Inspection on 14/11/06 for Watchbell House

This inspection was carried out on 14th November 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Watchbell House 06/10/08

Watchbell House 03/02/06

Watchbell House 17/05/05

Watchbell House 21/09/04

Watchbell House 01/04/04

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Insight - Eastchurch

Southfields

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Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Watchbell House Watchbell Street Rye East Sussex TN31 7HA Lead Inspector Jason Denny Key Unannounced Inspection 14th November 2006 13:40 Watchbell House DS0000021279.V318318.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 Watchbell House DS0000021279.V318318.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. Watchbell House DS0000021279.V318318.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Watchbell House Address Watchbell Street Rye East Sussex TN31 7HA 01797 222059 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) Canterbury Oast Trust Vacant Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Watchbell House DS0000021279.V318318.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. People will be over eighteen and under sixty five years of age on admission 3rd February 2006 Date of last inspection Brief Description of the Service: Watchbell House is one of two care homes, owned by the Canterbury Oast Trust in the picturesque and historic town of Rye. The home provides social and residential care for six adults with mild to moderate learning disabilities. Accommodation is on three floors, having sufficient [3] bathroom and toilet facilities. At the rear of the premises there is a small, private courtyard garden with patio, barbeque area and gazebo. This home offers a particularly attractive and homely setting for the small group of able-bodied Residents accommodated. Watchbell House is a listed building situated in an elevated position with extensive views. The shopping areas, rail and bus links are within safe walking distance. The home has its own people carrier vehicle. The Trust provides a range of work opportunities such as in a local Restaurant and at the Rare Breeds centre a farm based near Ham street 10 miles from the home. Information on the range of fees charged is within the homes current statement of purpose/service user guide and is a standard charge of £807.23 per week. Service users [Residents] are not personally charged for extras if they choose personal items, additional activity outings and hairdressing they fund this themselves with most managing all their own financial affairs. Inspection reports are not routinely sent out to families and advocates after each publication although a copy is kept on display in the reception area of the home and can be obtained via the manager. A service user guide containing the most recent inspection report is sent to any interested person [or their representatives] looking to move into the home. Watchbell House DS0000021279.V318318.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an Unannounced key Inspection, which included a visit to the home which took place between 1.40 and 6 pm on November 14, 2006. This inspection focused on the key major areas such as how needs are being met. Activities, lifestyles, environment staffing of the home, along with how the home is managed, and how concerns are dealt with, was looked at. During this inspection process, which covers the period since the last inspection February 3, 2006 and the week of the home visit, a number of social workers have been spoken with. All 6 Residents returned survey cards, which indicated good levels of satisfaction with the home, especially the staff and the care. Some relatives and all 6 Residents were spoken with, and observed during the inspection, which also included discussion with some staff and observation of care-practices. The focus of the inspection was looking at 3 of the 6 Residents in detail. Some diversity and equality areas were explored in relation to lifestyles. Care records for 3 Residents along with health and medication needs were looked at. Discussions with management and senior staff looked at progress since the last inspection. The inspector toured all communal areas of the home. Meal arrangements were examined. A record of complaints was inspected. Staffing was looked at in detail along with the homes management, including measures to ensure quality for Residents. Two [2] outcome areas is assessed as Excellent, and the other six [6] areas is assessed as Good overall. What the service does well: The Inspector again found a pleasant, warm and comfortable atmosphere during his visit. Health needs are closely monitored and overall care needs of all Residents are regularly reviewed to an exceptional extent. All Residents were observed to be relaxed with arrangements with them socialising well together. All Residents have clear routines based on their choice and are confident about approaching staff and stating their views and choices. Staff are positive, along with being knowledgeable and attentive to Residents needs. All Residents were found to have active lifestyles especially those who are more independent who have an exceptional range of choices and opportunities. Some Residents came and went from the home throughout the inspection. New Residents are only admitted to the home after all information is gathered and only after the person has visited the home several times to test things out. Other resident’s view on anyone new is sought. The group of women in the home were found to be compatible and are encouraged to take sensible risks to improve independence. Staff are clear about how to both identify possible abuse and report it. Watchbell House DS0000021279.V318318.R01.S.doc Version 5.2 Page 6 Staff operate with a clear sense of direction with clear plans, which helps them fully meet resident’s needs. The home smoothly manages itself based on resident involvement. Residents are regularly consulted about their views with this recorded. Social workers and relatives spoken with indicated high levels of satisfaction with the home. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Watchbell House DS0000021279.V318318.