Inspection on 07/04/05 for 15 Preston Drove

This inspection was carried out on 7th April 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

15 Preston Drove 24/07/07

15 Preston Drove 06/10/05

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 15 Preston Drove 15 Preston Drove Brighton East Sussex BN1 6LA Lead Inspector Jenny Blackwell Unannounced 7 April 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. 15 Preston Drove Version 1.10 Page 3 SERVICE INFORMATION Name of service 15 Preston Drove Address 15 Preston Drove Brighton East Sussex BN1 6LA 01273 555291 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) Brighton & Hove City Council Mr Roger Hewitt Care Home 5 Category(ies) of Learning Disability (LD) 5 registration, with number of places 15 Preston Drove Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1 The maximum number of individuals to be accommodated is five (5). 2 Individuals must be aged between eighteen (18) and sixty-five (65) years on admission. 3 Individuals with a learning disability only to be accommodated. Date of last inspection N/A Brief Description of the Service: The home is registered to support up to five adults who have a learning disability. The home is a detached two-storey building set in the Preston Park area of Brighton. Although the home was not purpose built for people with disabilities adaptation have been made to the home that includes a passenger lift and accessible bathrooms. The home is opposite Preston Park and close to local shops, pubs and sports clubs. The home has its own mini bus with a tail lift that enables people who use wheelchairs to access their local community. 15 Preston Drove Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During this summary the people who live at the home will be referred to as people/person, and the people who work at the home as staff or by their job title. This was the first inspection of the home under the Care Standards Act and it was unannounced. The people who live at the home, some of the staff team, deputy and manager were present during the inspection. Time was spent with three of the five people who live at the home and the other two people where seen briefly in between trips out. The manager and deputy were spoken to individually and six staff were spoken to throughout the day. The day was arranged to fit around the activities organised for the day. As this was the first inspection for the home four areas where prioritised. These were the environment, numbers of staff working at the home, health care needs for the people who live at the home and their activities and interests. These areas were prioritised because of issues raised during communications between the manager and the Commission and Regulation 26 reports from the reviewing officer for the service. What the service does well: The manager and staff arranged daily activities with the people at the home and a daily shift planner was seen which detailed outings and activities for each individual with a named staff member. During the inspection all the people who live at the home were involved in a variety of activities. Two people went out with staff to a local garden centre to buy flowers. When they returned home they were present when the flowers were arranged and displayed in their rooms. During the day staff were seen to interact respectfully with the people who appeared to respond positively. In one instance a staff member was taking time in supporting a person with personal care paying particular attention to the persons appearance and styling her hair. This was carried out in the privacy of her bedroom. The records looked at during the inspection where of a reasonable standard which included particularly positive description of peoples details, likes and dislikes and interest in their care plans. During the inspection the staff where asked about the vacancies in the team each person acknowledge that it had been a difficult time in the service but agreed they had managed to maintain good morale despite the difficulties. 15 Preston Drove Version 1.10 Page 6 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 15 Preston Drove Version 1.10 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 15 Preston Drove Version 1.10 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) 2 and 4. The home provides adequate information for perspective new people moving into the home. This information is usually written and not currently accessable for people who do not read. The last person to move to the home has benefitted from the move although the process was deemed to be rushed. EVIDENCE: Two peoples care plan were looked. Both had assessments carried out by their social workers or reviewing officers that were up to date. Each person health care needs were assessed to determine whether the home could provide appropriate support in this area. Both people concerned do not read or use the spoken word to communicate. Evidence was not seen of how the staff help the people to be involved in their assessment process. However the staff spoken to during the inspection felt that the current group of people living at the home had been assessed well and they believed their current needs were being met. As the people at the home did not use words for communication, time was spent with people observing their movement around the home, their access to staff, and the general interaction with staff. It was noted that the home appears to meet the current assessed needs of the people. Issues about the 15 Preston Drove Version 1.10 Page 9 suitability of the environment will be address in environmental standards section. The manager and inspector discussed the experience of the last person to move to the home. The outcome for the person has been positive as she appeared to be well settled, in better health and comfortable in her surroundings. However the process was rushed to enable another person to move into the woman’s room in her previous home. It is required the manager ensures that each perspective person moving to the home is appropriately assessed and a planned transition in consultation with the person or their representatives is adhered to. 15 Preston Drove Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 and 7. The persons individual care plans contained detailed information including likes and dislikes, activity arrangements and guidence on supporting people with personal care and health needs. The plans in some areas need to be updated in type and review dates entered. The staff and managers