Inspection on 29/03/07 for 50a Avis Road

This inspection was carried out on 29th March 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 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

50a Avis Road 22/02/06

50a Avis Road 01/08/05

50a Avis Road 17/01/05

50a Avis Road 08/06/04

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 50a Avis Road 50a Avis Road Newhaven East Sussex BN9 0PN Lead Inspector Elaine Green Key Unannounced Inspection 29th March 2007 10:00 50a Avis Road DS0000021014.V325939.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 50a Avis Road DS0000021014.V325939.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. 50a Avis Road DS0000021014.V325939.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 50a Avis Road Address 50a Avis Road Newhaven East Sussex BN9 0PN 01273 612171 01273 612171 avisroad@onetel.com 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 Mr Peter Flood Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 50a Avis Road DS0000021014.V325939.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is five (5). Service users must be aged between eighteen (18) and sixty five (65) years on admission. Only adults with a learning and physical disability are to be accommodated. Date of last inspection Brief Description of the Service: 50a Avis Road is a care home, which provides personal care and accommodation for up to five residents with complex learning and physical disabilities. The home is owned and run by Southdown Housing Association who are a large voluntary organisation that have been providing services to people with learning disabilities across East Sussex for over 16 years. The home is a spacious purpose built bungalow on the outskirts of Newhaven, close to a large supermarket, garden centre, restaurant, local pub, train station and bus stop. The town centre is within walking distance. Each service user has their own bedroom, which is personalised with their own possessions, photographs and pictures. Communal areas include a large kitchen/dining area, lounge and a garden. There are two bathrooms, which have adapted equipment to meet the needs of the service users. The service users undertake a range of activities in the home and in the community. There are two vehicles, both of which are wheelchair accessible. The home is well decorated and maintained throughout and has a friendly and homely atmosphere. The home provides personal care and support to residents who are funded by Social Services. The home’s fees as of 29th March 2007 are £1539 per person per week this includes, chiropody every 5 weeks, all ‘in house’ activities, outings (excluding entrance fees), transport, the cost of occasional meals out and the staffing and cost of meals for an annual 5-day holiday. Individual residents are responsible for paying for their own personal toiletries, magazines, clothing, entrance fees to tourist attractions, shows, cinema etc and a charge of £25 per session is made for a massage every 2 weeks for those who want one. Prospective residents and their relatives are provided with written information regarding the services and facilities provided at the home prior to admission. A copy of the home’s most recent inspection report is available on request from 50a Avis Road DS0000021014.V325939.R01.S.doc Version 5.2 Page 5 the home. 50a Avis Road DS0000021014.V325939.R01.S.doc Version 5.2 Page 6 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 Regulation Act 2001, uses the term ‘service user’ to describe those living in care home settings. For the purpose of this report, those living at Avis Road will be referred to as ‘residents’. This unannounced inspection took place on Thursday 29th February 2007. All five residents were accommodated on the day of the inspection. The Registered Manager facilitated the majority of the inspection. In order to gather evidence on how the home is performing, individual discussions took place with three members of staff. Four care records were examined in some detail for the purpose of monitoring care. One survey was returned to the Inspector that had been completed by a relative of one of the residents. Feedback form this is included in the report. Other records and documentation inspected included: the home’s Statement Purpose and Service Users’ Guide, medication practices, the provision activities, quality assurance systems, complaints procedure and the systems place to safeguard residents from harm, staffing levels and the provision relevant training. All communal areas and individual rooms were seen. of of in of A detailed pre-inspection questionnaire was received prior to the visit to the home. This provided the Inspector with information relating to the residents accommodated, premises, maintenance and associated records and details of the homes policies and procedures. What the service does well: 50a Avis Road is an excellently managed service, which is staffed by a dedicated, skilled and effective staff team. The staff are knowledgeable about the needs and support required for each person living at the home. Four of the residents living within the home have done so for many years and have therefore developed strong relationships with each other and the staff. Another resident recently admitted to the home is settling in well and the staff team have worked closely with the residents relatives to ensure that the transition to moving into Avis Road ran smoothly and was a positive experience for the individual. The home’s care plans are comprehensive. They contain relevant, detailed information and the guidelines required by staff to support the residents appropriately in their daily living. Resident’s personal choices and needs are clearly recorded ensuring that their preferences are taken into account. The underpinning ethos of the home and attitude of the staff enables residents to choose, maintain and develop life skills that are important to the person. 