Inspection on 11/05/05 for 56 St Saviours Road

This inspection was carried out on 11th May 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

56 St Saviours Road 20/10/09

56 St Saviours Road 06/12/06

56 St Saviours Road 09/11/05

56 St Saviours Road 12/10/04

56 St Saviours Road 10/05/04

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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 56 St Saviours Road St Leonards On Sea East Sussex TN38 0AR Lead Inspector Caroline Johnson Unannounced 11 May 2005 14:30 & 25 May 16:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 56 St Saviours Road H59-H10 S21338 56 St Saviours Road V220024 110505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service 56 St Saviours Road Address 56 St Saviours Road St Leonards On Sea East Sussex TN38 0AR 01424 443657 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Sussex Autistic Community Trust (Care Services) Limited Vacant Care Home 3 Category(ies) of Learning Disability (LD) 3 registration, with number of places 56 St Saviours Road H59-H10 S21338 56 St Saviours Road V220024 110505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. That only service users with an autistic spectrum disorder may be admitted. 2. The maximum number of service users to be accommodated must not exceed 3 (three). 3. The people accommodated will be between the ages of 18 (eighteen) and 65 (sixty-five) years of age on admission. Date of last inspection 12 October 2004 Brief Description of the Service: 56 St Saviours Road is a semi detached property situated in a residential area of St Leonard’s on Sea; the town centre with its shops and railway station is approximately one mile away.Resident accommodation is on two floors with a lounge and dining room on the ground floor and bedroom accommodation situated on the first floor. The home is registered to accommodate three adults with a learning disability who have an autistic spectrum disorder. The home is one of four homes in East Sussex that are run by The Sussex Autistic Community Trust (care services) Ltd. 56 St Saviours Road H59-H10 S21338 56 St Saviours Road V220024 110505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the first in the year running from April 1 2005 to March 31 2006. The inspection started on 11 May from 2.30pm to 5.00pm and was continued on 25 May from 4.00pm to 6.45pm. The second visit was considered necessary as on the first day there was carpet being laid on the stairs and it was not possible to meet the residents or to see the communal areas of the home. Time was spent going through various records and documentation. All communal areas were seen along with one of the bedrooms. One member of relief staff was interviewed and there was also an opportunity to speak with another member of relief staff briefly. There was an opportunity to meet with one of the residents for approximately 10-15 minutes in the lounge. A second resident chose not to meet with the inspector. At the time of inspection the acting manager had only been appointed to the position the previous week. She has however worked in the home for a number of years. She has yet to apply for registration as manager. What the service does well: What has improved since the last inspection? What they could do better: At the time of inspection there were no permanent care staff apart from the acting manager. The home employs a small number of relief staff (staff 56 St Saviours Road H59-H10 S21338 56 St Saviours Road V220024 110505 Stage 4.doc Version 1.20 Page 6 employed by the Trust on a casual basis) to work in the home. This is working well in the short term due to the acting manager’s organisation skills. However, it is essential that permanent care staff be recruited as soon as possible. It is also essential that relief staff have the same training opportunities that permanent care staff would have. There is a bolt lock on the bathroom door and this should be replaced with a more suitable lock. The shower needs to be repaired and the hot water in the bathroom should be delivered at a safe temperature. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 56 St Saviours Road H59-H10 S21338 56 St Saviours Road V220024 110505 Stage 4.doc Version 1.20 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection 56 St Saviours Road H59-H10 S21338 56 St Saviours Road V220024 110505 Stage 4.doc Version 1.20 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3,5 The home ensures that as far as it is possible to the residents understand the placement agreement document. EVIDENCE: There is a detailed statement of purpose in place. This will need to be amended to reflect the new management arrangements for the home. There is a placement agreement document, which has been produced in pictorial format. The acting manager advised that staff have read through the document with residents to ensure that they understood the contents. The three men accommodated at St Saviours have lived together for a number of years therefore the home has not needed to use their admission procedure for some time. Through reading care plans and discussions with staff and with one of the residents it was evident that the needs of the residents are being met in the home. 56 St Saviours Road H59-H10 S21338 56 St Saviours Road V220024 110505 Stage 4.doc Version 1.20 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,9 The quality of care planning is very good. The only area that could be improved upon is keeping a more detailed daily record of the action taken on a daily basis to meet each of the resident’s individual goals. EVIDENCE: Two of the care plans were examined in detail. Care plans include a detailed assessment of the needs and abilities of each resident and an autistic spectrum assessment. In addition there were risk assessments, primary care guidelines, behavioural guidelines, development and training plans. On the notice board in the office there is a list of the all the key information that a member of staff would need to be aware of to plan a shift and know each of the residents’ individual needs. This information is very detailed and a relief staff member spoken with stated that this information is invaluable as it ensures that everyone is consistent in their approach and residents receive clear communication. Daily records are kept in respect of each resident. The format refers to goal plans but it is a tick system. Records do not show details of the progress made in respect of the individual goals so it is not easy to see how progress is measured or evaluated. 