Inspection on 05/05/05 for 267 Old Shoreham Road

This inspection was carried out on 5th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

267 Old Shoreham Road 13/06/07

267 Old Shoreham Road 19/10/06

267 Old Shoreham Road 20/10/05

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 08/07/2008.

CARE HOME ADULTS 18-65 267 Old Shoreham Road 267 Old Shoreham Road Portslade East Sussex BN41 1XF Lead Inspector Jenny Blackwell Unannounced 5th May 2005 13:00 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. 267 Old Shoreham Road Version 1.10 Page 3 SERVICE INFORMATION Name of service 267 Old Shoreham Road Address 267 Old Shoreham Road Portslade East Sussex BN41 1XS 01273 295477 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) Brighton & Hove City Council Mr Glen Campbell Care Home 3 Category(ies) of Learning Disability (LD) registration, with number 3 of places 267 Old Shoreham Road Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of individuals to be accommodated is three (3) 2. Individuals must be aged between eighteen (18) and sixty-five (65) years on admission. 3. Individuals with a learning disability only to be accommodated. Date of last inspection N/A Brief Description of the Service: The home is set in a residential are of Portslade on a main road. The building is semi-detached and has three stories, with the office and staff sleeping in rooms on the top floor. The home is domestic in scale and is situated near local shops and amenities. Hard standing parking space is available at the front of the home. The home can accomodate up to 3 people with learning disabilites who are physically able. Each person have their own individually decorated bedroom and share communal space, a lounge, kitchen/dining room and bathroom facilities. The home was designed around the needs of the current 3 people and has speacialist adaptations to provide a safe enviroment for the people. 267 Old Shoreham Road Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During this summary the people who live at the home will be referred to as people/person (except in the requirement section) and the people who work at the home as staff or by their job title. This was the first inspection of the home under the Care Standards Act and it was unannounced. An announced follow up visit took place on the 25th May 2005. The people who live at the home, some of the staff team, deputy and manager were present during the two-day inspections. Time was spent with two of the three people who live at the home, and the other person was seen briefly in between trips out. The manager and deputy were spoken to individually and several staff was spoken to throughout the day. The day was arranged to fit around the activities organised for the people. As this was the first inspection of the home several areas where prioritised. Firstly, getting to know the people at the home and observing the staff interaction with them. In addition the assessment of people’s needs, the environment, their activities and interests were looked at. These areas were prioritised because of issues raised during communications between the manager and the Commission and Regulation 26 reports from the reviewing officer for the service. What the service does well: The manager and staff arrange individual activities with each person based around their interest and support needs. The staff views each person as individuals and the manager produces a staff rota that is built around leisure activities. The staff team endeavour to work in a consistent manner with each person. This is supported by individuals support plans. Detailed guidelines were in place that described how the people preferred to be supported with the aim to reduce people’s anxiety levels. The staff team were focused and helped people to deal with their levels of anxiety, focusing on supporting people to reduce certain behaviours. 267 Old Shoreham Road Version 1.10 Page 6 As the home is fairly new the staff have been committed in helping each person to settle into their new home and people have been given the opportunity to develop new interest and skills. People have an activity planner for the week that is drawn up from their interests. The staff had continued to review these activities with the person to see if they would continue to fulfil their needs. The manager ensures that staff had access to training both mandatory and specialist that focuses on the support needs of the people. Good relationships had been built up with external agencies such as health care professionals and speech and language therapists that enabled the team to provide a rounded approach to people support needs. What has improved since the last inspection? What they could do better: Two of the three people did not have a community care assessment in place. The manager and team ensured that in house reviews of each person’s needs took place. However, no evidence was seen to suggest that the placing authority had undertaken reviews of the placement. The manager and team have devised ways of reducing levels of restrictions for the people in the home. Further improvements are necessary and a requirement has been made to review the need for a lock on one person’s door. The manager and staff regularly work with the Council’s relief staff called Care Crew and agency members of staff. It was noted during the inspection that although the staff team work closely with relief staff they were unable to 267 Old Shoreham Road Version 1.10 Page 7 attend staff meetings. The manager stated this was due to resource issues. To improve continuity of the staff team, all members of the team regardless of employment status need to share in the information sessions such as staff meetings and supervision. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 267 Old Shoreham Road Version 1.10 Page 8 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 267 Old Shoreham Road Version 1.10 Page 9 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 and 2 The home provides adequate information for prospective new people moving into the home. This information is usually written and is not currently accessable for people who do not read. Assessments are not in place for two of the three people living in the home. EVIDENCE: The home was set up as a service particularly for the current people living at the home. The environment was adapted prior to them moving in to suit their needs. Evidence was seen in the support plans that people’s needs were being monitored by the staff during the early stages of their move. However, two people did not appear to have a Community Care Assessment and their funding authority was not monitoring their move to the home. This was particularly concerning as this was a new home for the people and the move to the home was seen by staff as a challenging time for each person. 267 Old Shoreham Road Version 1.10 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 and 9. Care plans were in place for all three people, containing information that enabled staff to provide a consistent support to each person. The manager and staff worked sensitively with individuals to engage them in the decision making process throughout the day. The risk assessment process was thorough which enabled each person to move towards a more independent lifestyle although further adjustments are needed to the environment to fully achieve this. EVIDENCE: The care plans were looked at for each person. They contained information that described a persons interest, likes, dislikes, family and friends connections, basic health and social care needs. Activity timetables were in the plans and were tailored to each person’s interest. The care plans showed that the staff approached each person in an individual manner. The keyworkers contributed to the plans and has kept them up dated. Care was taken when describing each person’s support needs. The plans presented as being respectful to the person. The manager and staff team at the home regularly review the guidelines that are in place for each person and a formal review of each person’s care is conducted every six months. However, as stated in the previous section, two 267 Old Shoreham Road Version 1.10 Page 11 of the three people have not had their placements reviewed by their placing authority. During the inspection, staff were seen supporting people to make decisions throughout the day. One person was encouraged to put up photographs of her activities for the day on her daily planner in the dining room. The staff member went through the photographs with her to ensure she was aware what was going to happen the next day. The staff also used sign language (Makaton) and objects of reference to help people engage during the day and make choices about what they want to do. It was noted that some restriction to the home are in place for example an external lock on one persons bedroom door. It had been reported to the Commission by the manager that the lock had been used to contain the person briefly on two occasions. The reports described these incidents as being in an emergency to protect staff and other people at the home. Staff working during the inspection were asked about the lock. They gave varying views on the use and need of the lock, some felt it was necessary to provide a safe environment whilst others believed it was not and had never felt the need to use containment of the person. It was required that the manager ensures that any containment of the people at the home is lawful and the use of the lock is reviewed. The manager and staff undertake comprehensive environmental and task risk assessments. 267 Old Shoreham Road Version 1.10 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) 12,13.14,15 and 17. The manager and staff were commited to supporting each person with their daily interests. The home was concerned with the individual and did not group people together during activities for ease. People were supported to be part of the community. The manager and staff had fostered good relationships with family members who were involved in the home. Privacy was respected and staff freely engaged with the people at the home rather than restrict conversation amongst themselves. The menus appeared to offer nutritional and balanced meals. EVIDENCE: During the two visits to the home each person was out in the community participating in a variety of activities. This included using day services locally and in Lewis as well as going shopping and for walks. 