Inspection on 24/01/06 for 306 Southend Road

This inspection was carried out on 24th 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

306 Southend Road 23/05/07

306 Southend Road 14/09/05

306 Southend Road 07/03/05

306 Southend Road 12/10/04

306 Southend Road 19/03/04

Similar services:

Claremont House

Coopers Mill Ltd

Sun Court Nursing Home

Pocklington House

Bramley Avenue (73)

Paradise Lodge

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Upaya Ananda

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

CARE HOME ADULTS 18-65 Southend Road (306) 306 Southend Road Wickford Essex SS11 8QW Lead Inspector Ms Vicky Dutton Unannounced Inspection 24th January 2006 11.30 Southend Road (306) DS0000018121.V277831.R01.S.doc Version 5.1 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 Southend Road (306) DS0000018121.V277831.R01.S.doc Version 5.1 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. Southend Road (306) DS0000018121.V277831.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Southend Road (306) Address 306 Southend Road Wickford Essex SS11 8QW 01268 570702 01268 570702 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) Hamelin Trust Manager post vacant Care Home 4 Category(ies) of Learning disability (4), Physical disability (4), registration, with number Sensory impairment (2) of places Southend Road (306) DS0000018121.V277831.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th September 2005 Brief Description of the Service: 306 Southend Road is a modern purpose built bungalow providing care and accommodation for up to four people with profound physical, learning and sensory disabilities. The premises are owned by Mosaic Essex, but managed and run by Hamelin Trust. A web site is available for the organisation on www.hamelintrust.org.uk The home is located a short distance from Wickford. Local facilities are available in the village of Shotgate where the home is located. The town centres of Basildon and Southend are a short journey away. The home provides residential accommodation on one level and there is adequate space for wheelchair users. Specialist equipment and adaptations such as hoists and bathing aids have been incorporated into the design to enhance the facilities for residents. There is an enclosed garden with a small patio area to the rear of the property. Limited parking is provided to the front and side of the property. The home is located on public transport routes. The home has their own minibus to facilitate community access. Southend Road (306) DS0000018121.V277831.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over a period of five hours. Residents at the home have complex needs and are unable to express their opinion of the service. During the inspection one resident was at home during the day. Two others arrived home from their day care placements during the late afternoon. One resident was on home leave. Residents appeared happy and relaxed. Staff had a good understanding of their needs and preferred routines. During the inspection care, medication, staffing and health and safety records were sampled. Time was spent with residents and staff. One visitor was spoken with. Since the previous inspection the acting manager has left the home. The inspector was assisted by senior support workers at the home. The director of Hamelin Trust also attended for part of the inspection. What the service does well: What has improved since the last inspection? To assist in caring for residents care documentation has improved. Further development is planned that will provide a clearer and more user friendly care plans. Southend Road (306) DS0000018121.V277831.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Southend Road (306) DS0000018121.V277831.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Southend Road (306) DS0000018121.V277831.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1. A service users guide needs to be in place to assist any future planned admissions. EVIDENCE: Most residents at 306 Southend Road have lived at the home for some years. The most recent admission took place nearly three years ago. The standards under this section were not therefore assessed. A copy of the homes Statement of Purpose has been received by CSCI. The director of Hamelin Trust said that a Service Users Guide had also been developed. This was not readily available in the home. Staff thought that it would be on the homes computer. A copy of this should be sent to CSCI. It is recognised that due to the complex needs of residents accommodated at Southend Road any service users guide will need to be tailored to meet the specific needs of any future planned admissions. Southend Road (306) DS0000018121.V277831.