56 St Saviours Road H59-H10 S21338 56 St Saviours Road V220024 110505 Stage 4.doc Version 1.20 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15,17 Residents are supported to lead very active and interesting lives. Independence is encouraged, all risks are carefully considered and measures are put in place to minimise the risk of accidents/incidents. EVIDENCE: One of the residents works two and a half days a week. He attends college two days a week and has a half-day at home. In addition to his busy schedule he has a number of hobbies including, ten-pin bowling, cinema, clubs, theatre and board games. He also invites his girlfriend to tea occasionally. The other residents also attend day centres through the week. One of the residents has recently started attending college for two hours one day a week and it is hoped that if he enjoys this he will be able to increase his hours. Residents have the opportunity to have an annual holiday. Records of meals served indicate that residents receive varied and well balanced diets. The acting manager advised that they are making arrangements for the relatives of one of the residents to visit and provide advice and guidance on how to prepare Indian food. Staff advised that whilst weekdays are very structured, weekends are less so. Residents tend to opt for lunch out on Saturdays and enjoy a brunch on Sundays. Residents are supported to maintain regular 56 St Saviours Road H59-H10 S21338 56 St Saviours Road V220024 110505 Stage 4.doc Version 1.20 Page 11 contact with their families and friends. One of the residents stated that he likes living at St Saviours. He enjoys opportunities to draw and paint and to display his work in his bedroom. He also stated that he likes having his family to visit him regularly. 56 St Saviours Road H59-H10 S21338 56 St Saviours Road V220024 110505 Stage 4.doc Version 1.20 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 The manager is good at communicating clearly with staff so that they know what is expected of them to ensure that each resident’s physical and emotional needs continue to be met. EVIDENCE: Residents are supported to attend a wide range of health care appointments to meet their individual needs. Records show that when residents require specialist support then arrangements are made for this to happen. The importance of consistency in approach is impressed upon staff to ensure that residents have security in knowing what is going to happen next. Care plans provide the detailed advice that staff need to ensure that this happens. 56 St Saviours Road H59-H10 S21338 56 St Saviours Road V220024 110505 Stage 4.doc Version 1.20 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 There are clear procedures in place to ensure that anyone wishing to make a complaint can do so. EVIDENCE: There is a detailed complaint procedure in place. The last complaint recorded was in 2003. There is a procedure in place on adult protection and prevention of abuse. In addition there is a flowchart on the notice board advising of the steps to be taken should abuse be suspected. 56 St Saviours Road H59-H10 S21338 56 St Saviours Road V220024 110505 Stage 4.doc Version 1.20 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,27,28,30 St Saviours is homely and the furniture provided is comfortable and attractive. It is essential that the problem with the temperature of the hot water accessible to residents be addressed. It is also essential that the bolt lock on the bathroom door be replace with a more suitable lock. EVIDENCE: Communal areas consist of a lounge, a kitchen/diner and a separate dining room. There is an attractive garden to the rear of the property. During the first day of inspection new carpet was being fitted on the stairs. Only one of the bedrooms was seen on this occasion. The room was well decorated and had been personalised to reflect the personality of the resident. There is a bolt lock on the bathroom door and it was recommended that this be removed and replaced with a more suitable type lock. The shower in the bathroom does not work properly. There is a new format for recording the testing of emergency lights and this will also be implemented in the near future. Staff receive training in fire safety. 56 St Saviours Road H59-H10 S21338 56 St Saviours Road V220024 110505 Stage 4.doc Version 1.20 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,35,36 Although there are no permanent care staff employed to work in the home apart from the manager, there are a small core of relief staff that work in the home regularly and this works well. This is considered satisfactory as a temporary measure only and it is essential that the home continue to recruit for permanent staff. It is also essential that relief staff have access to the same training opportunities as permanent care staff. EVIDENCE: At the time of inspection, apart from the acting manager there were no staff employed to work in the home. The vacant positions had been advertised and interviews were due to be held. In the interim there were three relief staff that work mainly in St Saviours. The manager provides regular supervision sessions for the relief staff. The arrangements for ensuring that relief staff receive training are unclear. The acting manager was clear that one member of relief staff had recently received training on autism focus, POVA and the role of the keyworker. Another member of relief staff who predominantly works in another care home run by the Trust advised that she has not received any training. The acting manager advised that this issue has been discussed at a recent management meeting and arrangements will be made to ensure that relief staff have the same opportunities to receive staff training as permanent staff. Staff recruitment records are held in the main office. 