Inspection on 06/10/06 for 25 Alexandra Road

This inspection was carried out on 6th October 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

25 Alexandra Road 23/09/08

25 Alexandra Road 28/09/05

25 Alexandra Road 19/04/05

25 Alexandra Road 07/12/04

25 Alexandra Road 21/07/04

25 Alexandra Road 06/05/03

25 Alexandra Road 06/05/03

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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 25 Alexandra Road St Leonards-on-sea East Sussex TN37 6LD Lead Inspector Jeanette Denereaz Key Unannounced Inspection 6th October 2006 03:30 25 Alexandra Road DS0000021320.V311625.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 25 Alexandra Road DS0000021320.V311625.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. 25 Alexandra Road DS0000021320.V311625.R01.S.doc Version 5.2 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 Vacant Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 25 Alexandra Road DS0000021320.V311625.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated will be three (3) The service users accommodated will be aged over eighteen (18) and under sixty-five (65) years on admission. 28th September 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. The current scale of fees range from £650.00 to £947.00. 25 Alexandra Road DS0000021320.V311625.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulations 2001, uses the term ‘service user’ to describe those living in care home settings. For the purpose of this report, those living at 25 Alexandra Road are referred to as ‘residents’. This report reflects a key inspection based on the collation of information received since the last inspection and an unannounced site visit conducted by an Inspector on the afternoon of the 6th October 2006 starting at 03.30pm, when residents returned home from their day activities, and continues on the 9th October 2006. The site visit included a tour of the premises and an examination of various records including medication, care and staffing records. The Inspector met with the Team Leader who has overall management responsibilities for the home, and the staff member on duty. During this site inspection visits, the inspector met with all residents collectively and in private. Also during this visit the inspector met with the Aroma-therapist who visits the home to undertake aromatherapy with residents; she described the home as having ‘a wonderful atmosphere’. The CSCI also received ‘Have your say about 25 Alexandra Road’ from all three residents and they were positive about the service. The residents were very forthcoming in their praise of the home and staff during this inspection and made comments about how they liked the staff working with them. Comments made were ‘Nigel (Staff) is a laugh’, ‘Staff sort things out for you’, ‘Staff are nice, friendly and helpful’. There have been discussions between EVH and the CSCI regarding the feasibility of introducing sector management to the three homes in Alexandra Road, and this now has come to fruition with the appointment of a Sector Manager for the three services in Alexandra Road as from the 6th November 2006. She will be making application to be the registered manager of 25 Alexandra Road with the CSCI in due course. What the service does well: It is evident through observation, discussion with residents and from reading records and documentation held, the home does most things well, and the residents really feel this is their home and are very relaxed and happy living at 25 Alexandra Road. The residents made the inspector very welcome, and showed her around their home, including their bedrooms. They spoke about their recent holiday and their activities during weekdays and weekends. As stated in the introduction a manager has been appointed as the Sector Manager for the three services in Alexandra Road. She will be making 25 Alexandra Road DS0000021320.V311625.R01.S.doc Version 5.2 Page 6 application to the CSCI to become the registered manager of all three services 19, 25 & 27 Alexandra Road. It was discussed with the inspector during this inspection visit by the residents and staff on duty, and it was evident all personnel involved had been consulted and the plans have been openly discussed. 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. 25 Alexandra Road DS0000021320.V311625.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 25 Alexandra Road DS0000021320.V311625.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): 1,2,3,4 & 5 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Prospective service users can be confident their needs will be assessed, and when they take up residence and their aspirations will be met. EVIDENCE: EVH has a robust organisational policy and procedures for the admittance of new residents to the service. There have not been any new residents since the last inspection, and the three residents have lived together at 25 Alexandra Road for at least two years, and seem to get on well together. During this inspection visit they were interviewed collectively in the lounge and individually, and all three residents stated they were happy living at 25 Alexandra Road. Also during this inspection visit the inspector observed the residents getting on well together, and being very considerate toward each other. Each resident has a copy of their contract and service user guide. 25 Alexandra Road DS0000021320.V311625.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): 6,7,8,9 & 10 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The staff can demonstrate their knowledge of the individual residents, and are aware of the complex needs of the residents and encourage them to have an independent lifestyle as far as possible. EVIDENCE: The inspector reviewed all three care plans, and it seems that the plans are regularly reviewed. The staff members on duty and the team leader have a good knowledge of the individual residents and this was reflected in the care plans. Each care plan had detailed information on the life of the individual, which are very different, and one resident spoke to the inspector about how he would like to move and live more independently. This was also discussed with the team leader, and from the reading of the minutes from a recent review meeting, this is on the agenda. 25 Alexandra Road DS0000021320.V311625.R01.S.doc Version 5.2 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): 12,13,15,16 & 17 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The home’s links with the local community are good and enrich residents’ lives socially and educationally. The staff have a strong commitment to enabling residents to develop their skills, including social, emotional, communication and independent living skills. EVIDENCE: Residents have an individual care plan and their participation into the community has increased since the last inspection. One resident is now in work experience placement at the local supermarket, another is involved a supportive employment scheme packing and delivering vegetable boxes to local people. There are a variety of day activities, but one resident does attend the day centre as part of a very varied week of activities, but he does not enjoy his day at the day centre and told the inspector so. 25 Alexandra Road DS0000021320.V311625.R01.S.doc Version 5.2 Page 11 The team leader is aware of his dislike for the day centre and since the last inspection his attendance has been reduced. The menus were seen, and residents have a healthy diet and are involved in the menu setting the shopping and sometimes the cooking. The team leader feels it depends who is on duty to what involvement the residents have in helping with the cooking. This is an area that should be reviewed; with individual residents wanting to have a more independent lifestyle, knowing how to cook a healthy meal would be an advantage. Also there was evidence during the inspection that some staff do not have the skills to cook a healthy meal with confidence, and the skills to engage residents. 