Inspection on 22/08/06 for 17 Shakespeare Road

This inspection was carried out on 22nd August 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

17 Shakespeare Road 23/09/08

17 Shakespeare Road 10/01/06

17 Shakespeare Road 05/09/05

17 Shakespeare Road 13/12/04

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Insight - Eastchurch

Southfields

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

CARE HOME ADULTS 18-65 17 Shakespeare Road Worthing West Sussex BN11 4AR Lead Inspector Ms B Tye Key Unannounced Inspection 14th September 2006 09:30 17 Shakespeare Road DS0000061335.V309319.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 17 Shakespeare Road DS0000061335.V309319.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. 17 Shakespeare Road DS0000061335.V309319.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 17 Shakespeare Road Address Worthing West Sussex BN11 4AR 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) 07903 234457 Sutton Court Associates Ltd Mr Paul James Sullivan Care Home 6 Category(ies) of Learning disability (6) registration, with number of places 17 Shakespeare Road DS0000061335.V309319.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Up to 6 male and/or female service users in the category of learning disability may be accommodated. Only persons between the ages of 18-65 years of age may be admitted/accommodated. 10th January 2006 Date of last inspection Brief Description of the Service: 17 Shakespeare Road is a care home registered for up to six service users in the category LD (Learning Disabilities 18-65 years). The establishment is a converted premises situated close to Worthing town centre. Public transport services are easily accessible. Accommodation is provided over two floors and all rooms are single occupancy with en-suite facilities. The service is privately owned and the registered provider is Sutton Court Nursing Associates. Mr N Ramdin is the Responsible Individual on behalf of the organisation. Mr P Sullivan is the Registered Manager in charge of the day to day running of the home. 17 Shakespeare Road DS0000061335.V309319.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on the 22nd August 2006. Prior to the inspection, all information held on file was examined including any official documentation relating to the home. On the day of the inspection, the inspector noted a relaxed atmosphere at the home. The manager and staff were happy to engage with the inspection process and were able to provide information and relevant files as requested. Three residents files were case tracked. Policies and procedures, risk assessments, training files, medication records and all health and safety records were examined. In addition a tour of the premises was undertaken, staff were spoken to, and two residents were interviewed to gain insight about their experience of living at the home. Where assessed standards continue to be met, the text of the inspection report will remain unchanged from the last report. This inspection is the first of the inspection year 2006/07. It is called a key inspection and will determine the frequency of visits/inspections hereafter. What the service does well: Pre admission assessments are detailed to ensure prospective residents are clear about what the home has to offer. Recording systems for care planning are structured and efficient. This provides staff with an on going, detailed picture of individuals needs. Administrative systems are well organised. All health and safety records are kept in good order. The activities programme on offer at the home is well run and varied offering residents the opportunity to pursue areas of interest. The home is well decorated with a good standard of furnishings providing the residents with a pleasant and comfortable living environment. 17 Shakespeare Road DS0000061335.V309319.R01.S.doc Version 5.2 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 report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 17 Shakespeare Road DS0000061335.V309319.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 17 Shakespeare Road DS0000061335.V309319.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, & 5 Pre-admission assessments are completed prior to admission to the home and information gained forms the basis of an on going plan of care. Each resident, signs a contract of Terms and Conditions, prior to them undertaking the programme. The quality of this outcome area is good. This judgement has been made from available evidence, including a visit to the service. EVIDENCE: A Statement of Purpose and Service Users Guide is available at the home, which provides all prospective residents with relevant information about the service, prior to admission. Each document is provided in a format suitable for residents so they are aware of what the service offers prior to admission. Individual care files for two residents were case tracked. Each contained preadmission information, which was relevant and detailed. Records showed residents had undertaken pre admission assessments with the provider and/or manager of the service. Individuals are able to view the home and contribute to identifying their care needs and aspirations. Terms and Conditions for the home are signed by each resident on arrival. Copies of these are held on individual files. This ensures residents are fully aware of their rights and exactly what the home has to offer them. 17 Shakespeare Road DS0000061335.V309319.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Examination of care records confirmed that the home meets individuals changing needs and personal goals appropriately. Residents are provided with the opportunity for decision making, in line with agreed risk assessments. The quality of this outcome area was good. This judgement has been made from available evidence including a visit to the service. EVIDENCE: Care records for two residents were case tracked during the visit to the home. Each plan is formed from the initial assessment and contains detailed information relating to the residents assessed care needs including health, personal and social care. Residents have the opportunity to contribute to the care planning process, which reflect their changing needs, through one to one keywork sessions and formal reviews. Each plan of care contains detailed risk assessments. This includes information relating to individuals personal history, mental health and behaviours. Each care file also contained risk/behaviour management guidelines. This practice promotes independence for residents in line with assessed risk and agreed limitations and ensures the manager and staff can provide care within safe boundaries. 