56 St Saviours Road H59-H10 S21338 56 St Saviours Road V220024 110505 Stage 4.doc Version 1.20 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,40,42,43 The acting manager is methodical in her approach and provides clear and detailed advice for the staff. The result is a home that is run well. She provides good support to her staff and they find her advice helpful and know that they can call on her for advice and guidance when needed. Action needs to be taken to ensure that hot water accessible to residents is delivered at a safe temperature. EVIDENCE: The acting manager has worked in the home for a number of years but had only been appointed to the role of manager the previous week. She has yet to apply for the role of registered manager. On the first day of inspection she was not clear about the need for registration and was also not clear about the extent of the responsibilities of the job. She was due to meet with her line manager the following day to discuss these issues. The need for increased supervision sessions was discussed. By the second inspection date the acting manager was very clear about the extent of her role and responsibilities. In addition she confirmed that her line manager had agreed to increase the frequency of supervision sessions. 56 St Saviours Road H59-H10 S21338 56 St Saviours Road V220024 110505 Stage 4.doc Version 1.20 Page 17 There was an opportunity to observe the weekly staff team meeting. There were good discussions held on a variety of topics. Staff were encouraged to share their views and conclusions were reached following discussions. The acting manager praised the staff team on a number of occasions for the quality of their work. Staff spoken with during the inspection also praised the acting manager for her support and stated that `she is very approachable’. One relief member of staff stated that if she has not worked in the home for a number of weeks the acting manager gives her a very detailed handover prior to her first shift. The temperature of hot water in the bath was tested and the recording was below that of the recommended safety standard. Records showed that when the water was tested previously in October 2004 the temperature was well in excess of the recommended safety limit. A new format has been produced for recording the temperature of hot water accessible to residents. The acting manager advised that this would be implemented in the near future. The date on the business insurance certificate on display in the home had expired. The acting manager was confident that this would have been renewed and agreed to chase up the new certificate. Some of the home’s policies and procedures have not been reviewed since 2002. There is also a need to introduce further policies and procedures and the home was referred to the Standards to identify those needed. Records seen in respect of accidents were sufficiently detailed. Between the first and second inspection date there was one incident recorded. Records showed that the incident was managed and recorded well. A risk assessment was drawn up to ensure that staff would be prepared should there be a similar incident. The member of staff on duty at the time of the incident stated that the manager talked through the incident fully with her and was very supportive. It was recommended that staff carry a mobile phone with them when out to ensure that they can contact others in an emergency situation. This is particularly important for St Saviours, as generally there is only one member of staff on duty. SCORING OF OUTCOMES 56 St Saviours Road H59-H10 S21338 56 St Saviours Road V220024 110505 Stage 4.doc Version 1.20 Page 18 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 x 3 x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x 2 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 x 3 Standard No 31 32 33 34 35 36 Score 3 3 2 x 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 3 x 2 x 2 2 56 St Saviours Road H59-H10 S21338 56 St Saviours Road V220024 110505 Stage 4.doc Version 1.20 Page 19 YES 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 24 Regulation 23(4)(c) Requirement Timescale for action 30 June 2005 3 August 2005 2. 27 3. 4. 5. 6. 7. 8. 27 33 35 37 42 43 Emergency lights must be tested on a monthly basis.(This was a requirment of the previous inspection. Timescale 12/10/04) 13(4)(a)(c The bolt lock on the bathroom ) door must be removed and replaced with a lock that conforms to National Minimum Standards. 23(2)(j) The shower in the bathroom must be repaired. 18(1)(a) 18(2)(c)(i ) (8)(1) 13(4)(c) 25(2)(e) Care staff must be employed to work in the home. Relief staff must receive similar training opportunities as permanent staff. The acting manager must apply for registration as manager of the home. Records must show that hot water accessible to residents is delivered at a safe temperature. The registered provider must ensure that there is a current business insurance certificate in the home. 30 September 2005 30 August 2005 15 July 2005 15 July 2005 30 August 2005 15 July 2005 56 St Saviours Road H59-H10 S21338 56 St Saviours Road V220024 110505 Stage 4.doc Version 1.20 Page 20 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 6 40 Good Practice Recommendations Goals identified in care plans should be measureable and achieveable. Daily records should be used to monitor progress made in achieving the goals. The home should refer to the NMS to identify any policies and procedure that still need to be produced. A number of the policies and procedures already in place should be reviewed. Care staff should have a work mobile phone to take with them when they are out with residents so that they can seek help in the event of an emergency. 3. 42 56 St Saviours Road H59-H10 S21338 56 St Saviours Road V220024 110505 Stage 4.doc Version 1.20 Page 21 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 56 St Saviours Road H59-H10 S21338 56 St Saviours Road V220024 110505 Stage 4.doc Version 1.20 Page 22 - 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. 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