Inspection on 28/08/08 for 16 Hawthorn Crescent

This inspection was carried out on 28th August 2008.

CSCI found this care home to be providing an Good service.

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

16 Hawthorn Crescent 24/09/07

16 Hawthorn Crescent 05/09/06

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Extracts from inspection reports are licensed from CQC, this page was updated on 30/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 16 Hawthorn Crescent 16 Hawthorn Crescent Worthing West Sussex BN14 9LU     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jo Hartley     Date: 2 8 0 8 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 25 Information about the care home Name of care home: Address: 16 Hawthorn Crescent 16 Hawthorn Crescent Worthing West Sussex BN14 9LU 01903202790 01903821868 rosie_lis@talk21.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Rosemary Lis Type of registration: Number of places registered: Care Management Group Ltd care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 4. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home 16 Hawthorn Crescent is a care home that is registered to provide care for four adults with learning disabilities between the ages of 18 and 65. The Registered Provider is Care Management Group Ltd. The Registered Manager is Rosemary Lis. The home is a semi-detached property, situated in a quiet residential street, just outside Worthing town centre. There is easy access to all community facilities, including local rail and bus stations. The current scale of charges is between £1,346 and £1,550 per week. There are additional charges for hairdressing, toiletries, trips out, holidays and clothes. Care Homes for Adults (18-65 years) Page 4 of 25 Over 65 0 4 Care Homes for Adults (18-65 years) Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This site visit formed part of the key inspection process and was carried out over three hours. The manager completed an Annual Quality Assurance Assessment (AQAA) document, which was returned to the Commission for Social Care Inspection prior to the visit to the home. The information obtained to inform this report was based on viewing the records of the Care Homes for Adults (18-65 years) Page 6 of 25 people who use and work at the service, speaking with staff and one resident, and observing care and support practices. Previous inspection reports and information held by the Commission regarding the home were examined prior to the site visit. A tour of the home took place and documents relating to health and safety were viewed. The last inspection on this service was completed on 24th September 2007. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents have their individual needs and aspirations assessed prior to moving into the home. Evidence: The home has a Service User Guide which is available in a pictorial format. All the residents of the home have a copy of the guide in their personal files. There is a comprehensive pre-admission assessment in place. The manager told us that part of the admission procedure would for the new resident to have transitional visits to the home to enable them to get used to their new environment. No new residents have moved into the home since the last inspection. Care Homes for Adults (18-65 years) Page 10 of 25 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs and personal goals are reflected in their care plans. They are able to make decisions about their lives with assistance if needed. They are supported to take risks as part of an independent lifestyle. Evidence: We looked at four residents files during the visit. They all had detailed care plans that are completed using information from the pre-admission assessments. Care plans are person centered and include individuals likes, dislikes, preferred routines and activities. Each resident has a keyworker who compiles a monthly review report that is used to inform any changes needed in the care plan. Local Authority reviews were also seen on files. Staff support residents to make decisions about their lives by providing information and advice. For example one resident is looking for employment. Staff have supported him in this and he has a file that includes information and resources on gaining Care Homes for Adults (18-65 years) Page 11 of 25 Evidence: employment. Each resident has comprehensive risk assessments to ensure that they are able to participate in the community, and live in the home, safely. These are reviewed every three months. Care Homes for Adults (18-65 years) Page 12 of 25 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are able to take part in age, peer and culturally appropriate activities and are part of the local community. Their rights are respected and they are able to make choices in their daily lives. They are offered healthy meals that they enjoy. Evidence: The home provides a variety of activities and outings for the residents. These include hydrotherapy, music, Scope, church, swimming, visiting friends, going out for meals, discos, garden parties and shopping. One resident is looking for employment and staff are assisting him with this. Others attend courses at college. Residents have taken holidays this year. Two went to Majorca, one went to Devon and another went to Lourdes with his church. Records show that residents are supported in maintaining links with their families. Care Homes for Adults (18-65 years) Page 13 of 25 Evidence: It was noted at the last inspection that the home shares a vehicle with the home next door that is owned by the same provider. A Recommendation was made that the home has its own vehicle. Although the home has not acquired its own mini bus, two of the residents now own their own cars so more outings are now taking place. Records show that a choice of healthy, nutritional meals are provided. On the day of the visit one resident was going to a day centre and took a packed lunch with him. Residents have told us that the staff are good cooks. Daily records clearly show that residents have choice and control over their lives. One resident made fairy cakes at college and chose to save some to give to his family. Another resident decided he wanted to play computer games instead of his planned activity and was able to do this. Residents are able to go to bed and get up when they like. Care Homes for Adults (18-65 years) Page 14 of 25 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in the home