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Inspection on 16/09/05 for 26 Shakespeare Road

Also see our care home review for 26 Shakespeare Road for more information

This inspection was carried out on 16th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

26 Shakespeare Road provides a home from home environment for residents. Residents living at the home regard the other residents, staff and management of the home as their family. Residents, who are able, are encouraged to retain an independent lifestyle, accessing local communal facilities and maintaining relationships. Care plans are clear and provide staff with the information, which they need to meet the needs of the residents whilst encouraging them to retain some levels of independence. The staff team treat residents as individuals and are able to assist them to maintain their dignity. Meals are varied, nicely presented, offer choice and are served in pleasant surroundings. Residents spoken with all had confidence in the managers approach to running the home. The skill sharing approach with the staff team offers development opportunities for all individuals. The company offer good training opportunities to ensure that staff have the combined skills to meet the changing needs of the residents.

What has improved since the last inspection?

Residents say that the home is much quieter now and that they feel less worried. The kitchen has been redecorated at the request of the Environmental Heath officer. A cupboard has been installed in the laundry room to accommodate COSHH materials. Recent changes to benefit system with regard to Direct Payment has resulted in all residents opening bank accounts which means that need support with dealing with finances but it also encourages independence and choice and dignity. Arrangements have been made with the local GP surgery`s to ensure that destroyed medication can be replaced. This had been a problem highlighted at the last inspection.

What the care home could do better:

The method of recording supply and monitoring self-administration should be reviewed.

