Inspection on 10/11/08 for 26 Tennyson Road

This inspection was carried out on 10th November 2008.

CSCI found this care home to be providing an Good service.

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

26 Tennyson Road 26/03/07

26 Tennyson Road 09/02/06

26 Tennyson Road 10/05/05

26 Tennyson Road 09/12/04

26 Tennyson Road 13/07/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

Extracts from inspection reports are licensed from CQC, this page was updated on 30/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 26 Tennyson Road 26 Tennyson Road Bognor Regis West Sussex PO21 2SB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Annie Taggart     Date: 1 0 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. the things that people have said are important to them: They reflect 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: 26 Tennyson Road 26 Tennyson Road Bognor Regis West Sussex PO21 2SB 01243869882 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ian Alexander Higgins Type of registration: Number of places registered: United Response care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 5 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: Learning disability (LD) Date of last inspection Brief description of the care home 26 Tennyson Road is a care home registered to accommodate up to five service users with learning disabilities between the ages of 18 and 65 years. The registered providers are United Response, for which Mr Tim Jones is the Responsible Individual. Mr Ian Higgins is the registered manager. The property is a detached house, with accommodation provided over two floors. Communal areas include a lounge, a dining room, newly fitted kitchen and garden area at the rear of the house. The home is located in the town of Bognor Regis close to the seafront and local shops and 5 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 27 Brief description of the care home amenities, with easy access to local rail and bus stations. Cuurent fees are approx. from seven hundred and fifty to eight hundred and fifty pounds per week. Care Homes for Adults (18-65 years) Page 5 of 27 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: two star good 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: In order to prepare for this key inspection visit an AQAA (Annual Quality Assurance Assessment) was sent to the manager for completion. This was returned within the given timescales and gave good information about the services on offer in the home. Surveys were sent to service users, staff and healthcare professionals but none were returned to the Commission. The visit was carried out at 1.30pm on Tuesday 18th November 2008 and during the visit we spoke with service users both in their private bedrooms and in communal areas, we spent time with staff on duty and observed staff practice. Care Homes for Adults (18-65 years) Page 6 of 27 Three care plans and all supporting evidence were tracked and we looked at the medication system, menus and daily records. We saw three staff recruitment files and found that the file for the most recently recruited staff member was not in the home for inspection. We looked at evidence of staff training and support, health and safety records and the management of service users personal monies. The Registered Manager was in the home and received feedback following the visit. 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 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 27 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. Prospective service users and their families have the information they need about the services on offer in the home. Evidence: In order to ensure that any new service users have the information they need about the services on offer in the home, there is a Statement of Purpose and Service user Guide in place. From looking at the records of current service users we saw that there is an assessment process in place and people told us that they were able to visit the home prior to moving in. No new service user have been admitted since the last key inspection. Care Homes for Adults (18-65 years) Page 10 of 27 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. Comprehensive care plans and a system of index information cards ensure that the staff team have the information they need to meet the changing needs of the people living in the home. Evidence: There are comprehensive person centred care plans in place that provide detailed information to the staff team on how each person living in the home wishes and needs to be supported. The care plans are supported by an index card system that cover all areas of service user needs including how people wish to have their personal care support provided and how their social and emotional needs are to be met. Care plans include such areas as behaviour management plans, likes and dislikes, individual communication methods and nutritional assessments. Detailed risk Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: assessments both personal and environmental are also completed with service users and those that we saw were designed to promote peoples choice and independence whilst still ensuring their safety. Regular reviews are undertaken, service users, their families and funding authorities are involved in the process and goals for future development are agreed and documented. The Registered Manager, Mr Higgins told us that there is a key worker system in place and a pictorial rota and activity planner in the home communicates to service users who will be supporting them during the day. During the visit we observed a staff member referring to the board when a service user had a query about what was happening the next day. The home ensures that the changing needs of service users are addressed and examples shown to us were how that home is involving other professionals in managing the ageing process in people and in assessing and supporting one service user who may be showing signs of dementia. Care Homes for Adults (18-65 years) Page 12 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in the home have access to a wide variety of activities and outings and are part of their local community. Fresh, home cooked meals are provided but records should be improved to evidence that peoples nutritional needs are being met. Evidence: From looking at daily planners, care plans and from talking to service users and staff we saw that the people living in the home are involved in a wide range of activities both social and educational Records of peoples