Inspection on 02/02/06 for 63 Collier Road

This inspection was carried out on 2nd February 2006.

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

63 Collier Road 22/03/07

63 Collier Road 11/10/05

63 Collier Road 23/02/05

63 Collier Road 05/08/04

63 Collier Road 21/01/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

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33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 63 Collier Road Hastings East Sussex TN34 3JS Lead Inspector Caroline Johnson Unannounced Inspection 2nd February 2006 09:30 63 Collier Road DS0000021434.V273476.R01.S.doc Version 5.1 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.V273476.R01.S.doc Version 5.1 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.V273476.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 63 Collier Road Address Hastings East Sussex TN34 3JS 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) 01424 430743 mikeyoung63@tiscali.co.uk A S D Unique Services Limited Michael Norman Douglas Young Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 63 Collier Road DS0000021434.V273476.R01.S.doc Version 5.1 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 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 care homes in the area, both registered to accommodate adults with autistic spectrum disorders. 63 Collier Road DS0000021434.V273476.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the second inspection in the year running from April 1 2005 to March 31 2006. The inspection lasted from 9.30am until 1.10pm. During the inspection there was an opportunity to meet with a relief member of staff. The manager was not on shift but came to the home at 12.00pm. A number of records were examined, including fire safety, medication, staff training, accident and incident records and house meeting minutes. There was an opportunity to meet briefly with the three residents. What the service does well: What has improved since the last inspection? What they could do better: Five requirements were made: - to ensure that the numbers of MAR (medication administration records) charts in use at any one time for each individual is kept to a minimum; to ensure that a more detailed risk assessment is carried out to determine if there is a need for fire doors on the first floor; to ensure that the home documents all action taken as a result of their fire safety audit; to ensure that they continue to try to achieve having 50 of the staff team trained to NVQ level four and to ensure that they make arrangements to have portable appliances tested. 63 Collier Road DS0000021434.V273476.R01.S.doc Version 5.1 Page 6 Four recommendations were made: - to ensure that more detailed records are kept of house issues discussed in house meetings; to ensure that the home’s medication administration procedure is expanded upon; to complete the assessment of residents’ wishes in relation to dying and death and to review the set questions included in the format for carrying out Regulation 26 reports. 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.V273476.R01.S.doc Version 5.1 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.V273476.R01.S.doc Version 5.1 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 home has involved the residents in the production of the service user guide and this is considered good practice. EVIDENCE: Since the last inspection the service user guide has been completed. The manager advised that the residents were involved in the process and were happy with the outcome. The terms and conditions of residence document has also been updated as recommended at the last inspection. 63 Collier Road DS0000021434.V273476.R01.S.doc Version 5.1 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): 7,8 The home is good at ensuring that residents are included in all aspects of the running of their home. However, record keeping in relation to house issues needs to be more detailed highlighting the topics discussed, individual contributions made by residents and the outcomes agreed. The residents are aware of their individual responsibilities and contributions towards the running of their home. EVIDENCE: House meetings continue to be held weekly and they are an opportunity for residents to make decisions about how they would like to spend their weekends. They are also an opportunity for staff or residents to raise any house issues so that everyone has an opportunity to have their say on the running of the home and to be kept informed. Record keeping shows that particular topics are discussed but there is no record of the detail of the discussion or the outcome. For example, headings can include holidays or staffing, but no other information is included. During the inspection it was noted that residents were involved in activities such as laundry, hoovering their bedrooms and cleaning up after their lunch. 63 Collier Road DS0000021434.V273476.R01.S.doc Version 5.1 Page 10 They did not require prompting to carry out these tasks and were aware of their individual responsibilities in relation to the running of their home. 63 Collier Road DS0000021434.V273476.R01.S.doc Version 5.1 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): 12,13,14,16 The residents continue to lead active and interesting lives and the numbers and range of activities provided is gradually increasing. EVIDENCE: One of the residents is supported by staff to attend a photography course. One of the new projects planned is to develop skills in night-time photography. The staff member supporting this resident used to work in photography so it is a strong interest that they both share. Another resident attends a mainstream art course and is currently in his second year. He travels independently by taxi to this course. Day activities generally remain the same as at the last inspection. Two of the residents continue to work for a few hours each week. One of the residents spoken to stated that he enjoys this experience. Emphasis is being placed on supporting residents to be more independent with travel. Staff have carried out risk assessments in relation to certain routes and have determined the safest places for crossing roads. Clear arrangements are made with residents in relation to travel times and phone calls. 63 Collier Road DS0000021434.V273476.R01.S.doc Version 5.1 Page 12 During the inspection one of the residents showed the manager the work he had done in the morning to contribute to the `nutty news,’ which is a newsletter produced by the residents. The newsletter features areas of interest to the residents and they also write about what they have done and plan to do before the next edition. The residents are currently planning their annual holiday. This year they have decided on a trip to York. They have yet to decide how they would like to get there, that is by train or car. The residents enjoy planning their trips and so one of the residents has decided to get information from the tourist board and another has said that they will buy a book on the area. 63 Collier Road DS0000021434.V273476.R01.S.doc Version 5.1 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): 19,20,21 The system of having too many MAR charts for one resident and having the next months chart in the folder too early could lead to confusion and errors. The home needs to ensure that the assessment of residents’ wishes in relation to dying and death is completed. EVIDENCE: One of the residents does stretching exercises on a daily basis that have been recommended by a physiotherapist for lower back pain. Another resident has also been complaining of lower back pain and his doctor is making arrangements for him to be seen by a physio. There were a mixture of hand written and printed MAR charts for one of the residents. Also the charts for the following month were also included in with the current month. The home’s drug administration procedure had not been updated as recommended at the last inspection of the home. The manager has yet to complete the process of assessing the wishes of the residents in relation to dying and death. 