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 Watchbell House DS0000021279.V318318.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, & 5. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The home has improved the accessibility and accuracy of the information in its guide with only very minor work nearing completion. Prospective new Residents are carefully assessed before moving in with existing Residents under regular and effective ongoing assessment to ensure their needs continue to be met. Standard 4 was exceeded at the last inspection it was looked at 17/05/05. EVIDENCE: The Resident’s guide [service user] to the home and organisation was found to be clearly on display in the home along with most recent inspection report. All the information in the guide has been updated and is now presented in a more accessible way for people with learning difficulties/ disabilities. The guide contains a range of useful information and views of Residents with their picture included to aid identification. Information about the complaints procedure and the various levels of management in the organisation were found to have been updated. Watchbell House DS0000021279.V318318.R01.S.doc Version 5.2 Page 9 The guide was just awaiting some photographs of some of the Trusts managers the home manager and some staff. The manager was found to be in the process of purchasing an appropriate camera. It was recommended at the last inspection that a talking tape be produced summarising the information in the guide to aid those with reading difficulties. The manager was made aware of the need to send the Commission any updated versions of the homes guide statement of purpose. The most recent inspection report was found to have been read and discussed with Residents at one of their regular meetings in July 2006. No new Residents have moved in to the home since the last inspection. This aspect of the home had previously been assessed as good. The group of Residents were all found to be compatible as confirmed in observations, records, and discussions with Residents, staff, relatives, and Social workers. All needs were found to be met. Evidence was also seen in records and in discussions with staff on how well particular Residents are being reassessed to ensure their changing needs continue to be met. Contracts between the Residents and the home were again found to be good and transparent and have been inspected in detail on previous visits with no subsequent changes to the Resident group. All Residents are charged the same fee of £807.73 with all funded by Social Services. Watchbell House DS0000021279.V318318.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7, & 9. Quality in this outcome area is Excellent. This judgement has been made using available evidence including a visit to this service. Care-Plans were found to contain good information subject to regular review with all relevant people. Care-planning goals were found to be met A particular resident was found to be especially benefiting from independent advocacy and other support organised over the last year. Sensible, full, and positive risk assessing take place based on promoting safe independence. EVIDENCE: Three care-plans were looked at in some detail. The key worker together with the manager and the resident carries out care planning. Residents have access to their plans and may choose who is to attend their review meetings. Watchbell House DS0000021279.V318318.R01.S.doc Version 5.2 Page 11 Social Workers spoken with confirmed how well prepared Residents are at reviews and how well managed they are by the home, with them kept fully up to date. The care plan includes an assessment of all aspects of personal and social support and healthcare needs. Daily notes and risk assessments also form part of the care planning process and are wide ranging covering all activities with a helpful index. Those Residents who go out independently ensure that have working mobile phone along with number of other safety measures. Plans were found to be full and up to date with reviews taking place every 6 months. Shorter daily care-plans to complement the larger care-plan folders, and routines have been developed since the last Inspection. This aids the information given to staff especially if any new staff join the home and need summarised daily information to follow. The shorter plans are designed to show how needs are met in practice on a daily basis. All staff seen during the inspection clearly show an understanding of how best to meet Residents needs in line with their preferences and their care-plans. All Residents were spoken with, three in detail where their care plans were looked at. They stated happiness with the home and that all their needs were being met. The newest resident was found to have settled in well to the home as seen in records and observation. Over the last year a resident whose records showed that she needed independent advocacy has had this arranged along with fortnightly support from a psychologist as confirmed in records. The resident indicated how helpful she was finding this support where it has improved her quality of life. which was observed in the inspection. It is also noticeable that there has been a reduction in challenging behaviour with all staff more knowledgeable about how to meet her needs, which included changes to her daily care-plan. Residents attend reviews where they discuss their needs with the organisation, their care manager, and their parents. This Resident has since the last Inspection increased their independence by using public transport independently. No other Residents currently receive independent advocacy. The home has details of suitable organisation but it has been explained that there is no current need for this service, which is not funded for. Watchbell House DS0000021279.V318318.