CARE HOME ADULTS 18-65 26 Shakespeare Road 26 Shakespeare Road Worthing West Sussex BN11 4AS Lead Inspector Mrs D Peel Announced Friday, 16 September 2005, 2pm, V241589 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 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 Stationary 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. 26 Shakespeare Road H60-H11 S14297 26 shakespeare Rd V241589 160905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 26 Shakespeare Road Address 26 Shakespeare Road, Worthing, West Sussex, BN11 4AS Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01903 230029 Sussex Oakleaf Housing Association Limited Mrs Vanessa Brenda Saunders Care Home 8 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (MD(E)) - 1 of places Both, Mental disorder, excluding learning disability or dementia (MD) - 7 Both 26 Shakespeare Road H60-H11 S14297 26 shakespeare Rd V241589 160905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 03/02/05 Brief Description of the Service: 26 Shakespeare Road is a care home registered for up to eight residents in the category of Mental Disorder. One resident may be over sixty five of age. The property consists of a large semi-detached house in a residential area of Worthing with local shops and other amenities within walking distance. The seafront and beach are within walking distance. 26 Shakespeare Road H60-H11 S14297 26 shakespeare Rd V241589 160905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over 4 hours on the 16thh July 2005 and was carried out by a regulatory inspector and a pharmacist inspector. The inspectors arrived at 2pm and were welcomed by the manager and staff at the home. Residents were preparing to leave for their Friday afternoon art therapy session. During the visit a partial tour of the home took place with all communal areas, two flatlets and one single bedroom being visited in the company of residents who offered to show the inspector their private accommodation. Three residents were spoken with privately to find out if they felt that their needs were being met and other residents were spoken with informally in the lounge before the evening meal. The care records of two residents were inspected during the visit along with other records, which showed how care needs are to be met. The records of two staff were also inspected and staff were spoken with informally. What the service does well: 26 Shakespeare Road provides a home from home environment for residents. Residents living at the home regard the other residents, staff and management of the home as their family. Residents, who are able, are encouraged to retain an independent lifestyle, accessing local communal facilities and maintaining relationships. Care plans are clear and provide staff with the information, which they need to meet the needs of the residents whilst encouraging them to retain some levels of independence. The staff team treat residents as individuals and are able to assist them to maintain their dignity. Meals are varied, nicely presented, offer choice and are served in pleasant surroundings. Residents spoken with all had confidence in the managers approach to running the home. The skill sharing approach with the staff team offers development opportunities for all individuals. The company offer good training opportunities to ensure that staff have the combined skills to meet the changing needs of the residents. 26 Shakespeare Road H60-H11 S14297 26 shakespeare Rd V241589 160905 Stage 4.doc Version 1.40 Page 6 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. 26 Shakespeare Road H60-H11 S14297 26 shakespeare Rd V241589 160905 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection 26 Shakespeare Road H60-H11 S14297 26 shakespeare Rd V241589 160905 Stage 4.doc Version 1.40 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 standard(s) 1,2,3,4,5 Prospective residents and their families are provided with the information they need to make an informed choice about the home. Residents are assessed prior to moving into the home to make sure that the home can provide a care plan which residents or their families know will meet their needs. Prospective residents, their relatives and friends have an opportunity to visit the home to look at the facilities available and assess its suitability before moving in. Residents have a licence agreement so that they are clear about what their obligations are and what is covered in the fee being paid. EVIDENCE: Comprehensive information is available about the service in the Statement of Purpose and Service user Guide available to all prospective residents, residents and their families and friends. Care records viewed showed that assessments are carried out by the placing authority and the home before a resident is admitted. Residents spoken with confirmed that they had the chance to visit the home to have a look around and meet other residents and staff. The Statement of Purpose explains the referral process from the initial enquiry to the offer to take up residence at the home. It clearly states that all placements are initially for a trial period of three months to make sure that the home can meets the needs of the resident and to give the resident a chance to 26 Shakespeare Road H60-H11 S14297 26 shakespeare Rd V241589 160905 Stage 4.doc Version 1.40 Page 9 decide if the home is somewhere that they want to live. The licence agreements/contracts viewed were detailed and outlined obligations; house rules termination agreements and what services are included in the fee being paid. 26 Shakespeare Road H60-H11 S14297 26 shakespeare Rd V241589 160905 Stage 4.doc Version 1.40 Page 10 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 standard(s) 6,7,8,9,10 Care plans establish person centred programmes of care, which cover all aspects of personal, social support, and healthcare needs. Residents are provided with the information and assistance, which they need to make decisions about their lives. There are opportunities for residents to take part in the day-to-day running of the home so that residents feel that they play an influential part in decisions made. Risk management strategies are in place, which allow residents to take informed risks. EVIDENCE: Care plans viewed