Inspection on 17/10/06 for 57 Sackville Gardens

This inspection was carried out on 17th October 2006.

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 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

57 Sackville Gardens 18/09/08

57 Sackville Gardens 08/12/05

57 Sackville Gardens 06/07/05

57 Sackville Gardens 01/10/04

57 Sackville Gardens 17/05/04

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

CARE HOME ADULTS 18-65 57 Sackville Gardens 57 Sackville Gardens Hove East Sussex BN3 4GJ Lead Inspector Merle Blakeley Unannounced Inspection 17th October 2006 10:00 57 Sackville Gardens DS0000014153.V306867.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 57 Sackville Gardens DS0000014153.V306867.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. 57 Sackville Gardens DS0000014153.V306867.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 57 Sackville Gardens Address 57 Sackville Gardens Hove East Sussex BN3 4GJ 01273 748031 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) Brighton Housing Trust Romanie Palmer Care Home 5 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (5) of places 57 Sackville Gardens DS0000014153.V306867.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is five (5). Service users must be aged 18 years or over on admission. Date of last inspection 8th December 2005 Brief Description of the Service: 57 Sackville Gardens is a small home, which provides care and accommodation for up to five adults aged between 18 years to 65 years with mental health disorders. The home is run by Brighton Housing Trust who also run another small home for people with mental health disorders at 9 Portland Road, Hove and additional supported housing projects in Westbourne Gardens, Leybourne Road, Buckingham Road and Sackville Gardens. The aim of the home is to provide care and support to residents by enabling them to improve their living skills, promote independence, manage their mental health issues and eventually move onto other supported living arrangements. The home is a semi-detached property located in a residential area of Hove, which is within easy reach of local transport, seafront, shops and other amenities. Accommodation is arranged over three floors and consists of four single bedrooms and one self-contained flat. Communal areas include a lounge, dining room, quiet room, kitchen and a small rear garden. The home would not be suitable for residents who have mobility problems, as there are quite a lot of stairs and the service does not have the use of a lift. The current fees are £271.00 per week. 57 Sackville Gardens DS0000014153.V306867.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection was carried out over a period of eight hours on 17th October 2006. As well as this site visit information was also gained from a returned pre-inspection questionnaire, four resident feedback survey forms, informal talks with four residents, three staff and the manager. The site visit consisted of a tour of the premises, looking at the needs of four residents, document reading and observing staff interactions with residents. There are currently four residents living at 57 Sackville Gardens. What the service does well: What has improved since the last inspection? During the last inspection the home received four requirements, which have all been attended to. More frequent reviews are being carried out on residents who self medicate. Fire drills are now being carried out more frequently and the home has a dedicated fire warden. A bath panel has been repaired and the home has installed hot water mixer valves to ensure that the correct hot water temperatures are being delivered. New flooring has also been replaced in the bathroom. 57 Sackville Gardens DS0000014153.V306867.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 57 Sackville Gardens DS0000014153.V306867.R01.S.doc Version 5.2 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 57 Sackville Gardens DS0000014153.V306867.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All prospective residents are assessed before they move into the home. EVIDENCE: Before a resident moves into the home the mental health accommodation team carries out a thorough assessment. The home will receive this information and will then carry out their own assessment to ensure the service can meet the person’s needs. Only residents who have a low risk assessment level can be admitted into the home. Assessment records were viewed for two current residents. 57 Sackville Gardens DS0000014153.V306867.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home maintains informative and up to date care plans for each resident. Residents have produced their own Bill of Rights. Residents are supported and encouraged to take responsible risks. EVIDENCE: All four care plans were viewed and they were found to be very informative and up to date. The last reviews had been carried out in July 2006. Residents are involved with their care plans and reviews and they are able to contribute to them along with their key worker. One resident has shown good progress and he is now ready to move on to more independent living. Residents have produced their own Bill of Rights, which outlines how they wish to be treated, their right to confidentiality and their right to be part of the decision making process. Staff are there to support residents in making important life decisions. Three residents were asked if they could make their own decisions and all responded that they could. 