Inspection on 03/09/08 for 287 Dyke Road

This inspection was carried out on 3rd September 2008.

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

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

287 Dyke Road 19/01/08

287 Dyke Road 23/07/07

287 Dyke Road 15/06/06

287 Dyke Road 14/02/06

287 Dyke Road 10/08/05

287 Dyke Road 11/01/05

287 Dyke Road 27/07/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/06/2011.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 287 Dyke Road 287 Dyke Road Hove East Sussex BN3 6PD two star good service The quality rating for this care home is: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Nigel Thompson Date: 0 3 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to:  Put the people who use social care first  Improve services and stamp out bad practice  Be an expert voice on social care  Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Information about the care home Name of care home: Address: 287 Dyke Road 287 Dyke Road Hove East Sussex BN3 6PD 01273 566804 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): jwood@cmg-operations.com Care Management Group Ltd Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 8 0 care home 8 learning disability Additional conditions: The maximum number of service users to be accommodated is eight (8). That service users to be accommodated have a learning disability, not falling within any other category. That service users should be younger adults aged between eighteen (18) and sixtyfive (65) years on admission. Date of last inspection 0 3 0 9 2 0 0 8 A bit about the care home 287 Dyke Road is a care home, which provides personal care and accommodation for up to eight people with profound physical and learning disabilities. The home is owned and run by Care Management Group (CMG) who are a large organisation that provides care for people with learning disabilities. The home is a large detached property, which is located on a main road on the outskirts of Brighton. There is nearby access to some local amenities and to public transport. There is limited parking available at the home, but on-street parking is permitted. All rooms are for single occupancy with en-suite facilities and are located over three floors. There is a passenger shaft lift available to allow access to all floors. It should be noted that although the home complies with the required communal area, there is no communal area that can accommodate all eight residents at any given time. The home provides personal care and support to residents who are funded by Social Services. The home?s fees as of 23 July 2007 ranged from #1800 - #2200 per person per week. Additional costs are charged for hairdressing (#10), chiropody (#10) and external activities such as shows and concerts. Prospective residents and their relatives are provided with written information regarding the services and facilities provided at the home prior to admission. A copy of the home?s most recent inspection report is available on request from the home. Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: This is what the inspector did when they were at the care home The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This key unannounced inspection took place over five hours in September 2008. It found that all the key National Minimum Standards that were assessed had been met or partially met and the overall quality of care provided was satisfactory. The purpose of this inspection was to assess compliance with the requirements of the previous inspection and to generally monitor care practices at the home. On the day of the inspection there were six residents living at the home. Residentss relatives spoken with as part of the inspection process expressed satisfaction with the home, the staff and the service provided. The inspection involved a tour of the premises, observation of working practices, examination of records and documentation and discussion with two residents relatives, three members of staff and the appointed manager. The focus of the inspection was on the quality of life for people who live at the home. What the care home does well What has got better from the last inspection Copies of all residents terms and conditions of contract inclusive of the fees payable, as required are now kept within the home and were made available for inspection. Medication policies and procedures have been reviewed and improved including the development and implementation of individual epilepsy management guidelines which are in place for staff to follow. In order that all residents are protected from potential harm, neglect and abuse, relevant training, relating to safeguarding vulnerable adults, has been provided to ensure that all staff working in the home know when and how to respond in the event of suspecting and alerting potential abuse. What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Nigel Thompson The Oast Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 01622724950 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries.southeast@csci.gsi.gov.uk or by telephoning our order line - Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The improved admission policy and procedure ensures that residents are admitted only on the basis of a full needs assessment, undertaken by people competent to do so. Prospective residents know that the home is able to meet their individual care and support needs. Evidence: There have been no admissions to 287 Dyke Road since the previous inspection. All six residents currently living in the home are evidently very happy and settled. The manager confirmed that should a vacancy exist any prospective resident would only be accepted on completion of a full assessment process. Referrals are made by social services through a care management process. CMG continues to employ a team of centrally based Assessment Referral Officers, who are responsible for considering and assessing all initial referrals for each of the homes. However it is evident from discussion with the appointed manager that the situation has significantly improved and she is now directly involved in the assessment process and admission procedure. To effectively demonstrate this improved practice, the manager confirmed that despite there being two vacancies at the home, two recent referrals who were assessed were not offered a place as they were considered unsuitable for the home or incompatible with existing residents. Contracts have been drawn up and are in place for each resident. However, it was noted that individual Service User Agreements, outlining terms and conditions of residency, had not been signed by a relative or advocate on behalf of the resident. Prospective residents and their relatives are encouraged to visit the home and have the opportunity to look around and meet with members of staff and existing residents. In care plans examined there was evidence of a comprehensive Transition Programme having been undertaken in respect of residents admitted to the home. The manager confirmed that any new resident would undergo a flexible trial period at the home, during which time their suitability and compatibility are assessed and it is established whether their identified care and support needs are able to be met. Information regarding the service is available to prospective and existing residents in various formats. The Statement of Purpose and Service User Guide have been thoughtfully and imaginatively produced to a high standard and are both comprehensive and informative. However it was noted that the Statement of Purpose was last updated in March 2007 and consequently certain information, including contact details for the CSCI, were innaccurate. Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Residents care plans enable staff to meet assessed needs in a structured and consistent manner and individual plans, including risk assessments reflect changing support needs. Systems for consultation and participation remain effective and residents are treated with respect and encouraged and enabled to make decisions about their day-to-day living. Evidence: ‘Person centred care and support plans are being developed and implemented for each resident. Individual plans that were examined contained a detailed Pen portrait and informative section entitiled All about me. Personal risk assessments and comprehensive details of their physical, psychological and emotional support needs were examined and found to be accurate, up to date and generally well maintained. The manager confirmed that residents relatives, advocates or representative have the opportunity to be directly involved in six monthly care plan review meetings. Such reviews are held to discuss and monitor an individuals progress, review previous goals, as well as agreeing action points and setting goals for the future. The agenda for such meetings also covers day services, leisure activities, holidays and relationships with family and friends. It was evident that, as with care plans, these reviews are recorded in the first person. The manager confirmed that following reviews individual plans are subsequently amended, as necessary, to reflect any changing needs or circumstances. In addition to the regular care plan review, the appointed keyworker for each resident completes a monthly report which includes significant news / progress, any issues and problems (including how these are being addressed), activities and any relevant information from their Support and Health Action Plan. These monthly reports are made available to Care Managers and residents relatives. As far as is practicable independence and individuality continues to be encouraged and promoted within the home and is reflected in the personalising of residents rooms, the choice of bedclothes and colour schemes and individual preferences for recreational and leisure activities. The manager emphasised the importance of staff developing close working relationships with individual residents. Despite the variable and limited communication of the residents, effective and regular interaction and consultation takes place constantly throughout the home. This was evident from direct observation residents being supported in a professional, sensitive and respectful manner. Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Residents are enabled and supported to maintain contact with family and friends as they wish and effective links with the community enrich their social and educational opportunities. Residents benefit from appropriate recreational and leisure activities reflecting their individual likes and preferences. Evidence: The recreational and leisure interests of residents are identified and recorded in their individual care plan and they continue to be supported to access activities and facilities, reflecting their individual needs, preferences and abilities. Individual support plans examined confirmed that residents are enabled to access a variety of recreational and leisure activities, including horse riding and hydrotherapy. The in-house physiotherapist, spoken with during the inspection is employed to assist and support residents with their individual postural management routine. He confirmed that residents from the home currently use the hydrotherapy pool once a week. However this is due to become more frequent as he intends to provide specific training for care staff to increase residents opportunities for movement. Community participation evidently remains a focus in the home and staff confirmed that residents are encouraged and supported to attend day services, visit local shops and other amenities. Visiting to the home is largely unrestricted and relatives and friends are made welcome at any reasonable time. Residents, as apprpriate, are encouraged and supported to maintain family links. Two residents are supprted individually to eat their meals orally. All other residents have clear feeding programmes in place, which staff are trained to administer via residents specialist feeding tubes. Individual guidelines are in place, which were seen in care plans. The local Community Learning Disability Team (CLDT) maintains overall responsibility for Speech and Language Therapy support at the home, with responsibility for assessing, planning and reviewing individual care and support needs and providing relevant training for staff. Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Staff have developed close and positive relationships with residents and demonstrate an awareness and sound understanding of their individual care and support needs. Residents are protected by improved, clear and comprehensive policies and procedures in place for the control and safe administration of medication. Evidence: The manager emphasised the importance of staff developing close working relationships with individual residents and being aware of changes in mood or behaviour. In accordance with their personal care plan, residents are fully supported and enabled, as far as practicable, to exercise control over their lives and maintain maximum levels of independence and individuality. As previously documented, during the inspection residents were observed being supported in a sensitive, professional and respectful manner. Documentary evidence was in place to demonstrate that the health and emotional care needs of residents continue to be met within the home. Since the previous inspection, as required, the policy and procedure regarding epilepsy awareness and intervention has been reviewed and specific staff training has been provided. All residents are registered with local GPs and have access to other health care professionals, including district nurses and dentists, as required. It is evident that all medical appointments with, or visits by, health care professionals are recorded appropriately in individual care plans. The manager confirmed that, as previously documented, the service also works very closely with the local Community Learning Disability Team, (CLDT), which provides valuable guidance, support and specific staff training, including epilepsy awareness. Up to date and detailed policies and procedures relating to the control, storage, administration and recording of medication are in place. Medicines are stored and recorded appropriately. All staff responsible for administering medication have received training, as part of their comprehensive induction programme, and are individually assessed and authorised to do so. The manager confirmed that, following risk assessments, no resident currently selfadministers their own medication. Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The homes complaints poilcy ensures that residents, staff and visitors to the home feel able to express any concerns, confident that they will be listened to and acted upon. Residents are protected through improved policies and procedures relating to abuse and Safeguarding Vulnerable Adults. Evidence: The organisation has produced a complaints policy and procedure, as part of the Statement of Purpose and Service User Guide. As previously documented, following discussion with the manager, it is recommended that the procedure be service specific and amended with updated contact details for the CSCI. Residents relatives and members of staff, spoken with as part of the inspection process, confirmed that they would have no hesitation in speaking to the manager or making a complaint if necessary and each person was confident that they would be listened to. It was noted that there have been no complaints received by the home since the previous inspection. The organisation has produced detailed policies and procedures relating to adult protection and abuse, including a whistle blowing policy. In line with other policies and procedures, the abuse policy has a Staff compliance form, which each member of staff is expected to sign to confirm that they have read and understood the relevant document. The manager confirmed that staff have all recently undertaken specific training, in accordance with the multi agency guidelines relating to safeguarding vulnerable adults. This was supported through discussions with members of staff during the inspection and evidenced through individual training records. Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The service is accessible, safe and clean and is clearly suitable for its stated purpose. Residents benefit from pleasant accommodation that is comfortable, well maintained and furnished and decorated to a satisfactory standard. Evidence: During my guided tour of the building, including idividual bedrooms and communal areas, it was evident that the premises have been decorated to a high specification and, with good quality furniture and furnishings, provide a comfortable, pleasant and homely environment for the people who live there. Residents have their own flat screen television and audio equipment in their bedrooms and there are a number of photographs and pictures displayed throughout. There is a small lounge area on the ground floor of the home, which as previously documented, although it meets the minimum requirements of the National Minimum Standards cannot accommodate all the residents at any one time. At the bottom of the large rear garden, each keyworker has worked with residents in choosing vegetables and flowers in a Garden of Eden. Residents evidently enjoy: the experience and sensory time of the smells and tastes. The manager confirmed that independence is promoted within the home, as far as is practicable, and this is evident from the personalising of residents rooms, which clearly reflects individual tastes, preferences and interests. Appropriate specialist equipment is provided, including electronically operated beds and pressure relieving mattresses for those who need it. Infection control procedures are in place and clearly adhered to and levels of cleanliness were found to be high throughout. Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . There is always sufficient trained and competent staff on duty to meet the assessed needs of the service users. Service users are protected by satisfactory staff recruitment policies, procedures and documentation. Evidence: There is evidently sufficient staff on duty at all times to meet the current assessed care and support needs of the residents. The rota indicated that there is a minimum of four staff employed mornings and evenings, with two waking members of staff on duty each night. A pictorial staff rota board has been developed enabling residents to see clearly who is on duty and who is on each shift. The manager clearly recognises the importance of a skilled and competent workforce. A training matrix has been developed and implemented and it was noted that all new staff receive comprehensive induction and foundation training. The manager confirmed that: In a staff team of 18, only one night duty has yet to complete NVQ 2. In addition to this programme, appropriate core skills training is provided, including first aid, moving and handling, food hygiene and fire safety. This was confirmed through discussions with staff and supported by training records examined: There is plenty of opportunity for training here. In accordance with company policy, the manager confirmed that formal supervision is provided for all care staff on a regular basis. Supervision sessions are appropriately recorded. Through direct observation and discussions with members of staff, it is evident that the manager also operates an open door policy, with staff feeling confident and able to discuss any issues at anytime. The home evidently operates thorough and robust recruitment procedures, to ensure the protection of service users. Individual files that were examined, relating to recently appointed members of staff, were found to be well maintained, containing all relevant and necessary information, including two satisfactory references, proof of identity and satisfactory Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) disclosures. Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Residents benefit from a competent and experienced manager and are protected by satisfactory health and safety procedures. Their best interests are safeguarded by adequate and effective quality monitoring systems. Evidence: The experienced manager is clearly competent to run a home. She has been employed by CMG since 2004 and has been the acting manager of 287 Dyke Road since September 2006. She has attended a number of different training courses relevant to her current role and successfully completed her Registered Managers Award (RMA) earlier this year. Her application to become the registered manager of the home is currently being processed by CSCI. From direct observation and through discussions with members of staff, it is evident that the manager demonstrates a clear and positive sense of leadership and direction. She is conscientious, motivated and approachable: She is a brilliant manager - very hands on and always ready to get stuck in. Really helpful and supportive - and very approachable. The home operates effective quality monitoring systems, including satisfaction questionnaires for residents, next of kin, advocates and other visitors to the home. The home evidently maintains responsibility for residents personal monies. It was noted that individual balances are checked on a regular basis and all financial transactions are recorded. The manager confirmed that the health, safety and welfare of residents and staff remains of paramount importance within the home. Staff training is provided in many aspects of safe working practices, including moving and handling; food hygiene; fire safety and first aid. All staff training is recorded. COSHH assessments and guidelines are in place. Regular fire drills are undertaken and recorded. Temperature regulators are fitted to all hot water outlets, accessible to residents All accidents, incidents and injuries are recorded and reported, as required. Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 1 It is recommended that the Statement of Purpose be reviewed and amended to accurately reflect the current situation within the home. It is recommended that the Service User Agreement be signed by the resident or a relatiive or representative on their behalf, to confirm understanding and agreement. 2 5 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web:www.csci.org.uk We want people to be able to access this information. 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