Inspection on 11/01/06 for 5 Ellasdale Road

This inspection was carried out on 11th 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 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

5 Ellasdale Road 20/08/07

5 Ellasdale Road 10/08/06

5 Ellasdale Road 19/07/05

5 Ellasdale Road 09/02/05

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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 5 Ellasdale Road 5 Ellasdale Road Bognor Regis West Sussex PO21 2SG Lead Inspector Mr D Bannier Announced Inspection 11th January 2006 10:00 5 Ellasdale Road DS0000061616.V267355.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 5 Ellasdale Road DS0000061616.V267355.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. 5 Ellasdale Road DS0000061616.V267355.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 5 Ellasdale Road Address 5 Ellasdale Road Bognor Regis West Sussex PO21 2SG 01243 865459 01424 202221 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) Sussex Autistic Community Trust (Care Services) Limited Mrs Karen Louise Phillips Care Home 6 Category(ies) of Learning disability (6) registration, with number of places 5 Ellasdale Road DS0000061616.V267355.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th July 2005 Brief Description of the Service: 5 Ellasdale Road is a care home, which is registered to provide personal care for up to six service users in the category learning disability (LD) who are between the ages of 18 to 65 years of age. It is a semi- detached property, which has been extended and adapted for its current use, and is located in the town of Bognor Regis. The property is a three storey building providing private accommodation to service users in six single bedrooms located on the first and second floors. Communal accommodation is made up of two lounges and a dining room located on the ground floor. An enclosed garden, which is available to service users, is located to the rear of the premises. The registered provider of this service is Sussex Autistic Community Trust (SACT). The Responsible Individual acting on behalf of the organisation is Mrs Jean Rose. Since the last inspection the registered provider has appointed a new manager to be responsible for the day to day running of the care home. This person has yet to be registered. 5 Ellasdale Road DS0000061616.V267355.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced and started at 10am. It took place over six and half hours. The inspector has received comment cards from each resident and also from each other relatives. Comments made were very positive about the care and facilities provided. More details of these comments can be found within the report. Residents accommodated have autistic spectrum disorders and find it very difficult to tolerate changes in routine or new people being introduced to them. Whilst the inspector spoke briefly to three residents it was not possible to have meaningful discussions with them. The inspector looked at how new residents are assessed before being admitted and how this information is used to ensure they are appropriately cared for. The inspector also looked at how staff help residents to keep in touch with their family and friends, how prescribed medicine is given to residents, how the home recruits staff and how the home is being run generally. The Commission has received complaints about this care home since the last inspection. The registered provider was asked to conduct an investigation into the matters raised. The Commission has written to the complainants and to the registered provider to confirm the outcome of the investigation and the action to be taken to address to those parts of the complaint that have been upheld. What the service does well: This is a care home where younger adults with autism are well looked after. There have been several changes to the staff team, including the appointment of a new manager. However, these changes have not affected how the residents have been cared for. Staff on duty were very caring and considerate and the atmosphere was very homely. 5 Ellasdale Road DS0000061616.V267355.R01.S.doc Version 5.0 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. 5 Ellasdale Road DS0000061616.V267355.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 5 Ellasdale Road DS0000061616.V267355.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): 1 and 2 A statement of purpose and service user’s guide have been drawn up in order to provide information to prospective residents and their representatives. However, these documents need to be reviewed and the information they contain updated. The registered provider has developed an assessment format to determine the needs and aspirations of prospective residents. EVIDENCE: A statement of purpose and service users’ guide have been produced and given to prospective residents and their families. These documents provide information with regard to the care and services provided by this care home. They have also been produced in pictorial form to help residents to understand. This information should help the resident, and their relatives, to make an informed decision as to whether the care home is suitable for them. However, these documents have not been reviewed since the care home was registered approximately 15 months ago. The inspector noted that the information provided needs to be updated. For example the registered provider has appointed a new manager since the last inspection; their name should be included within the statement of purpose. The manager has been advised to review each of these documents to ensure they also contain up to date and clear information about the care and services provided. 5 Ellasdale Road DS0000061616.V267355.R01.S.doc Version 5.0 Page 9 There have been no new residents admitted since the care home was first registered. The manager showed the inspector an assessment format that has been produced by the registered provider. This document demonstrated that residents’ needs are thoroughly assessed to determine if the care home is able to meet them. This also includes residents’ care needs specifically related to autism. 5 Ellasdale Road DS0000061616.V267355.