Inspection on 11/10/05 for 63 Collier Road

This inspection was carried out on 11th October 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 no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

63 Collier Road 22/03/07

63 Collier Road 02/02/06

63 Collier Road 23/02/05

63 Collier Road 05/08/04

63 Collier Road 21/01/04

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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 63 Collier Road Hastings East Sussex TN34 3JF Lead Inspector Caroline Johnson Announced Inspection 11th October 2005 09:30 63 Collier Road DS0000021434.V250581.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 63 Collier Road DS0000021434.V250581.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 63 Collier Road DS0000021434.V250581.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 63 Collier Road Address Hastings East Sussex TN34 3JF 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) Ex Directory Mr Dominic Paul Kennard Mrs Francesca Sarah Kennard Michael Norman Douglas Young Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 63 Collier Road DS0000021434.V250581.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is three (3) Only service users with an autistic spectrum disorder can be accommodated Service users should be aged between 18 (eighteen) and 40 (forty) years on admission 23rd February 2005 Date of last inspection Brief Description of the Service: 63 Collier Road is registered to provide long term specialist care for three adults with autistic spectrum disorders. The property is situated in a popular area of Hastings and the town centre is within easy walking distance. There is also a bus route close to the home. The proprietors also own another two other homes in the area, both registered to accommodate adults with autistic spectrum disorders. 63 Collier Road DS0000021434.V250581.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, the first in the year running from April 1 2005 to March 31 2006. The inspection lasted from 9.30am until 2.20pm. During the inspection there was an opportunity to share lunch with the residents, the manager and one member of care staff. A second member of care staff was interviewed in private. A number of records were examined, including one care plan, records held in relation to menus, fire safety, medication, staff training, duty rotas and complaints. The majority of the building was seen on this inspection. What the service does well: What has improved since the last inspection? What they could do better: The task of introducing a service user guide must be completed. This is a requirement that has been outstanding from the two previous inspections. Other requirements made included; the need to review the home’s fire risk assessment in relation to the fitting of fire doors on the first floor and the need to improve record keeping in relation to fire drills. In addition the manager 63 Collier Road DS0000021434.V250581.R01.S.doc Version 5.0 Page 6 needs to make arrangements for care staff to commence training for an NVQ at level two or above. Three good practice recommendations made at the last inspection are also repeated this time. They include: updating the terms and conditions of residence, expanding upon the administration of medications policy and completing the assessments of residents’ wishes in relation to dying and death. Two further recommendations were made, one to write to the relatives of residents confirming the home’s complaints process and advising them about how to gain access to inspection reports. The second recommendation relates to the monthly report carried out on behalf of the proprietors. It was recommended that the format used be amended to allow space to record the views of residents and staff rather than just asking set questions each month. 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. 63 Collier Road DS0000021434.V250581.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 63 Collier Road DS0000021434.V250581.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,5 The manager needs to ensure that the task of introducing a service user guide is completed. A minor amendment needs to be made to the terms and conditions of residence. EVIDENCE: At the last inspection a requirement was made to produce a service user guide and to send a copy to the Commission. The manager advised that the guide is almost complete and a copy will then be forwarded to the Commission. There were no vacancies in the home. The terms and conditions of residence document needs to be updated to reflect that the home is registered with CSCI rather than East Sussex County Council. 63 Collier Road DS0000021434.V250581.R01.S.doc Version 5.0 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): 6,8,9,10 The quality of care planning remains good. Staff have detailed information to enable them to support the residents in their care. The weekly meetings are a good opportunity to ensure that all residents are kept up to date with house issues and to ensure that everyone is given a choice about how they wish to spend their weekends. It also ensures that there is time to make arrangements (such as arranging extra staffing) to accommodate the decisions made by the residents. EVIDENCE: One care plan was examined and it was found to contain up to date information for staff to follow to ensure that the resident’s needs could be met. Where there is a perceived risk a written risk assessment is carried out and reviewed at regular intervals. Weekly house meetings are held and during this process residents make choices and decisions about their menus, activities and about their home. The home’s policy on confidentiality has been reviewed as was recommended at the last inspection and staff have signed to indicate that they have read and understood the document. 