Inspection on 10/01/07 for 368 The Ridge

This inspection was carried out on 10th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

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

CARE HOME ADULTS 18-65 368 The Ridge Hastings East Susex TN34 2RD Lead Inspector Jeanette Denereaz Key Unannounced Inspection 10th January 2007 09:30 368 The Ridge DS0000067861.V325640.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 368 The Ridge DS0000067861.V325640.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 368 The Ridge DS0000067861.V325640.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 368 The Ridge Address Hastings East Susex TN34 2RD Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01424 754703 01424 854376 East View Housing Management Ltd Patricia Anne Turner Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 368 The Ridge DS0000067861.V325640.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is four (4). Service users must be aged between eighteen (18) and sixty-five (65) years on admission. Date of last inspection N/a new service Brief Description of the Service: 368 The Ridge is a 4-bedroom detached house situated on a main road. The home is registered for 4 younger adults with learning disabilities, and at present all residents are young men. The home is a spacious residence, offering a large lounge, a further communal room/dining room and a wellequipped kitchen. The office is in a separate room by the front door. There is a separate utility room with domestic style washing machine and tumble dryer. All residents have their own bedrooms, which are en-suite. There is also a bathroom on the first floor. The house has a good front and very large back garden. There are local amenities within walking distance, and is a short journey to Hastings town centre. The home is part of East View Housing Management Limited (EVH). The current scales of fees range from £730.56 to £1270.70 per week. 368 The Ridge DS0000067861.V325640.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulations 2001, uses the term ‘service user’ to describe those living in care home settings. For the purpose of this report, those living at 368 The Ridge are referred to as ‘residents’. This report is the first key inspection based for this service and is the collation of information received by the CSCI and an unannounced site visit conducted by an Inspector on the 10th January 2007 The site visit included a tour of the premises and an examination of various records including medication, care and staffing records. The Inspector met with the registered manager, staff members on duty and residents that were at home during this inspection visit. The Residents have limited verbal communication skills, and therefore the inspector made judgements from observation during this inspection visit and the reading of documentation to ascertain the residents are receiving the service that meet their needs and aspirations. What the service does well: 368 The Ridge offers an excellent standard of accommodation, with all bedrooms offering en-suite facilities. The home was found to do most things well, and has the promise and vision to make improvements in the future. The home was found to provide good support and the manager and staff are committed to providing a good quality of care for residents. Staff spoke positively about the home, with and one staff member commented: ”It’s a brilliant job” 368 The Ridge is very good at keeping families and friends informed about the home. A family member contacted by the inspector stated that it was early days yet but to date the care of their relative has been “ Excellent”. They also reassured the inspector that if at any time things were not right that would raise their concerns. 368 The Ridge DS0000067861.V325640.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. 368 The Ridge DS0000067861.V325640.R01.S.doc Version 5.2 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 368 The Ridge DS0000067861.V325640.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4, & 5 Quality in this outcome area is excellent, This judgement has been made using available evidence including a visit to this service. The statement of purpose and service user guide clearly says what service will be offered. Prospective service users can be confident their needs will be assessed, and the home will meet their needs and aspirations. EVIDENCE: This is a new service, but three of the residents were living together in another home owned by EVH. However, there have been one new resident new to the service since moving into 368 The Ridge. The resident had a very individual introduction to 368 The Ridge and case tracking confirmed good practice. The manager under took a pre-assessment of the resident, he was visited in his previous placement, he in turn visited 368 The Ridge and also met up with the other residents on social occasions in Hastings. The manager confirmed that the previous home transferred very comprehensive documentation with regards to the residents care needs, and 368 The Ridge DS0000067861.V325640.R01.S.doc Version 5.2 Page 9 they had been very supportive during the transition. There is still contact between 368 The Ridge and the previous home. The inspector had the opportunity to meet with him during this inspection visit, the resident has limited verbal skills, but the inspector observed him during the visit, and his behaviour confirmed he was happy living at 368 The Ridge. . 368 The Ridge DS0000067861.V325640.