CARE HOME ADULTS 18-65
Brighton Road (64) 64 Brighton Road Horley Surrey RH6 7HT Lead Inspector
Penelope Calthrop Announced 23 June 2005 09:15 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. Brighton Road (64) H58-H09 S13526 64 Brighton Road V223491 230605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Brighton Road (64) Address 64 Brighton Road, Horley, Surrey, RH6 7HT 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) 01293 822891 01999 999999 www.theavenuestrust.co.uk The Avenues Trust Limited River House, 1 Maidstone Road, Sidcup, Kent, DA14 5TA To be confirmed Care home only (PC) 5 Category(ies) of Learning disability (LD), 5 registration, with number of places Brighton Road (64) H58-H09 S13526 64 Brighton Road V223491 230605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1 The age/age range of the persons to be accommodated will be: 32-65 YEARS 2 One (1) named person may be aged over 65 years. Date of last inspection 25 October 2004 Brief Description of the Service: 64 Brighton Road is a registered care home for five adults with moderate to severe learning disabilities. The property is owned by the Metropolitan Housing Association and run by the Avenues Trust, a private company with charitable status. The building is detached. Communal facilities comprise two lounges and an open plan kitchen and dining room area on the ground floor. Five single bedrooms and two bathrooms are located on the first floor. Outside there is a large enclosed garden to the rear of the property. The home is set off the main Brighton Road with parking spaces at the front. It is close to the facilities of Horley town centre and transport links are nearby. All the service users living at the home are currently male Brighton Road (64) H58-H09 S13526 64 Brighton Road V223491 230605 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This announced inspection took place on one day, over a period of six and a half hours. The manager was present for the inspection process and the service manager for part of the time. All five of the service users were seen during the course of the visit, although were going off on various activities during the day. The views of three members of staff, apart from the manager, were obtained during the visit. A relative of one of the service users who was visiting, gave an opinion about the home with regard to what they felt had been a lot of changes in staff and management of the home over the past months. They observed that they thought this was unsettling for the service users living there. Due to the communication difficulties of the service users living in this home, their direct views could not be obtained. Therefore observations of individuals within the home and interaction between service users and staff formed part of the inspection process. Service users were observed to be confident in approaching staff. Staff were seen to be responsive to individual service users behaviours, which they use as a means of communication. One individual was seen to take staff by the arm and into the kitchen and point at the kettle, indicating that they wanted a drink. Another individual was reported as not able to indicate as directly as this, staff therefore have to be vigilant and were seen responding to a particular behaviour which meant that they wanted a drink. A tour of the premises occurred and records were sampled during the visit. For the purposes of this report ‘person centred plans’ will be referred to as ‘care plans’. The Commission for Social Care Inspection would like to thank the staff and service users for their hospitality throughout the inspection process. What the service does well:
The individual needs of the service users are being well met in this home. There is evidence that the new manager is reviewing the health needs of individuals and a number of referrals to specialists have been made and are receiving attention. Examples being a specialist auditory team, speech and language therapist and behavioural team. Methods of communication are addressed, with some staff trained in Makaton. One of the service users is learning Makaton and another attends a communication group. The activities that service users attend are also being reviewed, with the intention of expanding those that individuals particularly enjoy. Finding appropriate sessions for one service user, is a particular challenge for this home and one that they were seen to be addressing. Two individuals had just been away for a week’s holiday and a week has already been booked for two others for
Brighton Road (64) H58-H09 S13526 64 Brighton Road V223491 230605 Stage 4.doc Version 1.30 Page 6 September. Efforts were seen to be made to include service users in the dayto-day life of the home, examples being encouraging them to help weed the garden and take responsibility for watering the plants. Appropriate adaptations in the form of rails and equipment are in place to help meet the needs of one individual in particular. Positive comments were received from staff spoken with, about the democratic and supportive management style of the new manager and a spirit of teamwork was reported. This will result in a positive atmosphere for service users living in the home. The home manager was enthusiastic about his new role and keen to discuss ideas for improvement during the visit. Positive feedback was received from staff about training opportunities within The Avenues as an organisation. What has improved since the last inspection? What they could do better:
Feedback from staff spoken with and the comments of a relative, indicate that this home needs a period of stable management and staffing. Changes over the past months have been unsettling for staff and service users cannot help but have picked up on this. The home needs to complete the transition to the full use of the new care plans. This should enable better organisation and storage of all information held on each service user, which is currently held in separate files and is difficult to negotiate around. The impact of this will be a more accessible system for staff to use and update, with a positive outcome for service users. It was recommended this be completed as soon as possible. Recommendations are also made that service users emotional needs are clearly identified, particularly due to their lack of verbal communication and that skills building is also clearly identified within care plans. This will assist staff in meeting service users needs. A recommendation was also made that the home manager
