Inspection on 09/01/06 for 27 Graham Avenue

This inspection was carried out on 9th January 2006.

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 no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

27 Graham Avenue 10/05/07

27 Graham Avenue 27/09/06

27 Graham Avenue 18/07/05

27 Graham Avenue 14/12/04

27 Graham Avenue 19/04/04

Similar services:

Insight - Eastchurch

Southfields

Thorndene

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 27 Graham Avenue 27 Graham Avenue Brighton East Sussex BN1 8HA Lead Inspector James Houston Unannounced Inspection 9th January 2006 08:15 27 Graham Avenue DS0000014126.V265328.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 Graham Avenue DS0000014126.V265328.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 Graham Avenue DS0000014126.V265328.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 27 Graham Avenue Address 27 Graham Avenue Brighton East Sussex BN1 8HA 01273 503058 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) Hallcreed Limited Ms Kathleen Penney Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 27 Graham Avenue DS0000014126.V265328.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is four (4). Service users must be aged between eighteen (18) and sixty-five (65) on admission. Service users with a learning disability only to be accommodated. Date of last inspection 18th July 2005 Brief Description of the Service: The home is situated in a pleasant residential area of Brighton close to local shops and pubs. It is convenient for bus services into Brighton and other areas, and Preston Park train station is also nearby. The building is a threestorey semi-detached property with large rooms and has a patio area with a barbecue in the long rear garden. Residents have the use of a large lounge, a kitchen/dining room and a music room. They also have the advantage of the use of a hydrotherapy pool at one of the other properties owned by Hallcreed Ltd. There is ample free parking in the road outside the home.27 Graham Avenue is registered to accommodate up to four people with a learning disability; it does not provide nursing care. 27 Graham Avenue DS0000014126.V265328.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over five hours during the early morning and later during the afternoon of the ninth of January 2006. A tour of the premises was made. During the inspection the manager, a member of staff, and all the residents were spoken with. A variety of records, policies and procedures were read including four care plans. Four residents were living in the home on the day of the inspection. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 27 Graham Avenue DS0000014126.V265328.R01.S.doc Version 5.0 Page 6 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 Graham Avenue DS0000014126.V265328.R01.S.doc Version 5.0 Page 7 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): 3,and 4. The home meets the needs of residents. Residents are admitted after careful introduction to the home. EVIDENCE: After meeting the manager, staff and residents and reading a range of policies and records the inspector formed the opinion the home can meet the needs of its current resident group. The manager said that the home would not admit prospective residents whose needs it could not meet. The home has not had a vacancy for several years. The manager outlined the procedure, which had been followed on the last occasion, and this complied fully with this standard, with a prolonged introduction to the home and admission for a trial period. 27 Graham Avenue DS0000014126.V265328.R01.S.doc Version 5.0 Page 8 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 and 10. Care plans are well drawn up but should be more regularly reviewed. The importance and limits of confidentiality are understood. EVIDENCE: Individual care plans are completed for each resident. These are not reviewed six monthly as recommended and the recommendation from the last inspection to this effect is repeated. New risk assessments about residents have been drawn up by the manager and are being typed up. They were available for inspection. The home has appropriate policies setting out aspects of confidentiality. A staff member spoken to knew when information given to them in confidence must be shared with their manager or others. 27 Graham Avenue DS0000014126.V265328.R01.S.doc Version 5.0 Page 9 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): 11,12,14 and 17. Residents are well integrated into the local community with many local amenities and facilities being accessed. Mealtimes provide variety and interest for residents. EVIDENCE: No residents currently have expressed spiritual needs. All of the residents attend day centres five days a week, participating in a wide range of activities. The home encourages residents to attend events open to all people and not just those with disabilities. The home has its own people carrier, and staff said that residents enjoy going out to a wide variety of venues such as pubs, restaurants and cinemas. The manager said that residents usually have two holidays each year and that planning for this year’s holidays is underway. Residents are encouraged to pursue their own interests and hobbies and the home has its own music room. The home has a menu and this was made available to the inspector. Staff said that they have a record of food likes/dislikes and that they have the time to give discreet assistance to residents at mealtimes if and when needed. 27 Graham Avenue DS0000014126.V265328.R01.S.doc Version 5.0 Page 10 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): 20 and 21. Medication administration records need attention. The needs of dying residents would be well met. EVIDENCE: Medication policies and procedures were in place and medicines were securely stored. Staff have had relevant training. The record of medicines showed several gaps and an immediate requirement has been made regarding this. The home has policies that set out in detail the actions staff should take in the event of a sudden death. A brief statement of each person’s arrangements is in their care plan. 27 Graham Avenue DS0000014126.V265328.R01.S.doc Version 5.0 Page 11 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 and 23. The home has a suitable complaints procedure and should develop an appropriate version for residents. Adult protection policies are in place. EVIDENCE: The home now has a complaints policy that gives the required information. The part of the requirement from the last inspection about an appropriate version being drawn up and given to all residents has not been met and has been repeated. The home or the Commission has received no complaints concerning the running of the home for Social Care Inspection. The home has suitable adult protection and whistle-blowing policies. A senior carer and a staff member are due to go on a course about adult protection training. A minor amendment to the home’s policy on staff and gifts and Bequests for residents were made during the inspection. 