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The manager and staff demonstrate their knowledge of the individual residents, and are aware of the complex needs of the residents and encourage them to have an independent lifestyle as far as possible. EVIDENCE: The recordings staff undertake in the day-to-day file is very comprehensive, and ensure all the staff are fully aware of the needs of the residents. There is a staff team of six people, and the two staff the inspector met during this inspection visit were very committed and attentive to the residents. The residents have a varied core of activities and some are based within the home. The manager has prepared a list of activities the residents enjoy from her experience and knowledge of the individual resident (She has been the 368 The Ridge DS0000067861.V325640.R01.S.doc Version 5.2 Page 11 manager of the previous home 36 Burry Rd for over 3 years) for when they are not at organised day service. The inspector saw the staff member supporting a resident to make cakes, and supervising a trip out. There was a good atmosphere in the home, and the two residents at home during this inspection visit seemed very relaxed. 368 The Ridge DS0000067861.V325640.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 & 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home’s links the local community are excellent and enrich residents’ lives socially and educationally. EVIDENCE: During this inspection visit the inspector reviewed in-depth the care plans of the newest resident and found them to be very detailed and comprehensive. 368 The Ridge DS0000067861.V325640.R01.S.doc Version 5.2 Page 13 The system used within the home is called Central Lifestyle Plan, which contains information to promote the lifestyle preferred by the resident, including photographs of people important to the resident and other personalised information. All Central lifestyle Plans files for the 4 residents were seen and including all information and protocol for each individual, containing guidelines for staff working with the residents, and examples of the guidelines are: • Guidelines for an individual who wanders at night in the home. • Out in the community • Fear of dogs • Making tea. • Information of activities, day services and local community. The residents have a mixture of traditional day services, time spent at home and in the community and all activities are recorded and reviewed regularly. The home also ensured that contact with families is maintained, and residents had photographs of family in their bedrooms and regular telephone calls and visits are made. 368 The Ridge DS0000067861.V325640.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive personal support appropriate to their physical, emotional and healthcare needs. EVIDENCE: All four residents are registered with local GPs and when required have the services of other health professionals, including the support from the local Community Learning Disability Team (CLDT) The inspector reviewed in-depth the personal and healthcare of the newest resident to the home, and found he was registered with a local GP, dentist and optician appointments were in the process of being made. 368 The Ridge DS0000067861.V325640.R01.S.doc Version 5.2 Page 15 The medication files and storage were inspected and found to be in order. All staff have had the relevant training and are all deemed to be competent in the administrating of medication to the residents. The medication comes from a large Chemist chain, and in the past the company has sent a pharmacist out to homes to do an audit on the storage and administration of the medication. However, new guidance from the Chemist chain is they will not be undertaking the annual audit of medication in small homes, but the pharmacist has stated she is still available if the home needs advice and support with medication. 368 The Ridge DS0000067861.V325640.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives’ complaints would be taken seriously and investigated. The staff have the knowledge and understanding to take the correct action to safeguard residents from abuse. EVIDENCE: The Complaint book held within the home had no entries. Staff on duty were interviewed and the manager and the staff had a good understanding about the protection of vulnerable adults and what action they would take if they saw or were told of any form of abuse within the home. Adult protection is discussed at staff induction and the training matrix included in the Pre-questionnaire sent to the CSCI prior to this inspection visit confirmed there is planned Adult Protection training for staff. . A family member contacted by the inspector stated that it was early days yet but to date the care of their relative has been excellent. They also reassured the inspector that if at any time things were not right that would raise their concerns with the home. 368 The Ridge DS0000067861.V325640.R01.S.doc Version 5.2 Page 17 368 The Ridge DS0000067861.V325640.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The overall standard of the environment including the décor and furnishing are very good and provide a homely and attractive place for residents to live. EVIDENCE: The Inspector toured communal parts of the home such as the kitchen and dinning area, utility room, lounge, bathrooms and bedrooms. The inspector was invited to visit the residents’ bedrooms .The rooms were found to be comfortable and very individually decorated and furnished reflecting the residents’ hobbies and interest. The whole environment is of a very good standard of décor and furnishing. 368 The Ridge DS0000067861.V325640.R01.S.doc Version 5.2 Page 19 The manager undertakes regular inspections and any defects are reported to the maintenance person. There has been a blocked drain since early December 2006, the maintenance person had investigated but was unable to clear the blockage. There is a need for professional service to ensure the home is a safe environment. As well as the manager’s checks, the EVH Health and Safety Officer also makes monthly audits of the home, which includes a Health and Safety documentation audit and general review of the environment, with his findings reported back to the Senior Management Team. 368 The Ridge DS0000067861.V325640.