Brighton Road (64) H58-H09 S13526 64 Brighton Road V223491 230605 Stage 4.doc Version 1.30 Page 7 obtains any original assessment documentation that may be held at The Avenues head office. This is particularly relevant for the new care plan format and may provide additional information the home does not have about individuals. A previously made recommendation with regard to making the service users guide and statement of purpose more accessible to service users has been partially completed and needs to be finished off. This will enable better access for existing service users and for the future, anyone potentially interested in finding out about the home. A number of requirements were made with regard to the environment at the home. These are that a rusty hinge outside the kitchen window be removed (completed on the inspection); the bathroom light not working to be replaced; the sealant behind the kitchen sink be replaced as mildew is present; the levelling of uneven paving stones on the patio area must take place. These are all health and safety matters, some of which could result in injury to service users and must receive attention to prevent this. Additionally, two recommendations were made. These are that the unused frame of the swing chair in the garden be removed if this is no longer used, as it is unsightly. Also, that the refurbishment of the kitchen is budgeted for within the next 6-12 months. The units are dated and one worktop has a worn area on it, service users all freely access the kitchen and refurbishments have not kept pace with those in the rest of the home. A requirement is made that bank staff records must be held at the home. This to enable the home manager to see documented, the relevant information on all staff that may be working with service users for their protection. A recommendation is made that one individual, discussed with the manager during the visit, is given their own room key. It is thought they would be able to use this and it would give them some autonomy over who enters their room. A further recommendation is made that the new manager amend/update the development plan for the home. This will enable him to demonstrate the plans he has to improve outcomes for service users living there. 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. Brighton Road (64) H58-H09 S13526 64 Brighton Road V223491 230605 Stage 4.doc Version 1.30 Page 8 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 Brighton Road (64) H58-H09 S13526 64 Brighton Road V223491 230605 Stage 4.doc Version 1.30 Page 9 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) 1 & 2. There is information available about the home, but the inclusion of this into a format accessible to service users needs to be fully completed. There is some assessment documentation available about individuals within their care plan. Ensuring original assessment documentation is obtained will help give as accurate a picture as possible, when completing individuals care plans. EVIDENCE: While some information about the home is in pictorial format others is not, meaning not all information can be accessed by service users with communication difficulties. This was a recommendation made following the last inspection and has been partially completed. Further discussion took place with the home manager about this and this remains a recommendation of this inspection. Assessment information was present within the files held about each individual by the home. Some of this information was scant and it was not known whether more and original assessment documentation may have been archived. It was recommended that the home manager check on whether there is any assessment information held at The Avenues head office. This will enable access to as much information as possible when completing or updating the new care plans and ensure relevant background information is included. Brighton Road (64) H58-H09 S13526 64 Brighton Road V223491 230605 Stage 4.doc Version 1.30 Page 10 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, 9 & 10. Care plans were in place and risk assessments formed part of the care planning process. Improvements were needed in respect of the organisation of the information held about each service user to make this easily accessible for staff. Service users participate within their levels of comprehension in all aspects of life at the home, with the aim being one of inclusion for those that live there. There is awareness of Data Protection by home staff. EVIDENCE: The home has moved to a new system of care planning. There was evidence that this change in system still has some work to be undertaken to complete it. This was reported by the service manager for the home as being planned for the near future. Currently information is unwieldy and can be difficult to find, with the result that staff may struggle to locate important information. Within the information held, there was obvious attention to areas such as means of communication. This was positive, particularly given the lack of verbal communication skills of the service users living at this home. They rely on staff being alert to many non-verbal cues to assist them meet their needs. An example of this was observed during the visit, when one individual started to hit his chest area. This behaviour was correctly interpreted as meaning he wanted a drink, which a staff member then provided for him. Skills building and emotional needs would benefit from being more clearly identified within
Brighton Road (64) H58-H09 S13526 64 Brighton Road V223491 230605 Stage 4.doc Version 1.30 Page 11 the care plan and this was recommended. Cultural needs are assessed and there was evidence of attention to meeting these in a care plan sampled. Areas of risk were seen to be identified for individuals, enabling them to participate in activities within a risk management framework. General areas of the home were also risk assessed, an example being safe access to the kitchen. Service user participation in daily life decisions has to be actively promoted within this home. Small, but important decisions such as what to eat and others, such as whom to go on holiday with and where, are made with the assistance and encouragement of staff, particularly key workers. Key workers spend regular time with service users, to enable them to monitor their well being in a one to one situation and ensure their wishes are included in the day to day running of the home. Staff need to know individuals well and often have to interpret their behaviours, as this may be the way they communicate their wishes to staff. Staff are aware of their responsibilities regarding confidentiality of information, this is covered in the home’s induction. All records were observed to be securely locked away in appropriate storage facilities. Service users can be confident that personal information about them is not inappropriately shared with others. Brighton Road (64) H58-H09 S13526 64 Brighton Road V223491 230605 Stage 4.doc Version 1.30 Page 12 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) 11, 12, 13, 14 & 16. All aspects of personal development needs to be clearly identified and recorded as part of individual care plans, to ensure all staff are aware of and working on these. Access to the community occurs, with local facilities utilised to the benefit of individuals at the home. Activities timetables are in place for each service user and are under review by the home manager. Holidays are booked for the coming year. Service users have no restrictions on being able to enter all communal areas of the home. EVIDENCE: Please see comments made under the previous section with regard to identifying independent living skills, as part of an individual’s personal development and the recommendation made. Please also see comments made in respect of communication needs, which there is evidence the home are particularly aware of. This is vital due to the limited verbal communication of all the service users living there and need for staff to be particularly aware of individual means of communicating their wishes. Service users access the local community for various activities such as going to the leisure centre, using the shops, going to the local pub and horse riding.
