Inspection on 12/01/10 for 26 Shakespeare Road

This inspection was carried out on 12th January 2010.

CQC found this care home to be providing an Poor service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

26 Shakespeare Road 23/02/09

26 Shakespeare Road 04/08/07

26 Shakespeare Road 20/02/07

26 Shakespeare Road 08/02/06

26 Shakespeare Road 16/09/05

26 Shakespeare Road 03/02/05

26 Shakespeare Road 20/10/04

26 Shakespeare Road 24/02/04

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

Crossways Community

Belle Vue Country House

Extracts from inspection reports are licensed from CQC, this page was updated on 28/03/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: 26 Shakespeare Road 26 Shakespeare Road Worthing West Sussex BN11 4AS     The quality rating for this care home is:   zero star poor service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Sarah MacLennan     Date: 1 2 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. that people have said are important to them: They reflect the things 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. Care Homes for Adults (18-65 years) Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: 26 Shakespeare Road 26 Shakespeare Road Worthing West Sussex BN11 4AS 01903230029 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: psmith@sussexoakleaf.org.uk www.sussexoakleaf.org.uk Sussex Oakleaf Housing Association Ltd care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users to be accommodated is 8. The registered person may provide the following category/ies 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 categories: Mental disorder, excluding learning disability or dementia (MD) Date of last inspection Brief description of the care home 26 Shakespeare Road is a care home registered to provide accommodation and personal care for up to eight persons with mental disorders. The home currently accomodates seven people who are between fifty and seventy years of age. The service is provided by The Sussex Oakleaf Housing Association Ltd for whom the Responsible Individual is Mrs Tracey Faraday-Drake. The registered manager, Ms Philippa Smith, commenced Maternity Leave 4th January 2010 and there is an acting manager is in post. Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 8 2 3 0 2 2 0 0 9 Brief description of the care home The property consists of a large semi-detached house in a residential area of Worthing with local shops and other amenities such as the seafront and beach within easy walking distance. For specific information regarding the current range of fees charged for living at the home please contact the service. Care Homes for Adults (18-65 years) Page 5 of 28 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: zero star poor service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This unannounced visit formed part of a key inspection and was carried out on 12th January 2010. The acting manager was present as the representative for the establishment. It was a thorough look at how well the service is doing. It took into account detailed information provided by the manager and any information that CQC/CSCI has received about the service since the last key inspection. On the day of this visit we met with some of the people who use the service and information was gained from staff on duty. Some of the comments made to us on the day of this visit are quoted in this report. The home sent us their annual quality assurance assessment (AQAA). The AQAA is a self-assessment that focuses on how well outcomes are being met for residents living Care Homes for Adults (18-65 years) Page 6 of 28 at the home. It also gives us some numerical information about the service. The AQAA was clear and gave us the information we asked for. Service user care plans, staff recruitment and training records, menus, health and safety check lists, activity records, quality assurance monitoring audits, medication records and storage were all seen and assessed on the day of this visit. We looked at how well the service was meeting the standards set by the government and have in this report made judgements about the standard of the service. We would like to thank the people who use the service and the staff for their time, assistance and hospitality during this visit. Care Homes for Adults (18-65 years) Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 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 9 of 28 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. The needs of the people who use the service are fully assessed prior to their admission. Evidence: All of the people who use the service have been at the home for a number of years, there has not been a new admission since 2006; and there have been no changes to the homes admissions policies since the previous inspection. Previous inspections found that assessments had been completed for new residents and comprehensive information had been obtained; including a Care Management Assessment and relevent health reports. Care Homes for Adults (18-65 years) Page 10 of 28 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. The people who use the service are involved in planning the care and support they receive; they are encouraged to be as independent as possible and to make their own choices. Evidence: The care plans and files of the people who use the service were randomly sampled; four care plans and service user daily logs were looked at in detail. The care plans were person centred and covered a range of needs; including mental health, physical development and personal development. Three of the four plans seen had been signed by the people who use the service, which demonstrates their involvement in the planning of their care. The care plans contained some evidence of review; however it was not always clear if the planned review had taken place. The acting manager stated that he was planning to change the way that this information was recorded. Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: The daily log sheets evidenced that the care plans were followed and provided details of the service users 24 hour day. Care Homes for Adults (18-65 years) Page 12 of 28 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. The provision of activities and food are suitable for the needs of the people who use the service. Evidence: The activity records of the people who use the service were randomly sampled; four service users activity records and daily logs were looked at in detail. The activity records were incomplete; however the daily logs provided detailed information regarding any activities undertaken and lifestyle choices made by the people who use the service. The people who use the service access a variety of social and leisure resources in the community such as visiting the local shops, meals and drinks out in local pubs and coffee shops, attending the cinema, gym and various day centres. Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: Conversation with staff evidenced that the people who use the service are encouraged to be as independent as possible and to choose how they spend their day; such interactions were observed. The people who use the service are involved in the running of the home, they are given responsiblity for their personal laundry and some of the household chores; including loading and unloading the dishwasher, vacuum the communal areas of the home, cleaning drinks area, cleaning toilets and empty bins. These chores are discussed and allocated at the residents meetings. The main meal of the day is in the evening. On Sundays the people who use the service choose their food for the week from a set menu, there are two choice for each meal. A member of staff, assisted by a service user, does the food shopping twice a week. The people spoken with were happy with the provision of food. The permenant staff at the home had received food hygiene training, but none of the bank staff had food hygiene certificates. Care Homes for Adults (18-65 years) Page 14 of 28 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service are happy with the care they receive. Medication is not administered as prescribed placing the people who use the service at risk. Evidence: The people who use the service stated that they were happy with the care and support they received; additional specialist support including GP, chiropodist, optician and dentist were also available. Daily statements were made on each of the people who use the service, samples of which were seen at inspection. These statements were comprehensive in nature and related to the care plans. The medication administration records for all seven service users were seen. The administration of medication was not as prescribed, the medication administration records did not accurately reflect the medication being given. One service user had not been given prescribed medication for two weeks, another service user had their medication prescribed twice a day but had only been given it once. Some of the medication administration records had prescribed medication crossed out by the staff, Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: without any explanation. There was no evidence that the medication had been discontinued by the GP. There were no written guildlines in place regarding the administration of as required medication. The acting manager stated that all staff responsible for the administration of medication were suitably trained and that the medication administration records are audited daily. The audit was seen at inspection and had not picked up any of the shortfalls. Care Homes for Adults (18-65 years) Page 16 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home had a simple and accessible complaints procedure. Procedures are in place that offer safeguards to the people who use the service. The homes bank staff are not trained in the safeguarding vulnerable adults, which may place the people who use the service at risk. Evidence: The home had a simple and accessible complaints procedure, which was displayed in the hallway. There had been no complaints made directly to the home since the previous inspection. One complainant had contacted the Commission with information concerning a complaint about the service. This was referred to the Registered Manager and was appropriately investigated and resolved. All appropriate safeguarding adults policies and procedures were in place, the acting manager stated that the policies were readily available to staff. The Independent Safeguarding Authority (ISA) was discussed with the acting manager. The acting manager was referred to the ISAs website for further information. The permenant staff at the home had received safeguarding vulnerable adults training, but none of the bank staff had. Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: All service users spoken with stated that they felt safe at the home. Care Homes for Adults (18-65 years) Page 18 of 28 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. The home was found to be clean, tidy and suitable in layout for its purpose. Evidence: The inspector toured areas of the home. It was seen to be clean, tidy and free from offensive odours. The people who use the service were able to access all the communal areas of the home and grounds. The home was suitable for the needs of the people who use the service. Bedrooms reflected the individual style of the service users and contained their own possessions. The decor was domestic in nature. The hot water supply to the sink in staff bathroom was identified as a problem at the previous inspection. The acting manager stated that plumbers visited several times and the flow of water can be poor due to the nature of the building. Hot water is adequately delivered from bath taps and other sinks in the building. The acting manager stated that he will complete a risk assessment to include instructions to staff if the water is inadequate to the sink. The general maintenance of the building was discussed and the acting manager stated that the landlord, Hyde Housing, had visited and agreed to replace the broken fence. Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: The inspector was informed that paved area around the building that was identified as a potential health and safety risk to the people who use the service has now been relayed; however it was not possible to confirm the safety of this area due to the snow and ice on the day of this inspection. The acting manager stated that the service users had been advised to remain inside the building due to the adverse weather conditions. Care Homes for Adults (18-65 years) Page 20 of 28 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The bank staff used regularly by the home have not received training and a shortfall in the recruitment practices do not safeguard the people who use the service. Evidence: The staff rota was seen at inspection. The home currently has seven service users and maintains staffing numbers of two during the day and one sleep-in at night, the acting managers hours are in addition to this. In order to maintain these staffing numbers the home regularly uses bank staff. The week commencing 4th January 2010 seven shifts were covered by bank staff and ten shifts were on the rota as being covered by bank staff for the following week. A new staff member is due to start at the end of January which will reduce some of the bank hours. The acting manager stated that the staffing numbers would be reviewed dependent on the needs of an addtional service user. The home currently employs five permenant staff members and five bank staff, three of the permenant staff are new since the previous inspection. The staff files for all ten members of staff were seen, three of which were looked at in detail. Only one of the five permanent staff files contained any proof of identity, none of the 5 bank staff files did. One of the staff members was referred to by two different Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: surnames throughout the staff file, the staff file did not contain any explanation for this. The staff training records for all staff were seen and evidence that all the permenant staff members had received appropriate training including; diabetes, safeguarding, mental health, medication, fire, moving & handling, first aid and food hygiene. There was no evidence of any training undertaken by any of the bank staff. The acting manager stated that all the bank staff had had a medication competancy assessment. The requirement made at the previous inspection that all staff receive training remains un-met. Care Homes for Adults (18-65 years) Page 22 of 28 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. The management of the home is not safeguarding the people who use the service and the quality monitoring systems in place are not effective. Evidence: The service is provided by The Sussex Oakleaf Housing Association Ltd for whom the Responsible Individual is Mrs Tracey Faraday-Drake. The registered manager, Ms Philippa Smith, commenced Maternity Leave 4th January 2010 and there is an acting manager is in post. The acting manager was previously employed as a senior support worker at the home; he was present throughout the inspection. The acting manager stated that various quality audit systems were in place to ensure the staff and service users had a forum for airing their views. These included staff and service user meetings. The minutes of these were randomly sampled and provided evidence of service user involvement in some aspects of the running of the home, including the allocation of household chores. The acting manager stated that there were also health and safety and quality audit Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: systems in place to monitor the service provided. Samples of these were seen at inspection. A monthly health and safety audit is conducted by the staff on duty, this included a summmary sheet which detailed any actions taken. Regular reports in line with Regulation 26 of the Care Home Regulations take place, but not at the required monthly frequency. These reports were seen and they had not picked up on any of the shortfalls within the home. The Regulation 26 reports look at the internal and external fabric of the building and the lifestyle and choice of the service users, they do not look at the staff files, staff rota, staff training or medication records. The medication administration records are audited daily, but this audit had not picked up any of the shortfalls. The requirement made at the previous inspection regarding staff training remains unmet. Care Homes for Adults (18-65 years) Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes R 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 1 35 18 In line with Regulation 18(c) 23/05/2009 the registered person must ensure staff including the registered manager have mandatory training and updates as needed, including moving and handling, food hygiene and safeguarding. Staff must also received training on diabetes care and management. This must happen to ensure staff have sufficient knowledge to meet residents needs safely. Care Homes for Adults (18-65 years) Page 25 of 28 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 Requirement 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 Requirement Timescale for action 1 20 13 The registered person must ensure that all medication administration records are clear, accurate and up to date This must happen to ensure the healthcare needs of the service users are met safely without placing them at risk. 09/02/2010 2 20 13 The registered person must ensure that medication is given as prescribed. This must happen to ensure the healthcare needs of the service users are met safely without placing them at risk. 09/02/2010 3 34 19 The regisered person must 09/02/2010 ensure that proof of identity, including a recent photograph, is obtained for all persons working in the care home. Care Homes for Adults (18-65 years) Page 26 of 28 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 Requirement Timescale for action This must happen to safeguard the people who use the service. 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 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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. Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!