Inspection on 19/12/06 for 7 Princes Crescent

This inspection was carried out on 19th December 2006.

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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

7 Princes Crescent 16/10/08

7 Princes Crescent 07/12/05

7 Princes Crescent 20/06/05

7 Princes Crescent 17/11/04

7 Princes Crescent 21/05/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

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 7 Princes Crescent 7 Princes Crescent Hove East Sussex BN3 4GS Lead Inspector Jane Jewell Key Unannounced Inspection 19th December 2006 10:00 7 Princes Crescent DS0000014159.V324370.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 7 Princes Crescent DS0000014159.V324370.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. 7 Princes Crescent DS0000014159.V324370.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 7 Princes Crescent Address 7 Princes Crescent Hove East Sussex BN3 4GS 01273 733441 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) princres@onetel.com Southdown Housing Association Limited Mr Jon David Dimmer Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 7 Princes Crescent DS0000014159.V324370.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The number of people accommodated must not exceed 4 Date of last inspection 20th June 2005 Brief Description of the Service: 7 Princes Crescent is part of the Southdown Housing Association and is registered to provide residence and care to four younger adults with a learning disability. The home provided long term placements only. The home is a detached three-storey converted domestic property, which is situated close to the seafront in Hove. The home is close to local amenities, including food shops, pubs restaurant and transport links. Communal space consists of a large through lounge and combined kitchen dining room. There is a rear-enclosed garden. Resident’s personal accommodation consists of four single bedrooms with one providing ensuite facilities. Day care services are for all but one resident provided off site at local day care services. The homes literature states that it aims to maximise independence by involving service users in all aspect of running the home. The fees for residential care are currently £1,300 to £1,900 per week, depending on the services and facilities provided. Extra such as: hairdressing, chiropody, transport, toiletries are additional costs. 7 Princes Crescent DS0000014159.V324370.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The information contained in this report has been comprised from an unannounced inspection undertaken over five hours and information gathered about the home. This includes: residents and relatives survey questionnaires, discussion with stakeholders involved in resident’s care and records submitted to the Commission for Social Care inspection (CSCI) including a Pre-inspection questionnaire. The inspection involved a tour of the premises, discussion with residents and staff as well as observing residents going about their daily routines. The inspection was in the main facilitated by the service manager Jon Dimmer. There were three residents residing at the home at the time of the inspection, the other resident was visiting their family for the Christmas period. During this summary and report the people who live at the home will be referred to as tenants (except in the requirements section), and the people who work at the home as staff or by their job title. In order that a balanced and thorough view of the home is obtained, this inspection report should be read in conjunction with the previous inspection reports. The Inspector would like to thank the residents, staff and management for their assistance and hospitality during the visit. What the service does well: It was evident that respecting tenants rights to make decisions about their lives was integral to the ethos of the home. There is a strong focus on individual programmes of support tailored to suite the needs and preferences of each tenant. Tenants are given support in order to have active social and leisure experiences. There is an enthusiastic and skilled staff team with the manager and staff showing a good knowledge of tenants. Staff were observed working positively and respectfully with tenants offering encouragement, guidance and appropriate choices. It was clear that where the home had concerns about meeting the changing or emerging needs of tenants, additional support or advice is sought from health care professionals. The home balances the rights of tenants to take reasonable risks as part of an active lifestyle against any unacceptable risk to themselves or others. 7 Princes Crescent DS0000014159.V324370.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. 7 Princes Crescent DS0000014159.V324370.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 7 Princes Crescent DS0000014159.V324370.