Inspection on 28/08/08 for 18 Hawthorn Crescent

This inspection was carried out on 28th August 2008.

CSCI found this care home to be providing an Adequate 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

18 Hawthorn Crescent 25/07/07

18 Hawthorn Crescent 26/09/06

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Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 18 Hawthorn Crescent 18 Hawthorn Crescent Worthing West Sussex BN14 9LU The quality rating for this care home is: One star adequate 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. They reflect the things that people have said are important to them: 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. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 26 Care Homes for Adults (18-65 years) Audience Further copies from Copyright 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 26 Information about the care home Name of care home: Address: 18 Hawthorn Crescent 18 Hawthorn Crescent Worthing West Sussex BN14 9LU 01903821868 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): wwl2_hawthorn@btopenworld.com Care Management Group Ltd Name of registered manager (if applicable) Mrs Rositsa Taseva-Mancheva Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 4 0 care home 4 learning disability Additional conditions: The registered person may provide the following category 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 category: Learning disability The maximum number of service users who can be accommodated is: 4 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 26 A bit about the care home 18 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. There is no registered manager in post at present. The current scale of monthly charges are 1450.00. There are additional charges for hairdressing, toiletries, trips out, holidays and clothes. 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 home underwent major upgrading work last year that has included changing the internal structure, providing new toilet and bathing facilities and decorating throughout. Care Homes for Adults (18-65 years) Page 5 of 26 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: Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 26 How we did our inspection: This is what the inspector did when they were at the care home The quality rating for this service is 1 star. This means the people that use this service experience adequate quality outcomes. The purpose of the inspection was to assess how well the home is doing in meeting the key National Minimum Standards and Regulations. It was carried out by Jo Hartley. The findings of this report are based on several different sources of evidence. These include: previous reports of visits to the home, the Annual Quality Assurance Assessment (AQAA) completed by the home, surveys received from residents and staff, an unannounced visit to the home, which was carried out on the 28th August 2008. During the visit we looked around the inside and outside of the home, which included a sample of bedrooms and bathrooms. Staff and care records were sampled and we spoke to staff and residents. All regulatory activity since the last inspection was reviewed and taken into account including notifications sent to the Commission for Social Care Inspection. Page 7 of 26 Care Homes for Adults (18-65 years) The last inspection on this service was completed on the 25th July 2007. What the care home does well What has got better from the last inspection Since the last inspection improvements have been made in the management of medication. Unused medication is now being returned to the pharmacy and records are now being kept of the administration of medication that is not on the Medication Administration Sheets. Staff are now being supervised regularly. Care Homes for Adults (18-65 years) Page 8 of 26 What the care home could do better At present the home is waiting for a newly appointed manager to start. The new manager will need to register with the Commission when they are in post. The home has recently experienced some staff shortages which has meant that agency staff have been used quite frequently. More permanent staff should be employed so that residents are able to receive continuity in their care. Staff meetings should also be re-instated when the new manager arrives. The carpet in the dining room needs to be cleaned or replaced as it is stained from a leaking dishwasher. One residents room also needs redecorating as it is showing signs of wear and tear. We found that the home was recording when a thickening agent was being used for one resident but leaving gaps in the recording sheet when it wasnt needed. A reason why it was not used needs to be recorded. Care Homes for Adults (18-65 years) Page 9 of 26 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Jo Hartley 33 Greycoat Street London SW1P 2QF 02079792000 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 10 of 26 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 11 of 26 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 . New residents are only admitted following a full assessment. Evidence: There have been no new admissions in the home since the last inspection. The senior carer on duty at the time of the visit said that prior to admission a full assessment would be undertaken. This would be followed by a visit to the home and overnight stays. Care Homes for Adults (18-65 years) Page 12 of 26 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 are assessed and reflected in their care plans. They are supported to take risks and are able to make decisions about their lives. Evidence: We looked at the care plans of four residents. All care plans seen hold information on how to meet the personal, social and healthcare needs of the individual resident. Risk assessments are in place for minimising risks identified during assessment and reviews. Risk assessments include pressure care, verbally aggressive behaviour, eating and drinking and keeping money safe. Staff sign to say that they have read and understood the care plans and risk assessments for each resident. It was seen that care plans are reviewed at least yearly and risk assessments every two to three months. A resident told us that she is able to make choices in her life including how her room is decorated, what she eats and what she wears. Care Homes for Adults (18-65 years) Page 13 of 26 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 enjoy a varied activity programme and contact with friends and relatives. The food is varied and specialist diets are catered for. Evidence: Residents enjoy a full activity programme that includes going to college, accessing community activities and seeing their family and friends. Recent activities include visits to the Wetlands Trust, Tutankhamen exhibition, theatre, bowling, Hampton Court Palace and concerts. Residents choose the places they want to visit and what they want to do in their residents meetings. Two residents recently went on a helicopter ride. We looked at the menu at the home and found it to be varied and nutritious. One resident needs their food pureed and there are guidelines for staff in the care plan regarding this. Another resident has recently seen a dietitian for advice regarding diet. Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: Care Homes for Adults (18-65 years) Page 15 of 26 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 . People are supported with their healthcare needs. Medication is well recorded, however the home needs to ensure that a record is kept of why certain medications are not given on particular days. Evidence: The individual residents records that we looked at showed that they are supported to attend medical appointments when needed, including physiotherapists. All the residents are registered with a local General Practitioner. We looked at the medication records and found them to be in good order, except for one resident who has a thickening agent added to some meals/drinks. When the thickening agent was not required, nothing had been recorded on the record sheet. An entry needs to made with an explanation of why it was not given. At the last inspection it was found that left over medication for pain relief was not being returned to the pharmacy each month. Records were seen that show that this is now being done. A Requirement was made at the last inspection for the home to implement a record of medication held in the home that is not tracked on the medication administration sheet. This has now been put into place. It was also noted at the last inspection that there were no guidelines or protocol in place for the administration of a medication Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: that required an invasive procedure. This has now been changed to oral medication so the guidelines are no longer required. Care Homes for Adults (18-65 years) Page 17 of 26 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 . Systems are in place to record and respond to concerns and complaints and protect people from abuse. Evidence: The home has a system for responding to complaints and allegations. There is a clear procedure that is available in a pictorial format to make it more accessible. The complaint records were seen during the visit. There have been no complaints recorded since the last inspection. Care Homes for Adults (18-65 years) Page 18 of 26 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 . People who use this service live in a comfortable home, however some redecoration needs to take place. Evidence: On the day of the visit the home was clean and generally well presented. However, the carpet in the dining room needs cleaning or replacing as it is stained from a dishwasher that had leaked. The dishwasher has been repaired. The decoration in one residents room needs updating as it is showing wear and tear. An area of the garden is covered in grass with no walkway which can make it difficult for wheelchairs to access. Plans are in place to alter this. A separate laundry/utility room is provided with facilities to meet the needs of the residents. Care Homes for Adults (18-65 years) Page 19 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Residents are supported by trained and supervised staff. Agency staff are being used as there is a shortage of permanent staff. Evidence: We looked at the files of three members of staff, including the most recently recruited person. All the files included the required recruitment checks including an application form, two written references, Criminal Record Bureau and Protection Of Vulnerable Adults checks. Staff receive a wide range of training to enable them to meet the needs of the residents. This includes mandatory Health and Safety training and other courses such as Anti Discriminatory Practice, Learning Disabilities, Person Centred Practice and Risk Assessments. All new staff complete a thorough induction when they start work. At the last inspection it was found that staff were not receiving a minimum of six supervision sessions a year. We looked at staff supervision records during this visit and found them to be up to date. In the Annual Quality Assurance Assessment that the home returned to us it was stated that there have been staff shortages. This was discussed with the senior carer in charge during the inspection. We were told that agency staff have been used to Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: ensure that enough staff are available to meet the residents needs. The home tries to ensure that they have consistent agency staff so they are familiar with the residents. The home is currently trying to recruit more staff. Care Homes for Adults (18-65 years) Page 21 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . There is no registered manager in post at the home. There is an effective quality assurance system in place that involves the residents of the home. Evidence: There is no registered manager in post at present. The manager post has now been filled and the home is awaiting the new manager to start. The home has a Quality Assurance system in place that includes an annual survey for residents, their families and representatives. The organisation also has a quality assurance system with audits and objectives to be completed each month by the home. Meetings are held with residents every month to discuss aspects of the home including menus, staff issues and activities. We were told that the home usually has monthly staff meetings but have not had one recently due to their being no manager in post. The home has polices and procedures in place regarding Health and Safety. Staff receive regular training in Fire Safety, Manual Handling and Health and Safety. Risk Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: assessments are in place regarding safe working practices. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes  No  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 24 of 26 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 Description 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 Description 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 1 2 24 24 The dining room carpet should be replaced or cleaned as it is stained. The decoration in one of the residents bedrooms needs updating as it is beginning to show signs of wear and tear. Care Homes for Adults (18-65 years) Page 25 of 26 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. 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