267 Old Shoreham Road Version 1.10 Page 13 People were also engaged around the home. One person led the inspector to a box of items that interested her and time was spent with her reading books and looking at pictures she had made. Another person and a member of staff watched a video about Makaton sign language. The staff member used the signs with the person as they watched. An activity plan was seen for one person that included a variety of leisure activities such as shopping, swimming and walks in the park. Each activity was appropriately supported by correct staffing ratios. The staff supported family contact and regular visits by family members to the home and to the family’s home was encouraged. The menus for the meals at the home were seen. One staff member stated that the menus were written around the preferences of the people. Two of the three people regularly got involved with preparing the meals. The other person helps out particularly on Sundays with the meal. During the inspection the people were seen to make their own drinks and snacks and one person prepared the evening meal with support. 267 Old Shoreham Road Version 1.10 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) 19 and 20 The manager and staff ensure that the health needs of the people are monitored and supported. The medication is stored, administered and recorded appropriately. Staff training is orgainised regulary and staff are tested on their competency before administering medication. EVIDENCE: The medication procedure was observed during the inspection. Two staff members administered and recorded the medication in accordance with the home’s policy and procedures. Good verbal instruction was conducted between the staff. Staff must be trained in giving one person epilepsy medication before they are allowed to administer it. Those staff spoken to were able to describe the people’s current health concerns and were knowledgeable about medication they were taken and for which condition. The people at the home have been using a new G.P clinic and the staff reported that the G.P had been working closely with the staff to support the people to access the health care they are entitled to. The staff have been developing ways, with the support of community health care professionals, to 267 Old Shoreham Road Version 1.10 Page 15 desensitise individuals to health screening tests for the people in an attempt to reduce the possibility of distress that the people may experience. A discussion was held with the manager regarding the requirements in law to work to the Best Interest process as described in the Mental Capacity Act. This applies when medical intervention is required for people with reduced capacity. He confirmed his commitment to this process when supporting people living at the home to receive medical treatment. 267 Old Shoreham Road Version 1.10 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 and 23 The manager and staff were responsive to the concerns of the people living at the home. A formalised complaint procedure is in place for the home that adheres to the organisation’s policy. The organisation and manager emphasised the importance of protecting vulnerable adults, through policy, training and supervision. EVIDENCE: The complaints file was seen during the inspection. A verbal complaint from a neighbour had been recorded well and appropriately responded to by the staff. The staff spoken to knew their responsibilities in recording and reporting complaints. One person described how to use the forms and that she would pass the information on to the manager. It was recommended that the complaints log form have a space for the person who is filling in the form to sign. The people’s monies handled by the staff were checked at each handover. This was observed during the inspection. Two members of staff carried out the check. Each person’s money was checked and compared to the totals recorded on the sheet. The two staff described how any discrepancies would be followed up. New staff to the home were instructed in Adult Protection during their induction period. The training plan was looked at and this showed regular and organised A.P training for staff. All staff were expected to attend Adult Protection training and this was monitored by the manager. He ensured that people attended refresher courses regularly. 267 Old Shoreham Road Version 1.10 Page 17 An Adult Protection alert has recently been raised by the manager with Social Services and is being dealt with appropriately. 267 Old Shoreham Road Version 1.10 Page 18 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 and 30 The home was generally homely, comfortable and safe. Each person’s bedroom was adapted to suit their needs and effort had been made to personalise them. Further changes are needed to ensure the people fully experience a homely and comfortable environment. EVIDENCE: The home has been purposely adapted to meet the needs of the three people. The Council have invested significant sums in trying to achieve a safe environment for the people. The manager and staff worked with the planners at the development stage of the home to include facilities that would help people transfer from their previous homes as smoothly as possible. During the first year the staff found some difficulties with the environment as the people started to settle into the home. The manager commented that the room choices that were made had turned out to be not as successful as the staff team had hoped. Although he also felt that staff had been particularly flexible in their approach in order to make the best out of the environment for each person. It was noted that one person’s flooring in her bedroom needed to be replaced. It was required that the manager ensures that this happens. In addition, one 267 Old Shoreham Road Version 1.10 Page 19 person had safety material on her bedroom walls to protect her from injury. It was recommended that this be reviewed as soon as possible to ensure the suitability of this facility. The keyworkers and staff had carefully thought out each person’s bedrooms in order to reflect the person’s interest and create a safe environment. One person had a build in music system that allowed her to operate her own music, which suited her needs, as she was not keen on having a music player on display. The shared spaces in the house were kept in a reasonable order and generally had a homely feel. The kitchen and dining room were open plan and the people had unrestricted access to the kitchen facilities. The lounge was separate and had the facilities that are expected in a domestic home. The home was clean and well kept and the laundry facilities met the needs of the people. 