17 Shakespeare Road DS0000061335.V309319.R01.S.doc Version 5.2 Page 10 The manager stated the staff team is committed, where possible to providing a holistic approach to individuals and resources provided are always in line with specialist needs of the resident. Observations and care files examined by the inspector supported this. The individualised approach within the home promotes residents choice and provides an opportunity for decision-making. The inspector examined diary and daily recording sheets for each resident. These detailed any significant event, which needed to be handed over to other staff at shift change. This ensures consistency for residents in relation to their care needs. Resident’s personal information is held on files in a locked staff office, ensuring confidentiality of personal information, within the home. 17 Shakespeare Road DS0000061335.V309319.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 The residents at 17 Shakespeare Rd participate in group and individual activities both in the home and wider community. The menu offers a range of healthy balanced meals. Residents confirmed they enjoyed the meals provided at the home. The quality of this outcome is good. This judgement has been made from available evidence, including a visit to the service. EVIDENCE: The structured activities programme incorporates college attendance by all residents. Courses include ceramics, animal care, creative arts, independent living skills, fitness, video and photography. One resident is due to start an Adult Education course in literacy from September 06. Residents are also encouraged to participate in individual interests such as shopping, visits to the gym, trips to local pubs and restaurants, swimming, bowling, horse riding and regular attendance at day centres. 17 Shakespeare Road DS0000061335.V309319.R01.S.doc Version 5.2 Page 12 Case tracking and discussion with residents showed the home achieves a good balance between supporting residents to participate in structured activities and encouraging independence where appropriate, in line with agreed risk assessments. Regular community meetings and keywork sessions for the residents, provide the opportunity for individuals to air issues and contribute towards decision making in the home. The inspector observed a relaxed and friendly rapport between staff and the residents during the inspection. This demonstrated an awareness of how to communicate effectively, according to individual needs and behaviours. Information seen on care plans and feedback confirmed family contact and relationships outside the home is promoted. Some residents have home visits on a regular basis. Visitors are welcome to the home and a policy is in place to support this. The manager at the home has implemented a cooking programme for residents, which involves them buying ingredients for meals and preparing them from scratch with staff support. A rota is now in place for residents to undertake this on a rolling rota. This practice provides nutritional education as well as promoting independent living skills. The kitchen area was very clean and tidy. Food is stored appropriately and it was noted there was fresh fruit and vegetables, to ensure residents benefit from a healthy balanced diet. Menus are drawn up on a 4 weekly basis and records are kept of what is cooked each day. Staff shop twice a week to allow flexibility in the menus and to provide fresh produce where possible. Special diets are catered for, and where appropriate nutritional intake is monitored and recorded. 17 Shakespeare Road DS0000061335.V309319.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Care records were examined and showed that the health needs of residents are met and reviewed on a regular basis. Medication is stored and labelled appropriately. A requirement has been made for the manager of the home to address gaps and inconsistencies found in medication recording sheets. Overall the quality of this outcome is good. This judgement has been made from available evidence, including a visit to the service. EVIDENCE: Healthcare records were examined as part of case tracking. All were found to be detailed and in good order. Holistic needs are incorporated in each plan so in addition to physical health; emotional and psychological aspects of care are identified and reviewed regularly. Residents are registered with the local GP and have access to all NHS entitlements. Records of all dental and GP appointments are held on file. Individual files show residents have access to community health specialists, to ensure all aspects of their health needs are met both by the home and wider community. 17 Shakespeare Road DS0000061335.V309319.R01.S.doc Version 5.2 Page 14 Policies and procedures relating to all aspects of healthcare and medication are in place and up to date. Each resident is assigned a keyworker who provides a one to one session on a weekly basis. These meetings provide residents with the opportunity to talk through all aspects of their care needs and make supported changes where needed. All information from these sessions is recorded in their on going care plan. Records showed that staff have undertaken relevant training to dispense medication safely to the residents. Medication at the home was inspected and found to be stored appropriately. Medication charts examined during the inspection showed some gaps and inconsistencies. A requirement has been made for the manager to review the medication records on a regular basis to ensure all entries are accurate. In addition staff may benefit from refresher training in Medication Dispensing to provide consistency in line with the homes medication policies. 17 Shakespeare Road DS0000061335.V309319.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 The inspector concluded that the home has effective systems in place to protect the residents from abuse, neglect and self-harm. The quality of this outcome is good. This judgement has been made from available evidence, including a visit to the service. EVIDENCE: The home has a detailed Complaints policy and procedure, which is included in the Service Users Guide. Residents spoken to said they knew how to complain and who to. They stated they felt able to raise issues of concern either with the manager or provider. Adult Protection Training is provided at the home and staff spoken to are clear about their responsibilities should an incident occur. County Procedures and an up-dated policy and procedure for the Protection of Vulnerable Adults are available at the home for reference by staff. Weekly key work meetings and regular residents groups provide individuals with peer support and the opportunity to discuss any issues of concern as they arise. 17 Shakespeare Road DS0000061335.V309319.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 The home offers a modern, comfortable and clean living space for residents. Residents rooms contain personal possessions and all those seen were clean and homely. The quality of this outcome is good. This judgement has been made from available evidence, including a visit to the service. EVIDENCE: There is a large modern lounge with TV and stereo equipment for use by all residents. The dining room is adjacent to a light, brightly decorated kitchen, which residents have access to for cooking (with assistance) and drink making facilities. Residents rooms were a good size and furnished in their individual styles with personal possessions and pictures. The provider intends to redecorate the communal areas downstairs in the coming months, as part of the annual maintenance programme. 