Brighton Road (64) H58-H09 S13526 64 Brighton Road V223491 230605 Stage 4.doc Version 1.30 Page 13 One individual goes to a local shop daily where they are well known and the same local supermarket is used where staff recognise the service users. The home ensures that each service user has the opportunity for a holiday each year. Two individuals had recently returned from a week away with staff and two others are booked to go away later this year. The other service user may have a couple of shorter breaks that better meet their needs. Currently none of the individuals at the home have keys to their room, as this has not been appropriate due to their needs. However, the manager reported that he considered that it might be appropriate for one service user to now be asked if he would like his own room key. A recommendation was made that this be done, as it will give a sense of responsibility to this individual and is developmental. It was reported that if staff want to enter an individual’s room although they knock, due to service users being non verbal they would not receive a reply. Instead, they open the door a short way to see whether it is acceptable to the individual for them to enter the room. This demonstrates that staff are aware of the need to respect service users right to some privacy within their own room. Brighton Road (64) H58-H09 S13526 64 Brighton Road V223491 230605 Stage 4.doc Version 1.30 Page 14 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) 18 &19. There is evidence that service users personal care needs are met, with assistance provided by staff as needed to achieve this. Health needs are judged to be well met, with evidence of the new manager reviewing these and referring for specialist input where indicated. EVIDENCE: All service users need some assistance with their personal care needs. The home follows a routine whereby individuals bathe in the morning after breakfast. This was explained as being because the service users were previously in long stay hospital, where this was the routine and it is what they are used to. Although they could bath at differing times, they have not chosen to do so. The gender mix of staff at the home is split equally between males and females. The home manager reported that service users do not generally indicate a preference of whom they have to support them. Key workers will generally support the individual they key work with, to enable them to spend some time with them. Staff are reported to respect service users privacy, by ensuring there is no more than one staff in the bathroom supporting them and ensuring the door is locked. Physical health care needs are well met in this home, with evidence of the manager making recent relevant specialist referrals. The manager explained he was reviewing all health related needs, to ensure the information the home holds is up to date. This will also involve confirmation of for example, the
Brighton Road (64) H58-H09 S13526 64 Brighton Road V223491 230605 Stage 4.doc Version 1.30 Page 15 degree of sensory loss an individual has. This will ensure a clear and up to date picture is obtained of all health needs for each individual at the home. The provision of specialist equipment has been obtained for one individual to maximise their ability to remain as independent as possible. On the day of the inspection, the occupational therapist visited the home to demonstrate to staff how to operate a new bath seat. Service users have to rely on staff to organise all health related appointments on their behalf. They are also dependent on their observations to determine when they are unwell, as they are unable to verbalise this for themselves. Due to the communication difficulties of the individuals living at the home, they are not always able to verbally indicate their emotional needs to staff. They are therefore reliant on staff observations of their behaviours, which is often the way that their emotional needs manifest themselves. The home has a cultural needs section within the care plan information held on each service user, which does include reference to emotional needs. This needs to form a distinct part of the new care plan format-see recommendation made under section 6-10 in respect of this. Brighton Road (64) H58-H09 S13526 64 Brighton Road V223491 230605 Stage 4.doc Version 1.30 Page 16 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 & 23. Following an allegation made since the last inspection involving service users welfare, an internal investigation was conducted and meetings with the relevant statutory bodies held. Recommended actions were taken by The Avenues, which means service users at this home will now be better protected. No complaints have been received since the last inspection; the home has The Avenues complaints procedure in place. EVIDENCE: The home has had no complaints since the last inspection in October 2004. There is a complaints procedure in place and a complaints book on site in the home. The manager has attended the multi agency vulnerable adults training and the two senior support workers at the home are booked to attend this in September this year. This should ensure senior staff at the home are particularly clear about responsibilities and actions required, in respect of ensuring service users at the home are protected from abuse or neglect. Two individuals at the home do indulge in some self- injuring behaviour at times. The home manager has obtained the assistance of the behavioural team and in the case of one service user, adjustments to medication had precipitated the behaviour. With readjustment, the incidents have decreased although continue to be recorded and monitored. Strategies for the other individual have already been commenced with some success, following advice from a professional involved with them. It is likely that this service user indulges the behaviour when unoccupied. The manager is already making attempts to address this, by exploring additional and alternative activities and ensuring this individual is involved with as many areas of the home’s life as possible.