57 Sackville Gardens DS0000014153.V306867.R01.S.doc Version 5.2 Page 10 The ethos of the home is to allow residents to take responsible risks within a risk-assessed framework. Residents and their primary workers discuss responsible risk taking in the areas of health & safety, alcohol, hygiene, diet and being out in the community. 57 Sackville Gardens DS0000014153.V306867.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents take part in their favoured activities. Residents are out and about in the community. Residents are encouraged to maintain family links and friendships. Resident’s rights are respected. Residents are actively involved with the meals they eat. EVIDENCE: Residents are encouraged and supported to pursue activities outside of the home. One resident attends college and the others attend a local day centre. The home has organised a number of outings this summer and residents were asked to choose where they would like to go. Residents were asked about these day trips and all responded very positively about how much they had enjoyed them. Going out on excursions is quite a big step for some residents as there is a lot of anxiety about actually leaving the home. Other activities offered to residents include meals out, visits to the local pubs and cinema. Each resident was seen to have their own weekly plan of activities and appointments. Maintaining family links is important and residents are encouraged to visit relatives or keep in touch via the phone. Two residents have visits from family 57 Sackville Gardens DS0000014153.V306867.R01.S.doc Version 5.2 Page 12 members. The other two residents keep in contact by phone, as their relatives do not reside in the UK. As mentioned previously residents have produced their own bill of rights, which states how they wish to be treated. Residents were asked as to whether they felt that their rights were respected and all responded that they felt they were. Residents are encouraged and supported to now prepare their own meals in the home. The kitchen is open to residents at all times and they are free to prepare snacks and drinks whenever they like. The weekly menu is decided and discussed during the weekly house meeting. Each resident takes a turn in cooking an evening meal for the rest of the home. This enables residents to be more independent and responsible for their own diets. Staff are there for support and guidance. Overall it appeared that residents were receiving a reasonably well-balanced diet. 57 Sackville Gardens DS0000014153.V306867.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All residents are self-caring. Resident’s healthcare needs are being met. Three residents self-medicate and risk assessments have been carried out. EVIDENCE: All four residents are independent and manage their own personal care and staff are on hand to provide occasional support and prompting. The healthcare needs of residents were viewed and records indicated that they have all undergone regular healthcare check-ups. Residents also have access to their CPN’s social workers, psychiatrists, dentists, opticians and own GP’s. Residents are supported to attend healthcare appointments and staff will accompany them if requested. Three residents administer their own medication and risk assessments have been carried out to ensure that these residents are fully able to manage. Reviews of these assessments are now being carried out on a more regular basis. This was not being carried out before. Medication for these residents is very important as it has a direct impact on their mental health and wellbeing. The home has recently received a talk on medication from their local pharmacist and a medication audit was also a carried out at the same time. 57 Sackville Gardens DS0000014153.V306867.R01.S.doc Version 5.2 Page 14 The pharmacist also gave staff information on how to pre-pack medication boxes for residents. 57 Sackville Gardens DS0000014153.V306867.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a complaints policy and an adult protection policy and procedure. EVIDENCE: The home has produced a complaints policy and procedure, which is accessible to residents and displayed on the notice board in the home. A resident had made one complaint and records showed that it had been resolved satisfactorily and that the resident was happy with the outcome. The home has produced a policy and procedure for adult protection, which follows the East Sussex Multi-Agency guidelines. Staff have attended training in adult protection and some of the staff are due to update their training soon. There are no current adult protection issues within the home. Staff are aware of their responsibilities as regards to the reporting of any adult protection concerns or disclosures. 57 Sackville Gardens DS0000014153.V306867.