Inspection on 15/07/05 for 38 Den Hill

This inspection was carried out on 15th July 2005.

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 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

38 Den Hill 25/04/07

38 Den Hill 25/01/06

38 Den Hill 07/03/05

38 Den Hill 07/10/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 38 Den Hill 38 Den Hill Eastbourne East Sussex BN20 8SZ Lead Inspector Lucy Green Announced 15 July 2005 16:00 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. 38 Den Hill H59-H10 S40498 38 Den Hill V226414 150705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 38 Den Hill Address 38 Den Hill Eastbourne East Sussex BN20 8SZ 01323 646282 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) Autism and Aspergers Care Services Ltd Care Home 3 Category(ies) of Learning Disability (LD) 3 registration, with number of places 38 Den Hill H59-H10 S40498 38 Den Hill V226414 150705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. That only service users diagnosed as Autistic or having Aspergers Syndrome will be accommodated. Date of last inspection 7 March 2005 Brief Description of the Service: 38 Den Hill is a semi-detached home located in the Old Town area of Eastbourne. The home is registered to provide residence and support to three younger adults with Aspergers Syndrome. The home is owned by Autism & Aspergers Care Services. The service is accredited by the National Autistic Society and the home is also monitored by this agency to ensure specific standards are maintained. Each resident has their own single bedroom and access to a range of communal areas. One bedroom has ensuite facilities and the home has one bathroom which is accessed by residents and staff. The home has a well maintained garden to the rear of the property. The home seeks to promote autonomy and choice and residents are encouraged to work towards achieving independent living. Residents are supported to access a range of educational, vocational and leisure activities as appropriate. At the time of the inspection two residents were living at 38 Den Hill. 38 Den Hill H59-H10 S40498 38 Den Hill V226414 150705 Stage 4.doc Version 1.30 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 38 Den Hill will be referred to as ‘residents’. This announced inspection took place over two and a quarter hours on 15 July 2005. This is the first statutory inspection of this year. The purpose of this inspection was to meet with residents and staff and to generally monitor care practices at the home. A tour of the premises took place, rotas and care records were inspected. The two residents and the staff member on duty were spoken with. Comment cards were left for residents and relatives and four had been returned at the time of writing this report. The Inspector joined one of the residents in the dining room for his evening meal. The Registered Manager’s post is currently vacant at the home. The Deputy Manager is responsible for the daily running of the home with support from the Provider. What the service does well: 38 Den Hill has received consistently good reports on the services provided since it was first registered in 2002. The home continues to provide a good quality of service to the people who live at the home. The home offers a specialist service to younger adults with Aspergers and both the management team and staff have the necessary skills and experience to deliver this service well. In addition to inspections by the Commission for Social Care Inspection, the home is also accredited and monitored by the National Autistic Society. The home enables residents to develop new skills and work towards achieving independence. Each resident is involved in preparing a plan of care which outlines how they like and need to be supported. These documents are very detailed, whilst still being easy to read. The home has a committed team of staff who get on well with the residents. The residents at 38 Den Hill participate in a range of activities, both during the day and in the evenings. The two residents have recently been on holiday for a week with two members of staff. The home works closely with relatives and supports residents to build positive relationships with people they meet through College, courses or other social 38 Den Hill H59-H10 S40498 38 Den Hill V226414 150705 Stage 4.doc Version 1.30 Page 6 outings. The feedback received from relatives was complimentary of the service and the way it is delivered. 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. 38 Den Hill H59-H10 S40498 38 Den Hill V226414 150705 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 38 Den Hill H59-H10 S40498 38 Den Hill V226414 150705 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) 2 & 4 Residents benefit from a comprehensive admission process which enables them to ‘test drive’ the home and see if 38 Den Hill can meet their needs and expectations. EVIDENCE: At the time of the inspection, the home was preparing for a new resident to move into 38 Den Hill. The Inspector examined the assessment information for this person. There was documentary evidence that a thorough assessment process had been undertaken prior to this person coming to live at the home. Information had been gathered from a variety of sources including the opportunity for the resident to identify their own needs. Representatives from the home had visited the prospective resident at their current placement to assess them in their own environment. The resident has visited the home on several occasions to meet with the other residents and staff and ensure the home meets their expectations. A record of these visits was in place and therefore it was possible to track the number and success of these visits. New residents receive a minimum three month ‘settling in’ period, with a review after the initial month. Due to the importance that the home places on the compatibility of residents, the home does not accept emergency admissions. 