50a Avis Road DS0000021014.V325939.R01.S.doc Version 5.2 Page 7 Residents are supported to lead busy and active lifestyles in their local community. They are encouraged to go to college and participate in a variety of activities that they have chosen and that they enjoy. All residents are supported to have an individual annual holiday of their choice and also enjoy trips out to shows and the coast etc. Feedback from a relative included them saying that “The team at Avis way are highly trained and very in tune with X’s specific needs. They provide a large variety of weekend and evening activities for X to participate in.” and “X has always been given choices of what to do – he is able to communicate his likes and dislikes…….staff tailor most activities to enable him to watch or be part of the activity and involve him in making decisions if he is not physically able to be involved.” This home is well maintained and decorated and furnished to a good standard in a homely and modern style. All residents’ rooms are personalised and one of the fully adapted bathrooms has the luxury of optional ‘piped music’ and a spa facility. The staff team at the home are trained, competent and skilled. The staff observed on the day of the site visit demonstrated a good understanding of the residents needs and were able to communicate well with those residents who have communication problems. The relationship between the staff and residents appeared to be good and the atmosphere in the home was relaxed and informal. Residents and other stakeholders views are listened to. Management and administrations stems are good and the home is run in the residents’ best interest. 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. 50a Avis Road DS0000021014.V325939.R01.S.doc Version 5.2 Page 8 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. 50a Avis Road DS0000021014.V325939.R01.S.doc Version 5.2 Page 9 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 50a Avis Road DS0000021014.V325939.R01.S.doc Version 5.2 Page 10 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and others are provided with sufficient information prior to admission in order to support their decision of where to live. Good systems are in place to ensure that only residents whose needs can be met are admitted to the home. EVIDENCE: The home has a detailed Statement of Purpose and Service Users’ Guide in place, both of which have been updated since the last inspection. The Statement of Purpose provides the reader with an introduction to Southdown Housing Association, details of the Registered Manager, the number, relevant qualifications and experience of staff working in the care home and overall service provision including: the accommodation, the arrangements for residents to engage in social and leisure activities together with any therapeutic techniques, the arrangements for dealing with concerns or complaints and the systems for ensuring that residents’ needs are identified, met and reviewed in accordance with person centred planning. The Service Users’ Guide is presented in an easy to read and understand format, which incorporates the use of colour pictures and symbols including a 50a Avis Road DS0000021014.V325939.R01.S.doc Version 5.2 Page 11 photograph of the home. It gives an overview of the philosophy of care, purpose of the service, accommodation and outlines what support and care individuals can expect from the home including support and communication, personal space, individual planning, holidays, day service provision and terms of occupancy. The Manager was able to describe in detail the arrangements in place for assessing all prospective residents in order to ensure that the home could meet their needs. He explained that the recently admitted resident was given the opportunity to visit the home prior to moving in; including staying at the home both for the day, and overnight. The individual and their family members made several visits to the home prior to a decision being made. Documentary evidence examined confirmed that the home have worked closely with this residents family, care manager and professionals from and children’s services to ensure that the transition from living with their family to moving into 50a Avis Road went smoothly. The home has obtained detailed information about all areas of this residents life including what works well for this individual, how well they sleep, what food they like, what kind and how much support they required, their preferences in relation to how care is delivered etc. A relative of one of the residents “X was involved in the planning built. Both X and their family confirmed that they had received the resident moving in. wrote on a survey returned to the Inspector stages and visited the site as it was being were consulted on the move.” They also enough information about the home prior to 50a Avis Road DS0000021014.V325939.R01.S.doc Version 5.2 Page 12 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): 6,7,8&9. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are supported well by the home’s comprehensive care planning procedures. Residents are consulted about all aspects of the home and are supported to make decisions in all aspects of their lives to the best of their abilities. Clearly assessed and managed risks enable residents to undertake a wide range of activities in order to promote their independence. EVIDENCE: Four plans of care, which the home refers to as ‘support plans’ were examined in some detail. They were noted to be both detailed and person centred ensuring that residents have control over the way the support they receive from staff is delivered. At the front of each plan can be found a personal profile. This gives an overview of the person’s background, their needs and preferences e.g. if they prefer to have their personal care needs met by a member of the same sex and their likes and dislikes. Clear guidelines for staff 50a Avis Road DS0000021014.V325939.R01.S.doc Version 5.2 Page 13 to follow are also in place. These are aimed at supporting staff to meet individuals’ needs. Examples of those seen include: supporting a person with bathing, food preparation, communication, preferred routines. There was clear evidence that the plans are reviewed and updated on a regular basis with the involvement of the individual. Three members of staff commented on the day of inspection that they found the care plans to be very informative and useful documents. Residents are supported to make decisions in all aspects of their lives. They were observed being supported to make choices about activities, the food they wanted to eat and participating in house hold tasks. The staff team is innovative in the way they help residents make informed choices. Staff were observed responding to individuals appropriately when choices were being made. Care staff encourage residents as much as possible to participate in all aspects of life in the home. They are encouraged to help with meal preparation, undertake household tasks, make their own hot and cold drinks, go shopping and are consulted to the best of their abilities about how the home is run. All of the residents are encouraged to take responsible risks where necessary in order to promote their independence. Detailed risk assessments and guidance are in place for all activities of daily living, based on the needs of individuals. All those seen had been recently reviewed and updated as necessary. A relative wrote “X has always been given choices of what to do – he is able to communicate his likes and dislikes…….staff tailor most activities to enable him to watch or be part of the activity and involve him in making decisions if he is not physically able to be involved.” 50a Avis Road DS0000021014.V325939.R01.S.doc Version 5.2 Page 14 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): 11,12,13,14,15,16&17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are supported to take part in a wide range of activities to lead fulfilling lives, meet their needs and ensure their personal development. Residents play an active and fulfilling role in their community and maintain positive relationships with family and friends. The ethos of the homes promotes the right of residents to make choices in all aspects of their lives to the best of their abilities. EVIDENCE: Residents are supported to access a wide range of activities to meet their individual needs and preferences. In addition to daily records and plans of care, residents are supported to maintain diary of the activities they have undertaken. Activities include college courses, art and craft, going out for a drive, beauty sessions, massage, going to the cinema, going on holiday, shopping and staying with relatives. Residents play an active role in their local 50a Avis Road DS0000021014.V325939.R01.S.doc Version 5.2 Page 15 community, including going to the local shops, going to the hairdressers and the local pub. Due to the fact that the local day care centre has closed the staff team are working closely with residents to provide for them a range of activities that they can participate in on a day-to-day basis. The activities that are currently being offered to residents are based on the things that residents have expressed an interest in and are each activity is monitored to see whether or not residents are enjoying them. Residents are given a choice about whether they want to participate in the activities offered and are given alternatives. For example if a resident enjoys animals then an activity will incorporate animals in some way like going to a park, visiting a zoo, making a collage, watching a video etc. This enables the resident to maintain control of how they spend their time. Weekends and evenings are flexible; residents can choose to stay at home and relax, go for meals out, go to the pub, shopping etc or use a sensory room – also owned by Southdown Housing Association. Each of the residents have regular holidays, some of which have been abroad. Holidays are planned with the resident on a one to one basis and staff stated that residents have control over whether they go with other residents or not. Feedback from a relative included them saying that “The team at Avis way are highly trained and very in tune with X’s specific needs. They provide a large variety of weekend and evening activities for X to participate in.” An examination of residents’ daily diaries and the homes’ own daily records confirmed that residents are well supported by staff to keep in regular contact with their families and friends. Visitors are always made to feel welcome at the home at anytime. Details