CARE HOME ADULTS 18-65
19 Alexandra Road St Leonards-on-sea East Sussex TN37 6LD Lead Inspector
Jeanette Denereaz Unannounced Inspection 19th January 2006 4:00 19 Alexandra Road DS0000021309.V274138.R01.S.doc Version 5.1 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 19 Alexandra Road DS0000021309.V274138.R01.S.doc Version 5.1 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. 19 Alexandra Road DS0000021309.V274138.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service 19 Alexandra Road Address St Leonards-on-sea East Sussex TN37 6LD 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) 01424 446914 East View Housing Management Ltd Vacant Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 19 Alexandra Road DS0000021309.V274138.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The maximum number of residents to be accommodated will be three (3) The people accommodated will be over eighteen (18) and under sixtyfive (65) years on admission. 23rd August 2005 Date of last inspection Brief Description of the Service: 19 Alexandra Road is a three storey terraced Victorian house in a residential area of St Leonards on sea. It benefits from a small patio garden to the rear of the property that is access only through the kitchen. The home is conveniently situated a short distance from local amenities, including public transports and shops. The home is part of the East View Housing Organisation (EVH) and provides care for three younger people with learning disabilities. 19 Alexandra Road DS0000021309.V274138.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the second in the year running from April 1st 2005 to March 31st 2006. The inspection took place between 16.00 and 18.00. The overall focus of the inspection was on meeting with the residents and staff member on duty, and reviewing the progress of the requirements from the previous inspection, a full tour of the home. Time was spent meeting with the staff member, inspecting a number of records, policies, procedures and other documentation. All residents were spoken to and showed the inspector around the home including their bedrooms. As this report was made following the second unannounced visit, and does not cover all the standards, therefore for the reader to make a judgment about the home, it is recommended that a copy of the last inspection report of the 23rd August 2005 also be obtained to have a clearer picture of the home. What the service does well: What has improved since the last inspection?
Since the last inspection the residents’ day service has been reviewed, and they have a varied programme of activities, which are valued and fulfilling for the residents. At the last inspection the house had a musky odour, which could not be located, however, on this inspection there were windows open in bedrooms and the house had a fresher smell. The previous team leader left the service in August 2005, and now there is a new team leader who took up post in December 2005, she was not present at this inspection. 19 Alexandra Road DS0000021309.V274138.R01.S.doc Version 5.1 Page 6 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. 19 Alexandra Road DS0000021309.V274138.R01.S.doc Version 5.1 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 19 Alexandra Road DS0000021309.V274138.R01.S.doc Version 5.1 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): The key standard 2 was inspected at the last inspection on the 23rd August 2005 and was fully met. Also the home has not had any new residents since the last inspection. EVIDENCE: 19 Alexandra Road DS0000021309.V274138.R01.S.doc Version 5.1 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): The key standards 6,7 and 9 were inspected at the last inspection on the 23rd August 2005 and were fully met. EVIDENCE: 19 Alexandra Road DS0000021309.V274138.R01.S.doc Version 5.1 Page 10 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): The key standards 12,13,15,16,and 17 were inspected at the last inspection on the 23rd August 2005 and were fully met. EVIDENCE: One resident in the past always expressed his dissatisfaction with his day service, he did not enjoy going to the day centre. At the last inspection the inspector saw evidence that the staff were supporting him to join other community activities. This has continued and he now has a very varied day service, which he confirmed he really enjoys. 19 Alexandra Road DS0000021309.V274138.R01.S.doc Version 5.1 Page 11 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): 20 The residents’ health and care needs continue to be well managed and take into account their individual preferences and needs. EVIDENCE: The home uses the monitored dosages system of medication and the pharmacy is a leading High Street chemist chain, which undertake regular audits of the medication held in the home. All the staff are trained in the administering and control of medication, and all the residents are supported to administer and control their own medication following full risk assessments. The risk assessments were seen by the inspector and found to be in order. For daily usage the residents have a travelling pill planner wallet, and these are filled and visually checked by staff. The residents are all very happy and confident in taking control of their medication at this time. 19 Alexandra Road DS0000021309.V274138.R01.S.doc Version 5.1 Page 12 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): 23 The keys standards of 22 and 23 were inspected at the last inspection and were both fully met. However, further training is needed by staff to protect the residents. EVIDENCE: During this inspection it was found that no complaints have been recorded since the last inspection. Following a discussion with the staff member on duty at this inspection, it is recommended that staff have more in depth training in the Protection of Vulnerable Adults (POVA). The staff member stated that he was not very confident in this area, especially if he had to support residents with sensitive issues. 19 Alexandra Road DS0000021309.V274138.R01.S.doc Version 5.1 Page 13 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): 30 The residents at 19 Alexandra Road live in a warm nicely decorated and clean home. EVIDENCE: The musky odour present at the last inspection was not present during this inspection; the house was well aired with bedroom windows open. The home is well maintained, but in the interest of safety it would be advisable to investigate the wobbly and uneven floorboards on the ground floor corridor; this could become a trip hazard. 19 Alexandra Road DS0000021309.V274138.R01.S.doc Version 5.1 Page 14 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): The key standards of 32,34 and 35 were inspected at the last inspection on the 23rd August 2005 and were found to be fully met. EVIDENCE: The new team leader was not present at this inspection, but the small staff team is usually very stable. 19 Alexandra Road DS0000021309.V274138.R01.S.doc Version 5.1 Page 15 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): 39 Residents consider that the way the home is managed and run makes it an enjoyable place for them to live. Residents are safe in the home, being very well managed and maintained. EVIDENCE: The residents are very involved in the running of the home, and they have regular house meetings, where minutes are taken. They also have 1:1 meeting with an allocated key worker monthly, the home has an open door policy and this was evident during this inspection. The residents were totally involved in the inspection process and their views were constructive and helpful to the inspector. The staff member on duty during this inspection demonstrated a very clear understanding of the current needs of residents. 19 Alexandra Road DS0000021309.V274138.R01.S.doc Version 5.1 Page 16 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 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 2 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 X X X 3 X X X X 19 Alexandra Road DS0000021309.V274138.R01.S.doc Version 5.1 Page 17 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA37 Regulation 8&9 Requirement The Responsible Individual must ensure that the home has a registered manager that is qualified, competent and experienced to run the home. Timescale for action 31/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA23 Good Practice Recommendations It is recommended that staff have more in depth training in the area of the Protection of Vulnerable Adults (POVA). 19 Alexandra Road DS0000021309.V274138.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection East Sussex Area Office 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
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