CARE HOME ADULTS 18-65
27 Alexandra Road St Leonards-on-sea East Sussex TN37 6LD Lead Inspector
Jeanette Denereaz Key Unannounced Inspection 6th October 2006 15:30 27 Alexandra Road DS0000021321.V311650.R01.S.doc Version 5.2 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.V311650.R01.S.doc Version 5.2 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.V311650.R01.S.doc Version 5.2 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 Vacant Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 27 Alexandra Road DS0000021321.V311650.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The maximum number of service users to be accommodated will be three (3) The service users accommodated will be aged (65) years on admission Date of last inspection 2nd November 2005 Brief Description of the Service: 27 Alexandra Road is a three storey Victorian terraced house in a residential area of St Leonard’s-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. The current scale of fees range from £766.00 to £991.00 27 Alexandra Road DS0000021321.V311650.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulations 2001, uses the term ‘service user’ to describe those living in care home settings. For the purpose of this report, those living at 27 Alexandra Road are referred to as ‘residents’. This report reflects a key inspection based on the collation of information received since the last inspection and an unannounced site visit conducted by an Inspector on the afternoon of the 6th October 2006 starting at 03.30pm, when residents returned home from their day activities, and continues on the 9th October 2006. The site visit included a tour of the premises and an examination of various records including medication, care and staffing records. The Inspector met with the home manager who has overall management responsibilities for the home, and the staff member on duty. During this site inspection visits, the inspector met with two of the three residents collectively and in private. The CSCI also received ‘Have your say about 27 Alexandra Road’ from all three residents and they were positive about the service. The residents made the comments that if they were not happy they would speak to the manager, Mr Ron Hall. There have been discussions between EVH and the CSCI regarding the feasibility of introducing sector management to the three homes in Alexandra Road, and this now has come to fruition with the appointment of a Sector Manager for the three services in Alexandra Road as from the 6th November 2006. The sector manager will be making application to be the registered manager of 27 Alexandra Road with the CSCI in due course. 27 Alexandra Road DS0000021321.V311650.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection?
27 Alexandra Road has not had a registered manager for over two years, but the home manager has undertaken all the managerial duties within the home. As stated the EVH organisation have appointed a Sector Manager for the three services in Alexandra Road. The manager will be making application to the CSCI to become the registered manager of all three services 19,25 & 27 Alexandra Road. There were requirements made at the last inspection, and they have been fully addressed. The recruitment procedures and documentation held within the home has improved. The most recently employed staff member whilst waiting for his CRB clearance, was undertaking his induction and the rota indicated he always worked with supervision, this will continue until his CRB is received by the organisation. The home manager has gained in confidence and knowledge, and these skills will be utilised in his new role within the EVH organisation as the Health and Safety Officer. The kitchen has been modernised and decorated. 27 Alexandra Road DS0000021321.V311650.R01.S.doc Version 5.2 Page 7 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.V311650.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection 27 Alexandra Road DS0000021321.V311650.R01.S.doc Version 5.2 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 the following standard(s): 1,2,3,4 & 5 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Prospective service users can be confident their needs will be assessed, and when they take up residence and their aspirations will be met. EVIDENCE: EVH has a robust organisational policy and procedures for the admittance of new residents to the service. There have not been any new residents since the last inspection, and the three residents have lived together at 27 Alexandra Road for many years, and seem to get on well together. During this inspection visit, the two residents present were interviewed collectively and individually and both confirmed they enjoy living at 27 Alexandra Road. 27 Alexandra Road DS0000021321.V311650.R01.S.doc Version 5.2 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 the following standard(s): 6,7,8,9 & 10 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The staff can demonstrate their knowledge of the individual residents, and are aware of the complex needs of the residents and encourage them to have an independent lifestyle as far as possible. EVIDENCE: The inspector reviewed in depth the care plan of the resident that has been experiencing difficulties with certain aspects of his life. From conversation with the home manager and from information contained within the care plan the resident has been supported by the home and other professional bodies. The residents is now coping better and spoke to the inspector about his life, his family and he had very positive feedback about 27 Alexandra Road. 27 Alexandra Road DS0000021321.V311650.R01.S.doc Version 5.2 Page 11 All three residents have been affected by the news that the manager will be leaving, but it was evident that this has been discussed openly in a mature manner. The manager will not be leaving the EVH organisation and will continue to see the residents in his new role of Health & Safety Officer. The inspector was told that a member of the EVH Senior Management Team had consulted with the all the residents living in Alexandra Road about the staff changes. Also the residents at 27 Alexandra Road had informally discussed this issue around the dining table. 27 Alexandra Road DS0000021321.V311650.R01.S.doc Version 5.2 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 the following standard(s): 12,13,15,16 & 17 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The home’s links with the local community are good and enrich residents’ lives socially and educationally. The staff have a strong commitment to enabling residents to develop their skills, including social, emotional, communication and independent living skills. EVIDENCE: Residents have an individual care plan and their participate fully in the community. There are a variety of day activities for the three residents, with one resident attend the day centre, another is seeking employment with the support of the staff, and a job cleaning cars is looking very hopeful. There are a variety of daily activities recorded, and the residents spoke about their individual activities, which are very varied. One resident also has one day at home, which he enjoys. 27 Alexandra Road DS0000021321.V311650.R01.S.doc Version 5.2 Page 13 The residents also have very active social lives in the evenings and weekends, which include one resident being a member of a writers group, they also enjoy going out into the community. One resident who has limited communication skills does enjoy discos and funfairs and these activities were undertaken and recorded. The menus were seen, and residents have a healthy diet and are involved in the menu setting the shopping and the cooking. One resident wish to do his own cooking, and this is encouraged, and his diet is monitored and he is guided to cook healthy foods. 