of friends, relatives and people that are important to the person are clearly documented within individual plans of care and in their person centred plan. A relative wrote “We are always welcome and included in refreshments, meals and outings with X.” “X is escorted by two members of staff to come and visit his family.” Throughout the duration of the inspection all staff were observed to respect residents’ privacy and dignity. They always knock on residents’ bedroom doors prior to entering and address them by their preferred term as indicated within individual plans of care. All residents are supported by their relatives and care staff to exercise their rights and choices. All meals are prepared within the home by care staff and residents based on the choices and preferences of the individuals. Specialist diets and smaller snacks are appropriately catered for including low sugar alternatives. Residents are encouraged to dine together alongside staff in the kitchen/dining area, however they have the freedom to choose to eat at different times or in other parts of the house if they want to. Residents are encouraged to choose the menu for the week, purchase the ingredients and participate in meal 50a Avis Road DS0000021014.V325939.R01.S.doc Version 5.2 Page 16 reparation and clearing away afterwards. The Inspector joined a group of four residents and three staff for their midday meal. All residents were supported appropriately and given choices in relation to what they ate, whether they wanted condiments with their meal, whether they wanted the music on while they ate, whether they would like a hot or cold drink and then several choices e.g. normal tea, herbal tea, coffee etc. Those residents that needed support to eat their meal were supported appropriately and in a timely manner. Residents were at no time rushed to eat and were able to take their time. The whole mealtime was relaxed and informal and appeared to be a pleasurable experience for all. 50a Avis Road DS0000021014.V325939.R01.S.doc Version 5.2 Page 17 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. Staff provide sensitive and dignified support to meet the individual needs and preferences of residents. Residents are supported to access a range of healthcare services to meet their physical and emotional well-being. Residents are safeguarded by the homes policies and procedures for the safe administration of medicines. EVIDENCE: All residents are registered with a local GP and dentist and are supported to all healthcare appointments as necessary. Specialist advice from the Community Learning Disability Team (CLDT) and/or others is requested on an individual basis including community nursing, stoma care, speech and language therapy and physiotherapy. There was a clear audit trail for recent healthcare appointments. Individual guidelines are in place for staff to follow in relation to how to support residents with their health care needs e.g. the management of epilepsy. These guidelines ensure that staff are aware of what a normal seizure 50a Avis Road DS0000021014.V325939.R01.S.doc Version 5.2 Page 18 is for the individual and of how to support them personally if they have a seizure. All of the care plans that were seen clearly identified individuals’ preferences in relation to having their personal care needs met. Where specialist support is required for individuals due to healthcare needs, staff have received the appropriate training. Residents daily routines within the home are flexible. For example they can determine what time of day they would prefer to have a shower or bath and in most instances can choose the member of staff that they would like to support them (if necessary). The home’s medication records and storage systems were inspected. The home uses a pre-packed blister pack issued by the local pharmacy, which is easy to use and monitor. All members of staff have received the appropriate training and have been assessed as competent in the administration of medicines. Only senior members of staff hold responsibility for the re-ordering and returning of medicines to the pharmacy. A shortfall was identified on the medication administration records in relation to the lack of consistency in how staff record that residents are away on social leave. In light of the home’s detailed record keeping, which was seen on the day of inspection and that the fact that assurances were given by the manager that this would be rectified, this has not been reflected as an area for improvement this time. All medicines are checked and signed for by two members of staff. Clear and detailed guidance is in place for all medicines that are prescribed on as and when required basis (PRN). 