Inspection on 26/06/06 for 13 Wilbury Gardens

This inspection was carried out on 26th June 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

13 Wilbury Gardens 06/12/05

13 Wilbury Gardens 10/06/05

13 Wilbury Gardens 09/11/04

13 Wilbury Gardens 10/06/04

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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 13 Wilbury Gardens Hove East Sussex BN3 6HQ Lead Inspector Merle Blakeley Unannounced Inspection 26th June 2006 10:00 13 Wilbury Gardens DS0000014115.V292352.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 13 Wilbury Gardens DS0000014115.V292352.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. 13 Wilbury Gardens DS0000014115.V292352.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 13 Wilbury Gardens Address Hove East Sussex BN3 6HQ 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) 01273 205044 01273 771891 Royal National Institute for Deaf People Susan Ann Arnold Care Home 8 Category(ies) of Sensory impairment (8) registration, with number of places 13 Wilbury Gardens DS0000014115.V292352.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The maximum number of service users to be accommodated is eight (8) Service users must be aged between forty five years (45) and sixty five (65) years on admission Service users with sensory impairments only to be accommodated To admit one named service user who is aged forty-one (41) years of age on admission 6th December 2005 Date of last inspection 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 and mental health difficulties. 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. Current fees for the home range from £700.00 to £2,300 per week. 13 Wilbury Gardens DS0000014115.V292352.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection was carried out over a period of seven and a half hours on 26th June 2006. As well as this site visit, information was also obtained from a pre-inspection questionnaire, feedback survey forms, informal talks with seven residents with the assistance of a sign language interpreter, and talking with six staff members. The site visit also included a tour of the premises, looking at the needs of four particular residents, document reading and observing staff and residents interacting throughout the day. There are currently seven residents residing in the home plus two sensory impaired adults who attend twice a week. What the service does well: What has improved since the last inspection? A requirement was made during the last inspection for the home to ensure that all PRN medication is correctly recorded and this has been done. The home has replaced the sliding door in the conservatory, which has now made it easier to open and close. During this visit to the home records showed that residents seem to be participating in and being offered a lot more activities, which is very encouraging. All of the residents have been enjoying day trips out to various places that interest them and all seven residents are going away again on holiday this year. Weekly activities always include visits to the cinema, pub lunches, shopping etc. Residents spoke enthusiastically about their holidays and day trips. 13 Wilbury Gardens DS0000014115.V292352.R01.S.doc Version 5.1 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 DS0000014115.V292352.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 13 Wilbury Gardens DS0000014115.V292352.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): 2&5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The RNID is still not providing individual contracts for residents. EVIDENCE: The home carries out thorough assessments on all prospective residents prior to them moving into the home. These assessments ensure that the home can meet their needs. No new residents have moved into the home since the last inspection in December 2005. The need for the RNID to provide individual contracts for residents has become a long and protracted process. As of 26th June 2006, contracts are still awaiting approval and it is sincerely hoped that residents will receive their own contract during 2006. 13 Wilbury Gardens DS0000014115.V292352.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans were informative and up-to-date. Residents are able to make choices about their lives. Residents are supported to take responsible risks. EVIDENCE: Five of the seven residents care plans were viewed during this visit. They were found to be informative and up-to-date. Most of the care plan reviews had been carried out in April/May this year. As well as written records, staff also discuss each resident at group meetings to see how they can continue to improve the lives of each resident. The home maintains a daybook, which describes how each resident has spent the day. Any significant information in this book is transferred into the residents care plan. Although most of the residents have communication difficulties, it was evident that they were able to make choices and decisions about certain aspects of their lives. Several residents had decided on where they wanted to go on their holidays, they can also choose the meals they prefer, when they would like to go out and if they wish to participate in any activities. 13 Wilbury Gardens DS0000014115.V292352.R01.S.doc Version 5.1 Page 10 Residents are encouraged and supported to make informed choices and take responsible risks with assistance from staff where necessary. Risk assessments on each resident are carried out. Where risks are identified staff will accompany a residents. Several residents are supported to go on holiday, visit friends and go out alone. One resident is currently being supported to take responsibility for doing his own shopping, cooking his meals and dealing with his own medication. This is with a view to this person possibly moving into supported accommodation. 13 Wilbury Gardens DS0000014115.V292352.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): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The level of activities provided for residents has increased. Residents are out and about in the local community and they are able to maintain family links and personal friendships EVIDENCE: Records viewed during the day and discussions with staff indicated that residents are going out a lot more and they are being offered a wider variety of activities. Residents have gone out with staff on several day trips to places that are of interest to them. Holidays during the summer have also been organised and two residents are going to Norfolk, two are off to Spain, one resident is going to Blackpool and another two are taking a holiday in the London area. One resident has been encouraged and supported to attend more regular activities and he now goes swimming every week and also visits a sensory room weekly. Some residents are able to go out on their own independently. An activity rota for each resident is displayed in the office Most of the residents are out and about in the community and use the local services and shops. Residents also go out for meals, to the pub and the cinema. 13 Wilbury Gardens DS0000014115.V292352.R01.S.doc Version 5.1 Page 12 Residents are able to stay in touch with family and friends. Some relatives and friends visit and some residents keep in touch by phone using the Mincom system. With the assistance of a sign language interpreter, some residents were asked as to whether they felt their rights were respected and that they were given responsibilities where appropriate. Several stated that this was the case and staff treated them well. Several residents have daily tasks they like to be responsible for such as laying the table, loading the dishwasher etc. Residents can choose when to get up, when to eat and when they wish to go to bed. The home offers flexibility for mealtimes, as some residents like to eat other types of diets. Resident’s cultural needs are being met, as one person likes to prepare and cook his own Halal meals. Residents said that they enjoyed the meals that were prepared and felt there were enough choices available to them. The staff team cook most of the meals and they sit down and enjoy lunch/supper with the residents. This makes mealtimes a very convivial part of the day. 13 Wilbury Gardens DS0000014115.V292352.