approach individuals sensitively and offer choice to people in their daily lives. Further training of the manager and team in protecting people with a learning disability rights is required. EVIDENCE: Each persons care plan was looked at. They contained photo’s of people and included “Pen Pictures” which briefly discribe a persons interest, likes, dislikes, family and friends connections, basic health and social care needs. These were a good quick references tool for staff. Activitiy time tables were in the plans and were tailored to each person interest. Contributions to the plan was seen by the keyworkers and other staff and care was taken in describing some peoples health care support. Some information in the plans were hand written and not dated, it was unclear in parts, what guidelines staff were expected to follow. It was 15 Preston Drove Version 1.10 Page 11 recommended the plans are set out clearly with review dates when new information is added. The staff were seen to ask people directly about choices and decisions throughout the day. For people who were unable to directly respond in words staff were seen to adhere to their requests. For example when a person led to them to the kettle to make tea. On another occasion when a person was demonstrating he was upset, staff responded by using a process of elimination to understand what was concerning him. During the inspection it was noted that one person was due to have a major medical procedure. The manager and team had been working towards ensuring the processes of the person going to hospital, and having the procedure and return to the home was well managed. This included involving community health care professionals, and drawing up detailed guidelines. This work had been done sensitively and demonstrated a commitment by the staff to minimise the distress the procedure may cause the person. However not enough information had been given to the person about the procedure and little work had been done to attempt to inform the person about the consequence of the procedure. Where issues of capacity to consent to medical procedures are in doubt, the manager, staff and health care professionals have a duty under law to follow “Best Interest” procedures. It is required the manager ensures the people who live at the home make decisions in respect of their health and welfare and take their wishes and feelings into account. 15 Preston Drove Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,and 16. The managers and staff are commited to supporting each person with their daily interest. The home is concerned with the individual and does not group people together during activities for ease. People are supported to be part of the community. Staff generally do household task for people rather than with them and some enviromental restrictions are in place which need to be reviewed. Privacy is respected and staff freely engage with the people at the home rather than restrict conversation amoungst themselves. EVIDENCE: Each person’s activities were seen on an activities planner. Named staff were allocated to each person to facilitate the activity. This demonstrated a commitment from the staff to ensure activities take place. Two people went out with staff to buy flowers from a garden centre. On their return they were present when the flowers were arranged and placed in their rooms. Another person went to her day centre for the day. Activities such as 15 Preston Drove Version 1.10 Page 13 cycling, massage, tea making, visits to parks and garden centres were planned for the week. The staff spoken with had knowledge of what people’s personal preferences of activities were. The staff described days out and spoke about supporting people to try new activities. The staff discovered that one person really enjoyed cycling and the home had arranged for a specially adapted bike to be bought. Staff were seen to respect people’s privacy and address people in appropriate language. Most of the people at the home require the staff to help the access different parts of the home due to their restricted mobility. The staff were seen to support people in using different parts of the home to either mix with people or have time on their own. It was noted that the home had a locked gate to the kitchen. When asked about this the staff said it was locked for safety reasons, to restrict free movement in the kitchen by the people who lived at the home. It was required that the manager undertakes a review of these restrictions to ensure the wishes and feelings of the people living at the home are taken into account and the premise meet the needs of the people at the home. 15 Preston Drove Version 1.10 Page 14 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) 20. The medication is stored, administered and recorded appropriately. Staff training is orgainised regulary and staff are tested on their competency before administering medicatioion. EVIDENCE: The medication system was checked with the manager present and found to be managed and monitored well. Comprehensive information was held in the medication file that included criteria sheets that gave the staff information on the medication and it effects. The people who live at the home do not selfadminister medication but are given information by staff about their medication when they are given them. The manager demonstrated good knowledge of the procedures in the home and the organisations policies. It was recommended that stocks of liquid “as and when” medication be returned to the pharmacist. 15 Preston Drove Version 1.10 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 standard(s) None on this inspection. EVIDENCE: 15 Preston Drove Version 1.10 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 standard(s) 24,25,27and30. The home has been adapted to support people with disabilities and money has been spent on the building to provide specialist equipment. However the building is in poor condition internally and needs decorating. The home was unclean and shared areas were not homely. Peoples individual bedrooms were well kept and care had been taken to reflect the persons interests and personality in their rooms. The front and rear gardens were tidy. EVIDENCE: During a tour of the building many areas were found to be in a poor condition and dirty. The hallways wood panelling needed treatment and surfaces had layers of dust on. The lounge and dining room both had peeling and damaged paintwork, the flooring in the dining room was torn and the covers on the furniture in the lounge were dirty. Again dust and a significant amount of cobwebs had accumulated in the corners of the rooms. Paintwork was peeling in one bathroom and many of the original window frames were in a poor condition. 