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): 1, 2, 3 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The necessary information about the homes services and facilities is in place should the need arise for this to be shared with prospective tenants and their representatives to help them make an informed choice about whether to move to the home. Prospective tenants would benefit from an admission process that ensures their individual needs and aspirations are assessed prior to moving into the home. EVIDENCE: The homes statement of purpose continues to accurately reflect the function of the home and the services that are provided. There have not been any new admissions to the home for a number of years. This standard therefore could only be assessed in respect of the admission systems in place should a vacancy occur. The manager was able to describe the admissions process, including a pre-admissions assessments and the opportunity for prospective tenants to visit the home prior to choosing to move in. 7 Princes Crescent DS0000014159.V324370.R01.S.doc Version 5.2 Page 9 There are also policies to ensure an effective pre-admissions process and moving in plans. The previously made requirement that the needs of prospective tenants be assessed by a suitable qualified person is now met. The group of tenants that live at the home have very complex individual needs. There is a wide range of evidence that the home is able to meet these needs. Staff were able to demonstrate a clear knowledge and understanding of the needs of each tenant and also how those needs are consistently met. A health care professional said: “Overall it is a strong service and I feel the tenants are all supported well” a resident said that he liked living at the home as the staff were nice. It was clear that where the home has concerns about meeting the changing or emerging needs of tenants, additional support or advice is sought from health care professionals. In line with discussions at the last inspection each tenant has now, or is in the process of having an annual review of their support needs and goals with their placement authority. Each tenants has a licence agreement with Southdown Housing. The agreement details the terms and conditions of residency and efforts have been made to simplify the document and put it into pictorial format. 7 Princes Crescent DS0000014159.V324370.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Tenants benefit from support plans which provide the reader with detailed information about how to support them safely and appropriately, but would benefit further through their regular review to ensure changes in needs and preferences are promptly identified. Services are designed to provide appropriate care and support in ways, which maximise independence and choice for tenants. The home balances well the rights of tenants to take reasonable risks against any unacceptable risk to themselves or others. EVIDENCE: Each support plan was unique to the individual and contains in-depth information about the individual gathered over a long period of time. The continuity of care was important for the group of people living at the home and guidelines on how to support tenants consistently were recorded. 7 Princes Crescent DS0000014159.V324370.R01.S.doc Version 5.2 Page 11 Some support plans were bulky making if more difficult to retrieve current information and contained out of date information. The manager said that they are currently in the process of reviewing the information in each support plan in order to reduce the bulk. It was not always clear if support plans had been reviewed and by whom. This has now been made a requirement to ensure that any changes in tenants needs and preferences are being promptly identified. Tenants are involved, within the range of their strengths and tolerances, to participate in devising and maintaining their support plan. A relative has in the past been actively involved in the development and review of their relatives support plan and meets all new staff to discuss their relative’s needs. The standard of daily recording was good with a clear account of actions and events that had occurred, these were written in a style that was respectful and none judgmental. All staff consulted were very knowledgeable about tenants individual needs and preferences. This included an awareness of the subtle signs of some tenants well or ill being, where verbal communication is not the main method of communication. It was evident that integral to the ethos of the home is ensuring and respecting tenants rights to make decisions about their lives. A variety of communication tools are used by staff to provide appropriate choices and support tenants to make decisions. A visiting health care professional said “That there has consistently been a very high level of commitment and motivation around promoting the individual rights, needs and choices of all. The team have always tried hard to find ways to manage difficult behaviours and situations, reviewing guidelines etc, whilst putting tenants rights and choices first”. The home has a developed system in place for enabling tenants to take responsible risks as part of an independent lifestyle. For example the core risks faced and posed by tenants are assessed and any control measures put into place to help manage or reduce risks. However risk assessments were very complex and comprehensive hand written documents. It was not always clear or readable what risk management strategies were in place or whether the assessment had been regularly reviewed to reflect any changes in risks. It has been required that tenant’s individual risk assessments provide clear guidance for staff on how to manage or reduce risks and are reviewed frequently. Records containing personal information are stored securely. 7 Princes Crescent DS0000014159.V324370.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 15 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home facilitates and ensures that suitable arrangements are made for occupation and leisure depending upon the individual preferences of residents. Tenants are supported to maintain relationships with their families. The meals are good offering both choice and variety and catering for special dietary needs. EVIDENCE: Three tenants attend local day care services on each weekday, where they are offered a range of opportunities for informal education and occupation. For one tenant day care provision is organised and undertaken by staff at the home. An individualised programme of leisure activities has been established for this person, which is based on their needs and preferences. 