50a Avis Road DS0000021014.V325939.R01.S.doc Version 5.2 Page 19 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. The home has good systems in place to ensure that all complaints are dealt with appropriately. Residents are protected from potential harm, neglect and abuse through the home’s robust policies and procedures and through staff receiving appropriate training. EVIDENCE: The home has a detailed complaints procedure in place, which is included within the home’s Statement of Purpose and Service Users’ Guide. In addition, a copy of this is also included within individual plans of care. It gives clear guidance with regards to how a complaint can be made and how the complainant can expect it to be dealt with. No complaints have been received by either the home or the CSCI since the last inspection. All of the returned residents’ questionnaires confirmed that individuals would talk to their keyworker or Manager in the first instance. The home has a detailed Adult Protection and whistle-blowing policy and procedure in place in accordance with local multi-agency guidelines. Staff spoken with confirmed that recent training has been provided by Southdown Housing Association and that they would feel confident in reporting any concerns of suspected abuse and poor practices within the home. 50a Avis Road DS0000021014.V325939.R01.S.doc Version 5.2 Page 20 The Manager acts as an appointee for four residents. The home holds residents’ personal allowances at the home, which are stored securely. Detailed policies and procedures ensure that all monies are regularly checked daily and an examination of the relevant documentation confirmed this. 50a Avis Road DS0000021014.V325939.R01.S.doc Version 5.2 Page 21 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): 24,25,26,27,28,29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 50a Avis Road offers a friendly and relaxed environment that is kept in good decorative order. It presents as a clean, well-maintained and homely place to live. residents bedrooms suit their needs and promote their independence. EVIDENCE: 50a Avis Road is a large 5-bedroom bungalow in Newhaven within walking distance of the town centre, train station, supermarket, local pub and bus stops. The bungalow was purpose built in 1996. there is a courtyard garden which is accessible from patio doors from the kitchen. The kitchen is large and has a breakfast bar and a specially designed work top and sink which can be raised or lowered to the preferred height so that both people who use wheelchairs and those who don’t can use it. There is a separate laundry and a large lounge area where there is a TV and video/DVD and music system. There are two fully adapted bathrooms at the home one of which has the luxury of 50a Avis Road DS0000021014.V325939.R01.S.doc Version 5.2 Page 22 optional ‘piped music’ and a spa facility and this is referred to as the sensory bathroom. One of the bathrooms has recently had a new parker bath fitted. Improvements that have been made since the last Inspection includes the redecoration of three residents bedrooms and the staff sleeping in room/office. The manager explained that improvements are on going and that the organisation is very supportive of the home if improvements are needed particularly if they will benefit the residents in any way and further promote their independence. All areas seen were noted to be exceptionally clean, well-maintained and homely. Two residents indicated to the Inspector that they had been involved in choosing the décor for their rooms and all the rooms seen were individualised to the residents’ own taste. The manager and staff also stated that residents have been involved in choosing their furniture, accessories and décor. All residents have their own TV, video, stereo and/or sensory stimulating equipment in their rooms. All bedrooms are provide with a ceiling tracking hoist, a profiling bed, built-in wardrobes and drawers, a hand wash basin, call system for use in emergencies, TV aerial and phone sockets. Bedding, carpets, curtains, and a lampshade are also provided and rooms are painted to a colour of the residents’ choice. 50a Avis Road DS0000021014.V325939.R01.S.doc Version 5.2 Page 23 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): 32,33,34,35,36. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are supported by a skilled and dedicated staff team who continue to work hard to meet the needs of residents. Residents are supported and protected by the home’s robust recruitment procedures. The staff team are supported to provide consistent care and meet the needs of residents through regular supervision and staff meetings. EVIDENCE: The homes policies and procedures in relation to recruitment are safe and all the required security checks are completed prior to them being deployed to work in the home. All staff have been issued with a job description and have completed both of the required inductions one of which is an ‘in house’ induction the other is one all people working in care must complete within the first six months of employment. They have also completed all the mandatory training and other specialist training needed to support the residents living at this home appropriately. 50a Avis Road DS0000021014.V325939.R01.S.doc Version 5.2 Page 24 An examination of residents and staff duty rotas confirmed that there is always sufficient staff on duty to meet residents needs and enable them to participate in their chosen activities. Staff will work flexibly e.g. will work later in the evening if required to enable residents to stay to the end of events that may finish late at night. Five new staff have been appointed to work in the home since the last Inspection and this is largely related to the fact that a new resident has been admitted to the home so a higher staffing ratio was required. Many of the staff have worked at the home for number of years and have therefore developed positive relationships with each of the residents and each other. This was evident throughout the inspection. Prior to being able to work with any of the residents on a one to one basis, staff are required to shadow key members and undertake a detailed ‘ in house’ induction. Two of the members of staff on duty that day confirmed that they had had to shadow experienced members of staff for several