Inspection on 06/07/05 for 57 Sackville Gardens

This inspection was carried out on 6th July 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 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 17/10/06

57 Sackville Gardens 08/12/05

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 Hove East Sussex BN3 4GJ Lead Inspector Merle Blakeley Unannounced 6 July 2005 10:00 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. 57 Sackville Gardens H59-H10 S14153 57 Sackville Gardens V236330 060705 Stage 4.doc Version 1.40 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 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 Geraldine OHaire Care Home 5 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia (MD), 5 of places 57 Sackville Gardens H59-H10 S14153 57 Sackville Gardens V236330 060705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The number of people accommodated must not exceed 5 2. The people accommodated will be aged 18 years or over on admission Date of last inspection 1 October 2004 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. 57 Sackville Gardens H59-H10 S14153 57 Sackville Gardens V236330 060705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Unannounced Inspection took place over a period of nearly five hours on 6th July 2005. The inspection process included informal talks with staff and the manager, tour of the premises and document reading. Only one resident was in the home and when spoken to he stated that he liked living in the home and felt well looked after. The other three residents were out of the home. What the service does well: What has improved since the last inspection? What they could do better: The home still needs to record resident’s wishes in regards to illness and dying. There is one resident who self medicates and the home will need to reassess this person to ensure that it is still in his best interests to be self-medicating; it was noted in his records that he had missed taking certain drugs on several occasions. The home also needs to provide safer storage of resident’s confidential files, as these were seen to be stored on open shelves in the office. The deputy manager did state that this room is locked when not in use, however it was agreed that they could be stored in a more secure facility. The accident/incident book in the home is recording information about people who live in the supported housing project, which is located next door as well as information about the residents who live at 57 Sackville Gardens. 57 Sackville Gardens H59-H10 S14153 57 Sackville Gardens V236330 060705 Stage 4.doc Version 1.40 Page 6 Information about the non-registered housing project must be kept totally separate from the records of 57 Sackville Gardens. The home has been experiencing damp problems and this is coming through the south wall of the property. Some remedial work has been carried out in the past but the problem still remains. Some resident’s rooms are affected as well as the bathroom and shower room and here the paint is peeling off the walls. 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 H59-H10 S14153 57 Sackville Gardens V236330 060705 Stage 4.doc Version 1.40 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 57 Sackville Gardens H59-H10 S14153 57 Sackville Gardens V236330 060705 Stage 4.doc Version 1.40 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) 2 & 4 The home carries out comprehensive resident assessments. Visits to the home prior to admission are encouraged. EVIDENCE: To determine as to whether the home can meet residents individual needs; a thorough assessment needs to be carried out. A prospective new resident will normally have undergone a CPA Assessment, which will form the basis of the care plan. The homes assessment form covers information about the resident, support needed, current mental health, independent living skills, communal living and medication. After the initial referral a resident would be invited to visit the home for a coffee so they can meet other residents and staff. They will also be given information about how the home is run and managed. Overnight stays are also offered. Residents are under no obligation to stay at the home and they are able to leave at any time. 57 Sackville Gardens H59-H10 S14153 57 Sackville Gardens V236330 060705 Stage 4.doc Version 1.40 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, 8 & 10 The home maintains informative and up to date care plans for residents. Residents are consulted about any changes that may occur within the home. Care plans need to be stored in a more secure facility. EVIDENCE: The service maintains up to date individual care plans, which are very informative. Each resident is allocated a project worker who will work with them on a one-to-one basis. Reviews are carried out regularly with the involvement of the resident. Residents are able to participate and be involved in all aspects of life within the home. Residents meetings are held once a fortnight and here they can meet to discuss any issues or concerns that may have arisen. At this meeting residents will also decide on meal choices, As these meetings are important to the smooth running of the home it is compulsory for residents to attend. All confidential information is kept in the office on the ground floor. Residents care plans are located in files on an open shelf in the office; the inspector discussed with the deputy manager that these files need to be maintained in a more secure facility. The office is locked when not in use by staff members. The home has a comprehensive policy regarding confidentiality and this is included in the Resident’s Guide handbook. 