achievements showed us that people are engaged in activities such as going to the gym, working on a project in the community assisting local people with their gardens, one person goes to a local craft workshop and another person told us Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: they attended a horticultural centre. People are also assisted to follow their hobbies and interests and examples of this could be seen around the home and in peoples private bedrooms. People are also being supported to be part of their local community and help with food shopping and use local pubs, cafés and clubs. There is a pictorial week planner in the home and this details all of the activities people are undertaking and who will be supporting them to achieve this. During the visit one service user came back form working on the gardening project in the community and told us that they had enjoyed the day. The person was being supported by an outreach worker, employed by the service who told us, there is a nice atmosphere in the home, I mainly support people to do gardening but I also sometimes take people out socially for lunch out to other activities. The index card system in use in the home informs the staff team how people are to be supported in the community and we saw detailed plans for how one person likes to pack their clothes for holidays or weekends away. People told us that they had contact with their families and friends and were happy living in the home. Mr Higgins told us that peoples daycare needs had recently been reviewed taking into consideration the fact that people are getting older and may not have the mobility skills they once had and a staff member said that sometimes people did not feel up to going out in the evenings if they had been busy during the day. We looked at menus and food records and saw that although peoples nutritional needs are recorded and specialist diets catered for, menus only showed that main meal and not what the additions were. Examples of this were that most people had a packed or sandwich lunch during the day but there was no record of what the sandwiches contained. Also the main meal of the day only said for example, roast chicken or jacket potatoes but there was no record of how often people had fresh vegetables or salads or what the fillings were in the jacket potatoes. There were bowls of fresh fruit in the lounge and the staff on duty told us that fresh vegetables were provided regularly but without clear records being kept this cannot be evidenced. The member of staff on duty said that she would bring this issue to the next staff meeting. Care Homes for Adults (18-65 years) Page 14 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in the home receive support with both their physical and emotional healthcare needs and medication is being well managed. Evidence: From looking at care plans and service users medical files we saw that the people living in the home are receiving care in a way that meets both their physical and emotional heathcare needs. Records showed that people attend dental and optician visits and the home works well with the local learning disability team and other health care professionals. One service user has recently been assessed by an occupational therapist regarding their changing health and mobility needs and as a result a stair lift had been fitted in the home and the person has a walking frame. From looking at the staff communication book we saw that changes in peoples emotional needs are discussed and addressed by the staff team but we spoke to the Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: Mr Higgins about how evidence of this could be improved by the use of daily records for people being completed in order to better monitor their daily care. The system of using prompt cards details all of peoples health and emotional needs and informs the staff team how they need to support people in a positive and consistent manner. There are policies and procedures in place for the management and administration of medication and staff files show that the staff team receive training. Each person has a locked medication cabinet in their room, we looked at one persons medication and found that it was being well managed, there was a monthly audit system in place and MAR (Medication Recording Sheets) were fully completed. Care Homes for Adults (18-65 years) Page 16 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a system in place for recording and investigating complaints and concerns, the staff team receive safeguarding training and are aware of their responsibilities regarding protecting vulnerable adults from risk of harm or abuse. Evidence: There is a complaints procedure in place and there is also a system for recording and investigating complaints and concerns. In the AQAA we were told that no complaints had been received by the home since the last key visit and none have been received by the Commission. The Registered Manager, Mr. Higgins told us that he is currently setting up a system where smaller areas of concern from service users that arise on a day to day basis are recorded and the new system will evidenceof how these have been acted upon. There was evidence in training files that the staff team receive training in protecting vulnerable adults from risk of abuse and harm and two staff members spoken to during the visit were aware of their responsibilities and said that they would report any suspected abuse to the manager or area office. A safeguarding alert, made by the home since the last key inspection visit was Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: investigated by West Sussex County Council leading to a referral being made to the POVA ( Protection of Vulnerable Adults) list. Care Homes for Adults (18-65 years) Page 18 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is comfortable and homely and people have the equipment they need to support their independence. Service users are happy with their private bedrooms and the environment is clean and hygienic. A window that could be a risk must be made safe. Evidence: There is a programme of redecoration and refurbishment in place and recently some rooms have been redecorated, bathrooms and toilets have been updated and the laundry room has been improved. In the AQAA Mr Higgins told us that there was a plan in place to address areas of the home still in need if improvement. The people living in the home told us that they were happy with their private bedrooms and in the four bedrooms that we saw, people had their own belongings and