15 Preston Drove Version 1.10 Page 17 Staff spoken to said the homes decoration was “depressing” and felt that redecoration would help lift spirits in the home. Peoples bedroom were in better condition. Each person had their own room and the staff had helped the service users display personal belongings and items of interest for them. One person had sensory lights in her room and all had photos of themselves, friends or family. The bathroom facilities meet the needs of the people currently living at the home. Two specialist baths are upstairs which enable the staff to make a person comfortable when bathing. A walk in shower room is on the ground floor, these rooms were clean. It is required that the manager ensures that all part of the home are kept clean and are reasonable decorated. 15 Preston Drove Version 1.10 Page 18 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) 33. The home has not been appropriately staff. Staffing levels have been supported with agency and bank staff for an extended period and although senior managers in the organisation and the manager in the home have made considerable efforts to employ permanent staff, vacancies have not been filled. EVIDENCE: The morning support staff team was made up of two permanent staff members, one relief and two agencies staff. The manager and deputy were on 9-5 administration days. The manager and deputy describe the fact that two permanent staff were on shift as unusual, as in the previous weeks many shifts relied on one permanent member of staff and bank and agency staff. The staff members spoken to said it had been frustrating working on shift without team colleagues as support, although the relief and agency staff had been coming to the home regularly and knew the people at the home. The agency staff were asked about their induction the home. They stated they had received induction and had done shadow shifts before supporting the people at the home on their own. They were observed to work with the people 15 Preston Drove Version 1.10 Page 19 similarly to the permanent staff, approaching them with respect and responding to their needs. The responsibility of organising the shifts is placed on the permanent staff which was describe as sometimes stressful by one staff member. It was noted the deputy would be leaving the home at the end of April and a staff member had been promoted to deputy, causing another vacancy in the team. It is required that the manager ensures levels of permanent staff are in such numbers as are appropriate for the health and welfare of the people at the home. 15 Preston Drove Version 1.10 Page 20 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) 42. The manager demonstrated knowledge of monitoring health and safety issues at the home. Staff are trained in First aid, moving and handling and food hygiene. The home had appropriate fire protection proceedures. The home was generally a safe enviorment for the people who live and work in the home. EVIDENCE: Mainly the organisations contractors carry out health and safety checks. They visit the home to undertake checks on the fire system, water temperatures and general repair issues. The inspector discussed with the manager the need for the registered person to be accountable for the monitoring of the checks in the house. He demonstrated that he was aware of when checks where due and what work was undertaken. It is recommended that the manager and staff establish some in house checks such as the water temperatures and fire alarm systems. 15 Preston Drove Version 1.10 Page 21 During a tour of the building it was noted a temperature control device on one of the baths was easily overridden. The water temperature was measured at 67 degrees centigrade. An immediate requirement was made for the manager to have the control repaired or replace to ensure the water temperature is delivered at a safe temperature. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x 2 x 2 x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 1 x x x Standard No 24 25 26 27 28 29 30 STAFFING Score 1 3 3 x x x 1 Standard No 15 Preston Drove Version 1.10 Score Page 22 LIFESTYLES Standard No 11 12 13 14 15 16 17 Score x 3 3 3 x 2 x 31 32 33 34 35 36 x x 1 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x 15 Preston Drove Version 1.10 Page 23 NO 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 4 Regulation 14(1)(d) Requirement It is required the manager ensures that each perspective person moving to the home is appropriately assessed and a planned transition in consultation with the person or their representatives is adhered to. It is required the manager ensures the people who live at the home make decisions in respect of their health and welfare and take the wishes and feelings into account. It is required the manager undertakes a review of restrictions around the home to ensure the peoples wishes and feelings are taken into account and the premise meets the needs of the people at the home. It is required the manager ensures that all part of the home are kept clean and are reasonable decorated. Timescale for action Immediate 2. 7 12(2)(3) Immediate 3. 16 12(2)(3) 23(2)(a) 1st June 2005 4. 24, 30 23(2)(d) 1st June 2005 5. 33 18(1)(a) It is required the manager 1st June ensures levels of permanent staff 2005 are in such numbers as are appropriate for the health and welfare of the people at the home. Version 1.10 Page 24 15 Preston Drove 6. 42 13(4)(a)( b)(c) It is requirement the manager to have the temperature control on the bath repaired or replace to ensure the water temperature is delivered at a safe temperature 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. 2. 3. Refer to Standard 6 20 42 Good Practice Recommendations It is recommended the care plans are set out clearly with review dates when new information is added. It is recommended that stocks of liquid “as and when” medication be returned to the pharmacist. It is recommended the managers and staff establish some in house checks such as the water temperatures and fire alarm systems. 15 Preston Drove Version 1.10 Page 25 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 © 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 15 Preston Drove Version 1.10 Page 26 - 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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