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The kitchen requires refurbishments to be carried out. The home is clean and tidy. EVIDENCE: Since the last inspection in December 2005 several areas of the home have been redecorated. Bathrooms, the dining room and the laundry have been redecorated, as has the exterior of the home. The long-standing damp problem in the south wall of the house appears to have now been resolved. The only area in the home, which now needs attention is the kitchen. During this visit the kitchen was visited and work surfaces, cupboard drawers and the cooker were found to be in a poor state. Many of the work surfaces were damaged and this creates a health & safety risk to both residents and staff who use this area frequently, particularly the residents who prepare their snacks and main meals on these surfaces. Residents were asked about what they thought of the kitchen and three said that it could be better and that it looked ‘worn out’ and ‘old’. They also stated that the cooker was not very good as the fuses kept blowing. Overall the home was found to be clean and tidy. 57 Sackville Gardens DS0000014153.V306867.R01.S.doc Version 5.2 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): 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home employs a stable and experienced staff team. Staff recruitment files need to contain the correct CRB checks. Staff receive a good level of training to support them in their roles. EVIDENCE: The home continues to retain a very effective and experienced staff team. The team work between 57 Sackville Gardens and several other Brighton Housing Trust schemes. All four residents were asked about their feelings on the staff and the level of support they receive. All four residents spoke very positively about the staff and stated that they liked them and got on well with them. They also said that they felt well supported by the manager and the team. The deputy manager is currently studying for the National Vocational Qualification (NVQ) Level 4 and three other staff are studying for NVQ Level 3. Two have already completed their NVQ Level 3 training. Handover is carried out at each shift change and staff meetings are held weekly. From observing staff throughout the day and talking with them it was apparent that the team work very well together and provide residents with a very friendly and supportive environment. Several staff recruitment files were viewed and they indicated that not all staff have CRB checks from Brighton Housing Trust. CRB checks are not transferable 57 Sackville Gardens DS0000014153.V306867.R01.S.doc Version 5.2 Page 18 between care services and the home must ensure that all CRB checks are up to date. All other information contained in the recruitment files was satisfactory. Brighton Housing Trust are providing staff with a good level of training and the annual training manual was viewed. Staff are able to attend a variety of training courses, which cover equal opportunities, managing difficult behaviour, risk assessments, needs assessment, mental health awareness plus many more. Basic core skills training for staff such as first aid, manual handling, fire safety, POVA and health & safety are also offered. Some staff have also attended food hygiene training. 57 Sackville Gardens DS0000014153.V306867.R01.S.doc Version 5.2 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, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered manager runs the home in a caring and effective manner. The home has a quality assurance system. The home tries to ensure that the health & safety of residents and staff is maintained. EVIDENCE: Since the last inspection the deputy manager has undergone the process of becoming the registered manager and this was successfully completed this year. The manager has worked at 57 Sackville Gardens for seven years and has a total of seventeen years experience of working in social care. She is currently studying for the NVQ Level 4 and Registered Managers Award (RMA). Both residents and staff were asked if they felt the home was being well managed and all stated that they felt it was. They also stated that the manager was very approachable and understanding and provided good support. 57 Sackville Gardens DS0000014153.V306867.R01.S.doc Version 5.2 Page 20 The home has an effective quality assurance system and resident’s views are always sought. Resident meetings are held regularly and feedback surveys are carried out. Brighton Housing Trust also carries out other internal audits. A health and safety check of the home was carried out. Since the last inspection the home has installed new hot water blending valves, as previously hot water temperatures throughout the home had been excessive in certain outlets. These valves should now control the hot water temperatures. Fire drills were also required to be performed more regularly and this is now being carried out. The home now has a dedicated fire warden. Regular checks are carried out on the emergency lighting and fire alarms. There were no other health& safety issues identified. 57 Sackville Gardens DS0000014153.V306867.R01.S.doc Version 5.2 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 Standard No Score 1 X 2 3 3 X 4 X 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X 57 Sackville Gardens DS0000014153.V306867.R01.S.doc Version 5.2 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 YA24 Regulation 13(4)(a) Requirement That refurbishment work is carried out in the kitchen to replace damaged and worn work surfaces and to repair/replace broken cupboards and drawers. To ensure that service users have access to a cooker that works efficiently. To ensure that all staff have the correct CRB checks issued under Brighton Housing Trust. Timescale for action 17/04/07 2. 3. YA24 YA34 16(2)(h) Schedule 2 17/02/07 17/01/07 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 57 Sackville Gardens DS0000014153.V306867.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 57 Sackville Gardens DS0000014153.V306867.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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