63 Collier Road DS0000021434.V250581.R01.S.doc Version 5.0 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 the following standard(s): 11,14,15,17 Over the past two years residents’ timetables of activities have gradually increased. Each resident’s activity plan is individual to them and is based on their needs and wishes. Activities provided are varied and interesting and there is a good balance between work, learning and social activities. The menus are varied and balanced and residents participate in planning and shopping for their food. EVIDENCE: Each of the residents has a timetable of the activities that they participate in. Two of the men work on a voluntary basis for a few hours one morning each week. They both stated that they enjoy these mornings and find the work interesting. Timetables are busy including a good mixture of activities such as gym, guitar lessons, dog walking, piano lessons, swimming, aromatherapy, QiGong and creative writing. Residents enjoyed a recent day trip to a water park. The annual holiday this year was to Prague. The men chose the destination and planned the activities that they wanted to take part in whilst there. They all stated that they 63 Collier Road DS0000021434.V250581.R01.S.doc Version 5.0 Page 11 thoroughly enjoyed this trip. Residents are in regular contact with their families and where support is required to maintain this contact this is provided. There is a four-week rotating menu in place, which is varied and well balanced. In addition to the set meals there is extra fruit available for residents should they wish to have snacks through the day. There was an opportunity to share lunch with the residents during the inspection. The food provided was well presented, nutritious and appetising. The residents stated that they enjoy the food served. They assist in menu planning and shopping and take it in turn to assist in cooking the meals. The mealtime was unrushed and was a very social event. 63 Collier Road DS0000021434.V250581.R01.S.doc Version 5.0 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 the following standard(s): 20, 21 There are good arrangements in place in respect of the medication in use in the home. The policy in place is fairly detailed but further advice could be included detailing more explicitly the steps to be taken by staff when administering medication. This would be particularly useful as care staff often work on their own. The manager needs to compete the process of assessing the wishes of residents in relation to dying and death. It is acknowledged that the process of assessing wishes in this area can take some time. EVIDENCE: The arrangements in place for the storage and handling of medication were examined and were in order. A good practice recommendation was made at the last inspection of the home to provide more explicit advice for staff on the procedure to be followed when administering medication. This had not been achieved. However, this was discussed in more detail to ensure that the manager was clear about the action to be taken to meet this recommendation. As part of the process of assessing residents’ wishes and views in relation to dying and death a questionnaire was sent to relatives of residents to seek their views on the subject. The outcome of the questionnaires and the assessment process has yet to be concluded. 63 Collier Road DS0000021434.V250581.R01.S.doc Version 5.0 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 the following standard(s): 22,23 The complaint procedure is detailed and residents are encouraged to say if they are unhappy with any aspect of the care provided to them. The procedures for recording complaints and the action taken have improved. Residents generally manage their own monies and if the home has any involvement in finances they keep a record of the level of support given. EVIDENCE: The requirement made at the last inspection in relation to the recording of complaints was met. Since the last inspection there were three complaints recorded. Two of the complaints were in relation to the home and both were founded. Appropriate action was taken by the home and the complainants were satisfied with the outcome. The third complaint was a complaint made by one of the residents about the service user comment cards issued by the Commission. The complaint had not been sent to the Commission but a letter written on behalf of the resident was given to the Inspector on the day of the inspection. The inspector met with the resident concerned and agreed how his views about the service he receives would be obtained in the future. He advised that he was satisfied with the outcome of the discussion. There are different arrangements in place in respect of the management of residents’ finances. In relation to one resident, their relative acts as appointee. The other two residents are assessed as able to manage their own monies. Staff assist with budgeting on a weekly basis but the residents deal with all transactions. Bank statements are stored in the office at the request of the residents and the manager goes through these with the residents to assist in helping with budgeting and managing their accounts. 63 Collier Road DS0000021434.V250581.R01.S.doc Version 5.0 Page 14 There is a detailed procedure in place on adult protection and prevention of abuse. All of the staff team have attended training on the subject. 63 Collier Road DS0000021434.V250581.R01.S.doc Version 5.0 Page 15 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): 24,25,26,28,29,30 The home is decorated to a good standard. The furnishings are comfortable and homely in design. Bedrooms reflect the individual tastes and personalities of the residents. The manager needs to review the home’s fire risk assessment in relation to not having fire doors fitted to all rooms on the first floor. This is particularly important as one of the residents refused to leave his room during the last fire drill. EVIDENCE: Since the last inspection a new window has been fitted in the office. There are plans to repaint the exterior of the building next summer. The manager also advised that the kitchen would be repainted possibly at Christmas. Bedrooms seen were decorated well. They have been personalised and reflect the individual personalities of the residents. There are sufficient numbers of toilet and bathing facilities in the home. Communal areas consist of a large lounge a separate dining room and a garden area to the rear of the property. All areas of the home are well decorated and on the day of inspection there were no unpleasant odours. There is no specialist equipment used in the home. Fire procedures were examined in detail. Record keeping in relation to the testing of equipment was up to date. The home has a fire risk assessment in place. At the last inspection a requirement was made that the home confirm 63 Collier Road DS0000021434.V250581.R01.S.doc Version 5.0 Page 16 the timescale for the fitting of new fire doors to all first floor rooms. This requirement has not been achieved. There is a fire door fitted on one of the bedrooms. This room is the designated fire evacuation point from the first floor. However, it was noted in records of recent fire drills that one of the residents refused to leave his bedroom during a drill. The home needs to reassess the risk of not having fire doors fitted to all bedrooms. Fire drills are currently planned drills. Records do not provide information about how staff coped with the drills or details about how long it takes to evacuate the home. 63 Collier Road DS0000021434.V250581.