27 Graham Avenue DS0000014126.V265328.R01.S.doc Version 5.0 Page 12 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): 24,25,26,27 and 28. The home offers comfortable accommodation to residents that is of a high standard in all aspects. EVIDENCE: The home is comfortable, well furnished and decorated. It is well maintained and staff said that if matters need attention they are quickly dealt with. A leak in the music room has been attended to. The home offers residents a spacious lounge, a good-sized kitchen diner and a music room. At the rear of the property is a patio area with a long well kept garden. One resident has mobility problems but can access all areas of the house and garden. The house meets the requirements of the fire brigade and the environmental health officer. The home‘s four single rooms meet the size standard. All are well furnished and decorated. The home has sufficient bathrooms/WC facilities for residents. One bedroom has an en-suite bathroom. Suitable facilities have been provided for staff. There is a large staff sleep-in room/office. 27 Graham Avenue DS0000014126.V265328.R01.S.doc Version 5.0 Page 13 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 and 36. The home has an effective staff team. Recruitment procedures are robust. NVQ qualification levels and frequency of supervision given to staff need review. EVIDENCE: Staff said that they have been given job descriptions and copies of these were seen. Staff have access to a copy of the General Social Care Council code of Conduct. Staff were seen to accessible to and comfortable with residents. One of the three staff members has NVQ level 3 in care. The other 2 staff members do not hold an NVQ qualification. It is recommended that 50 of staff hold at least level 2. Sufficient staff were on duty to meet the needs of residents. The home’s duty rota was made available to the inspector. Staff meetings are held from time to time. The manager gave an assurance that all staff left in charge are aged at least 21 years. Staff on duty in the home are all experienced and have been at the home for a considerable period, affording continuity of care to residents. Staff confirmed that the manager and senior managers are on call. Staff recruitment records were available and those inspected were found to contain the required details. 27 Graham Avenue DS0000014126.V265328.R01.S.doc Version 5.0 Page 14 Staff said that that they receive regular supervision. Records inspected showed that this is not at the recommended frequency of six times per year. The manager confirmed that she has been given training in the supervising staff. 27 Graham Avenue DS0000014126.V265328.R01.S.doc Version 5.0 Page 15 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): 37,39,42 and 43. The home is well managed. The quality assurance processes and some risk assessments would benefit from attention. Reports on the home by a representative of the owners should recommence. EVIDENCE: The home’s registered manager has considerable relevant experience and has undertaken recent training to update her knowledge and skills. The manager holds NVQ level 2 in care and other qualifications, but is not at present intending to take the recommended qualifications. A staff member said that the manager is open and approachable. Since the previous inspection the home continues to use a pictorial feedback chart for residents to demonstrate how they are feeling. Care plans are reviewed regularly and contact from families is encouraged. It is recommended that feedback from stakeholders in the community be sought formally from time to time. 27 Graham Avenue DS0000014126.V265328.R01.S.doc Version 5.0 Page 16 Records inspected showed that a requirement made at the last inspection that all portable electrical appliances be tested had been actioned. A requirement that a risk assessment (COSSH) for all hazardous substances be produced had not been actioned and has been repeated. Records showed that staff have had recent training in fire safety, food safety, infection control, moving and handling and first aid. The manager said that the owner has a financial plan for the organisation. A current certificate of insurance was on display. Lines of accountability within the organisation are clear. The manager said that the headquarters of the organisation gives support with financial, legal and human resources issues. Monthly visits on the home by a representative of the owners of the home should be resumed and copies of their reports on their inspections left in the home available for inspection. 27 Graham Avenue DS0000014126.V265328.R01.S.doc Version 5.0 Page 17 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 X X 3 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X 3 X 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 X X LIFESTYLES Standard No Score 11 3 12 3 13 X 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score 3 2 3 3 X 2 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 27 Graham Avenue Score X X 2 3 Standard No 37 38 39 40 41 42 43 Score 2 X 2 X X 2 2 DS0000014126.V265328.R01.S.doc Version 5.0 Page 18 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. 2. 3. 4. Standard YA20 YA22 YA42 YA43 Regulation 17(1) & Sch 3(i) 22 (2)(5)(7) 13(4)(c) 26 & 17 (2)& Sch 4.5 Requirement Record fully all medicines given to residents. An appropriate version of the complaints procedure must be given to all service users. Risk assessments for all hazardous substances should be produced. Keep in the home available for inspection a copy of the report of the monthly visit to the home by a representative of the owner. Timescale for action 09/01/06 31/03/06 31/03/06 31/01/06 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. 3. 4. 5. Refer to Standard YA6 YA32 YA36 YA37 YA39 Good Practice Recommendations Care plans should be reviewed six-monthly. 50 of care staff attain NVQ level 2 in care. Staff receive formal supervision at least six times a year. The manager attains the recommended qualifications. Stakeholders are asked formally their views as to how the home achieves outcomes for its residents. 27 Graham Avenue DS0000014126.V265328.R01.S.doc Version 5.0 Page 19 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. 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