Inspection on 13/09/05 for 3a Grosvenor Road

This inspection was carried out on 13th September 2005.

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 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.

Other inspections for this house

3a Grosvenor Road 06/03/07

3a Grosvenor Road 25/04/05

3a Grosvenor Road 23/11/04

3a Grosvenor Road 15/06/04

3a Grosvenor Road 08/10/02

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 3a Grosvenor Road 3a Grosvenor Road Seaford East Sussex BN25 2BL Lead Inspector Jon Wheeler Announced Inspection 13th September 2005 14:45 3a Grosvenor Road DS0000021006.V249332.R01.S.doc Version 5.0 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 3a Grosvenor Road DS0000021006.V249332.R01.S.doc Version 5.0 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. 3a Grosvenor Road DS0000021006.V249332.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 3a Grosvenor Road Address 3a Grosvenor Road Seaford East Sussex BN25 2BL 01323 890435 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) Southdown Housing Association Limited Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 3a Grosvenor Road DS0000021006.V249332.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 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. Only service users with a learning disability are to be accommodated. Date of last inspection 25th April 2005 Brief Description of the Service: 3a Grosvenor Road is a Southdown Housing Association service registered to provide care to four younger adults who have a learning disability, as well as some challenging behaviours and other complex needs. The home is an attractive, detached property located in a residential area close to the Seaford town centre amenities, including main line railway station and bus routes. The home has two vehicles. On the ground floor, there are three single bedrooms, a large bathroom, kitchen, lounge and dining room. On the first floor is a self-contained flat with a bedroom, lounge and bathroom. There is a large, well-maintained garden to the rear of the property. 3a Grosvenor Road DS0000021006.V249332.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on 13 September 2005, starting at 2.45pm and lasting three and a quarter hours. The process included talking to the four service users, the manager of the home and three of the staff on duty. Staff were also observed working with service users. The inspection also included reading care plans and documentation; checking the storage, administration and recording of medication; and a tour of the premises. What the service does well: What has improved since the last inspection? The staff had worked hard with the service users who had lived in the home for some time to meet their needs and manage challenging behaviours. The organisation has continued to undertake regular monitoring of the service. It has also provided specific training for staff to meet the needs of a new service user and has provided a range of support for staff whilst there has been management changes. 3a Grosvenor Road DS0000021006.V249332.R01.S.doc Version 5.0 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. 3a Grosvenor Road DS0000021006.V249332.R01.S.doc Version 5.0 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 3a Grosvenor Road DS0000021006.V249332.R01.S.doc Version 5.0 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): 2 , 3, 4. The service has a comprehensive pre-admissions process, which enables the service to identify the needs of prospective service users and for the service users to visit the home prior to moving in. EVIDENCE: There was documentary evidence that a service user who had recently moved in to the home had had a comprehensive pre-admission assessment. There had been an opportunity to visit the home on a number of occasions, prior to moving in, including an extended stay. However, in discussion with staff and observation, there was evidence that the service was struggling to fully meet the needs of the new service user, which also was having an impact on the other service users. There was considerable evidence that the staff had worked hard to address the complex needs of the new service user, but whilst they had been successful in some areas, they were finding it difficult to address some of the needs and challenging behaviour. Staff were able to identify that as a team they needed to be more consistent in their approach, although there was a lack of robust guidelines to support the staff in their work. 3a Grosvenor Road DS0000021006.V249332.R01.S.doc Version 5.0 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, 7, 9. Not all care plans clearly identified the needs and support required to enable the home to meet all the needs of the service users. Service users, where possible, are supported to make informed choices in all aspects of their lives. Service users are protected by robust and up to date risk assessments. EVIDENCE: Generally, care plans contained comprehensive information about the background, needs, preferences and support for each service user. However, even though there was relevant information about one particular service user, there were not sufficiently detailed guidelines to enable staff to effectively manage challenging behaviour. There was a range of evidence that service users are supported to make decisions in all aspects of their lives. Two service users said that they are able to choose which activities they do, what time to get up and go to bed and what food to eat. Staff were observed providing sensitive and skilled support to 3a Grosvenor Road DS0000021006.V249332.R01.S.doc Version 5.0 Page 10 enable service users to make choices. Staff were knowledgeable about the various ways all the service users express their choices. There was documentary evidence of a range of risk assessments, which had been reviewed and updated. Risk assessments related to activities in the home and in the community, for all the service users. 