receive good healthcare support and medication is well managed. Evidence: Records show that all residents have access to a GP, dentist and optician. Other specialist services such as physiotherapy and chiropody are accessed when required. Each resident has a health action plan that includes weight record, health appointment records, medication reviews, information on their conditions, diet (including likes and dislikes), the support they need, sleep patterns and mobility. Specialist equipment including electric wheelchairs, track hoist systems and other aids and adaptations are in place to aid service user’s independence. At the last inspection it was noted that there were no risk assessments or agreements in place for the use of guard sides on residents beds. A Requirement was made that these be obtained. Risk assessments are now in place and agreements have been obtained from three residents. The fourth resident is unable to communicate Care Homes for Adults (18-65 years) Page 15 of 25 Evidence: agreement or disagreement. We looked at all the medication administration records and found them to be fully completed with no gaps. Reasons are recorded for the use of any as required medication administered. There is also guidance for staff on the use of these medications in the file. Records are kept of medication coming into and leaving the home including when residents are away from the home. The medication policies and procedures were seen, they were all easy to follow. Training records seen show that all staff who administer medication have received training. Care Homes for Adults (18-65 years) Page 16 of 25 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users and their families can be confident that complaints will be recorded and acted upon. The home’s procedures are designed to protect people from the risk of abuse. Evidence: The home has an accessible complaints procedure that uses pictures and words to aid understanding. A copy of this is on the wall in the hallway of the home. All residents also have a copy on their personal file. The home records any complaints it receives. There have been no complaints in the last year. The whistle-blowing policy and information regarding protecting vulnerable adults is also displayed in the hall of the home so they are easily accessible to staff and residents. Training records show that all staff have received training in safeguarding adults. Care Homes for Adults (18-65 years) Page 17 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is homely, comfortable and suitable for the needs of the residents. Evidence: Residents bedrooms are all personalised with their own belongings and have en-suite wet room style shower rooms. All the adaptations required in care plans are in place including hoists and rails. The kitchen, dining and living room are all one room. There is a small office in the adjacent conservatory. The dining room is still being used to write up notes but the medication cabinet and files are no longer stored in there, giving the residents more room. There is a patio style garden with seating areas and a BBQ. The house is very homely and comfortable. There are photos of residents parties and outings decorating the hall. Care Homes for Adults (18-65 years) Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs are being met by competent, well trained staff who are supervised regularly. Evidence: The home employs enough staff to meet the assessed needs of the residents. There are increased numbers of staff on duty at busy times. Residents told us there are enough staff to meet their needs. The home provides a good level of training for staff including mandatory courses that cover Health and Safety and courses that relate to the specific needs of the service users. These include Diabetes, Postural Management, Pressure Care and Epilepsy amongst others. The home has organisational policies and procedures in place regarding the employment of staff. Three staff files were seen and all contained the required documentation including a current Criminal Record Bureau Check and two references. At the last inspection a Requirement was made regarding the availability of staff records in the home. This has now been met. Care Homes for Adults (18-65 years) Page 19 of 25 Evidence: Records seen during the visit showed us that all new staff receive a structured induction and attend training relevant to their roles and responsibilities. The AQAA states that in the staff team of eleven people, seven have NVQ2 or above and two are working towards the award. At the last inspection a Requirement was made that staff receive regular supervision. At this inspection it was found that all staff supervisions are up to date, therefore this Requirement has been met. Care Homes for Adults (18-65 years) Page 20 of 25 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed by a competent and experienced manager. The health and welfare of the residents and staff are protected. Evidence: The current Manager registered with the Commission in June 2008. She has many years experience of working in care settings and is currently doing her Registered Manager Award. Regular residents meetings are held to enable the residents to give their views about the running of the home. The home undertakes an annual quality assurance assessment that seeks the views of residents, relatives and other stakeholders. The evidence is then collated and published. A copy of the outcomes from the last assessment was seen in the home. At the last inspection the home had a problem with the fire panel which kept breaking down, a Requirement was made that risk assessments be put in place until a new Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: panel was installed. This has now been completed. The new fire panel and related documentation was seen during the visit. It was found at the last inspection that staff fire training records were not up to date and a Requirement was made that this be attended to. At this visit we saw that the staff fire training records were up to date, this Requirement has now been met. Safety certificates for equipment in the home were seen and found to be up to date. The Health and Safety Policies and Procedures were seen to be thorough. Care Homes for Adults (18-65 years) Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 24 of 25 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 25 of 25 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!