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12,13,15,16, & 17. Quality in this outcome area is Excellent. This judgement has been made using available evidence including a visit to this service. Meaningful Activities take place on a regular basis for all Residents. Residents have continuous opportunities to learn new skills and further their education. Full structured routines are in place based on resident’s needs and choices Residents are encouraged to play a full role in the community and increase independence. Meal arrangements are good with Residents choosing the food that is cooked. Watchbell House DS0000021279.V318318.R01.S.doc Version 5.2 Page 13 EVIDENCE: A full, weekly programme of activities is agreed with Residents and these are entered on an activities board; the majority of these being off-site, including college courses, occupational activities and leisure outings. A variety of evening and weekend activities are also arranged. Residents access local community facilities and services on a daily basis; some have library and/or church membership; most enjoy pub visits, arranged with staff. Community links have been established within the community of Rye, where the local shopkeepers know the Residents. Three of the Residents take it in turns to do voluntary work in a local charity shop, others assist in a Mother and baby group. 4 Residents attend a college course at the local education centre. Some attend two evenings per week. The newest resident confirmed that in a short space of time she had tried several jobs in the local Trust’s restaurants before finding two jobs she enjoyed one involving horticulture and the other animal care requiring 4 mornings a week at the local Trust farm. Another Resident announced as evidenced in records that she has got a new job in the Farm’s restaurant. Records and staff showed how the new manager has further developed activities and opportunities for independence in line with the homes annual development plan developed in May 2006. Friends and family members are welcomed at the home, usually by prior arrangement as Residents spend much of their time off-site. Weekend trips home are arranged. Residents’ choice of whom they see, or invite back to the home is respected; the home has a policy on personal relationships. Contact with friends and family is actively encouraged. The trust has produced its own “Residents charter” based on the views of Residents. Residents confirmed that Staff respect their right to privacy; they were observed to attentive to the needs of Residents, whilst at the same time giving encouragement to develop self-help skills and promote independence. Residents treat the home as their own, freely coming and going, or spending time in the privacy of their own room, as they wish. This was observed during the inspection. The Inspector observed a resident cooking the evening meal with support from a staff person. Each resident has a rota so all can take turns. Another Resident was observed being carefully supported to making choices about the shopping list. One resident was scheduled to go swimming in the afternoon as confirmed by staff and in records but a shortage of staff at that time meant this could not occur, this was explained as an exceptional situation. Watchbell House DS0000021279.V318318.R01.S.doc Version 5.2 Page 14 A weekly menu plan is agreed in consultation with Residents. There is always a choice at mealtimes, a record being kept of any special diets or preferences. One resident was found to have changed her mind on return to the home and was supported to find an alternative meal. The home was found to have a range of fresh ingredients including meats, fruit and vegetables. Watchbell House DS0000021279.V318318.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19, & 20. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Resident’s health needs are closely monitored and reviewed. All Residents receive good care and attention based on helping them to be as independent as possible and to have a good quality of life. Medication arrangements are sound. EVIDENCE: Discussions with a senior staff person and review of one Resident’s records showed the close way that a particular mental health condition was being monitored with a range of support to help the Resident have a better quality of life which is affected by the condition. Records showed continuous review of medication and follow up medical appointments. Over the last year there has been a change to the frequency of a prescribed drug, which has had the positive effect of this Resident having more energy as confirmed by the Residents and records. Closer working with specialist services and her psychologist has assisted. The resident confirmed how improved support from staff and other services has improved her self-control well being. Watchbell House DS0000021279.V318318.R01.S.doc Version 5.2 Page 16 The Resident was found to be well during the inspection. All staff were seen to treat Residents with respect and dignity with all encouraged to become as independent as possible within a sensible risk assessed framework. Care-plans, observations, and discussions with Residents and staff showed how Residents personal care needs are sensitively met with full regard given to their rights, dignity, and respect. One Resident was observed to have her choice for a supported bath respected via a slight change to a routine. Comment cards filled in by relatives along with those spoken with on the phone, all indicated satisfaction with the care being provided to Residents. The inspector looked at medication stocks, record keeping, training records and observed trained staff dispensing medication all of which was found to be in order. The senior confirmed that the system for disposing of surplus medication in a timely manner has improved. Watchbell House DS0000021279.V318318.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, & 23. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Complaints and concerns are thoroughly investigated in the best interests of Residents although more evidence is needed in the home’s complaint’s file to reflect this. Residents benefit from staff being regularly trained in how to prevent abuse and protect vulnerable adults within an open and closely monitored home. EVIDENCE: The previous acting manager had introduced a new system of organising the complaints file, which allows for all information on a complaint to be filed in one place to aid accessibility. The file includes standard letters and forms for acknowledging complaints and investigating them with the involvement of the complainant along with confirmation of the outcome. The Inspector has d previously requested this due to a previous system where various elements of a complaint were filed separately making accessibility difficult. During this inspection the complaints file was inspected which showed that a complaint had been made in September 2006 along with a reference number but no other information. The Inspector assumed this was the same complaint made by a Resident, which the organisation [Trust] sent detailed evidence to the Commission showing an exceptionally thorough investigation and agreed outcomes by all parties involved. The inspectors spoke with the Resident concerned who confirmed that she was happy with how this complaint was handled. Watchbell House DS0000021279.V318318.R01.S.doc Version 5.2 Page 18 The complaint was found to be partly upheld as it had been acknowledged and concluded that there had been a ongoing clash of personalities and related communication issues. The Inspector advised the manager after the inspection that whilst it is recognised that due to the sensitive nature of some complaints full details should not be in the complaints file but stored elsewhere, there needs to be more general detail in the home’s complaint file for inspection. The manager agreed to promptly rectify this. With the exception of this one complaint there has been no other complaints over the last year. A “Grumbles book” has also been introduced to record minor concerns from Residents about their peers or the running of the home with a section to show how the issue is resolved Key workers are trained to respond to Resident’s wishes, suggestions, or concerns. Evidence was observed during the inspection in terms of the attentive and proactive way staff promoted Resident to make choices and be involved in the running of the home. Records showed how staff are regularly trained in adult protection including how to identify and report potential abuse. There have been no adult protection issues in the home for many years. Watchbell House DS0000021279.V318318.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from living in a character building which feels and looks like an ordinary home at the high end of the market in an historic town. Resident’s benefit from a homely, comfortable, and well appointed home the marked exception being the kitchen which is rapidly deteriorating and the bathrooms which need renewal. Standard 26 was met at the inspection of 170505. EVIDENCE: The home provides shared and private rooms that meet space requirements. There is a separate lounge, a dinning room, also used for craftwork, and a spacious entrance hall. Resident’s artwork is displayed on the walls. The pointing and redecoration needed on front of the home was found to have been addressed over the last year. Watchbell House DS0000021279.V318318.R01.S.doc Version 5.2 Page 20 A refit of the kitchen was reported at the last Inspection 3 February 2006 to be planned to take place by the end of 2006. The kitchen was observed to have markedly deteriorated since the last Inspection with the many cracks and loose paintwork a possible source for bacteria to grow. The manager and written records confirmed that the kitchen is on the home’s annual development plan along with bathrooms, which now have a slight odour. However this work is not now planed until June 2007. The inspector decided against making a requirements as the home has these jobs planned and advised that the kitchen is renewed as soon as possible to avoid unnecessary risks. The home overall was found to be clean and free from offensive odour. Many parts of the home are excellent such as the front, the lounge and courtyard, which Residents help maintain. Watchbell House DS0000021279.V318318.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, & 35. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from sufficient numbers of staff most of the time. Staff are carefully selected, and supervised, and benefit from regular training. EVIDENCE: The numbers remaining at the home varies according to the daily, off-site activities that Residents are engaged in. The duty rota more clearly show hours worked by each staff member along with their capacity and qualifications. The duty rota shows staffing levels that reflect the needs and number of Residents although the rota did not show when the manager was working on shift as a carer and when she works management hours. On the day of the inspection the senior explained that the manager had been on shift but had called out to a meeting at the farm HQ. The manager was not shown as working as care staff on the rota other than stating that the manager was 84pm. Watchbell House DS0000021279.V318318.R01.S.doc Version 5.2 Page 22 Assessed needs, numbers of Residents, and Statement of Purpose, and risk assessments, indicates there needs to be minimum of 2 staff to the 6 Residents during waking hours. During the inspection up until 4 pm there was just one care staff available. This meant that a planed swimming trip for 1 Resident could not take place. She was not visibly upset by this but with 4 Residents in the home until 4pm with I staff member activities were more limited due to staffing. The other two Residents were out independently on work placements. It was agreed that with just 1 member of staff on duty, responses to an emergency situations would be affected and be dependent on others outside the home to respond. The inspector discussed this with the manager following the inspection. The manager accepted that if she is on shift then she has to continue being on shift until staff cover arrives or cancel any management meeting. The manager confirmed that on the day of the Inspection she had been out looking at a replacement computer. It was agreed that the rota needs to be transparent in relation to management hours. Written supervisory records were not accessible due to the manager being absent from the home. At the last inspection two staff files where looked at and showed that fully detailed supervisions were now set to occur at least six times yearly. No new staff have been employed at the home since the last inspection. Recruitment files were not available for Inspection but have been found to be sound on previous