records showed that people were assisted by the staff team to keep their bedrooms clean and tidy. During the visit one person was being assisted to clean and hoover their bedroom and told us that helping to look after their own home formed part of service users activities during the week. People have the equipment they need to support their independence and this includes Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: hand rails and grab rails on stairways and in bathrooms. As already stated earlier in this report, a stair lift had been added to the home and risk assessments and guidelines for use had been completed and recorded. In one bathroom on the first floor a newly fitted double glazed window had been pushed open wide enough for someone to fall from. A Requirement was made regarding this window to ensure that the risk is addressed and the window made safe. Care Homes for Adults (18-65 years) Page 20 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are supported by a competent, caring and well trained staff team. There are robust recruitment procedures in place but these must be improved by records being available for inspection. Evidence: Staffing rotas show that there are two people on the early shift and usually one person working alone from 4pm. This person also carries out the sleep in duty and the early shift the next day. We asked how people are supported to go out in the evenings if there is only one staff member on duty and were told that extra staff were arranged if specific activities were being undertaken by service users. There are robust policies and procedures in place regarding recruitment of staff and in the AQAA we were told that all staff have a detailed job description to ensure that they are aware of their responsibilities. We looked at the records of three staff members and found that they contained all of the required documentation including a current CRB (Criminal Bureau Record) and two references. The recruitment file for one new staff member who was employed in September was not available and we were told Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: that it was still at the area office. A Requirement has been made for staff records to be available for inspection. In the AQAA we were also that new staff have a structured induction in line with the Common Induction Standards and records were on file in the home. 80 of staff hold the NVQ award at level 3 and one person has a Diploma in Social Work. A lone working policy is in use as there is usually only one staff member during the evenings. Training records show that there is an organisational national training programmer in place that ensures that mandatory training is kept up to date and the staff team also receive specific training such as managing challenging behaviour, epilepsy management and equality and diversity awareness. During the visit we saw that the staff on duty had a good rapport with service users and people were being treated in a kind and respectful manner. Service users told us that they were happy with the support they are receiving and a staff member said, this is a lovely happy house to work in, the new manager is very supportive and it is good to be able to support people out in the community. There is a process for staff supervision and appraisal in place but records showed us that these were not all up to date. Mr Higgins told us that he was currently updating supervisions and said that as he works alongside the staff team and holds regular staff meetings he is able to monitor and support the staff team on a day to day basis. Care Homes for Adults (18-65 years) Page 22 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is being managed by a competent and well qualified manager, there are good monitoring and audit systems in place and peoples monies are safely managed. Some improvements are needed to daily record keeping, staff records and safety issues. Evidence: The home is being managed by a competent and qualified manager who holds the Registered Managers award, NVQ 4 and is currently working towards an MA in learning disability. The staff on duty were complimentary about Mr Higgins management style describing him as being open and approachable. We saw that there were good monitoring processes in place and Regulation 26, Providers visits were comprehensive and detailed and highlighted improvements needed to the service. There is also an organisational audit cycle that covers all areas of management including practice issues, medication matters, financial management Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: and future development of the home. At the last key visit we were told that the local quality assurance process was being improved to include feedback from not only service users but also families and other professionals involved with the home. Mr Higgins told us that this had not yet happened but that he was working toward this. Policies, procedures and staff guidelines are in place for the management of service users monies. Each person has a locked cupboard in their bedroom where personal monies and valuables are stored. We looked at the records and money for one service user and found that they were correct ,with receipts being kept and a regular audit being undertaken. Health and safety checks are undertaken and recorded and we saw that this includes the fire system, hot water temperatures and all environmental risk assessments. Incidents and accidents are recored and acted upon and Regulation 37 reports are sent to the Commission as required As detailed in other parts of this report, improvements are needed to the quality of daily records in the home, recruitment records must be available for inspection and the bathroom window on the first floor must be made safe. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Adults (18-65 years) Page 25 of 27 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 24 13 The bathroom window on the first floor must be made safe. This is because there is no restrictor fitted and the window opens wide enough for someone to fall from. 15/12/2008 2 34 19 Recruitment records must be kept in the home and available for inspection This is so that the Commission can monitor that all recruitment records such as CRBs are in place. 15/12/2008 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 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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 © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - 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!