17 Shakespeare Road DS0000061335.V309319.R01.S.doc Version 5.2 Page 17 Residents are responsible for cleaning their own rooms with assistance from staff. Some residents participate in cleaning the communal parts of the home under staff supervision to promote daily living skills and provide a sense of ownership. Each bedroom has en-suite facilities. There are sufficient toilets throughout the building. All bedrooms have locks on the door and lockable cabinets for residents to store items of value. The home has a large, mature garden, which has a patio and lawned area for residents to make use of, in the warmer weather. The residents have now established a vegetable garden and are able to eat some of the produce they grow. A new shed in the garden is used for storage of residents bikes. A laundry room provides a large washing machine with sluice facilities and tumble dryer. Infection control training is provided to staff and policies and procedures were evidenced. This reduces the risk of infection spreading throughout the home. Staff certificates for food hygiene courses were displayed in the kitchen area. A fire alarm and emergency lighting system is in place. Records showed these are checked and serviced on a regular basis to ensure the safety of staff and residents. The inspector noted the fire extinguishers had not undergone an annual service by the fire inspector. A recommendation has been made for the manager to contact the fire department and follow this up. 17 Shakespeare Road DS0000061335.V309319.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34, 35 & 36 The staff employed to work at Shakespeare Rd have all been recruited and trained to meet the assessed needs of the residents. Residents benefit from a well supported and supervised staff team. The quality of this outcome is good. This judgement has been made from available evidence, including a visit to the service. EVIDENCE: The home provides an induction and training programme for staff members, including specialist training relevant to individuals assessed needs. Training records for staff indicated all staff have attended training since the last inspection and records were up to date. The home has achieved the national minimum guideline for National Vocational Qualification Level 2 or above with 60 completion by staff. Recruitment procedures are in place and records indicated all staff checks were fully up to date. Records seen on file were in good order. New staff had appropriate checks and references in place. 17 Shakespeare Road DS0000061335.V309319.R01.S.doc Version 5.2 Page 19 The home currently has a full staff compliment and does not use agency workers. This provides consistency of care to residents. Records show that staff receive regular supervision and support. This gives staff members the opportunity to reflect on their practice and identify areas of personal development. A staff supervison chart provides the manager with an effective monitoring system to ensure no sessions are missed. Staff attend regular meetings which are recorded. This forum enables them to have input about decision making processes in the home and discuss issues relevant to practice as a team. Feedback from residents, staff and observations led the inspector to conclude that the staff functioned effectively as a team and were supported by the management in doing so. 17 Shakespeare Road DS0000061335.V309319.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Good practice in the home was evident. This was supported by efficient administrative systems, which promote the health, safety and welfare of the residents. The quality of this outcome is good. This judgement has been made from available evidence, including a visit to the service. EVIDENCE: The inspector examined all safety records at the home including, fire records, training, incident and accident logs, water temperatures, maintenance book and the financial records. They were all up to date and in good order promoting the welfare and safety of the residents. The inspector found some incidents had been recorded fully in the homes log but the Commission had not been notified of these. It has been recommended that records of all major incidents that occur in the home be copied to the Commission as Regulation 37 notifications. 17 Shakespeare Road DS0000061335.V309319.R01.S.doc Version 5.2 Page 21 Good practice in the home was evident. This was supported by efficient administrative and daily recording systems. The manager of the home attend monthly management meetings with his peer group. In addition the provider has implemented a management audit where managers from each home spend time at another home to assess practice and management systems. The manager of Shakespeare Rd feedback that this had been an effective learning tool and had enabled him to recognise areas that needed improvement. The home has up to date policies and procedures in line with current legislation to safe guard the rights and interests of the staff and residents. Discussions and observations confirmed staff are given clear direction in their roles and good working practices are promoted through staff support and training. The Quality Assurance report includes feedback from residents and their families, providing them with an opportunity to contribute to the way the home is run. The most recent Quality Assurance report and Inspection report from the Commission is available to residents and parties involved in the home. The inspector concluded that the overall conduct and management of the home served the best interests of the residents and the staff who work there. 17 Shakespeare Road DS0000061335.V309319.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 x 17 Shakespeare Road DS0000061335.V309319.R01.S.doc Version 5.2 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 YA20 Regulation 13 Requirement To ensure staff maintain administration records for medication in line with the homes policies and procedures Timescale for action 31/10/06 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 2 YA38 YA24 Refer to Standard Good Practice Recommendations To inform the Commission (Reg 37) of any serious incident that occurs in the home To liase with local fire officer and seek advice about annual checks of fire extinguishers and appropriate wall fittings. 17 Shakespeare Road DS0000061335.V309319.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 17 Shakespeare Road DS0000061335.V309319.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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