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,35,36 Staffing levels are satisfactory to meet the needs of the residents. There are good training opportunities provided for staff. However, a date needs to be set for care staff to commence NVQ training. EVIDENCE: There is generally one member of staff on duty throughout the day and a sleep in duty is provided at night. The manager has designated shifts where he is not included in the numbers and some shifts where he is the designated shift worker. One member of staff is currently working through her induction programme. Everyone has completed first aid and fire safety training. Three staff need to complete basic food hygiene training and arrangements have been made for this is November 2005. Three of the four care staff have completed autism specific training and arrangements will be made for the fourth carer to attend training on completion of induction. Two of the staff team are hoping to start NVQ training. However a date has yet to be agreed. Staff advised that they receive supervision on a monthly basis and that they find this very useful. 63 Collier Road DS0000021434.V250581.R01.S.doc Version 5.0 Page 18 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): 37,38,39,40,43 The owner provides good support for the manager and the manager in turn also provides good support to his staff team. The manager should write to relatives of residents clarifying the complaint process and advising about the availability of inspection reports. As part of the monthly reporting on the conduct of the home, the set questions should be changed to subject headings only and a record could then be made of the comments made by staff and residents during this process. EVIDENCE: Since the last inspection of the home the manager has been successful in his application to become the registered manager of the home. He has worked with people with autistic spectrum disorders for a number of years and brings a number of positive skills to the team. He has just commenced studying for NVQ level four in management and care. Staff spoken with during the inspection advised that they are beginning to work really well as a team. Ideas are shared and the manager welcomes and values the opinions of his staff. They stated that he is `approachable and 63 Collier Road DS0000021434.V250581.R01.S.doc Version 5.0 Page 19 supportive’. Staff meetings are held regularly and records show that they are good opportunities for staff to raise issues and discuss the best approach to be taken. In addition a staff member also stated that the owner is also `very approachable’. `He treats everyone equally and if he can solve a problem he will’. As part of the inspection process, comment cards were sent to the residents and to their relatives to comment on the quality of the care provided in the home. (See standard 23). There was a 100 response showing that everyone was satisfied with the overall care provided. One of the relatives was not sure of the complaint process or how to gain access to inspection reports. The policies and procedures manual has been reviewed and updated this year. Hot water temperatures tested on the day of inspection were within agreed safety limits. A manager from one of the other homes owned by the proprietors, visits 63 Collier Road monthly on an unannounced basis. The purpose of the visit is to check on the conduct of the home. A copy of the report is then sent to the proprietors and to the Commission. There is a set format for carrying out these reports. One of the residents stated that he is not happy with continually being asked the same questions. The manager advised that the owner visits the home weekly and is in regular touch by telephone and e-mails. In addition he meets with the owner once a month to receive supervision. 63 Collier Road DS0000021434.V250581.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 X X X 2 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 4 12 X 13 X 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 2 3 X 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 63 Collier Road Score X X 2 2 Standard No 37 38 39 40 41 42 43 Score 3 3 2 3 X X 2 DS0000021434.V250581.R01.S.doc Version 5.0 Page 21 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA1 Regulation 4(1)(2) Requirement Timescale for action 15/01/06 2 YA24 3 YA24 4 YA32 A service user guide must be produced and a copy sent to the CSCI, each service user and to their relatives/representatives. [This was a requirement of the previous two inspections, timescale given 30/09/04] 23(4)(a)(b) The home’s fire risk assessment must be reviewed to determine the safety implications of not having fire doors fitted to all rooms on the first floor. 23(4)(e) Records of fire drills must include an evaluation of staff performance and provide information about the evacuation time. 18(1)(a)(c) Arrangements must be made for 50 of the staff team to commence training for a National Vocational Qualification (NVQ) at level two or above. 15/12/05 15/12/05 15/01/06 63 Collier Road DS0000021434.V250581.R01.S.doc Version 5.0 Page 22 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 YA5 YA20 Good Practice Recommendations The terms and conditions of residence document should be updated to reflect that the home is registered with CSCI and not East Sussex County Council. The home’s procedure for administration should be amended to include more explicit advice for staff on the procedure to be followed when administering medication. [This was a recommendation of the previous inspection]. The assessments of service users wishes in respect of dying and death should be completed. [This was a recommendation of the last two inspections]. The manager should write to relatives of residents confirming the complaint process and advising how they can locate the inspection report. The format for carrying out the monthly check on the conduct of the home should be amended in relation to the questions set for staff and residents. Comments expressed should be recorded rather than yes/no answers. 3 4 5 YA21 YA39 YA43 63 Collier Road DS0000021434.V250581.R01.S.doc Version 5.0 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 63 Collier Road DS0000021434.V250581.R01.S.doc Version 5.0 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. 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