Inspection on 02/11/05 for East View Housing

This inspection was carried out on 2nd November 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

East View Housing 23/09/08

East View Housing 06/10/06

East View Housing 07/06/05

East View Housing 02/11/04

East View Housing 07/06/04

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Insight - Eastchurch

Southfields

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33 St John`s Church Road

Dovedale Court

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 27 Alexandra Road St Leonards-on-sea East Sussex TN37 6LD Lead Inspector Jeanette Denereaz Unannounced Inspection 2nd November 2005 04:00 27 Alexandra Road DS0000021321.V261171.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 27 Alexandra Road DS0000021321.V261171.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 27 Alexandra Road DS0000021321.V261171.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 27 Alexandra Road Address St Leonards-on-sea East Sussex TN37 6LD Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01424 714014 East Homes Limited Mrs Shari Randy Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 27 Alexandra Road DS0000021321.V261171.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of residents to be accommodated will be three (3) The people accommodated will be aged (65) years on admission Date of last inspection 7th June 2005 Brief Description of the Service: 27 Alexandra Road is a three storey Victorian terraced house in a residential area of St Leonards-on-Sea close to local shops and amenities, including public transport. It benefits from a small patio garden to the rear of the property that is accessed through the kitchen. The home is part of the East View Housing organisation (EVH) and provides care for three younger people with learning disabilities. 27 Alexandra Road DS0000021321.V261171.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the second in the year running from April 1st 2005 to March 31st 2006. The inspection took place over two evenings the 2nd November and the 9th November 2005 between 16.00 and 18.00. The overall focus of the inspection was on meeting with the manager and reviewing the progress of the requirements from the previous inspection, a full tour of the home was undertaken. Time was spent meeting the manager, inspecting a number of records, policies, procedures and other documentation. All residents were spoken to and two showed the inspector around the home including their bedrooms. As this report was made following the second unannounced visit, and does not cover all the standards, therefore for the reader to make a judgment about the home, it is recommended that a copy of the last inspection report of the 7th June 2005 also be obtained to have a clearer picture of the home. What the service does well: The staff are now ensuring residents are supported to take an active part in the running of the home, and that 27 Alexandra Road in a real sense is their home. The manager explained that staff tend to do the big shopping, but residents are encouraged and enjoy shopping for the general forgotten or running short items and they go to the local shops independently. The home was found to do most things well. The management of the home was found to be especially good in supporting residents and staff. The residents once again said they were very happy living in the home because all their needs are being met and the staff are friendly and respectful, with comments of: • • • It’s great living here, good food, and lots of choice. The staff are good to us. I like the manager a lot, he is excellent, he is helping me to be more independent so I can move to my own flat someday The residents continue to be encouraged to maintain regular contact with their families and other external agencies and professionals. What has improved since the last inspection? The resident are now more involved in the running of the home including the cleaning, cooking and shopping. The staff and residents actively involving the resident with limited verbal communication in the decision making about the home and about his own life, and this information is now clearing recorded in his care plan. 27 Alexandra Road DS0000021321.V261171.R01.S.doc Version 5.0 Page 6 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. 27 Alexandra Road DS0000021321.V261171.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 27 Alexandra Road DS0000021321.V261171.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1&4 Prospective service users would be given all the information they need to be able to make an informed decision to live at 27 Alexandra Road. EVIDENCE: There has not been a new resident to the home since the last inspection, however, the home is part of the EVH and has detailed polices and procedures in place for prospective residents, which includes the opportunity to visit the home. 27 Alexandra Road DS0000021321.V261171.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7&8 All the residents continue to be treated with genuine respect and dignity by the staff. EVIDENCE: Since the last inspection the staff and residents are actively involving the resident with limited verbal communication in the decision making about the home and about his own life, and this information is now clearing recorded in his care plan. One resident made the comment that “He really is part of our home, and we know him well”. 27 Alexandra Road DS0000021321.V261171.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 & 15 The staff have worked towards ensuring the residents have every opportunity to live a fulfilled, responsible, value and socially active lives. However, the inexperience of the staff in managing sensitive situations could affect the welling of the residents. EVIDENCE: The service is excellent in promoting the development of educational, personal, social and emotional skills. They all have various interests and they are encouraged and supported to explore them, which include attending social clubs, writers’ club and for one resident visiting fairgrounds. Two residents have the opportunity to go independently and for the third there is 1:1 time at weekends. All the residents have contact with their families, which include visiting at the weekends or telephoning during the weekdays. Family and friends are very welcome to the home, and it was evident that the manager has a good rapport with the residents’ parents. There has been a sensitive incident at a day service attended by one of the residents, and it was evident that the manager has supported him and his family with this as far as he was able. The manager acknowledged he was 27 Alexandra Road DS0000021321.V261171.R01.S.doc Version 5.0 Page 11 inexperienced with dealing with sensitive issues and felt that there needed to be someone ready to support and advocate on the resident’s behalf. The manager had not been involved in the CLDT meetings regarding this incident, but had accompanied the resident through police interviews. The manager has concerns about how this is affecting the resident, and was unsure of the way forward, but recognises he needs specialist guidance and support. 