3a Grosvenor Road DS0000021006.V249332.R01.S.doc Version 5.0 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): 11, 12, 13, 14, 15, 16. Service users take part in a wide range of activities to ensure their personal development. They are supported to have appropriate relationships. Service users have their rights and choices respected and promoted in their daily lives. EVIDENCE: Service users are supported to access a range of activities and facilities to meet their individual needs and preferences. Activities include going to college, exercise sessions, shopping, going to clubs, pubs and cafes and various trips out. Activities are tailored for each service user and take account of personal choice, age, health and need. Activities are provided in the home and in the community. Two of the service users confirmed they were able to choose what activities they do. There was documentary and anecdotal evidence from staff that one service user is offered a range of activities, but often refuses. Staff are generally able to be flexible and can respond when the service user does choose to go out. 3a Grosvenor Road DS0000021006.V249332.R01.S.doc Version 5.0 Page 12 Staff had a good depth of knowledge about the activities the service users like to do. One service user has had an attractive, homely summerhouse built in the garden, where he chooses to spend considerable amounts of time. The staff help service users to maintain relationships with their families and friends. Contact is maintained by telephone as well as visits. Family are invited to care reviews and meetings. The ethos of the home and the organisation looks to promote the rights, choices and independence of the service users. Staff had a clear knowledge and understanding of the home’s ethos and were able to describe in detail how it operates in practice. Staff were observed interacting in a positive and sensitive way with service users to motivate them and to help them make choices. Service users are supported to make their own drinks and snacks. They have access to all areas of the home and garden, although the home is in the process of looking to install suitable locks on bedrooms doors to ensure the privacy of the service users and which meets their needs. Where some rights or choices are limited, there are suitable risk assessments in place to ensure any restrictions are thought about by the whole staff team and are only in place to ensure the safety and well-being of the service users. 3a Grosvenor Road DS0000021006.V249332.R01.S.doc Version 5.0 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, 21. Service users receive dignified and sensitive support and have their emotional and health needs met. There are appropriate systems for the storage, administration and recording of medication, to protect the service users. Service users receive sensitive care and suitable support to meet their changing needs. EVIDENCE: Staff provide dignified, sensitive and flexible care to meet the needs of the service users. There was documentary evidence of innovative and flexible personal care routines, which provide dignified support to service users, whilst respecting them and maximising their independence. The staff work hard to provide care which meets the individual needs of each service user. There was documentary evidence that staff enable service users to access a range of health services to meet their emotional and physical health needs. There was evidence of service users accessing services such as Psychology, Psychiatry Community Nursing and a local G.P. Where a service user requires a routine medical procedure, there was evidence that the home had worked alongside other professional and services. This was to ensure that where a 3a Grosvenor Road DS0000021006.V249332.R01.S.doc Version 5.0 Page 14 service user is unable to make an informed choice about treatment, any medical interventions are based on the need, the home’s duty of care and the rights of the service user. The staff were able to describe how the needs of the service users had changed, especially for one service user whose needs had changed because of ageing. Activities and support are provided in a way that respects the choices and changing needs of the service users. The home has a clear medication administration policy and all staff who dispense medication have received training. All medication was stored securely and had been dispensed and recorded accurately, in line with the home’s policy and procedure. 3a Grosvenor Road DS0000021006.V249332.R01.S.doc Version 5.0 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): 22, 23. Service users rights are protected by a suitable complaints procedure. Whilst there is a comprehensive adult protection policy, in conjunction with staff training, the lack of robust support guidelines to manage some challenging behaviours meant the service could not ensure the safety of service users. EVIDENCE: The home has an effective complaints procedure and two service users said they felt able to raise any concerns they had. Staff said they use observation and their experience of service users, who may not be able to clearly communicate their views and wishes. The organisation has a comprehensive adult protection policy. All staff receive adult protection training as part of their induction. However, there had been a number of incidents involving service users that had not been reported to the Commission, nor reported in line with the organisation’s policy and procedure for the protection of vulnerable adults. There was evidence that the staff had worked hard to try to meet the needs of the service users, but had been unable to effectively manage the challenging behaviour of one service user, which had impacted on the quality of lives and potential safety of other service users. 3a Grosvenor Road DS0000021006.V249332.R01.S.doc Version 5.0 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. The home offers a friendly and relaxed environment which is kept in good decorative order and offers sufficient communal space. There are sufficient bathroom and toilet facilities that meet the needs of the service users. The home is kept clean and tidy. EVIDENCE: The building is decorated in a homely style, which offers a relaxed and welcoming environment. There is a large bathroom on the ground floor, which has a bath and a shower. There is a bathroom upstairs that is used by the service user who has his bedroom on that floor. There is a comfortable lounge and a dining area, which offer sufficient communal space. There is little need for adaptations within the home, although there is a seat in the shower area to aid service users. The home was clean and tidy at the time of the unannounced inspection. Some fire doors were propped open during the inspection and an immediate requirement was made for them to be closed. There is a large garden and well-maintained garden around the home, which is used by the service users. The service has recently had a new attractive and comfortable summerhouse built for a service user, who spends most of his 3a Grosvenor Road DS0000021006.V249332.R01.S.doc Version 5.0 Page 17 time outside. The service was in the process of having heating installed in to the summerhouse to enable it to be used all year round. 