CARE HOME ADULTS 18-65
25 Alexandra Road St Leonards-on-sea East Sussex TN37 6LD Lead Inspector
Jeanette Denereaz Unannounced Inspection 28th September 2005 04:00 25 Alexandra Road DS0000021320.V251031.R01.S.doc Version 5.0 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 25 Alexandra Road DS0000021320.V251031.R01.S.doc Version 5.0 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. 25 Alexandra Road DS0000021320.V251031.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service 25 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 720749 East View Housing Management Ltd Mr John Williams Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 25 Alexandra Road DS0000021320.V251031.R01.S.doc Version 5.0 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 aged over eighteen (18) and under sixty-five (65) years on admission. 19th April 2005 Date of last inspection Brief Description of the Service: 25 Alexandra Road is a three storey terraced Victorian house in a residential area of St Leonard’s on Sea. It benefits from a small patio garden to the rear of the property that is accessed only through the kitchen. The home is conveniently situated a short distance from local amenities, including public transport and shops. The home is part of the East View Housing Organisation (EVH) and three service users with learning disabilities are in residence. 25 Alexandra Road DS0000021320.V251031.R01.S.doc Version 5.0 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 team leader and reviewing the progress of the requirements from the previous inspection, a full tour of the home. Time was spent meeting the team leader, 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 19h April 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 home has written and installed a risk management framework to safeguard the resident that was buying proprietary drugs and taking them inappropriately. The resident has received support from the Community Learning Disability Team (CLDT) and he is more settled and able to talk about his feelings. He stated that he feels very supported by and can talk to all the staff. Areas of the home have been decorated, and new sofas have been purchased for the lounge. 25 Alexandra Road DS0000021320.V251031.R01.S.doc Version 5.0 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. 25 Alexandra Road DS0000021320.V251031.R01.S.doc Version 5.0 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 25 Alexandra Road DS0000021320.V251031.R01.S.doc Version 5.0 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): 1&4 Prospective service users would be given all the information they need to be able to male an informed decision to live at 25 Alexandra Road. EVIDENCE: There has not been a new resident to the home since the last inspection, however, the home is part of the EVH and has detailed polices and procedures in place for prospective residents, which includes the opportunity to visit the home. 25 Alexandra Road DS0000021320.V251031.R01.S.doc Version 5.0 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): All these standards were inspected at the last inspection on the 19th April 2005 and were fully met. EVIDENCE: 25 Alexandra Road DS0000021320.V251031.R01.S.doc Version 5.0 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): 11 The residents have every opportunity to live a fulfilled, responsible, value and socially active life. EVIDENCE: The service is excellent in promoting the development of educational, personal, social and emotional skills. The residents made many references indicating how the staff support them in all aspects of their lives. They all have various interests and they are encouraged and supported to explore them. At the last inspection one resident was very unhappy with his day service, this was reviewed and he now participates in various activities including gardening, which he spoke about to the inspector with enthusiasm and knowledge. 25 Alexandra Road DS0000021320.V251031.R01.S.doc Version 5.0 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): 18 The residents’ health and care needs continue to be well managed and take into account their individual preferences and needs. EVIDENCE: The residents feel that they are treated as individual and that this is respected in the care given and support. One resident spoke of the support the staff had given him, when he was “feeling down” about his girlfriend. He said that he can always talk to ‘Tina’ (Team Leader) but he was fine now and things are going well. 25 Alexandra Road DS0000021320.V251031.R01.S.doc Version 5.0 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): Both these standards were inspected at the last inspection on the 5th April 2005 and were fully met. There have been no verbal or recorded complaints in the home since the last inspection. EVIDENCE: 25 Alexandra Road DS0000021320.V251031.R01.S.doc Version 5.0 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): 28 The residents live in a warm, and clean home. However, once again the residents brought to the notice of the inspector that their garden patio area is uneven and they are finding it difficult to use. EVIDENCE: The residents enjoy being in the garden, especially in the summer when they tend to dine outside evening and weekends. It was evident that some repairs had taken part, but the cement was already breaking up. This inspection, which was undertaken in the early evening, the light was fading and one resident told the inspector that an outside light in the garden was needed. 25 Alexandra Road DS0000021320.V251031.R01.S.doc Version 5.0 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): 32,34 & 36 The residents live in a home where training is important to the staff and management. EVIDENCE: The residents all spoke very highly of the team leader and the staff team. The organisation EVH has a robust recruitment policy and all staff undertake induction and mandatory training. Since the last inspection one member staff has retired and there is a new member of staff. Unfortunately his file was incomplete; there was a CRB check but no evidence of POVA clearance, record of interview or references. The team leader explained that interview report and references were still at the EVH Head Office, and therefore not available for inspection within the home. The new staff member is undertaking his induction, and another staff member is interested in the Ldfa training. Supervision notes were seen and indicated they were regular every two months. 25 Alexandra Road DS0000021320.V251031.R01.S.doc Version 5.0 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): 37,39,41 & 43 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, but 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. Once again the team leader demonstrated a very clear understanding of the current needs of residents. 25 Alexandra Road DS0000021320.V251031.R01.S.doc Version 5.0 Page 16 As the home is part of the EVH organisation the information regarding the financial accountability of the service would be held at the EVH Head Office. However, the team leader has responsibility for the household budget and records buying and spending appropriately, and EVH audits these accounts regularly. The Inspector had a meeting with the Senior Management Team on the 13th June 2005 and reviewed the past year and discussed future planning. The team leader has not yet made application to become the registered manager. 25 Alexandra Road DS0000021320.V251031.R01.S.doc Version 5.0 Page 17 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 x x 3 x Standard No 22 23 Score x x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score x x x x x Standard No 24 25 26 27 28 29 30
STAFFING Score x x x x 2 x x LIFESTYLES Standard No Score 11 3 12 x 13 x 14 x 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score x 3 x 2 x 3 CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
25 Alexandra Road Score 3 x x x Standard No 37 38 39 40 41 42 43 Score 2 x 3 x 3 x 3 DS0000021320.V251031.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? Yes 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 YA28 Regulation 23(2)(o) Requirement It is required that the Responsible Individual should ensure that the outside back garden patio area is levelled and becomes a usable space for residents. Also an outside light is required in this area. It is required that the Responsible Individual ensures that the recruitment information of staff is kept within the home, and be available for inspection. Timescale for action 01/03/06 2 YA34 8&9 30/11/05 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 YA37 Good Practice Recommendations It is recommended that the home have a registered manager in post. 25 Alexandra Road DS0000021320.V251031.R01.S.doc Version 5.0 Page 19 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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