38 Den Hill H59-H10 S40498 38 Den Hill V226414 150705 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 & 9 Residents are both enabled and protected by the information in place to support them. EVIDENCE: The Inspector viewed the care plans in place for both residents. The system of care planning at 38 Den Hill continues to comprehensively outline care needs in an accessible way. The Inspector was particularly impressed with the objective and goal focused approach to constructing care plans. The care plans identify individual goals for each resident to enable them to achieve maximum independence and develop their skills. Each goal is backed up by a training plan which explains how staff should support residents in order to achieve that goal. Goals are monitored and discussed regularly with the resident and reviewed formally at least every six months. A full care review is held at least once every six months, with interim mini reviews in-house. Minutes from these meetings were viewed and found to be detailed and focused. Residents are encouraged to attend their reviews, but if they choose not to attend, then they discuss their views with a keyworker who 38 Den Hill H59-H10 S40498 38 Den Hill V226414 150705 Stage 4.doc Version 1.30 Page 10 then advocates on their behalf at the meeting. Relatives are also invited to participate in the reviewing process. The home has a positive approach to risk taking and residents are supported to take risks to maximise choice and independence. Through careful risk assessment and support plans, it was in evidence that the home has enabled residents to make real achievements. Risk assessments have been developed using a triad system which balances: imagination, social/communication and interaction skills. Each risk assessment is directly linked to a training and support plan which shows how that risk is managed. There was evidence that risk assessments are regularly reviewed and updated. 38 Den Hill H59-H10 S40498 38 Den Hill V226414 150705 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, 12, 13, 14, 15 Residents are supported to lead healthy and fulfilling lives. Residents benefit from a range of nutritious and well-balanced meals. EVIDENCE: The residents at 38 Den Hill continue to lead active lives. An activity timetable is in place for both residents which shows that they participate in a range of appropriate and fulfilling activities. For one resident this includes attending a local College five days per week. The residents are involved in the running of the home and consequently time is built into their schedules for undertaking household tasks. The residents at 38 Den Hill also participate in a range of evening activities, including karate and social outings. On the evening of the inspection, the residents informed the Inspector that they had plans to meets friends at a nearby pub. One resident also said that he plays racquet ball each week, which he thoroughly enjoys. 38 Den Hill H59-H10 S40498 38 Den Hill V226414 150705 Stage 4.doc Version 1.30 Page 12 During a conversation over dinner, one resident and the staff member on duty chatted about a recent holiday. The holiday was reported a huge success and everyone enjoyed an action packed week away. The care plans focus on maximising opportunities for social development and this is reflected in the way residents spend their time. During the inspection, one resident was supported by a staff member to undertake his household tasks, the other resident was observed making his own meal. The Inspector noted the development in residents’ skills since the last inspection. Residents’ independence had increased and this has also been commented on in feedback received by relatives. 38 Den Hill encourages and supports residents to maintain contact with relatives and friends. Families continue to be actively involved in the home, including attending resident reviews and social occasions. Meals at 38 Den Hill are prepared according to a rotating menu. The menu is drawn up in consultation with residents to reflect the meals they wish to have. Residents also have responsibility for the purchasing of ingredients, preparation and cooking of their own meals. The menu displayed showed a range of varied and well-balanced meals. On the day of inspection, the Inspector joined one resident for his evening meal. The meal was appetising and well-presented and the resident expressed satisfaction with the food available at the home. Staff eat with the residents in the dining room and the mealtime was observed to be a relaxed and friendly occasion. 38 Den Hill H59-H10 S40498 38 Den Hill V226414 150705 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, 19 & 20 Residents benefit from the provision of flexible and respectful support. Residents are protected by the systems in place to manage medication. EVIDENCE: Residents at 38 Den Hill manage their own personal care. Staff support is provided by the offering of verbal prompts at identified key times. There is evidence in the care plans that staff support is offered in a sensitive and respectful manner. Risk assessments are in place to ensure the safety of residents at all times. The philosophy of the home is to support residents to achieve maximum independency and systems are in place to assist residents to take full responsibility for their personal care. Staff support residents to ensure their health needs are met. Care plans contain a record of any visits or contact with healthcare professionals. The storage and administration of medication were found to be satisfactory. Records are accurate and current. At the time of the inspection, only minimal medication was being held. Staff receive appropriate training in the management of medication and undertake a comprehensive competency test. The home prepares residents to manage their own medication within a risk assessment framework. 