Brighton Road (64) H58-H09 S13526 64 Brighton Road V223491 230605 Stage 4.doc Version 1.30 Page 17 An allegation made since the time of the last inspection regarding service users welfare, was reported to both social services and CSCI. This was investigated internally and recommendations made as a result, were implemented by The Avenues at the home. This should better protect service users at this home, together with the vulnerable adults training that is taking place, which will raise awareness amongst staff. Brighton Road (64) H58-H09 S13526 64 Brighton Road V223491 230605 Stage 4.doc Version 1.30 Page 18 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, 29 & 30. The environment is generally a comfortable one for the service users who live in the home. However, requirements and recommendations are made, some of which relate to health and safety and need to be complied with in view of this. The home was judged to have the equipment necessary to support those individuals needing this in the home. The home was clean and hygienic on the day of the inspection. EVIDENCE: The home was observed to be clean and comfortable. New flooring had been laid in the dining room since the last inspection, which made the room appear bright and clean. Bedrooms were nicely decorated and individual in appearance. The kitchen is somewhat dated in appearance, with units that look tired. There is also a small worn area on one of the work surfaces. Although still functional, this will need replacing within the next 6-12 months to continue to provide service users with a pleasant room. The sealant along the back of the sink was observed to have mildew growth and be coming away in places. This must be replaced for reasons of hygiene and also as it does not look pleasant. The light in one of the bathrooms was not working and must be replaced, although there was a shaving light above the washbasin that could be used as an interim measure for service users.
Brighton Road (64) H58-H09 S13526 64 Brighton Road V223491 230605 Stage 4.doc Version 1.30 Page 19 Outside in the back garden, there was a rusty bracket close to the kitchen window, which needed immediate removal, and this was completed during the visit. Although the paving slabs on the patio have received attention in the past to level them, some movement was again observed and must be attended to, as they are a potential trip hazard for service users. The old frame of a swing chair was present in the rear garden and it is advised this be removed if it is no longer in use, as it is unsightly. There are a number of rails that have been fitted to the home, which together with other equipment assist the home staff to meet one service users needs. The home had been assessed by an occupational therapist prior to this. The home manager advised that he will be further discussing the feasibility of providing ramped access to the back garden, to better meet the needs of one individual. Brighton Road (64) H58-H09 S13526 64 Brighton Road V223491 230605 Stage 4.doc Version 1.30 Page 20 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) 31, 33 & 34. The staff team at the home are competent to meet the needs of the service users. The home has benefited from recruitment to a vacant post and the appointment of a permanent manager since the last inspection and now needs a stable period with minimum changes to staff. Recruitment practice will be more fully assessed at the next inspection. It was noted that a procedure whereby CSCI inspectors can make necessary checks of recruitment records, is being put in place. EVIDENCE: Staff spoken with were clear about their roles and responsibilities within the home. These are outlined to them on their induction. One individual spoken with was positive about the opportunity the manager provided them with to ‘practice’ shift leading, whilst the manager was also on duty. This enables them to increase their confidence and attain competence in a safe environment, to the ultimate benefit of service users. The manager spoke about ensuring staff understand the role of being a key worker and what shift leading entails. There were adequate staff on duty in the home to meet service users needs on the day of the inspection. The manager reported that staffing numbers are sufficient to cover the needs of the home. One support worker vacancy was reported as being held open at present. If needed, the home use two regular bank staff who know service users well, as staff familiarity is particularly
Brighton Road (64) H58-H09 S13526 64 Brighton Road V223491 230605 Stage 4.doc Version 1.30 Page 21 important in order to meet the needs of the individuals living in this home. Staff reported that staff meetings are held every month and feedback given was that these are useful and provided the opportunity for all staff to meet up. Staff spoken with said that they felt there is ‘good team working’ and that ‘it is a team effort’ working at the home. Original staff recruitment records are held at The Avenues head office, not on site at the home. Some staff recruitment records were supplied to CSCI following a requirement made at the time of the last inspection. Copies of references were available on site at the home for this inspection, although no records were available for bank staff and a requirement was made. A procedure is being