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6. All residents have a care plan in place that provides a good basis for care. The home must ensure that regular reviews are undertaken and recorded. Development is needed to make sure that all relevant care information is readily available to staff caring for residents. EVIDENCE: Since the previous inspection work has been undertaken in improving and coordinating the information held on residents. Each resident now has an individual file containing a copy of the care plan and all relevant daily information. A further large individual file contains historical and other information. Care plans viewed had been agreed with relatives and provided a good basis for care. Some work is needed to ensure that all relevant information is readily available as, for example, current risk assessment information was held in the ‘archive’ file rather than the daily use file. Although related risk assessments were in place, risk assessments did not include a specific risk assessment in relation to residents moving and handling needs. It is understood that an improved format of care plan is to be introduced. The director of Hamlin Trust anticipated that these would be completed and in place within the next six months. The home aims to conduct quarterly care reviews with relatives. However one care plan was dated March 05, with a Southend Road (306) DS0000018121.V277831.R01.S.doc Version 5.1 Page 10 review date of 10/07/05. It was not evident that this happened. A senior support worker said that a round of reviews was currently planned. Southend Road (306) DS0000018121.V277831.R01.S.doc Version 5.1 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 the following standard(s): 12, 14, 15, 17. Staff have a good understanding of individual residents likes and dislikes in terms of routines, activities and diet. EVIDENCE: Residents at 306 Southend Road access formal day care at Viking Specialist Day Care Unit and Concorde Day Care Unit. On the day of inspection two residents had enjoyed attending day care placements. In spite of the residents severe disabilities staff were able to identify that each had their own interests and preferred activities. Care plans and residents rooms reflected their interests such as different music and books that can be read to them. At the previous inspection the acting manager said that the home were in the process of developing individual weekly activity programmes for residents to try to provide a more structured approach to their stimulation and occupation. This still seems to be a work in progress. A file was seen in relation to one resident whose occupational/activity needs had been assessed by an occupational therapist from the learning disability support team. Preferred activities and ways of providing these were identified. As part of this Southend Road (306) DS0000018121.V277831.R01.S.doc Version 5.1 Page 12 process activities outside the home at a hospital hydrotherapy pool were being provided. All residents at 306 Southend Road are strongly supported by their families, who are actively involved via parents management group meetings. There is no restriction on visiting at the home. During the inspection staff at the home were observed to communicate and work well with a relative. The home operates a four weekly menu plan. At the previous inspection the acting manager reported that she was working with a speech and language therapist and other parties to assess if any form of pictorial menus would be meaningful to residents. Staff at the home seemed unaware of this and no progress was evident. Good individual daily nutrition records are maintained. These showed that residents eat varied foods. Most residents at the home are under the care of a nutritionalist and regularly monitored. The kitchen at 306 Southend Road is large and residents enjoy being in the kitchen while food is prepared. Southend Road (306) DS0000018121.V277831.R01.S.doc Version 5.1 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 the following standard(s): 18, 19, 20 Staff at the home have a good understanding of individual residents personal support needs. The health needs of residents are well met with a range of other professionals involved in their care. EVIDENCE: The home is well equipped to meet the physical needs of residents. Hoists, specialist beds and other equipment are provided. Records showed that equipment such as wheelchairs are regularly reviewed by the relevant professionals to ensure that they continue to meet resident’s needs. During the inspection staff were observed to provide personal support in a way that supported residents preferences and choices and protected their privacy and dignity. Residents are unable to attend to their own personal healthcare needs. Full assistance is required by support staff and relatives. Care records and observations showed that resident’s health and wellbeing is closely monitored and any concerns acted upon. Residents access a range of healthcare professionals to meet their different medical needs. The home use a weekly dispensed monitored dosage system of medication administration (NOMAD). Although these boxes are checked and ‘booked in’ on a weekly basis, the system for booking in non boxed items was not clear. Southend Road (306) DS0000018121.V277831.R01.S.doc Version 5.1 Page 14 Many items had been handwritten on individual medication administration records but these entries had not been double signed by staff. Outstanding from the previous inspection is the need for information to be available on homely remedies in use, and the need for protocols to be in place for all medicines used ‘as and when required (PRN.) Southend Road (306) DS0000018121.V277831.R01.S.doc Version 5.1 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): 