weeks prior to being able to work on shift in their own right even though they both had previous experience with working in other care homes. They also explained that due to the complex needs of some of the residents and their communication difficulties, it takes a considerable amount of time to build up a good relationship with residents and for both the resident and staff to feel confident with each other. Staff were observed interacting with residents that have extremely limited communication and both residents and staff appeared relaxed and comfortable with each other. There was plenty of laughing and joking between residents and staff further indicating that the relationships between them are good. During a conversation with a member of staff one resident made a subtle eye movement and the staff member understood that they were asking ‘who is sleeping in to night.’ In addition to this throughout the whole mealtime experience that the Inspector observed, the staff demonstrated a good understanding and knowledge of the residents needs, likes and dislikes and were able to communicate with all the residents appropriately confirming that they are competent and skilled workers. Comments received from care staff during the inspection included: “This is a great home to work in.” “It is very different here to the places I have worked before, they focus on the outcomes of the residents a lot more.” Regular staff meetings are held. Minutes of which are kept. All staff are asked to contribute to the agenda. Staff said that these meetings are a useful source of sharing information and keeping up to date. Minutes seen concluded that much of the staff meetings are resident focused. The supervision of care staff is shared between the Registered and Deputy Manager. Supervision contracts are agreed and signed in advance and stored securely within the office. 50a Avis Road DS0000021014.V325939.R01.S.doc Version 5.2 Page 25 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 excellent. This judgement has been made using available evidence including a visit to this service. Both residents and staff benefit from an excellently managed and organised home. The views and rights of residents underpin the ethos and development in the home. Management and administration systems are good. EVIDENCE: The current Manager has been working for Southdown Housing Association for over 16 years. He holds a National Vocational Qualification (NVQ) level 4 for both the Management of Care and the Registered Mangers Award (RMA). A Deputy Manager supports him in his role. All staff supervision is shared equally between the two. Without exception, all of the staff spoken with, comments received from residents and the excellent outcomes for residents, 50a Avis Road DS0000021014.V325939.R01.S.doc Version 5.2 Page 26 which have been noted during this inspection, indicate that the home is managed well. A residents’ forum organised by Southdown Housing Association is regularly held. This enables residents to share their experiences of living within individual homes and offers them the opportunity to feedback to senior management about any concerns or complaints they may have. Minutes of these meetings are recorded and then fed back to staff during team meetings. The Manager has a quality assurance file in place, which has been produced by Southdown Housing Association. The modules contained within these are based on meeting the outcomes of the National Minimum Standards (NMS) in addition to ensuring that regular health and safety checks including the maintenance of the home’s vehicle are undertaken. Annual questionnaires are sent to relatives and visiting others in order to seek their feedback about areas they feel the home is doing well at and also to identify and particular areas where improvements could be made. These are then fed back to the staff team at an annual ‘quality monitoring day’ whereby the team get together to audit how well the home is performing and meeting residents’ needs. Some of the areas focused on include: staff team housekeeping, support and mobility for residents, meeting healthcare needs, person centred planning and health and safety matters. Evidence provided within the home’s returned pre-inspection questionnaire identified that all equipment is well-maintained and regularly serviced including: fire equipment and alarms, environmental health issues, wheelchair maintenance, electrical appliances and emergency lighting. It also stated that the organisations policies and procedures have all recently been reviewed and updated. All the records examined on the day of the site visit were accurate, legible, complete and stored appropriately. 50a Avis Road DS0000021014.V325939.R01.S.doc Version 5.2 Page 27 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 3 2 3 3 3 4 4 5 x 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 3 25 3 26 4 27 4 28 3 29 3 30 3 STAFFING Standard No Score 31 4 32 4 33 4 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 3 3 x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 4 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 4 3 4 3 3 3 x 50a Avis Road DS0000021014.V325939.R01.S.doc Version 5.2 Page 28 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. 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. Refer to Standard Good Practice Recommendations 50a Avis Road DS0000021014.V325939.R01.S.doc Version 5.2 Page 29 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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