57 Sackville Gardens H59-H10 S14153 57 Sackville Gardens V236330 060705 Stage 4.doc Version 1.40 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) 12, 13, 15 & 17 Residents are provided with opportunities for personal development. Most of the residents are out and about in the community. Family links are encouraged and supported. Residents choose the meals they will eat. EVIDENCE: Several of the residents attend day centres, the gym, adult day classes and various other social activities. The service informs all residents of what is available in the local area and they will decide on the types of activities they would like to become involved with. Staff will support and encourage them to attend. Most of the residents are out and about in the community on a daily basis either attending their own centres, shopping for their meals, going to local cafes, pubs etc. Visitors are always welcome and residents are responsible for them whilst they are in the home. Most of the current residents are in contact with relatives and friends. One of the residents has most of his relatives living in another country and he is able to keep in contact by phoning them on a regular basis. The home maintains good links with family members. Some of the residents have very full social lives. Residents are responsible for choosing their meals and at the fortnightly meeting they will get together and decide on a menu. 57 Sackville Gardens H59-H10 S14153 57 Sackville Gardens V236330 060705 Stage 4.doc Version 1.40 Page 11 Each resident takes a turn in cooking an evening meal for the rest of the home once a week and on Sundays residents will also take it in turn to cook a roast dinner for everyone. The kitchen is available at all times for residents to prepare lunches and snacks when they want it. Staff also like to cook some of the lunches and they encourage residents to become more confident in the kitchen. Residents also take it in turns to lay the table and do the washing up. MIND has come into the home to give residents an informative talk called ‘Food n’ Mood’, which discusses how certain types of food can effect a persons well-being. 57 Sackville Gardens H59-H10 S14153 57 Sackville Gardens V236330 060705 Stage 4.doc Version 1.40 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) 19, 20, 21 Resident’s healthcare needs are met. One resident self medicates and a new risk assessment needs to be carried out. The home needs to record the wishes of residents regarding illness and death. EVIDENCE: Resident’s care plans show that they have good access to a large array of healthcare professionals, which include their own choice of GP, Psychiatrists, Social Workers, Community Support Workers, Chiropodist, CPN’s and Occupational Therapists. Advocates are also in use for some residents. Only one of the residents self medicates and his records were viewed. There were some concerns highlighted for this person as his records show that he has missed taking his medication on several occasions. The home needs to undertake a reassessment of this resident to ascertain as to whether he is still able to safely self medicate. All the other resident’s medication records appeared to be in order. The home still needs to obtain the wishes of residents regarding illness and death and these wishes should be recorded in their care plans. The home recently suffered a bereavement when a long-term resident died of natural causes unexpectedly. On the day of the inspection a small and private gathering was being held at the home to celebrate this persons life. 57 Sackville Gardens H59-H10 S14153 57 Sackville Gardens V236330 060705 Stage 4.doc Version 1.40 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 The home has a complaints policy and procedure. EVIDENCE: The home has recently updated its complaints policy and procedure. Residents are provided with clear information on how they can make a complaint and whom they need to contact. The information on how residents can contact the CSCI needs to be corrected. The home has not received any complaints. 57 Sackville Gardens H59-H10 S14153 57 Sackville Gardens V236330 060705 Stage 4.doc Version 1.40 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 The home provides a comfortable and friendly environment. Adequate toilet and washing facilities are provided. The home has several communal areas for residents. EVIDENCE: 57 Sackville Gardens provides a comfortable and homely environment for residents and it is furnished in a domestic style. The four single bedrooms with en suite facilities are located on the first floor with a self-contained flat on the top floor. On the ground floor the dining room, kitchen, bathroom, office, laundry room and lounge are all located. Another bathroom is located on the first floor. Communal areas of the home include the lounge, dining room, kitchen, quiet room and a small rear garden. 