23. The home has a clear complaints process in place. Relatives are aware of how to raise concerns through the home or CSCI. EVIDENCE: The home has a complaints process in place. This was on display in the home. Relatives, as service users advocates, are fully aware of complaints processes. A record of complaints is maintained by the home. None had been recorded since the previous inspection visit. Southend Road (306) DS0000018121.V277831.R01.S.doc Version 5.1 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, 25, 26, 27, 28, 29, 30. Residents live in a safe and homely environment that meets their needs. All have their own rooms and there are sufficient shared communal spaces. EVIDENCE: 306 Southend Road is a purpose built and relatively new building. The building is owned by Mosaic Essex and they provide for the overall maintenance of the building and the decoration of communal areas. The home is situated in Shotgate and is very close to local facilities. All residents at the home use wheelchairs. The communal spaces of lounge, dining room, kitchen and garden are fully accessible to them. Furnishings and fittings give the premises a homely feel. Each resident has their own bedroom which is of a sufficient size to meet their needs. All residents’ bedrooms were viewed at this inspection. They were equipped with adaptations and fittings appropriate to each individual. All bedrooms were furnished and personalised according to residents and their family’s requirements. Resident’s bedrooms were noted to have many personal effects, these included photographs, stereo systems and sensory equipment. One bedroom was noted to require redecoration. This is the responsibility of Southend Road (306) DS0000018121.V277831.R01.S.doc Version 5.1 Page 17 Hamelin Trust. At the previous inspection the acting manager said that this was in hand. However at this inspection no action had yet been taken. Bedrooms at the home do not have en suite facilities. The home has one assisted bath and one assisted shower, which is not currently used by residents. Residents have access to a lounge, dining and kitchen area. The home has a reasonable size garden area. Plans to develop this area have not yet happened but it still provides a useable area for residents. All residents are provided with aids and equipment to meet their individual assessed needs. This includes wheelchairs with adapted and individualised seating, specialist beds, and sleeping systems. Records indicated that equipment is serviced and maintained. The home has a call alarm system, however none of the residents are able to utilise this equipment because of their disabilities. Adequate laundry facilities are provided at the home. On the day of inspection the home appeared to be cleaned to a reasonable standard and was odour free. Southend Road (306) DS0000018121.V277831.R01.S.doc Version 5.1 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 Staffing levels at the home are satisfactory but need to be kept under review. EVIDENCE: The home maintains a satisfactory staffing rota. The home has three staff on duty during the day and one awake member of night staff with another on call (but not on the premises). In relation to this at the previous inspections it had been reported that the home are working to produce a lone worker policy. This inspection could not evidence that this had yet happened. Staffing levels may vary during the day when residents are out attending day care. It was reported that at weekends when residents are not attending day care only one member of staff is on duty between 07.00 (when the night care goes home) and 08.00. This must be kept under review to ensure that resident’s needs are adequately met by this practice. The homes accident book recorded two incidents of a night support worker injuring their back. Staff at the home felt that residents nighttime needs could be supported with one member of staff, but this must be kept under review as residents needs change. The home does not employ any domestic staff so support workers undertake cleaning and laundry tasks. It was reported that there are currently no vacancies for support workers at the home. The home has some relief staff available, and sometimes agency staff are used. The home utilises specialist professional support i.e. social workers, community nurses, community psychiatrist, nutritionalist etc. The staff team at the home provide a mixture of ages and gender. Many staff at the home have worked Southend Road (306) DS0000018121.V277831.R01.S.doc Version 5.1 Page 19 there for some time and are very experienced. Staff files viewed showed that a range of relevant training had been undertaken by staff. A relative praised the staff team at the home. Staff recruitment records were not viewed at this inspection. Previous inspections of the home have shown that thorough recruitment processes are always followed by Hamelin Trust. Southend Road (306) DS0000018121.V277831.R01.S.doc Version 5.1 Page 20 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, 41,42 In the absence of a manager Hamlelin Trust have put appropriate strategies in place to ensure that the service is maintained. The home cares safely for residents but development is needed to ensure that their core skills are