Inspection on 11/07/05 for 3 4a The Beach

This inspection was carried out on 11th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 but made no statutory requirements on the home.

Other inspections for this house

3 4a The Beach 13/06/07

3 4a The Beach 16/02/06

3 4a The Beach 03/03/05

3 4a The Beach 16/06/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 3 & 4a The Beach Clevedon North Somerset BS21 7QU Lead Inspector Catherine Hill Announced 11 July 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 3 & 4a The Beach D53-D02 S8093 3 & 4a The Beach V225222 11.07.05 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 3 & 4a The Beach Address Clevedon North Somerset BS21 7QU Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01275 879053 01275 879053 Royal Mencap Society Mr Colin Evans Care Home - Personal Care Only 11 Category(ies) of Learning Disability - (11) registration, with number of places 3 & 4a The Beach D53-D02 S8093 3 & 4a The Beach V225222 11.07.05 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 11 persons aged between 18 - 64 years with learning disabilities. Date of last inspection 3 March 2005 Brief Description of the Service: 3 and 4a The Beach is registered to provide personal care to up to 11 adults with a learning disability. Only ten places are available now, as one of the undersize bedrooms has been converted to an office in addition to the staff sleeping-in room. Seven of the residents live in No.3 and four in No.4a. The two separate buildings are on opposite sides of the back garden. Each house has its own facilities but there is a shared outdoor bar-room. The home generally caters for a more independent resident group, most of whom are adults between the ages of 30 and 60, and aims to support people to develop their independence skills with a view to moving on to supported living, if this is what the individual wants. However, the home tries to adapt its service to enable residents to continue to live there as they grow older and their needs change. The home is on the seafront in Clevedon, close to local amenities and within easy reach of the town centre. 3 & 4a The Beach D53-D02 S8093 3 & 4a The Beach V225222 11.07.05 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. No.s 3 and 4a The Beach are run by Mencap, although a housing association owns the property at No.3. The two properties function as independent units to a certain extent but are registered and managed as one home. Most of the staff and residents have been associated with the home for many years, so strong relationships have developed over this time. The homes strength is its emphasis on residents rights and individuality. The way this attitude is ingrained in practice was evident in the staff approaches to residents, and in the way the residents clearly and confidently expressed their opinions. People had no hesitation in saying if they were not happy about something, but residents also described the efforts that staff make to put matters right for them. This was an announced inspection, conducted over the course of one day. The inspector mainly looked at records and talked with staff for the first part of the inspection, while most residents were out at work, and then spent time in the afternoon and early evening with the residents. The inspector had one-to-one conversations with most of the people who live in the home. Two residents had completed CSCI comment cards prior to the inspection, and these as well as other comments made during the inspection indicated that people are extremely satisfied with the way the home meets their needs. What the service does well: The team s practice is strongly person-centered. Control and choice is handed to the residents wherever possible, and they are at the centre of the running of the home. As examples of this: • residents who are able to read the written rota are given a copy of it at the beginning of the week so that they can compile the photo rota board, which allows all residents to be able to see for themselves who is coming on duty. Residents can then ask key workers put time aside for them for one-to-one activities on days of their choosing. • Each resident is given the support they need to manage their own money, including receiving their full benefit payments into their own accounts and arranging for fee payments to be made to Mencap from those accounts. Residents enjoy a varied and full lifestyle, with plenty of opportunities to pursue their individual interests with good support from staff. The team is prompt to involve external professionals for advice and support, 3 & 4a The Beach D53-D02 S8093 3 & 4a The Beach V225222 11.07.05 stage 4.doc Version 1.30 Page 6 and this helps to ensure that residents get the best possible service. Recording and administrative systems are well designed and well used. 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. 