267 Old Shoreham Road Version 1.10 Page 20 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) 33 and 35. The staff were observed throughout the inspection and asked about their induction to the home and training. Staff demonstrated competence when supporting the people at the home and in particular had adapted well to the support needs of a the new people living in a new home. EVIDENCE: The staff handover was observed. Each person’s activities for the day and support requirements for the next shift were covered. The staff present had a good understanding of each person’s needs and spoke in a respectful manner about them. Two staff members were asked about their views of the move to the new home. Both felt that initially things had been difficult but that the people and the team now knew each other much better and were settling into routines and trying out new things with confidence. One person in particular had lived on her own for some time and was taking some time to get used to sharing with other people. The deputy manager stated she felt the team were committed in supporting the people, who on occasions could be challenging, in a meaningful way. A training plan was viewed where all staff were expected to undertake mandatory training in Health and Safety, supporting challenging behaviour and 267 Old Shoreham Road Version 1.10 Page 21 manual handling. In addition staff have access to specialist training such as communication methods and autism. The manager ensures that he monitors the staff attendance on training courses via individual supervisions and staff meetings. It was noted that several shifts per week are covered by bank staff (Care Crew) and agency workers. The manager stated the staff used are familiar with the people who live at the home and have thorough inductions before working with people. However these workers do not attend staff meeting or have 1:1 supervision. It was required that the manager ensures the temporary staff have full access to information about the home to ensure continuity. In addition it was required that the manager ensures each member of staff (including temporary) receive codes of practice to work by. 267 Old Shoreham Road Version 1.10 Page 22 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) 42 The manager demonstrated knowledge of monitoring health and safety issues at the home. Staff are trained in First aid, moving and handling and food hygiene. The home had appropriate fire protection procedures. The home was generally a safe enviorment for the people who live and work in the home. EVIDENCE: The manager had nominated a named member of staff who undertook monthly audit of health and safety checks that included fire equipment and detection checks, water temperatures and fridge and freezer temperatures. Staff members carry out these checks on a daily and weekly basis. They are recorded as part of the detailed handover sheet, which are checked off and signed on each shift. External contractors test and service the fire equipment and detection and portable appliances. Records of these are held in the service and the manager and staff ensure that the checks are carried out in accordance with the contract. 267 Old Shoreham Road Version 1.10 Page 23 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 x x x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 2 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 2 x x x x 3 Standard No 11 12 13 x 3 3 Standard No 31 32 33 34 35 Score x x 2 x 3 Page 24 267 Old Shoreham Road Version 1.10 14 15 16 17 3 3 x 3 36 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x 267 Old Shoreham Road Version 1.10 Page 25 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 2 Regulation 14(1)(a) (c) 12(2)(3) 23(2)(a) 23(2)(d) 18(b) 18(4) Requirement The manager shall not provide acommodation to any person without a full and comprehensive assessment. The manager ensures that the lock to a service users bedroom is reviewed. That the manager replaces the flooring in one persons bedroon. That the manager ensures temporary staff have acess to staff meetings and supervision. That the manager ensures all staff have acess to codes of conducts. Timescale for action Immediate 2. 3. 4. 5. 7 25 33 33 Immediate 31st August 2005 Immediate Immediate 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. 2. Refer to Standard 22 25 Good Practice Recommendations That the manager ensures staff sign the complaints log form. That the manager reviews the need for the safety material one one person bedroom wall. 267 Old Shoreham Road Version 1.10 Page 26 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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