kept updated. EVIDENCE: Since the previous inspection the acting manager, who had applied for registration, is in the process of leaving Hamelin Trust. The director of Hamelin Trust outlined the arrangements for the appointment of a new manager and the interim management arrangements that have been put in place to cover the home. Although the home currently has no manager in post, opportunities are provided for staff and other stakeholders to voice their opinions. A staff meeting had taken place on the day before the inspection. The previous meeting recorded was in March 2005. The senior support worker said that other meetings had been held, and that the minutes may be on the computer. A relative spoken with said that parents had the opportunity to contribute at Southend Road (306) DS0000018121.V277831.R01.S.doc Version 5.1 Page 21 parents management group meetings. The home aim to hold these on a regular basis, although recently circumstances have made this difficult. Hamelin Trust has strategies in place to monitor the effectiveness of the service. The director reported that from an assessment of the home an improvement plan had been produced for the acting manager of the home to work with. As part of regulation (Regulation 26) the registered provider must undertake monthly visits to the home to assess the quality of the service. Previous requirements have highlighted the need for copies of the reports from these visits to be regularly sent in to CSCI. This has not happened. The most recent report available on file at the home was dated November 2005. During the inspection it was noted that the home was still displaying an old copy of their registration certificate. A new certificate had been issued to the organisation in October 2004, with a request to return the old certificate. This had been pointed out to the acting manager at the previous inspection. Staff records viewed showed that appropriate health and safety training had been undertaken. Staff had undertaken fire safety training on the previous day. A senior support worker said that she had just undertaken a four day first aid course. Staff records did however show that most staff at the home need to be updated in their moving and handling skills so that they can care safely for residents. The senior support worker said that this was in hand. In addition to this clear risk assessments for individual residents need to be developed and readily available for staff to refer to. Appropriate documentation was in place to show that systems and equipment are regularly serviced. Fire records were viewed and ‘monthly checks’ were last recorded as being carried out on 11/11/05. Southend Road (306) DS0000018121.V277831.R01.S.doc Version 5.1 Page 22 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 2 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 X ENVIRONMENT Standard No Score 24 3 25 3 26 2 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 X 33 3 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X X X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 3 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 3 2 X 2 2 X Southend Road (306) DS0000018121.V277831.R01.S.doc Version 5.1 Page 23 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 YA1 Regulation 5 Requirement A service users guide must be produced and a copy of this document supplied to the National Care Standards Commission. Previous requirements of 01/06/05 and 01/12/05 not met. Risk assessments must be in place for all relevant aspects of care. This includes moving and handling. Previous requirement of 01/11/05 not met. The registered person(s) must make appropriate arrangements for the safe handling and administration of medication in the home. This refers to the issues raised in the body of the report. The registered person(s) must ensure that the premises are suitably maintained and decorated. This refers to the need for the redecoration of some areas of the home. The registered person(s) must appoint a manager to run the DS0000018121.V277831.R01.S.doc Timescale for action 01/03/06 2. YA42 12 01/03/06 3. YA20 13 14/02/06 4. YA26 23 01/05/06 5. YA37 8 01/05/06 Southend Road (306) Version 5.1 Page 24 home 6. YA39 26 Copies of monthly registered persons visits undertaken as required under regulation 26 must be sent into CSCI on a regular basis. Staff must receive training appropriate to the work they are to undertake. This refers to the need for all staff to be kept updated in moving and handling techniques. 01/04/06 7. YA42 18 01/04/06 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. Refer to Standard YA6 YA6 YA33 YA41CSA 28 Good Practice Recommendations All relevant care plans and information relating to individual residents should be maintained in one place so that it is readily accessible to staff providing the care. Care plans should be reviewed at least six monthly Staffing levels and deployment in the home should be kept under review. A current certificate of registration must be displayed. Southend Road (306) DS0000018121.V277831.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Southend Road (306) DS0000018121.V277831.R01.S.doc Version 5.1 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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