25 Alexandra Road DS0000021320.V311625.R01.S.doc Version 5.2 Page 12 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 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents receive personal support appropriate to their physical, emotional and healthcare needs. All personal and healthcare needs are well documented. EVIDENCE: All residents are registered with local GP and health checks are regularly carried out. All three residents are registered with local GPs and when required have the services of other health professionals, including the support from the local Community Learning Disability Team (CLDT) which over the last year has provided psychological support and advice. The medication files and storage were inspected and found to be in order. All staff have had the relevant training and are all deemed to be competent in the administrating of medication to the residents. 25 Alexandra Road DS0000021320.V311625.R01.S.doc Version 5.2 Page 13 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 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents’ complaints would be taken seriously and investigated, and the staff have the knowledge and understanding to take the correct action to safeguard residents from abuse. EVIDENCE: The residents were interviewed and were asked if they were worried or concerns what would they do, they all answered they would talk to ‘Tina’ the team leader and the other staff and one resident stated “staff would sort thing out for you”. Both members of staff were very confident that they understood the issues of protected residents from all forms of abuse. The team leader also stated that the new member of staff was undertaking their induction and would be undertaking Ldfa (Learning disability framework Award) training, which also covers the issues of protecting vulnerable people from abuse. This staff member has been waiting for his CRB document to come through, and has not be able to work alone on a shift. 25 Alexandra Road DS0000021320.V311625.R01.S.doc Version 5.2 Page 14 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): 24,27 & 30 Overall the quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The premises are suitable for the needs of the residents and are kept clean and homely. However, there are signs of wear and tear and there are areas in need of repair and redecorating. EVIDENCE: The inspector accompanied by the residents, undertook a full tour of the home including all communal areas, including the kitchen, bathrooms the garden and individual bedrooms. The home is showing signs of wear and tear and there should be a programme plan of routine maintenance, repair and decorating to ensure the home is always in good decorative order, especially in the kitchen, which is in need of replacement and decorating. The residents and staff are aware that there are plans to replaced the kitchen units, but no timescale has been given by the Senior Management Team to the home when this work will be carried out. The home was very clean, and there were new soft furnishings around the house, which makes it very homely. The residents have a proud in their surroundings, and their bedrooms are very personalised to meet the individual needs and interests. One resident who has the smaller bedroom, has his music set up in the small hobby room on the first floor. 25 Alexandra Road DS0000021320.V311625.R01.S.doc Version 5.2 Page 15 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): 31,32,33,34,35 & 36 Overall the quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to this service. The staff employed have the experience to meet residents needs and support them however there is a need for staffing levels and their skills within the home to be review to ensure residents’ changing needs are met. EVIDENCE: As stated in the section of ‘lifestyles’ there was evidence that some staff need training in basic cookery and nutrition, as they do not have the skills to cook a healthy meal with confidence, and the skills to engage residents. All staff have completed a full induction and there is regular training opportunities. All staff are now also receiving regular supervision, and the inspector saw supervision records. There is a concern that for residents to fully meet their potential, aspirations and changing needs, staffing levels should be reviewed. The staffing levels within the home were discussed with the individual staff and the team leader and there is evidence of staff working long hours to cover the shifts. However, there is a new member of staff ready to start working, but the home is waiting for the CRB clearance to come before the staff member can work on a shift alone. 25 Alexandra Road DS0000021320.V311625.R01.S.doc Version 5.2 Page 16 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): 37,38,39 & 42 Overall the quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The Team Leader has a good understanding on the area in which the home needs to improve, she has a clear development plan and vision for the home, and welcomes the new initiative of Sector Management in which she will have an integral role. EVIDENCE: For sometime 25 Alexandra Road has not had a registered manager in post, and the team leader has had the management responsibility for the home. The Senior management Team have been considering a way forward for the three homes in Alexandra Road, and they have been in discussion with the CSCI regarding setting up sector management (one registered manager for the three homes) to ensure the homes have good staffing levels and a registered manager in post. As stated in the summary a manager has been appointed as the Sector Manager for the three services in Alexandra Road. 25 Alexandra Road DS0000021320.V311625.R01.S.doc Version 5.2 Page 17 She will be making application to the CSCI to become the registered manager of all three services 19,25 & 27 Alexandra Road. The overall maintenance of the home is good, but there are now signs of wear and tear in the bedrooms, the kitchen and some communal areas. However, all the requirements relating to the health and safety of the home are up to date and accurate and in order with documentation seem at the inspector visit and through information contained in the Pre-Inspection questionnaire sent to the CSCI prior to the inspection. 25 Alexandra Road DS0000021320.V311625.R01.S.doc Version 5.2 Page 18 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 3 2 3 3 3 4 3 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 2 25 X 26 X 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 2 33 2 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 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 3 X 3 3 3 X X 2 X 25 Alexandra Road DS0000021320.V311625.R01.S.doc Version 5.2 Page 19 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 YA33 YA32 Regulation 18(1)(a) Requirement It is required that the Responsible Individual and the manager must ensure there is sufficient numbers of staff employed within the home to support residents at all times, and have the skills to ensure residents needs and aspirations are met. Timescale for action 31/12/06 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 YA24 YA42 Good Practice Recommendations It is recommended that the Responsible Individual should ensure there is a programme of routine maintenance, repair and decorating to ensure the home is always in good decorative order, and residents and staff are kept fully informed of progress. 25 Alexandra Road DS0000021320.V311625.R01.S.doc Version 5.2 Page 20 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 © 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 25 Alexandra Road DS0000021320.V311625.R01.S.doc Version 5.2 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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