3 & 4a The Beach D53-D02 S8093 3 & 4a The Beach V225222 11.07.05 stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection 3 & 4a The Beach D53-D02 S8093 3 & 4a The Beach V225222 11.07.05 stage 4.doc Version 1.30 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 standard(s) 1 & 3 Residents get exceptionally clear information about what they can expect from the home. They get good support to cope with times of change. EVIDENCE: The Statement of Purpose doubles as the Service Users Guide and is an excellent document. It is clear, easy to read and the information is made more accessible by the addition of pictures. No new residents have moved into the home for some time. Since the last inspection, one person has had to move on due to the level of challenging behaviour they were presenting, and another person is about to move because their needs have changed beyond the point where the home is able to meet them. In both cases, staff handled the situation with great diplomacy, and each of the residents felt very positive about the planned moves. 3 & 4a The Beach D53-D02 S8093 3 & 4a The Beach V225222 11.07.05 stage 4.doc Version 1.30 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 standard(s) 6-10 Residents needs are well documented, and they are fully involved in this recording. Residents have a good deal of say in the way the home is run. EVIDENCE: A new file format has been designed for recording residents personal information in a way that will be more accessible to them. Staff went through this new format with each person, and the general response from the residents was that they liked the idea. One person was able to talk the inspector through her new file. Sections in it include About Me (which is key information that all people working with the person need to have ready access to), My Dreams and Hopes, day-to-day notes, My Support Plan, My Money and Possessions, My Health (which includes the persons NHS health plan), accident and incident records, Learning Activities, Thinking about Risk and Choice, and support plan reviews. This person also confirmed that she had been involved in her care plan meeting, and felt that it was about what she wants and what she chooses: while she was given advice and suggestions, she was quite clear that no one was telling her what she has to do. Care Plan reviews showed the progress the person had made. Staff had helped her to draw up a list of her achievements 3 & 4a The Beach D53-D02 S8093 3 & 4a The Beach V225222 11.07.05 stage 4.doc Version 1.30 Page 10 over the past year. When we went through this together, her smile of satisfaction and her enthusiasm in giving me a bit more detail about these achievements showed what a successful idea this list has been. Staff do not usually write the daily records with the residents, but residents knew that they were written about politely and positively. There is a Welcome and Induction file for agency staff that contains pen pictures of the residents, copies of the risk assessments, a map of the house, a brochure, a fire procedure and information on where the fire points are. Risk assessments are detailed and useful, and are well cross-referenced with other relevant documentation to ensure that all staff are reminded of their existence. Residents get an unusual degree of control over the running of the home. As well as being involved in interviewing staff and planning menus, they negotiate with staff how time will be allocated during each shift. The home is now looking at voice-activated computer programmes so that residents can do the minutes of their own meetings. 3 & 4a The Beach D53-D02 S8093 3 & 4a The Beach V225222 11.07.05 stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11-17 Each person is supported to follow the lifestyle of their choice. EVIDENCE: Key workers support residents to develop really interesting and individual timetables of vocational, social and leisure activities, building on residents natural talents and interests. The residents the inspector spoke with were really excited about things that are happening in their lives. Some residents have part-time jobs and evidently get a great deal of satisfaction from working in a capacity where they help other people. Additional, intensive input on independence skills has been arranged for a couple of the residents, and these people feel they are learning really useful skills. Family links are actively supported by the staff team. Residents get an unusual degree of support in keeping up these relationships, and the team involves families appropriately so that everyone concerned with the persons care can give consistent support. 3 & 4a The Beach D53-D02 S8093 3 & 4a The Beach V225222 11.07.05 stage 4.doc Version 1.30 Page 12 Residents choose what time they eat. They plan the menus as a group but individual people are supported to prepare alternatives if they wish. Staff work with one or two residents to cook the evening meal each day. Residents draw up a rota of household chores. 