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, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Most of the residents carry out their own personal care. Resident’s healthcare needs are being well met. The home administers and records medication appropriately. EVIDENCE: Most of the residents are able to carry out their own personal care with only prompting from staff on occasions. Two residents need some assistance with baths and dressing. Resident’s healthcare needs appear to be well met by the home. The home has a separate appointments file, which clearly indicates when residents have a medical appointment and which staff may accompany them. Outcomes of visits and medical tests are also recorded in this file. Recently one of the service users had to go into hospital for an operation and four staff members accompanied him on a shift basis to ensure that there was someone with him at all times, as this resident has very limited communication skills. Resident’s weights are regularly checked and they have access to local doctors, district nurses, auditory services, chiropodists, dentists etc. Medication records were checked and were found to be in order. The home has made improvements on how PRN medication is now recorded. There are two 13 Wilbury Gardens DS0000014115.V292352.R01.S.doc Version 5.1 Page 14 separate books to record when antibiotics and PRN medication is given, however staff must be clear about which medication goes in which book, as some staff were recording medicines in the wrong book. Medicines are securely stored within the home. 13 Wilbury Gardens DS0000014115.V292352.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents concerns and complaints are listened to. The home has a policy and procedure regarding the protection of vulnerable adults. EVIDENCE: The home has produced a complaints policy and procedure, which is included in the service users guide in widget format. There have been four complaints/concerns between two of the residents. These concerns were successfully resolved with input from a social worker and RNID managers. The home has an adult protection policy and procedure. Staff have received training in the protection of vulnerable adults. There are no current concerns within the home. Several resident’s finances were checked and were found to be in order. 13 Wilbury Gardens DS0000014115.V292352.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe and comfortable environment. The home is maintained to a good standard. EVIDENCE: 13 Wilbury Gardens provides residents with a homely and caring environment. A lift is available to the first floor bedrooms. All the communal areas are on the ground floor and the home has recently purchased a new lounge suite for the living room. The sliding door in the conservatory has been replaced. Several bedrooms were viewed and they are all decorated and furnished to each resident’s personal taste. Special flashing bells are installed on each bedroom door for resident’s privacy. Special pillows and mattresses are also installed to alert residents in an emergency. The home is clean and tidy and well maintained. 13 Wilbury Gardens DS0000014115.V292352.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The current staff team are meeting the needs of residents in a caring and supportive manner. The home normally carries out suitable recruitment practices. 40 of the staff have gained NVQ qualifications. EVIDENCE: The home has a very effective and committed staff team and there are a good mix of both non-hearing and hearing staff. Residents have a designated key worker allocated to them. During the day the inspector was able to view the very positive and relaxed relationships that staff have built up with the residents. Staff have a very good understanding of each resident, as many of them have quite complex needs aside from their hearing impairments. The inspector was able to communicate with most of the residents with the aid of a sign language interpreter and all stated that they felt well cared for by the staff. Four of the ten staff members have obtained their NVQ Level 3 qualification and two more are due to commence NVQ training this year. All staff are trained to various different levels in sign language skills. Future training needs include challenging behaviour, autism, mental health training and health & safety. Six staff were spoken to during this visit and they all stated that they worked very well together as a team and felt well supported by their colleagues and senior management. They also felt that they received a good level of training 13 Wilbury Gardens DS0000014115.V292352.R01.S.doc Version 5.1 Page 18 to work effectively in their roles. There are some staff shortages at the moment and interviews are due to be carried out next week to recruit additional staff. Recruitment files were not able to be viewed during this inspection as the manager was on annual leave, however all recruitment files were viewed at the last inspection in December 2005 and they were found to contain all the required information as set out in the National Minimum Standards. Senior staff on duty did not have keys to the recruitment information files. All records within the home do need to be made available at all times for inspection purposes. 13 Wilbury Gardens DS0000014115.V292352.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. An experienced and qualified manager runs the home effectively. The home seeks feedback from residents, relatives and visiting professionals. There were no health & safety concerns found on the day. EVIDENCE: The registered manager has several years experience of working with people who have sensory impairments. The manager has successfully completed the Registered Managers Award this year. She is able to communicate proficiently in BSL sign language and manages the home in a friendly and relaxed manner. Both residents and staff stated that the manager was very approachable and she would always deal with any issues or concerns. Staff also stated that they felt well supported by the manager. The home has a quality assurance programme, which includes seeking feedback from residents, relatives and visiting professionals. Regulation 26 13 Wilbury Gardens DS0000014115.V292352.R01.S.doc Version 5.1 Page 20 visits are carried out monthly by the RNID and very informative reports are compiled from these visits. There were no health and safety concerns identified during this inspection. The home carried out its last fire drill in March 2006. Fire alarms are checked weekly. 13 Wilbury Gardens DS0000014115.V292352.R01.S.doc Version 5.1 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 X 2 3 3 X 4 X 5 1 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 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X 13 Wilbury Gardens DS0000014115.V292352.R01.S.doc Version 5.1 Page 22 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 YA5 Regulation 5C Requirement That the RNID provide each service user with a standard form of contract. PREVIOUS REQUIREMENT FROM THE LAST FOUR INSPECTIONS. Timescale for action 30/11/06 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 YA41 Good Practice Recommendations To ensure that senior staff on duty have access to all files when the manager is away. 13 Wilbury Gardens DS0000014115.V292352.R01.S.doc Version 5.1 Page 23 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. Extracts may not be used or reproduced without the express permission of CSCI 13 Wilbury Gardens DS0000014115.V292352.R01.S.doc Version 5.1 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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