57 Sackville Gardens H59-H10 S14153 57 Sackville Gardens V236330 060705 Stage 4.doc Version 1.40 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) 32, 34, 35 & 36 The current staff team are suitably qualified and experienced to meet the needs of residents. The recruitment procedures for the home still need to include proof of identity and photos for all staff. A reasonably good level of staff training has been achieved and staff receive regular supervision. EVIDENCE: The vast majority of the staff team have either completed their NVQ training or have just commenced it. Out of a team of seven two staff have completed NVQ Level 3 and another three staff commenced Level 3 a few months ago. The Deputy Manager is due to commence the NVQ Level 4 qualification later this year. This is a great improvement as during the last inspection in October 2004 a requirement was made for the home to increase the level of training as only one staff member held an NVQ qualification. Staffing recruitment files have also improved with more information now readily available. CRB checks have been carried out and returned on all staff members. The home still needs to provide copies of each staff member’s proof of identity and a recent photo to be maintained in their files. A high level of core skills training had been completed during the last inspection and basically most staff are up to date in this area. This year the home has been concentrating on staff commencing their NVQ training. Staff said that they received regular supervision sessions, which up to now have been on a fortnightly basis; the manager stated that these sessions would now be on a monthly basis. 57 Sackville Gardens H59-H10 S14153 57 Sackville Gardens V236330 060705 Stage 4.doc Version 1.40 Page 16 The staff team work in a very professional and friendly manner and provide a very high level of care and support to residents. Four staff members were spoken to during the inspection and they all said that they enjoyed working in the home and felt that it was a very happy and friendly team to work in. 57 Sackville Gardens H59-H10 S14153 57 Sackville Gardens V236330 060705 Stage 4.doc Version 1.40 Page 17 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) 38, 40, 41 & 42 The home is run in a very open and inclusive manner. The home has all the required policies and procedures. All the required records are maintained. The home is experiencing continuing damp problems from the south-facing wall and this needs attending to. EVIDENCE: The home appears to be run in a very open and friendly manner. The inspector was only able to briefly speak to one resident during the day, as the other three residents were all out of the home. The service maintains a very good set of policies and procedures and residents have adopted their own ‘Bill of Rights’ for the home. This states how each resident has the right to be treated in a respectful and dignified manner and acknowledges their right to be treated as a unique individual. A number of records were checked and were found to be in order. The home must maintain totally separate records for 57 Sackville Gardens and not include incidents that have occurred in the supported housing project next door. 57 Sackville Gardens H59-H10 S14153 57 Sackville Gardens V236330 060705 Stage 4.doc Version 1.40 Page 18 Overall the home is well maintained, however there is a continuing damp problem occurring on the entire south facing wall of the property. This dampness is evident in some of the bedrooms and is causing paint to peel off in the bathrooms. 57 Sackville Gardens H59-H10 S14153 57 Sackville Gardens V236330 060705 Stage 4.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x 3 x 2 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x 3 3 x x Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x 3 Standard No 31 32 33 34 35 36 Score x 3 x 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 57 Sackville Gardens Score x 3 2 2 Standard No 37 38 39 40 41 42 43 Score x 3 x 3 2 x x H59-H10 S14153 57 Sackville Gardens V236330 060705 Stage 4.doc Version 1.40 Page 20 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. 2. 3. 4. 5. Standard YA21 YA10 YA20 YA34 YA42 Regulation Schedule 3 17(1)(b) 13(2) Schedule 2 13(4)(a) Requirement That service users wishes are documented regarding illness and death. Previous Requirement That service users confidential files are stored in a more secure facility. That an assessment is carried out on the service user who self medicates. That staffing files contain proof of indentity and photos for all current staff. That the home addresses the damp problem, which is occurring in the south wall of the property. Timescale for action 30/9/05 31/8/05 Immediate Immediate 31/11/05 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. Refer to Standard Good Practice Recommendations 57 Sackville Gardens H59-H10 S14153 57 Sackville Gardens V236330 060705 Stage 4.doc Version 1.40 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 57 Sackville Gardens H59-H10 S14153 57 Sackville Gardens V236330 060705 Stage 4.doc Version 1.40 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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