Inspection on 22/03/07 for 63 Collier Road

This inspection was carried out on 22nd March 2007.

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

63 Collier Road 02/02/06

63 Collier Road 11/10/05

63 Collier Road 23/02/05

63 Collier Road 05/08/04

63 Collier Road 21/01/04

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33 St John`s Church Road

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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 3JS Lead Inspector Caroline Johnson Key Unannounced Inspection 22nd March 2007 09:20 63 Collier Road DS0000021434.V318237.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 63 Collier Road DS0000021434.V318237.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. 63 Collier Road DS0000021434.V318237.R01.S.doc Version 5.2 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 Position Vacant Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 63 Collier Road DS0000021434.V318237.R01.S.doc Version 5.2 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 2nd February 2006 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 three care homes in the area. The fees for the service range from £1,080 to £1,180 each week. Additional charges are made for hairdressing, toiletries, magazines and papers. Inspection reports are made available at the home and reference to the availability of reports is also included in the home’s statement of purpose. 63 Collier Road DS0000021434.V318237.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. As part of the inspection process an unannounced site visit was carried out on 22 March 2007 and lasted from 09.20am until 3.00pm. During the inspection there were opportunities to speak with two of the three residents and to meet with the manager and two staff members. A range of documentation was examined including one care plan, staff recruitment records, house meeting minutes, complaints, medication and health and safety records. Bedrooms were not seen on this occasion but all communal areas were seen. What the service does well: What has improved since the last inspection? There is now a picture board in the hallway of the home showing photos of the staff on duty, those on annual leave or on training days. The format for recording minutes of the house meetings has been amended and the new format allows for more detailed information to be recorded. The residents take it in turn to write the minutes of their meetings. The owners have recently taken over responsibilities such as the carrying out of monthly-unannounced visits to the home and writing reports on the outcome and responsibility for staff recruitment. These two areas will free up the manager to concentrate on other management tasks. There is a new healthy eating policy in place and greater emphasis is placed on ensuring that the diet provided includes ample fruit and vegetables. One resident advised that one of the outcomes of his review was that staff should receive training on visual awareness. He was pleased that all of the staff team have now received training on the subject. 63 Collier Road DS0000021434.V318237.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. The summary of this inspection report can be made available in other formats on request. 63 Collier Road DS0000021434.V318237.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 63 Collier Road DS0000021434.V318237.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. The home’s statement of purposes provides good information to assist prospective residents in making a decision about whether the home could meet their needs. EVIDENCE: The statement of purpose is detailed and has been amended since the last inspection to reflect the changes in the management of the home. The service user guide now needs to be amended as it shows photos of the previous manager. The manager advised that he would ask the residents if they would like to produce a new guide to the home. There have been no new admissions to the home since the last inspection. Records show that the home continually assesses the abilities and needs of the residents. 63 Collier Road DS0000021434.V318237.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is (excellent) This judgement has been made using available evidence including a visit to this service. Care plans inform staff about the needs and abilities of the residents and the action to be taken to ensure that identified needs are met. EVIDENCE: One of the care plans was examined in detail. The care plan was very detailed and included up to date information about the resident, their abilities and their needs. A recent review had been held and as part of this process several goals were identified. It was reported that during the review the resident advised that he didn’t want any more goals as he felt it would be too much. The resident when speaking with the inspector advised that he had two main goals that he wanted to work on. One of the main goals was to increase independent travel. There was evidence that the home is working hard to assist the resident to develop skills in this area. Risk assessments were in place to determine safety implications. This resident also stated that one outcome of his recent review was that staff should receive visual awareness training so that they could understand what it was like for him to have a visual 63 Collier Road DS0000021434.V318237.R01.S.doc Version 5.2 Page 10 impairment. Training has been held and all but one staff member has attended this. The resident said it was too soon to see if the training had been of benefit to the staff team and to him. The manager advised that since the training the home has reviewed and revised the walking guidelines in place for staff assisting this resident. In addition to the home’s review, there was also an educational programme 2006-07 progress review. One of the main aims stated was to extend this resident’s social skills and confidence in speaking and performing music in public. The resident was able to give examples of some presentations that he had prepared. A staff member spoken with talked knowledgeably about the needs of the resident that he is keyworker to and stated that he is supported through supervision to ensure that the care plan is kept up to date and accurate. House meetings are held on a weekly basis. There are guidelines in place for staff to advise them of the action they need to take prior to the house meetings. The residents take it in turn to take the minutes. Two of the residents write the minutes and one chooses to type the minutes. There was evidence that residents were fully involved in discussions about house issues and all decisions reached were documented. 63 Collier Road DS0000021434.V318237.