3a Grosvenor Road DS0000021006.V249332.R01.S.doc Version 5.0 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): 32, 33, 34, 36. There is a skilled and dedicated staff team who continue to work hard to meet the needs of the service users. The staff team are supported by regular supervision and staff meetings. The organisation has robust employment procedures to protect the service users. EVIDENCE: There was evidence of a dedicated and skilled staff team who continue to work hard to try to met the needs of the service users. Staff were honest and professional in their appraisal of the skills required to meet the needs of the service users. Staff were able to identify that as a team they had not always been consistent in their approach with one service user, which had resulted in them struggling to manage some challenging behaviours. However, staff were able to identify what they needed to do to provide a consistent approach and were receiving appropriate training to help them put together workable structures and guidelines to help them manage challenging behaviours of service users. Staff were able to demonstrate a clear knowledge and understanding of the needs of the service users who had been in the home for a number of years, and were working hard, in conjunction with information received as part of the pre-admissions assessments, to identify and meet the needs of a newly 3a Grosvenor Road DS0000021006.V249332.R01.S.doc Version 5.0 Page 19 admitted service user. Whilst staff identified that they had struggled recently to be wholly effective for all service users, they demonstrated the knowledge, dedication and skills to be able to work together to meet identified needs. They would be aided by the production of clear support guidelines and with effective and consistent management. The home had one part-time vacancy, which was being covered by relief staff who regularly worked in the home. It was reported by staff that there are good staffing levels in the home, with generally at least three staff per shift during the day. There was evidence that the organisation had acknowledged the difficulties in the home, and had put in a range of measures, including more linemanagement and specific training to help staff identify and develop the skills necessary to enable them to meet the needs of the service users. It was confirmed by the manager that the organisation has a robust recruitment procedure, and there was documentary evidence in the home of CRB checks, references and photographic identification having been taken. Staff stated that they had regular supervision and felt that the manager was supportive. There was documentary evidence of regular team meetings, where the staff discuss a range of issues which affect the home and the service users. 3a Grosvenor Road DS0000021006.V249332.R01.S.doc Version 5.0 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, 42. There has been a lack of consistency and direction due to the number of changes in manager in the last two years. Despite a range of regular checks, fire doors propped open did not ensure the safety of service users and staff. EVIDENCE: The service had not had the benefit of consistent management, with there having been four managers in the last two years. At the time of the inspection, the manager stated that he was leaving, and his post would be covered for six months by a temporary replacement. It was reported that the replacement is a skilled and experienced practitioner, whose expertise in working with people with challenging behaviour would benefit the staff team and enable them to formulate clear and consistent support guidelines. In addition, there had been three area managers in the last two years providing line-management support for the home. Therefore there was a feeling that the changes in management had had an unsettling effect on the staff team and the service users. Staff felt 3a Grosvenor Road DS0000021006.V249332.R01.S.doc Version 5.0 Page 21 that they could access support from managers, but also felt the lack of continuity had made things difficult. There was evidence that the organisation had done all it could to address the manager vacancies and had provided adequate cover whenever the manager or area manager was not available. The manager and the staff were able to describe the clear ethos and set of values of the organisation, which was based on respecting the rights, choices and independence of the service users. There was documentary evidence of the service undertaking a range of health and safety checks, including regular reviews of fire safety equipment and systems; water temperature checks and an on-going maintenance plan. However, during the unannounced inspection, a number of fire doors were found to be propped open with wedges. An immediate requirement was left for all fire doors to remain closed. It was discussed that where it is deemed necessary for fire doors to remain open, they should be fitted with approved automatic door closing mechanisms. 3a Grosvenor Road DS0000021006.V249332.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 2 3 X Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 3 3 X 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 3a Grosvenor Road Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 2 2 X X X 2 x DS0000021006.V249332.R01.S.doc Version 5.0 Page 23 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 2 Standard YA6 YA23 Regulation 15 (1) 37(1)(e) Requirement Timescale for action 01/11/05 3 YA42 23 (4) Care plans accurately reflect the care given to service users. All significant events which affect 13/09/05 the health or well-being of service users are reported to the Commission. Fire doors remain closed unless 13/09/05 fitted with approved automatic door closing mechanisms. 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 3a Grosvenor Road DS0000021006.V249332.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection East Sussex Area Office 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. Extracts may not be used or reproduced without the express permission of CSCI 3a Grosvenor Road DS0000021006.V249332.R01.S.doc Version 5.0 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. 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