were informative and gave staff the information, which they need to meet the needs of the residents in all aspects of heath, personal and social care whilst enabling residents to maintain levels of independency. Those care plans seen had been reviewed and showed that residents are involved in the review of their care plan. Residents confirmed that they have regular meetings to discuss all aspects of life at the home as a group and individually with their link worker. Care records showed that residents are encouraged to participate in the day to day running of the home and during the visit examples of this was seen to take place with one resident carrying out their afternoon task of recycling waste and 26 Shakespeare Road H60-H11 S14297 26 shakespeare Rd V241589 160905 Stage 4.doc Version 1.40 Page 11 other residents setting the tables for the evening meal. Risk assessments were seen to be available in care plans viewed at this visit, which showed how residents are supported to take risks to develop their life experiences. 26 Shakespeare Road H60-H11 S14297 26 shakespeare Rd V241589 160905 Stage 4.doc Version 1.40 Page 12 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 standard(s) 11,12,13,14,15,16,17 The home provides a life style, which enables residents to develop new skills through educational and social activities. Residents, who are able, are encouraged to maintain contact with their family and friends so that they so that they can satisfy their social and emotional needs. Residents are treated with dignity and their rights and responsibilities are recognised. Meals are well managed offering choice and variation. EVIDENCE: When the inspectors arrived at the home some residents were preparing to leave for their Friday afternoon art therapy session. Each resident has a weekly timetable of activities with the more able residents organising their own time in addition to their allocated household chores. One resident has a particular interest in recycling of waste and they commented that they was pleased to be able to combine this interest with recycling the homes waste products. Other residents attend formal activities such as Rowans Day Centre and have activities such as swimming and theatre trips arranged for them. 26 Shakespeare Road H60-H11 S14297 26 shakespeare Rd V241589 160905 Stage 4.doc Version 1.40 Page 13 The home has a visitor’s policy, which is included in the Service Users Guide. It actively encourages visitors but also sets out guidelines for conduct whilst visiting the home. Care plans viewed were seen to detail what arrangements residents have for contact with visitors/relatives or if they didn’t want contact with certain people this is also recorded. Residents who have their own flat lets are encouraged to do their own shopping and provide their own breakfasts and snacks. They join the other residents for the main meal of the day. Residents spoken with commented about the theme nights, which the home has. They like how they are given the opportunity to sample meals, which are traditionally from other countries. On the evening of the visit a Spanish evening was being held with the staff cooking Spanish omelette and Spanish potatoes. However it was noted that one resident who’s favourite food is fish was provided with a fish dish. 26 Shakespeare Road H60-H11 S14297 26 shakespeare Rd V241589 160905 Stage 4.doc Version 1.40 Page 14 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 standard(s) 18,19,20 Care planning systems give clear information to assist with all aspects of health and personal care needs. Records are in place to monitor the health care needs of residents to make sure that any signs of residents being unwell are recognised Medication handling had improved. The home has systems to support residents who want to self-administer. EVIDENCE: Residents spoken with commented about their preferences about times of getting up and going to bed. They spoke about the assistance, which they felt they needed with daily personal care and the support they needed from staff. Care plans viewed for the residents spoken with were seen to reflect the needs, which these residents felt they had. Care records viewed showed that all aspects of personal and healthcare support have been taken into consideration. Individual care records keep a clear record of recent appointments or check ups with health professionals. A resident spoke of recent visits to the hospital after falling in the garden and breaking an arm. Records of receipt, administration and disposal were seen. Previous problems with availability of some medicines had been resolved. Staff who administer medicines are assessed within the home and their certificates kept on file. It is intended to send staff on medication training provided by a local college. 26 Shakespeare Road H60-H11 S14297 26 shakespeare Rd V241589 160905 Stage 4.doc Version 1.40 Page 15 The home has an agreement with the supplying pharmacy to give pharmaceutical advice and the points raised on the last checklist had been addressed. Residents who wish to self-administer, some or all of their medicines, are supported to do this. There are systems for recording the supply and monitoring of self-administration, which were discussed. Lockable storage is available in rooms, but a resident said that it was difficult to turn the lock. It was agreed that this would be corrected. 26 Shakespeare Road H60-H11 S14297 26 shakespeare Rd V241589 160905 Stage 4.doc Version 1.40 Page 16 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 standard(s) 22,23 The clear complaints procedure enables those using the service to have the confidence that their compliant will be responded to within a maximum of 28 days. Residents are protected by the homes policies and procedures to prevent residents being harmed, neglected or suffering from abuse. EVIDENCE: There is a complaints procedure included in the Service User Guide and on display in the home. It was observed that the home has a formal process for dealing with and recording complaints, which are made directly to the home. There have been no complaints made to the Commission for Social Care Inspection since the last visit. Information provided prior to the visit to the home confirmed that the home has its own policies and procedures for responding to suspicion or evidence of abuse or neglect in addition to the West Sussex Multi-Agency Policy for protecting vulnerable adults from abuse. There have been two Adult Protection matters investigated through the West Sussex Adult Protection procedures since the last inspection. The manager and providers dealt with these matters promptly, co-operating fully with the Adult Protection team. It was not found necessary to refer any individual to the Protection of Vulnerable Adult Register and the CSCI did not become involved in the investigations. 