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is (excellent) This judgement has been made using available evidence including a visit to this service. Opportunities are available for residents to participate in activities that stimulate them and encourage independence. EVIDENCE: All of the men now have work placements for between one to two and a half hours a week. One resident is supported by staff to achieve this, but the other two residents work independently. The home is working with the staff in the work placement to provide training so that they can eventually withdraw their support as the resident becomes more independent. Activities are based upon the individual needs and wishes of the residents so they vary. One resident enjoys playing the piano so he attends piano tuition and has regular piano practice. He also enjoys swimming and gym and attends choir practice once a week. He visits a friend on a regular basis for a meal and invites his friend to his house in return. During the past year this 63 Collier Road DS0000021434.V318237.R01.S.doc Version 5.2 Page 12 resident enjoyed a trip to Dordrecht with the Hastings Philharmonic Choir. He also joined the other residents on a trip to York. The other residents enjoy some similar activities; one receives guitar tuition, attends a social skills group and enjoys creative writing. The other enjoys Qi – Gong, attends art at college and gym. All three residents enjoy a weekly trip to a local pub and a cinema outing. There is a computer for use by the residents in the lounge. Two of the residents have decided to have their annual holiday in Dublin this year and one opted instead to travel to Vienna. The manager advised that initially the men were given several options for holidays but following further discussion the men decided their destinations and the decisions reached were not on the original list of options. At the time of inspection one resident took a taxi independently to attend his piano lesson. A second resident was attending to self-care tasks and the third was carrying out household tasks. Each of the two men carried out their tasks independently. Contact with relatives is encouraged, two of the residents write and phone their relative who lives abroad and the third resident phones his relative occasionally but also visits with his family on a regular basis. There is a four-week menu in place that is reviewed seasonally. The set menu runs from Monday through to Thursday although alternatives to the menu are also available. At the weekend menus are varied and flexible. Three options are given for each mealtime. Preferences are discussed at house meetings. The manager advised that they have introduced a new healthy eating policy and there is more emphasis on ensuring that everyone has five fruit/veg a day. Staff are due to attend a nutrition and menu planning course in April 2007 and the residents have also been asked if they would like to attend this course. 63 Collier Road DS0000021434.V318237.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. There are good arrangements in place for the management of medication but increased attention needs to be given to signing for medication administered to residents in order to reduce the medication being given twice. EVIDENCE: The home uses advice and support for specialist services where required to meet the individual needs of the residents. One of the residents had an accident a few months ago that required attendance at the local hospital. The home kept detailed records of the accident and the support provided following the accident. The home has a generic policy for the administration of medication but it has yet to introduce a local policy. However they have introduced new guidelines on how to order medication. There is also information in place on all medications used in the home and their side effects. In addition a photo is now in place on each MAR (medication administration record) chart. Records were seen in relation to medication administered to residents. There were a 63 Collier Road DS0000021434.V318237.R01.S.doc Version 5.2 Page 14 number of gaps evident. The medication was not in the blister pack so it was assumed that the medication had been administered but not signed for. In relation to dying and death it was noted that the views of each resident is now documented. 63 Collier Road DS0000021434.V318237.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. The home is good at ensuring that residents are given regular opportunities to raise concerns either on a formal or informal basis. EVIDENCE: There is a detailed complaint procedure in place. There was one complaint recorded since the last inspection. Records showed that the complaint had been investigated and the matter was resolved to the satisfaction of the complainant. The manager advised that two of the residents do not like or want the formality of the complaint procedure but if they have a complaint they will informally discuss the matter with the manager. The third resident uses the complaint procedure if there is a matter that he is unhappy with. There have been no complaints made to the Commission about this service since the last inspection. All of the staff team have attended training on the protection of vulnerable adults. The manager advised that the home’s procedure has been reviewed and updated recently. There have been no adult protection matters since the last inspection. 63 Collier Road DS0000021434.V318237.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. The continual programme of redecoration ensures that the quality of the décor is maintained and the residents have a comfortable home. EVIDENCE: The building is well maintained. Bedrooms were not seen on this occasion. Communal areas are well decorated. Some of the jigsaws completed by one of the residents have been framed and are on display in the lounge. All areas of the home seen were clean and fresh. The manager advised that they had recently introduced a cleaning rota to ensure that the quality of cleanliness is maintained. It was reported that there are plans to replace the floor covering in the hallway and landing and in the dining room and to repaint these areas. The loft is also to be insulated and the external building is to be repainted. It was reported that arrangements are being made to have a fire risk assessment carried out. As part of fire safety checks a visual checklist is carried out on a monthly basis. Extinguishers are serviced annually. Fire drills 63 Collier Road DS0000021434.V318237.R01.S.doc Version 5.2 Page 17 are held on a regular basis and staff reported that the response time is very good and usually the men are at the evacuation point quicker than the staff. All staff received fire safety training earlier in March 2007. 63 Collier Road DS0000021434.V318237.