3 & 4a The Beach D53-D02 S8093 3 & 4a The Beach V225222 11.07.05 stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18-21 Residents health care needs are closely monitored and well met. Medications practice is generally safe, but some further training may be required to ensure that all staff operate the procedure consistently. EVIDENCE: Residents personal records showed that they are in charge of how they receive any support needed with personal care. Residents records showed that they are regularly referred for routine health care checks, and that external health care professionals are promptly involved where necessary. Medications records were generally in very good order, but there were several unexplained gaps over the past few days. One of these was particularly worrying as it looked like a crucial medication had not been given for three days in a row. However, the remaining supply of medicines indicated that these doses had in fact been administered. There was an additional medications error the weekend before this inspection, when one person was given anothers tablets. This incident was reported to the CSCI by the manager, who also reminded the staff member concerned about good medications handling practice. As it is the same staff member who was giving out medications on the recent shifts when records have been unsigned, the 3 & 4a The Beach D53-D02 S8093 3 & 4a The Beach V225222 11.07.05 stage 4.doc Version 1.30 Page 14 inspector suggested that further action, such as more medications training, may be necessary. The needs of one resident have changed quite dramatically recently, and the team has been very flexible about adapting its practice and approaches. Relevant staff training was also arranged. 3 & 4a The Beach D53-D02 S8093 3 & 4a The Beach V225222 11.07.05 stage 4.doc Version 1.30 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 standard(s) 22 & 23 Residents are listened to and protected. EVIDENCE: Mencap has an exceptionally effective complaints procedure, which enables most of the residents at this home to make a complaint without the home knowing about it. Each resident has a complaint pack that includes an audio cassette on what to do, plus a postcard addressed to Mencap that they simply have to put into a letterbox to alert a senior manager to the fact that they are worried about something. In practice, each of the residents the inspector spoke with gave examples of how open the staff are to listening to their comments and concerns. Several of the residents made a complaint regarding the behaviour of another resident last year. This proved very difficult to resolve promptly, but the complainants felt very well supported by Mencap as an organisation and the team of staff in the home. Adult protection procedures were followed, and strategy meetings were held with the Social Services Adult Protection Manager and the CSCI inspector. The home keeps a Smiley File, made up of cards and letters of thanks from relatives. 3 & 4a The Beach D53-D02 S8093 3 & 4a The Beach V225222 11.07.05 stage 4.doc Version 1.30 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 standard(s) 24-30 The environment is generally safe and well-suited to residents needs. EVIDENCE: Residents bedrooms are very individual, and each person has been supported to set up their room to suit their tastes. There is a toilet and bath or shower on each floor of both houses. Many areas have been repainted over the past year, and overall two houses look much more welcoming and homely. However, a few individual items still need improvement: • The radiator in the bedroom at the top of the stairs was painted following an earlier requirement, but the paint is flaking badly again and requires attention. This was also the subject of a recommendation by the Environmental Health Officer earlier this year. The gate to the garden between the two houses is made of wrought iron which has rusted through and become very soft in some places but very sharp in others. This needs to be replaced to ensure the safety of people D53-D02 S8093 3 & 4a The Beach V225222 11.07.05 stage 4.doc Version 1.30 Page 17 • 3 & 4a The Beach using it. The manager undertook to remove this and replace it with a new gate within the next month. • A new hall, landing and stairs carpet is needed, as the existing one is extremely worn. This was also the subject of a requirement by the Environmental Health Officer in March this year. One of the kitchen cupboards has a door missing that needs to be replaced in order to keep its contents clean. Several of the drawers are rather rickety, and some had no stop to prevent them from being pulled out entirely. Given the needs of some of the people who live in this home, this could prove quite dangerous. The beading is coming away from the edge of some of the unit doors, exposing the MDF beneath. • It was recommended at the last inspection consideration be given to repairing or replacing the cooker in No. 3 as the symbols on the controls have worn away and are very hard to read. This could be unsafe for the people who use it. The manager confirmed at todays inspection that a new front panel for the cooker has been ordered from the local supplier. Residents and staff have been working hard on creating improvements to the garden. Designs were drawn up, and a contractor has recently carried out the work. Two of the residents were planting up the new raised bed when the inspector arrived. 