27 Alexandra Road DS0000021321.V311650.R01.S.doc Version 5.2 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 the following standard(s): 18,19 & 20 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents receive personal support appropriate to their physical, emotional and healthcare needs. All personal and healthcare needs are well documented. EVIDENCE: All three residents are registered with local GPs and when required have the services of other health professionals, including the support from the local Community Learning Disability Team (CLDT) which over the last year has provided psychological support and advice to two of the residents. Also the residents have been involved in an initiative in conjunction the Community Learning Disability Team (CLDT) called ‘My Health action plan’ which has been completed by the residents and staff which highlights the health issues they may have. The medication files and storage were inspected and found to be in order. All staff have had the relevant training and are all deemed to be competent in the administrating of medication to the residents. 27 Alexandra Road DS0000021321.V311650.R01.S.doc Version 5.2 Page 15 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): 22 & 23 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives’ complaints would be taken seriously and investigated, and the staff have the knowledge and understanding to take the correct action to safeguard residents from abuse. EVIDENCE: The residents were interviewed and were asked if they were worried or concerns what would they do, they both answered they would talk to ‘Ron’ the home manager or the other staff working in the home. Both the home manager and the staff member on duty during this inspection were very confident that they understood the issues of protected residents from all forms of abuse. The new staff member has been waiting for his CRB document to come through, and has not been able to work alone on a shift, but he has been undertaking his induction and other mandatory training. During this inspection, the staff member’s CRB had been received and he could now start to work in the home unsupervised. 27 Alexandra Road DS0000021321.V311650.R01.S.doc Version 5.2 Page 16 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 & 30 Overall the quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The premises are suitable for the needs of the residents and are kept clean and homely. However, when there have been repairs undertaken, they need to be inspected and finished to a good standard. EVIDENCE: The inspector accompanied by the residents, undertook a full tour of the home including all communal areas, including the kitchen, bathrooms the garden and individual bedrooms. The residents are very proud of their new kitchen. The home was very clean, and the furnishings around the house make it very homely. The residents’ bedrooms are very personalised to meet the individual needs and interests. The inspector found there were areas that had been repaired but not finished, especially in one bedroom. Therefore to ensure the home is always well maintained, repairs need to be inspected and finished to a good standard. 27 Alexandra Road DS0000021321.V311650.R01.S.doc Version 5.2 Page 17 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): 31,32,33,34,35 & 36 Overall the quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The staff employed have the experience to meet residents needs and support them, however there has been staffing issues. EVIDENCE: Since the last inspection there has been staffing issues, relating to staff leaving and recruitment being hindered by the slow return of CRB information. It was evident that EVH has fully adhered to their recruitment policy and procedures, and a staff member had been recruited to work at 27 Alexandra Road. The new staff member had been working along other staff, undertaken his induction and mandatory training, but he was unable to work alone on shifts. Therefore, this has affected other staff members by having to work more shifts and the organisation having to employ agency staff, which they are always been reluctant to do. However, as stated within this report the staff member has now received his CRB clearance and can now work in the home. Whilst waiting for the CRB the staff member had got to know the residents at 27 Alexandra and they were looking forward to him being able to work in the home with them.
27 Alexandra Road DS0000021321.V311650.R01.S.doc Version 5.2 Page 18 The staff have been receiving regular supervision, and the inspector saw supervision records, and the staff member on duty confirmed that she always feels supported by the home manager, and she is also very sorry he is leaving 27 Alexandra Road. 27 Alexandra Road DS0000021321.V311650.R01.S.doc Version 5.2 Page 19 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): 37,38,39 & 42 Overall the quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The manager has been instrumental in the development of the home, and has a good understanding on the area in which the home needed to improve. He welcomes the new initiative of Sector Management. EVIDENCE: For sometime 27 Alexandra Road has not had a registered manager, but the home manager has had the management responsibility for the home. The Senior management Team have been considering a way forward for the three homes in Alexandra Road, and they have been in discussion with the CSCI regarding setting up sector management (one registered manager for the three homes) to ensure the homes have good staffing levels and a registered manager in post. As stated in the summary the EVH organisation have appointed as the Sector Manager for the three services in Alexandra Road.
27 Alexandra Road DS0000021321.V311650.R01.S.doc Version 5.2 Page 20 She will be making application to the CSCI to become the registered manager of all three services 19, 25 & 27 Alexandra Road. The overall maintenance of the home is good, however there were areas seen during the inspection that had been repaired but not finished, especially in one bedroom. The repairs and maintenance within the home need to be inspected and finished to a good standard. This will be an area addressed by the new Health and Safety Officer, which will include the maintenance and up keep of all the properties owned or managed by EVH. All the requirements relating to the health and safety of the home are up to date and accurate and in order with documentation seem at the inspection visit and through information contained in the Pre-Inspection questionnaire sent to the CSCI prior to the inspection. 27 Alexandra Road DS0000021321.V311650.R01.S.doc Version 5.2 Page 21 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 Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X X 3 X 27 Alexandra Road DS0000021321.V311650.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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. 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. Refer to Standard Good Practice Recommendations 27 Alexandra Road DS0000021321.V311650.R01.S.doc Version 5.2 Page 23 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
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