agreed by CSCI and The Avenues to enable CSCI inspectors to make the necessary checks as part of their visit in the future. Brighton Road (64) H58-H09 S13526 64 Brighton Road V223491 230605 Stage 4.doc Version 1.30 Page 22 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) 37, 38, 39 & 42. The management style of the home was judged to be open and democratic. The development plan for the home needs updating, based on aims and outcomes for service users. There is evidence of general attention to service users welfare, although the requirements made in this report under section 2430, will better ensure service users well being. EVIDENCE: Staff spoken with provided positive feedback about the newly appointed manager. He was said to ‘be supportive’ and felt to be a good manager with ‘tasks being shared out democratically’. This was reported to generate a feeling of positive teamwork at the home, which benefits service users. There was evidence that the home was being run competently. The manager has been working at the home as acting manager prior to his appointment, but now needs to register with CSCI. The Avenues as an organisation address quality auditing of their homes, this will be explored in full on the next inspection. A previously made recommendation made regarding the need for the home to have it’s own
Brighton Road (64) H58-H09 S13526 64 Brighton Road V223491 230605 Stage 4.doc Version 1.30 Page 23 development plan, had been met in part. This was further discussed during the visit and remains as an objective for the new manager, with specific reference to the service users living at this home. The home has a designated member of staff who takes the lead within the home on matters of health and safety. A full monthly audit is undertaken of the home. The Avenues have a system whereby health and safety representatives attend regular updates at head office, to ensure they are aware of any new legislation that is relevant to their role. The home has two members of staff that includes the manager, who are fully qualified in first aid. All other staff attend some training in first aid. There was evidence documented earlier in this report, of particular attention to ensuring that information on the health needs of service users is reviewed and up to date. The collective measures taken by the home ensure that service users health, safety and welfare are adequately protected, with health needs being particularly well addressed. Two requirements made under the environment section regarding the rusty hinge and paving slabs, indicate that the home need to be particularly vigilant in ensuring that the safety of service users is not compromised. Brighton Road (64) H58-H09 S13526 64 Brighton Road V223491 230605 Stage 4.doc Version 1.30 Page 24 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 3 x x x Standard No 22 23
ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 2 x 3 3 3
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 2 x x x x 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 x 3 x Standard No 31 32 33 34 35 36 Score 3 x 3 2 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Brighton Road (64) Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x x 2 x H58-H09 S13526 64 Brighton Road V223491 230605 Stage 4.doc Version 1.30 Page 25 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 24 Regulation 13(4)(a) Requirement The rusty bracket attached to the external wall outside the kitchen must be removed.(Completed on visit.) There must be attention to the light which is not working in the bathroom at the far end of the landing. The paving slabs in the patio area must recieve attention to ensure they are level and do not present a trip hazard. The sealant behind the sink area in the kitchen must be replaced as there is mildew present and it is a hygiene issue. Staff records held on site, must include staff who regularly work bank shifts at the home Timescale for action Immediate 23/6/05 30/6/05 2. 24 23(2)(p) 3. 24 13(4)(a) 6/8/05 4. 24 13(4)(C) 6/8/05 5. 34 19(b)(i) 6/8/05 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 1 Good Practice Recommendations That the service user friendly format is completed in respect of the service users guide.
H58-H09 S13526 64 Brighton Road V223491 230605 Stage 4.doc Version 1.30 Page 26 Brighton Road (64) 2. 3. 4. 5. 6. 7. 8. 2 6 16 24 24 29 39 That the manager obtain where possible, original assessment documentation on each service user. That the change to person centred plans is completed as soon as possible and clearly identifies meeting emotional needs,independent living skills and service user goals. That one service user discussed on the inspection is offered the opportunity to hold a key to their room. That the frame of a swing chair is removed from the back garden if no longer in use. That the organisation upgrade the kitchen within the next 6-12 month period as it is showing signs of wear and is dated. That the further advice of the occupational therapist is sought, in relation to promoting ease of access to the garden for one service user. That the development plan for the home is updated and extended. Brighton Road (64) H58-H09 S13526 64 Brighton Road V223491 230605 Stage 4.doc Version 1.30 Page 27 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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