3 & 4a The Beach D53-D02 S8093 3 & 4a The Beach V225222 11.07.05 stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31-36 Residents well-being is well protected by staffing practices in the home. EVIDENCE: Each staff role has a detailed job description. Staffing levels have been increased following a reassessment of each persons support needs. A recruitment checklist is kept on each member of staffs file, as a quick means of auditing that all the required checks have been carried out on prospective staff. The files sampled included evidence that all the required checks had been carried out thoroughly. Four residents were on the interview panel with the home s manager recently when three new staff were selected. Residents have had some basic training on interview techniques and equal opportunities requirements. The manager has been arranging number of teambuilding events away from the home recently, to help new team members integrate with the existing team, and to give the everyone the chance to discuss current issues in depth. The staff the inspector met had found these meetings positive and constructive. Agency staff who are known to the residents cover the home during these events. 3 & 4a The Beach D53-D02 S8093 3 & 4a The Beach V225222 11.07.05 stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37-43 Residents benefit from a well-run home with an open culture. EVIDENCE: Residents felt that they are listened to, and that staff act on their comments. Staff described good communication and felt that their views are valued. A large sample of the residents, their friends and family, and professionals who regularly visit the home were recently asked to complete a questionnaire to find out what people think of the services in the home. The responses by residents and by others were then broken down into separate lists, and an action plan was drawn up. Mencap does a yearly inspection to look at quality assurance issues in depth, and the home does a quality audit every few years. The manager draws up a quality assurance plan on a yearly basis, based on consultation with residents and significant others, and this also reflects the progress made on the previous years plans for improvement. 3 & 4a The Beach D53-D02 S8093 3 & 4a The Beach V225222 11.07.05 stage 4.doc Version 1.30 Page 20 Staff files and conversation with staff showed that each member of staff has one-to-one supervision sessions with the homes manager. These are usually every month or so. Staff meetings are held every month, as are residents meetings. The minutes of the latest residents meeting are posted on the noticeboard in the hallway. The health and safety file showed that an approximately monthly check of the premises is carried out that covers issues such as fire escape routes, the safe storage of chemicals in the home, and hot water temperatures. Mencap has very thorough procedural guidance on all aspects of the running of the home, including the handling of residents money. The homes records of residents cash are detailed and clear, and indicate that residents are encouraged to retain control as far as possible over their own finances. The inspector suggested that staff completing residents cash records note clearly whether the cash has been handed to the resident for a particular purpose or whether staff have made the purchase on the resident s behalf. 3 & 4a The Beach D53-D02 S8093 3 & 4a The Beach V225222 11.07.05 stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 4 x 3 x x Standard No 22 23 ENVIRONMENT Score 4 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 4 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 3 & 4a The Beach Score 3 3 2 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 3 D53-D02 S8093 3 & 4a The Beach V225222 11.07.05 stage 4.doc Version 1.30 Page 22 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 35 Regulation 17 Requirement Training records must show that the requirement for a minimum of three days training per year is being met for all staff. This requirement was first made on 16/6/04. The radiator in the bedroom at the top of the stairs must be repainted. The gate to the garden between the two houses must be replaced. The hall, landing and stairs carpet must be replaced. Broken kitchen units must be repaired. Accurate records must be maintained of medications administered. Timescale for action 19/7/05 2. 24 23 11/11/05 3. 20 13 (2) 11/7/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. 3 & 4a The Beach D53-D02 S8093 3 & 4a The Beach V225222 11.07.05 stage 4.doc Version 1.30 Page 23 No. 1. Refer to Standard Good Practice Recommendations 3 & 4a The Beach D53-D02 S8093 3 & 4a The Beach V225222 11.07.05 stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Riverside Chambers Castle Street Tangier Taunton TA1 4AL 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 3 & 4a The Beach D53-D02 S8093 3 & 4a The Beach V225222 11.07.05 stage 4.doc Version 1.30 Page 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!