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 Individual care plans have been drawn up for each resident. EVIDENCE: During the last inspection it was recommended that care plans be revised. This is to ensure information they provide about how residents’ needs are met is clear. This will mean that staff can provide good quality care to residents that meet their needs consistently and continuously. This is particularly important to residents with autism. The inspector looked through several care plans. Although this work is not yet finished, it was clear that improvements have been made to ensure information about each resident’s care needs is more easily accessible. The inspector advised the manager to ensure care plans also include clear instructions or directions to staff with regard to how residents’ needs are to be met. Again, this is to ensure consistency and continuity of care. For example, records included phrases such as that staff should “support” a resident. The manager was advised that care plans should include information to staff about how each individual should be supported, including frequency and the level of 5 Ellasdale Road DS0000061616.V267355.R01.S.doc Version 5.0 Page 11 support required. This standard will be reviewed again during forthcoming inspections. 5 Ellasdale Road DS0000061616.V267355.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 Arrangements have been made to enable residents develop and have appropriate relationships with others. Other key standards were assessed as fully met during the last inspection. EVIDENCE: Care plans include clear details about significant family contacts and others who are important to each resident. They also include clear information with regard to the levels of support each resident needs to keep in contact with family and friends. The inspector advised the manager to ensure care plans also include clear directions to staff with regard to how each resident should be supported. 5 Ellasdale Road DS0000061616.V267355.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): 19 and 20 Appropriate action has been taken to ensure residents’ physical and health care needs have been met. Some work is required to ensure procedures for administering medication protects the wellbeing of residents. Other key standards were assessed as fully met during the last inspection. EVIDENCE: Care records seen included clear information with regard to appointments made of behalf of residents with primary health care staff including GP’s and psychologists. Records included information with regard to the reason why the appointment has been made. It also includes the outcome of such visits such as changes to medication or other prescribed treatment. This means that all staff have up to date information with regard to any health care needs of each resident. This is particularly important where a resident is not able to inform staff themselves. Currently no residents are considered capable of administering their own medicines. Residents’ abilities were assessed when they were first admitted to Ellasdale Road. The manager informed the inspector that one resident might be able to take some control of their medication in the near future. However, 5 Ellasdale Road DS0000061616.V267355.R01.S.doc Version 5.0 Page 14 to ensure this is done safely, this will be subject to appropriate assessment and review of the resident’s capabilities. Policies and procedures have been drawn up, which staff are expected to follow, for dealing with prescribed medicines. It is understood that the registered provider is carrying out a review of all policies and procedures. As part of this process, it is recommended that procedures are rewritten to ensure they are relevant to local circumstances. For example, the current procedure has been devised to cover all services managed by the registered provider and states that only senior staff may administer medication. However, it is the practice in this care home for all staff that have been appropriately trained to administer medication. Current practices for the administration are considered unsafe. Medicines are usually administered at mealtimes. The member of staff administers the medication whilst in the office, where medicines are stored. The medication is then taken to the resident in a plastic pot. This means there is a risk of the resident being given the wrong medication, as there is no means of checking the directions before the resident is given the medication. The manager is advised to review procedures and practices to ensure the medicines are administered to residents from containers marked with the name of the medication, the time it is due to be taken, the dosage and the name of the resident for whom the medicine has been prescribed. Staff administer medication to one resident by concealing it in food. This is because the resident will not take their medication otherwise. It was not clear if this practice is in accordance with the resident’s care plan that has been agreed with the resident or their representatives. This is to ensure that this practice is in the best interest of the resident. It is recommended that this is reviewed and, if necessary the care plan is amended to include clear guidance to staff. 5 Ellasdale Road DS0000061616.V267355.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): 23 Some work is required to ensure residents are protected from abuse. EVIDENCE: Training records showed that all staff have received training in recognising and reporting abuse. A “Whistle Blowing” procedure has also been developed so that staff know that they can report instances of abusive practices to the manager confidentially. In addition, other training provided includes how to communicate and work with people who have autistic spectrum disorders and how to safely deal with challenging behaviour. However, some work is required to ensure care plans provide staff with clear guidance with regard to how individual residents’ needs are to be met. Instances where this is necessary have been highlighted earlier in this report. For example where a resident’s medication is concealed in food, care records must provide clear evidence to confirm that this practice is in the best interests of the individual and in accordance with best practice guidelines. 5 Ellasdale Road DS0000061616.V267355.