey is carried out at least twice a year. THIS IS A PREVIOUS REQUIREMENT. That copies of proof of identity are maintained in staffing files and must include a recent photo. That the RNID provide each service user with a standard form of contract. That the home record any adverse events to service users on the Regulation 37 Form. On completion this form must be forwarded to the CSCI. Timescale for action 31/8/05 2. 3. 4. YA34 YA5 YA42 Immediate Immediate Immediate RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA6 Good Practice Recommendations That any additional notes written into service users care plans are signed and dated. 13 Wilbury Gardens H59-H10 S14115 13 Wilbury Gardens V229147 100605 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection 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
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