27 Alexandra Road DS0000021321.V261171.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 The residents’ health and care needs continue to be well managed and take into account their individual preferences and needs. EVIDENCE: The residents feel that they are treated as individual and that this is respected in the care given and support. One resident spoke of his recent situation and how he felt supported by the manager. The home has a key worker system in place and the two verbal residents spoke highly about their key workers The home has input from the all health professional when needed, and health records show regularly visits to the dentist and opticians as well as appointments with the GP. There are no residents that administer or control their own medication, and all the staff are trained to administer medication. The home has regularly pharmacy audits from the pharmacist and the last audit was on the 3/10/05, which was very positive, and the next audit is in January 2006. 27 Alexandra Road DS0000021321.V261171.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Both these standards were inspected at the last inspection on the 7th June 2005 and were fully met. There have been no verbal or recorded complaints in the home since the last inspection. EVIDENCE: 27 Alexandra Road DS0000021321.V261171.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 27 Residents live in a warm, nicely decorated and clean home. However there are outstanding requirements from the last inspection regarding the repair of the broken kitchen units, and other areas where found to need attention to ensure that the home is meeting the individual’s care needs. EVIDENCE: The home is well presented, homely and clean. Residents showed the inspector around the home including their bedrooms. There are ongoing issues with the broken kitchen units, and repairs to the bathroom, which are outstanding from previous inspections. 27 Alexandra Road DS0000021321.V261171.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33,34 & 36 The residents live in a home where training is important to the staff and management. EVIDENCE: The residents all spoke very highly of the team leader and the staff team. The organisation EVH has a robust recruitment policy and all staff undertake induction and mandatory training. However, following the inspection of staff files within the home, the inspector found one staff file incomplete; there was no record of a completed CRB check but no evidence of POVA clearance, record of interview or references. The manager explained that interview report and references were still at the EVH Head Office, and therefore not available for inspection within the home. One staff member is undertaking the Ldfa training and the manager is working towards his NVQ 4 and RMA. Supervision notes were seen and indicated they were regular every two months. 27 Alexandra Road DS0000021321.V261171.R01.S.doc Version 5.0 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 & 40 The residents consider that the way the home is managed and runs makes it and enjoyable place for them to live. There is a motivated and enthusiastic manager and staff team. However, the lack of knowledge and training in Care Home Regulations (2001) and procedures could lead to residents and the staff team vulnerable and at risk. EVIDENCE: The overall management of the home ensures that the residents live in a safe and homely environment. However, support and information from the senior management of the EVH organisation and not been satisfactory in supporting the manager to understand and complete Regulation 37 notifications, and it seems he had not been fully informed or involved in the procedures and progress of the on-going incident within the home e.g. He had not attended any of the Adult Protection meetings. The CSCI had not been notified of this and other significant events in writing at the time of this inspection. 27 Alexandra Road DS0000021321.V261171.R01.S.doc Version 5.0 Page 17 The manager has totally supported the resident during this time, and continues to do so; the resident confirmed to the inspector that the manager had been a great help to him. 27 Alexandra Road DS0000021321.V261171.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 X X 3 X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X 2 X X X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 2 16 X 17 Standard No 31 32 33 34 35 36 Score X X X 2 X 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 27 Alexandra Road Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 2 2 X 1 X X X DS0000021321.V261171.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? Yes 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 YA15 Regulation 23(2)(i) Requirement Timescale for action 06/12/05 2. YA24 16(2k) 23(2p) 3 YA27 23(2j) 4 YA34 8&9 It is required that the manager must ensure that residents have the information and specialist guidance to help them make appropriate decision in their intimate and personal relationships. It is required that the kitchen 31/12/05 units be replaced and are of a good quality, fulfilling their purpose and to maintain hygienic conditions. This is a requirement from previous inspections 02/11/04. 01/09/05 It is required that shower be 31/12/05 repaired or replaced. Also the manager should reassess residents’ bathing needs and ensure the home is offering appropriate facilities. This is a requirement form previous inspection 01/09/05 It is required that the 09/11/05 Responsible Individual ensures that the recruitment information of staff is kept within the home, including evident of CRB/POVA clearance and be available for inspection. If for any reason there is a delay in the clearance DS0000021321.V261171.R01.S.doc Version 5.0 27 Alexandra Road Page 20 5 YA37YA38 8&9 12(5) 37 of CRB/POVA the staff member should not be working in the home. It is required that the Responsible Individual must ensure that the manager of the home has the training and knowledge of the Care Home Regulations to enable him to support residents and staff. He should also be fully involved in all Adult Protection issues of the residents living at 27 Alexandra Road. 02/11/05 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 YA40 Good Practice Recommendations It is recommended that the manager has a working knowledge of the current legislation and recognised professional standards. 27 Alexandra Road DS0000021321.V261171.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 27 Alexandra Road DS0000021321.V261171.R01.S.doc Version 5.0 Page 22 - 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. 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