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): No standards in this section were assessed on this occasion. Key standards had been fully met during the last inspection. EVIDENCE: 5 Ellasdale Road DS0000061616.V267355.R01.S.doc Version 5.0 Page 17 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): 33,34 and 36 As a new manager and several staff have recently been appointed it was not possible to determine if the staff team is effective. Some work is required to ensure residents are supported and protected by the home’s recruitment policy and practices. As the manager has recently been appointed it was not possible to determine if the staff feel well supported and supervised. Other key standards were fully met at the last inspection. EVIDENCE: Following an induction period, the manager took over the day-to-day running of the care home two days before this inspection took place. In addition, four of the staff team have been appointed within the last three months. This staff team is therefore in a period of change. It will therefore, be necessary to reassess their effectiveness as a staff team over forthcoming inspections. Information provided prior to the inspection showed that criminal records checks had been obtained with regard to all newly appointed staff before commencing work at the care home. This would ensure that, as far as possible, vulnerable residents have been protected from possible abuse. Such checks are carried out by the Criminal Records Bureau (CRB) and include checks 5 Ellasdale Road DS0000061616.V267355.R01.S.doc Version 5.0 Page 18 against the Protection of Vulnerable Adults (POVA) register. Information provided indicated that checks carried out by the previous employer of staff have been accepted. The manager was informed that such checks are not transferable. The manager was advised to ensure that she applies for such checks to be carried out on all members of staff employed at the care home without delay. In the meantime, staff without CRB checks must supervised by another suitably experienced member of staff for whom a check has been obtained. The member of staff should also sign a self -declaration stating that they do not have a criminal record, which would put at risk vulnerable adults. The manager confirmed that she has begun to establish a process for ensuring all staff are supported sand supervised in their work. Given the needs of residents with autism, this will be an important feature to ensure all residents are appropriately supported in achieving their individual goals. This standard will be reassessed over forthcoming inspections. 5 Ellasdale Road DS0000061616.V267355.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 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 and 39 This care home has been run in the best interests of the residents. It is evident that the registered provider undertakes regular self -monitoring, review and development of this care home. However, it was not clear of the extent that residents’ views are sought and whether they underpin this process. EVIDENCE: This care home has undergone some significant changes since the last inspection. A new manager has been appointed and a new local management structure for the care home is being implemented. In addition, a significant number of care staff have been appointed within the last three months. Yet despite this the care home continues to be run in the best interests of the residents. 5 Ellasdale Road DS0000061616.V267355.R01.S.doc Version 5.0 Page 20 Comment cards were received from all six residents who live in this care home. The inspector also received comment cards from six relatives. A resident helped to find out the views of residents who lives her by designing pictures so that questions that were in written form could be better understood by residents. All residents said they like living in this care home. They said that they felt safe and well cared for. Staff treat them well and their privacy is respected. They were able to tell the inspector that, if they were unhappy they knew whom they could speak to. Residents also said that they are involved with the decision making at the care home. All relatives said they are welcomed into the care home by staff and were able to visit their relative in private. When their relative has been unable to make decisions they said they are consulted about their care. They said that, in their opinion, there was always sufficient staff on duty. They have been made aware of the complaints procedure, but no one has found it necessary to make a complaint. All relatives said they were satisfied with the overall care provided. Records seen showed that registered provider has arranged to have the care home visited on a monthly basis by a representative in order to monitor the care and services provided. The inspector was told that residents and staff are spoken to during such visits. However, it was not clear from the records of such visits what is discussed and how this affects the way the care home is run. It is recommended that more detail is included in the report to provide evidence that residents and staff are consulted with regard to the running of this care home. 5 Ellasdale Road DS0000061616.V267355.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 x x x Standard No 22 23 Score x 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 x x x x Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 3 16 x 17 Standard No 31 32 33 34 35 36 Score x x 2 2 2 x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 5 Ellasdale Road Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 x 2 x x x x DS0000061616.V267355.R01.S.doc Version 5.0 Page 22 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 YA1 Regulation 6 Requirement Timescale for action 16/04/06 2 YA20 13(2) 3 YA34 19(1)(b) as amended The registered person shall keep under review and, where appropriate, revise the statement of purpose and the service users guide and notify the Commission and service users of any such revision within 28 days. The registered person shall make 13/02/06 arrangements for the safe administration of medicines received into the care home. The registered person shall not 13/02/06 employ a person to work at the care home unless subject to paragraphs (6), (8) and (9), he has obtained in respect of that person the information and documents specified in paragraphs 1-9 of Schedule 2. 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 Good Practice Recommendations DS0000061616.V267355.R01.S.doc Version 5.0 Page 23 5 Ellasdale Road 1. Standard YA39 It is recommended that Regulation 26 are amended to include clear and sufficient evidence which confirms that service users and their relatives have been interviewed. 5 Ellasdale Road DS0000061616.V267355.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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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