26 Shakespeare Road H60-H11 S14297 26 shakespeare Rd V241589 160905 Stage 4.doc Version 1.40 Page 17 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 standard(s) 24,25,26,,28,and 30 The home is clean and residents have a comfortable, safe, and homely environment to live in. Bedrooms are comfortable and meet the needs of the residents. Residents are encouraged to contribute to making their bedrooms their own by having their own personal possessions around them EVIDENCE: The home is situated close to the town centre and offers access to local amenities and transport. It consists of adequate communal space, five single bedrooms and three flatlets, each with en suite facilities. The flatlets also have their own kitchens. The inspector looked around the home visiting all the communal accommodation. Two flatlets and one individual bedroom were viewed by invitation of the residents occupying those rooms. These rooms were seen to be in good decorative order and bedrooms reflect individual’s interests. 26 Shakespeare Road was observed to be clean and had a fresh appearance. It was well maintained and has many homely touches to encourage residents to feel comfortable. 26 Shakespeare Road H60-H11 S14297 26 shakespeare Rd V241589 160905 Stage 4.doc Version 1.40 Page 18 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,36 The staffing numbers and skills mix are set at level, which allows residents assessed needs to be met. Recruitment procedures safeguard and protect residents at the home. Staff are supported and residents are able to benefit from staff that are well supported by the management team at the home. EVIDENCE: Staff rotas were seen prior to the visit taking place. Residents spoken with in private were of the opinion that there is sufficient staff and one resident said “the staff are very kind”. During the visit the recruitment records of two staff were examined along with evidence that Criminal Record Bureau (CRB) and Protection of Vulnerable Adult (POVA) clearance had been acquired to safeguard the residents living at the home. Those staff records viewed showed that staff have the benefit of attending training such as: encouraging behaviour change, self harm, adult protection awareness, mental heath awareness, first aid infection control, and many other courses. Information provided prior to the visit to the home recorded that three staff have an NVQ (National Vocational Qualification) and two staff are currently undertaking the NVQ programme. Nine staff hold a current first aid certificate. 26 Shakespeare Road H60-H11 S14297 26 shakespeare Rd V241589 160905 Stage 4.doc Version 1.40 Page 19 Records on display in the office show a regular programme of supervision and support for the staff at the home which enables residents to benefit from a team of staff who are not only well trained but also have good support systems in place. 26 Shakespeare Road H60-H11 S14297 26 shakespeare Rd V241589 160905 Stage 4.doc Version 1.40 Page 20 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,39,40,41,42,43 The home is well managed and there are clear lines of accountability, which ensures that residents benefit from a well run home. Resident’s best interests are safeguarded by the homes record keeping which ensures that up to date information is available for use by staff. The home provides a safe environment for residents to live in. EVIDENCE: Residents spoken with spoke highly of the dedication of the manager and the staff team. One resident said, “the manager is lovely”. Residents spoken with made reference to the regular residents meetings held at the home during which individual residents can make suggestions about life and any problems which they may be experiencing which affects other residents living at the home. The organisation has an effective quality assurance system, which offers residents the opportunity to provide feedback of the service. There is a service user forum run by the organisation to enable residents to share experiences of their services with other projects. The quality assurance system being used 26 Shakespeare Road H60-H11 S14297 26 shakespeare Rd V241589 160905 Stage 4.doc Version 1.40 Page 21 promotes the sharing of good practice across the company and tackles pertinent issues. Records viewed during the visit to the home included: Care plans, accidents records, medication records, staff records. All records seen were up to date and in good order. 26 Shakespeare Road H60-H11 S14297 26 shakespeare Rd V241589 160905 Stage 4.doc Version 1.40 Page 22 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 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 4 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 x 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 26 Shakespeare Road Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 4 4 4 3 3 3 x H60-H11 S14297 26 shakespeare Rd V241589 160905 Stage 4.doc Version 1.40 Page 23 No Are there any outstanding requirements from the last inspection? 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 Regulation Requirement Timescale for action 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 YA 20.1 Good Practice Recommendations The method of recording supply and monitoring selfadministration should be reviewed. 26 Shakespeare Road H60-H11 S14297 26 shakespeare Rd V241589 160905 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Ridgeworth House Liverpool Gardens Worthing, West Sussex BN11 1RY 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 26 Shakespeare Road H60-H11 S14297 26 shakespeare Rd V241589 160905 Stage 4.doc Version 1.40 Page 25 - 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!