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. Permanent staff are trained and well supported and equipped to carry out their role. Arrangements need to be put in place to ensure that relief staff have the same level of support and that they are trained and equipped to carry out their role. This is particularly important, as generally there is only one member of staff on duty. EVIDENCE: Rotas provided showed that there is always at least one member of staff on duty. Occasionally in order to provide support to individual residents there are two staff. The manager advised that currently he spends 22 hours a week on management tasks and 17.5 hours on shift. Two staff members are due to enrol for NVQ training with a start date to be in September 2007. It was reported that there is a CRB (Criminal Records Bureau) check in place for all staff employed to work in the home. The home either has or has made arrangements to have a CRB for all staff employed on a casual basis to provide activities. 63 Collier Road DS0000021434.V318237.R01.S.doc Version 5.2 Page 19 A relief member of staff was on duty at the time of inspection. This staff member advised that they had been working for the company on a part-time basis for one year. They had been given an induction pack when they commenced in post. However, they had not received a formal supervision session. The manager advised that this worker does not work in the home on a regular basis. It was not clear who has responsibility for monitoring completion of the induction package or who has responsibility for providing supervision. A new policy recently introduced states that mandatory training is to be funded by individual relief staff and that NVQ training is considered part of mandatory training. It this not clear who has responsibility for monitoring whether relief staff have completed this training or not. Time was spent with a permanent staff member who advised that they receive regular supervision. They are still working through their induction and although they have an NVQ level 3 in children and in families, they intend to study for level 3 in social care. They advised that since commencing in post they have completed courses in fire safety, food hygiene and pova. Arrangements have also been made for training in moving and handling next month and their first aid certificate is still in date. This staff member also advised that arrangements would also be made for him to attend autism specific courses in the near future. Staff recruitment records were seen in relation to one staff member and records held provided detailed information about the staff member. Records showed that this staff member had received regular supervision. All new staff receive a thorough induction into the home. 63 Collier Road DS0000021434.V318237.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is (excellent) This judgement has been made using available evidence including a visit to this service. There are good systems in place to ensure that the home is managed effectively and that the health and welfare of the residents are paramount. EVIDENCE: Since the last inspection the registered manager has left his position. The new manager has managed 63 Collier Road in the past. He has applied for registration as manager of the home and at the time of inspection he was awaiting an interview date. He has completed NVQ level four and the Registered Manager’s Award. Staff spoken with described the manager as ‘approachable’. A staff member stated that since starting work in the home he has been ‘impressed with the standard of care provided’. 63 Collier Road DS0000021434.V318237.R01.S.doc Version 5.2 Page 21 Since the last inspection there is now a picture board in the hallway of the home showing photos of the staff on duty, those on annual leave or on training days. As part of the home’s quality assurance system there are a number of audits in place that need to be carried out on a regular basis. This includes IPP monitoring, complaints monitoring and health and safety monitoring. In addition the manager has to write a report on the home for the managers’ meeting that are held on a regular basis. Satisfaction questionnaires are sent to relatives on an annual basis. It was noted that these are now overdue. The residents do not respond well to formal questionnaires but regularly share their opinions during the weekly house meetings. There is no annual development plan for the home but there is a company development plan. The manager advised that it is his intention to draw up a development plan for the home. As part of the inspection process comment cards were sent to the residents in advance of the inspection to seek their views of the care provided. Two comment cards were returned. Both residents were supported to complete the cards. Rather than writing comments the residents chose to use the tick boxes provided to answer the questions. One resident responded positively to all questions with the exception of one question ‘do you make decisions about what you do each day’. Rather than ticking ‘always’ the resident chose to respond ‘usually’. The second resident also stated ‘usually’ for this question and in relation to a question about ‘do you know how to make a complaint’ he stated ‘never made one- not sure’. Responses to all other questions were positive. This feedback was provided to the manager during the inspection. As part of the last inspection a good practise recommendation was made that the home amend their report format for carrying out monthly-announced inspections. This was achieved. However, it was noted that for a period of months monthly visits were not undertaken. The owners have now taken over this task and reports were in place for the previous two months. Records showed that portable appliances were tested in July 2006. There was also evidence that heating, gas and equipment used by the home is serviced on a regular basis. 63 Collier Road DS0000021434.V318237.R01.S.doc Version 5.2 Page 22 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 2 2 X 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 3 25 X 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 3 3 X LIFESTYLES Standard No Score 11 4 12 4 13 3 14 4 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 3 3 4 3 X X 4 3 63 Collier Road DS0000021434.V318237.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO 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 Attention must be given to ensuring that there are no gaps in the recording of medication administered to residents. Arrangements must be made to ensure that relief staff complete their induction, receive regular supervision and that they have training to meet the needs of the residents accommodated. Timescale for action 15/05/07 2. YA32 YA36 18(1) & (2) 30/06/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA1 Good Practice Recommendations The home’s service user guide should be updated and if possible residents should be encouraged to take part in the process. 63 Collier Road DS0000021434.V318237.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V318237.R01.S.doc Version 5.2 Page 25 - 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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