visits. The questionnaire filled in by the manager prior to the inspection showed that all checks had been carried out with all staff having Police CRB’s with the Trust carrying out fresh checks periodically such as in 2005. The homes questionnaire, discussions with the senior staff person and those training records looked at Showed that an exceptional number of staff, 6 of the 7 permanent staff ,have at least National Vocational Qualification at a basic level 2 with some having or studying for level 3 [senior level] and two including the manager having National Vocational Qualification at level 4 [management level]. All staff have regular rolling programme of relevant training as well as health and safety areas such as Moving an Handling, first aid, food safety, and fire. Staff are currently undertaking Dementia training in relation to one of the current Residents. The manager is also organising SCIP training for staff to enable them to be fully ware of how to help prevent the likelihood of any challenging behaviour. Watchbell House DS0000021279.V318318.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, & 42. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from a home, which is well managed in their best interests. The home continues to run smoothly at all time with Residents as fully involved as possible in its running. Health and Safety maintenance is good overall. EVIDENCE: Since the last inspection the organisation [Trust] has appointed a permanent manager who has passed all checks. An initial application to be registered was received by the commission in August 2006 but it was returned due to being incomplete. Shortly after the inspection an completed application was received by the Commission for processing. Watchbell House DS0000021279.V318318.R01.S.doc Version 5.2 Page 24 The manager confirmed that the organisation have recently resubmitted the application with the manager expected to be registered within the next 3 months. The manager has all necessary qualifications and was the registered manager of another home in the Trust before transferring to Watchbell house. Residents and staff spoke positively about the new manager and pointed to improvements to activities as one of her immediate achievements. It was evident to the inspector that the organisation of paperwork had also improved. The homes team leader [senior] who deputises in the manager’s absence has now completed a National Vocational Qualification level-4 in Management and Care along with the registered managers award. The home benefits from detailed and regular visits from the Trust’s area manager. At least monthly a report is made of one of these visits, which is promptly sent to the Commission. These visits cover all of the standards over a period of time with the voice of Residents central to these reports. The new manager has developed an annual development plan for the home dated May 2006. This identifies the need to further improve activities and opportunities for independence and community presence building on previously good outcomes and practice. This plan also identifies the kitchen and bathrooms for renewal. This plan was is also published in the homes service user [Residents] guide. Regular staff and Residents meetings occur ,with the latter occurring fortnightly as evidenced in minutes. The last staff meeting took place on 27 /10/06 as seen in minutes with the focus on how Resident’s goals plans will be supported by key- workers. It was again evident during the inspection the open, inclusive, and positive atmosphere that is maintained in the home. Residents indicated the easy access they have to both the manager and the area manager within the Trust. The organisation of the health and safety records in the home was found to have improved with all information easily accessible. The policy on food handling was found to have been revised on 17’05/06 in line with changing legislation. All necessary equipment such as portable electrical equipment [06/06 is regularly serviced. The Gas boiler was serviced on 09/11/05 The home ensures that there is always a qualified first-aider on shift at all times, with a range of regular safety training available to all staff including those who work in flexible non-permanent-roles as confirmed by one such staff person on the inspection. A fully completed visitors book is maintained in the home. Records of accidents are appropriately maintained. Watchbell House DS0000021279.V318318.R01.S.doc Version 5.2 Page 25 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 3 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 2 34 3 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 4 X LIFESTYLES Standard No Score 11 4 12 4 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 2 4 3 X X 3 X Watchbell House DS0000021279.V318318.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA33 Regulation 18[1][a] Requirement That the Registered person must ensure that at all times there are sufficient numbers of staff to meet assessed needs such as activities and risk assessments, and maintain minimum staffing levels. That the Manager by the date shown sends the Commission the contingency plan for covering the home when the Manager cannot work a care shift. That a copy of planned rotas for the next month are sent to the Commission by the date shown and show when the manager is on shift as a carer. Timescale for action 28/12/06 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 YA22 Good Practice Recommendations That the homes complaint’s file accessible to all staff DS0000021279.V318318.R01.S.doc Version 5.2 Page 27 Watchbell House 2 3 YA24 YA33 contains more information about the nature of the complaint and the outcome, with a reference to where requests can be made for full information That the kitchen planned for renewal in June 2007 has this timescale brought forward where possible to reduce risks. That the rota maintained in the home clearly shows care hours worked and management hours worked in relation to the manager. Watchbell House DS0000021279.V318318.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Watchbell House DS0000021279.V318318.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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