38 Den Hill H59-H10 S40498 38 Den Hill V226414 150705 Stage 4.doc Version 1.30 Page 14 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 and visitors to the home benefit from and are protected by, the open culture at 38 Den Hill. EVIDENCE: The home has a complaints procedure in place and both residents and relatives confirmed they knew how to make a complaint if necessary. There have however, been no complaints made about the service at 38 Den Hill since the last inspection. The home seeks to operate an open culture where issues are openly discussed and opinions shared. Positive interaction was observed between residents and staff during the inspection. The home has a number of systems in place to protect residents from abuse. New staff are employed subject to robust recruitment procedures and the necessary checks being undertaken. The systems for supporting residents’ with their finances have been recently reviewed and extra security measures are now in place. Staff are aware of their responsibilities in respect of protecting vulnerable adults. The home has recently been involved in its first adult protection investigation and the General Manager who has being overseeing the running of the home has received a letter of commendation from Sussex Police for the way in which she supported them in their investigations. The home has demonstrated the effective way incidents are handled at the home and that the systems for protecting residents work. 38 Den Hill H59-H10 S40498 38 Den Hill V226414 150705 Stage 4.doc Version 1.30 Page 15 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 Residents benefit from a homely, safe and comfortable environment. EVIDENCE: 38 Den Hill is an attractive semi-detached house which is situated in the Old Town area of Eastbourne, a short walk from local shops and public transport links. The home is pleasantly decorated and well-maintained both internally and externally. The home comprises of three single bedrooms and an office/sleep-in room. The lounge and dining room provide residents with sufficient communal space to meet their needs. Residents have access to a garden at the rear of the property. Residents are supported to take responsibility for keep the home clean and tidy and this was found to be the case at the time of the inspection. 38 Den Hill H59-H10 S40498 38 Den Hill V226414 150705 Stage 4.doc Version 1.30 Page 16 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) 33, 34 & 35 Residents benefit from an experienced and dedicated team of staff who know how to support them effectively. EVIDENCE: 38 Den Hill is a small home and for the majority of the time, residents are supported by one member of staff per shift. At night, one staff member sleeps-in. At the time of the inspection, there were two residents living at 38 Den Hill and their needs were found to be being met by the current staffing levels. As staff generally work alone, the home has a variety of systems in place to ensure the effective handover of information and communication across the staff team. As such, regular staff meetings and supervisions are held. The Inspector viewed the minutes taken at these meetings and it was evident that the systems for sharing information and maintaining consistency of approaches is working well. Residents spoke positively about their relationships with staff and commented that they liked the people who work with them. At the time of the inspection, the atmosphere was friendly and relaxed and positive relationships were observed. 38 Den Hill H59-H10 S40498 38 Den Hill V226414 150705 Stage 4.doc Version 1.30 Page 17 The recruitment files for two new staff members were viewed and found to contain the required information, thus demonstrating a robust system of recruitment. There was documentary evidence that both new members are working towards completion of approved induction and foundation programmes. 38 Den Hill H59-H10 S40498 38 Den Hill V226414 150705 Stage 4.doc Version 1.30 Page 18 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) 42 Residents benefit from living in a home where their health and safety are protected and promoted. EVIDENCE: The home has a number of systems in place to ensure the health, safety and welfare of residents are protected. As such, regular checks of the environment are undertaken to ensure risks are identified and appropriately controlled. Staff receive training in fire safety and regular fire drills are conducted. 38 Den Hill H59-H10 S40498 38 Den Hill V226414 150705 Stage 4.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 4 x 4 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 x x 4 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 3 3 3 4 3 x 3 Standard No 31 32 33 34 35 36 Score x x 3 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 38 Den Hill Score 3 3 4 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x H59-H10 S40498 38 Den Hill V226414 150705 Stage 4.doc Version 1.30 Page 20 NO 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 Regulation Requirement Timescale for action 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. Refer to Standard Good Practice Recommendations 38 Den Hill H59-H10 S40498 38 Den Hill V226414 150705 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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