63 Collier Road DS0000021434.V273476.R01.S.doc Version 5.1 Page 14 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): These standards were not inspected fully at this inspection and will be inspected at the next inspection of the home. EVIDENCE: There were no complaints recorded since the last inspection of the home. 63 Collier Road DS0000021434.V273476.R01.S.doc Version 5.1 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): 24,28,30 The home continues to be well maintained and accommodation provided is to a good standard. The risk assessment carried out to determine whether fire doors need to be fitted to all rooms on the first floor needs to be more detailed. The home needs to find a way of highlighting to all staff (particularly relief staff) that there is only one fire door on the first floor. EVIDENCE: Communal areas were seen during this inspection. It was noted that the kitchen had been repainted since the last inspection. All areas of the home seen were clean and there were no unpleasant odours. Records were seen in relation to fire safety and they were generally up to date. Staff are now recording a more detailed evaluation of all fire drills held in the home. A fire safety audit was carried out on November 2005. This document had not been signed and there were no records to indicate when or if action has taken to address areas highlighted during the audit. Since the last inspection the manager carried out a risk assessment on the evacuation procedure from the first floor. However a staff member spoken with during the inspection had forgotten that there was only one fire door on the first floor. The manager advised that it is still considered necessary to have fire doors 63 Collier Road DS0000021434.V273476.R01.S.doc Version 5.1 Page 16 fitted to all doors on the first floor. It is essential that this be included in the risk assessment along with timescales for the work to be carried out. 63 Collier Road DS0000021434.V273476.R01.S.doc Version 5.1 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 Changes to the staff team can be unsettling for the residents and the manager has worked hard to ensure that only staff that are familiar with the residents work in the home. There are good arrangements in place to ensure that new staff shadow a more experienced member of staff until they feel competent in the role. There are good training opportunities available for staff and the home needs to ensure that they continue to work towards having 50 of the staff team trained to NVQ level two or above. EVIDENCE: Since the last inspection of the home one member of staff has left employment and another member of staff has gone on maternity leave. A new member of staff has been appointed subject to a satisfactory CRB check and the home are looking to appoint a temporary member of staff to cover the maternity leave. In the interim there has been a high use of relief staff but the manager advised that due to the size of the home they try to keep the numbers of relief staff down to a minimum. A member of staff spoken with stated that the home’s induction was thorough. She had had opportunities to shadow staff on several shifts before working on her own. There was also an opportunity to shadow shifts in the other homes owned by the company. She advised that she liked the daily record sheets in use in that they provide very clear information about what has happened during each shift. In addition she also stated that the arrangements for 63 Collier Road DS0000021434.V273476.R01.S.doc Version 5.1 Page 18 managing petty cash were also very clear. Arrangements for supervision had been discussed with her and she felt `well supported’ in her role. One of the staff team has applied to study for NVQ level three. It is expected that on completion of their induction to the home the new member of staff will also complete a NVQ. The manager confirmed that all new staff complete their mandatory training within six months. He has recently arranged for staff to receive training on health and safety. Arrangements are also being made for staff to attend autism specific training. 63 Collier Road DS0000021434.V273476.R01.S.doc Version 5.1 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): 37,42,43 The manager needs to ensure that arrangements are made for annual testing of portable appliances. A good practice recommendation made at the last inspection in relation to the format used for carrying out Regulation 26 reports needs to be addressed. EVIDENCE: The manager continues with his studies to achieve NVQ level four. In relation to health and safety it was noted that the gas had last been serviced in May 2004. The manager advised that the gas had been serviced and they were awaiting the certificate. Portable appliance testing was last carried out in May 2004. Detailed records are kept of accidents and incidents that occur in the home. The manager confirmed that he has written to the relatives of the residents confirming the home’s complaint procedure and advising them how they can gain access to copies of inspection reports. 63 Collier Road DS0000021434.V273476.R01.S.doc Version 5.1 Page 20 A recommendation was made at the last inspection that the format used for carrying out Regulation 26 reports be reviewed in relation to the questions set for staff and residents. This has yet to be done. 63 Collier Road DS0000021434.V273476.R01.S.doc Version 5.1 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 3 2 X 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 3 34 X 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 3 2 X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 X 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 2 2 3 X X X X 2 2 63 Collier Road DS0000021434.V273476.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? YES 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 YA20 Regulation 13(2) Requirement Timescale for action 30/03/06 2. YA24 3. YA24 4. YA32 In relation to records held in respect of medication administered to residents, the number of MAR charts in use at any one time for each resident must be kept to a minimum. 30/03/06 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. [This was a requirement of the last inspection and has been partly completed timescale given 15/12/05]. 23(4)(a)(c)(iii) Action taken to address 15/04/06 issues raised, as part of the home’s fire safety audit must be clearly documented. The home must ensure that all staff working in the home are aware of the arrangements for evacuation of residents on the first floor. 18(1)(a)(c) Arrangements must be made 30/04/06 for 50 of the staff team to commence training for a DS0000021434.V273476.R01.S.doc Version 5.1 63 Collier Road Page 23 National Vocational Qualification (NVQ) at level two or above. [This was a requirement of the last inspection timescale given 15/1/06]. 5. YA42 13(4)(a, c) Arrangements must be made for portable appliance testing to be carried out. 15/04/06 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 YA8 YA20 Good Practice Recommendations Minutes of house meetings should include details of the topics discussed, residents’ views and the outcome reached. 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 two inspections]. The assessments of residents’ service users wishes in respect of dying and death should be completed. 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. YA21 YA43 63 Collier Road DS0000021434.V273476.R01.S.doc Version 5.1 Page 24 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. 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