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,34,35 &36 Overall quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staff employed have the skills and experience to meet residents needs and support them. However, the manager must ensure that recruitment references of the candidate are taken up and staffing records are up to date and available within the home for inspection. EVIDENCE: There are six staff employed within the home, and the inspector review the recruitment and induction of two staff members in-depth. EVH has a robust recruitment policy and procedures but there had been a downfall in the procedures of obtaining references for the two staff being reviewed. Reference request had been sent out, but not all returned. 368 The Ridge DS0000067861.V325640.R01.S.doc Version 5.2 Page 21 Both staff had had PoVA and CRB checks carried out and had undertaken the organisation’s induction training. During the inspection visit the manager contacted the organisation’s senior management team and information missing from the files were brought to the home during the inspection. Since this inspection visit EVH has reviewed the procedures of obtaining and reviewing references for staff, and have made a managerial decision that the manager of the individual homes will take responsibility of obtaining references and following up late or absent references before the staff member take up duty. The decision was made that with a third person i.e. the head office of EVH sending out and receiving or not receiving references for all the EVH homes was not consistent, and not always following up late or absent referees and therefore not safeguarding residents. The Senior management team will be informing all the managers of this new procedure, and give advice and training in the sending, reading and interpret references. There has been regular supervision for staff, and the inspector saw records of these meeting. The manager feels there is a good motivated staff team, and the staff members on duty during this inspection confirmed they were very happy and was enjoying their new role, and expressed how good the training was. They stated that: “Good, Love it, this is my first job in the care field” ”It’s a Brilliant job”. There was a matrix of training display and it was evident all staff are involved in training. 368 The Ridge DS0000067861.V325640.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,40,41 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 368 The Ridge is well managed in the best interests of residents who are fully involved in the running of the home. The home benefits from an experienced manager, who is supported by motivated Proprietors and enthusiastic staff team. A safe environment is maintained for residents. 368 The Ridge DS0000067861.V325640.R01.S.doc Version 5.2 Page 23 EVIDENCE: The registered manager is a very experienced manager, as she was the registered manager of the home that closed, and residents moved to this new registered home. Supervision of staff is now undertaken regularly, and the inspector saw supervision records, they are planned and minutes taken. Records showed that all aspects of health and safety were being met this included looking at appliance safety certificates, staff training, and accident records. All staff receive regular mandatory training and training that has taken place since the last inspection as been in Moving and Handling training, fire safety, food hygiene and Medication administration. The manager is in the process of re-naming the documents from the previous home to the new home of 368 The Ridge. The senior management team (SMT) of the EVH organisation also undertake monthly visits to the home as part of the Care Home Regulation (26), which requires a responsible person of the organisation to inspect the home, and write a report on the conduct of the home. All accidents and significant incidents are promptly reported to the CSCI. 368 The Ridge DS0000067861.V325640.R01.S.doc Version 5.2 Page 24 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 4 2 4 3 4 4 4 5 4 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 4 26 3 27 4 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 X 34 2 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 4 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 3 3 3 X 368 The Ridge DS0000067861.V325640.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection n/a 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 YA24 Regulation 13 (4)(a) 23(2)(a) 39(h) Requirement It is required that the registered manager and the Responsible Individual instruct professional services when maintenance is needed beyond the skills/expertise of the staff, to ensure a safe environment. This is in connection with the block drains. It is required that the registered manager and the responsible individual ensure there are full staff records within the home and available for inspection at all times. It is required that the registered manager and the responsible individual ensure that before staff are employed in the home, two written references are obtained relating to the person. Timescale for action 28/02/07 2 YA34 17(2) Schedule 4 (6) 28/02/07 3 YA34 Schedule 2 (5) 28/02/07 368 The Ridge DS0000067861.V325640.R01.S.doc Version 5.2 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 368 The Ridge DS0000067861.V325640.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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