7 Princes Crescent DS0000014159.V324370.R01.S.doc Version 5.2 Page 13 Staff are knowledgeable about the local resources, and records showed that use is made of the many local amenities in the area including pubs, cafes, cinemas and leisure centre. On the evening of the inspection a tenant was planning to attend a local music event. The home has a range of equipment suitable for in-house entertainment, including puzzles, games and audio equipment. Tenants are provided with the opportunity of going on holiday. Staff also spoke of going on holiday with tenants and how much the tenants seemed to enjoy the experience. The home has its own transport, which enables access to a wide range of leisure and recreational facilities. Staff were knowledgeable about local events and places of interest. The support plans describe the significant others for each tenant and where there is family contact staff support the tenant to maintain regular contact. For one tenant this involves regular evening visits home. For another this involved overseas visits. The manager was sensitive to the potential areas of conflict regarding relatives views on care needs. Mechanisms were in place to take on board all party’s wishes. Staff were observed involving tenants in as much choice in planning their day to day support and activities as possible, depending upon their individual tolerances. During the inspection tenants were observed to move around the communal space freely, choosing which rooms to be in and what level of company they wanted to enjoy. Tenants were able to choose when to spend time on their own, and can do so in their own bedrooms. The kitchen area is locked at night and food pantry during the day. It was previously required that an assessment of the restriction to the kitchen be undertaken. The manager reported that this had been undertaken and the kitchen had been unlocked at night for a trail period. Based on the outcome of the trial the manager reported that it is once again locked on the grounds of health and safety for all tenants and staff. At the time of the inspection the main evening meal was being prepared by staff. Tenants were able to walk in and out of the kitchen when the meals were being prepared and staff engaged with them and encourage them to participate. Staff consulted demonstrated an in depth knowledge of the individual food preferences of tenants. 7 Princes Crescent DS0000014159.V324370.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 20 and 21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from the provision of flexible and respectful personal and healthcare support. Generally tenants are protected by the homes system for the administration of medication. EVIDENCE: Staff were observed providing dignified and sensitive support in a relaxed and friendly manner. Support plans viewed contained information to guide staff in the delivery of personal care and support. Residents are assisted in choosing their own clothes, hairstyles and to ensure this reflects their individual personalities. There was documentary evidence that tenants are supported to access a range of health services, to meet their individual needs. 7 Princes Crescent DS0000014159.V324370.R01.S.doc Version 5.2 Page 15 Tenants are registered with a local GP, and are able to access specialist support from the local community health team. There was documentary evidence that medical intervention or advice is promptly sought. The storage and administration of medication was generally satisfactory, with the exception being in the administration of “As directed” or PRN Medication. There is a need to ensure that individual instructions are recorded for these types of medication. This is to ensure that staff are fully aware of the individual requirements for when these medications should be administered. As a matter of good practice, it is recommended that all medication received into the home be checked and recorded to ensure that all medication can be accounted for. In order to fully eliminate the associated risk when copying prescribed instructions onto medication administration records (MAR), it is recommended that hand written MAR charts be checked and countersigned for accuracy by a second member of staff. MAR charts often recorded lists of medication that were not currently being used. This often resulted in several pages of MAR charts, which was potentially confusing for staff. It was suggested that following discussion with the GP and pharmacy, that medicines no longer prescribed be removed from these charts. It was previously recommended that information about the medication tenants were taking be detailed for all tenants and that lunchtime medication be stored in blister packs. These recommendations have now been assessed as met. 7 Princes Crescent DS0000014159.V324370.R01.S.doc Version 5.2 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. 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. An effective complaints procedure and appropriate adult protection policies and training for staff protect the rights and interests of tenants. EVIDENCE: There is a complaints procedure, although it is recognised by staff that the tenants would require support to make a formal complaint. The Manager stated in information submitted both before and during the inspection, that there have not been any complaints about the service in the last twelve months. A relative, in writing, has raised several informal concerns and these were responded to by the manager in a timely manner. The relative said that they did not feel comfortable making a formal complaint due to the delicate nature of their relationship with the management team. This was fedback to the manager to discuss directly with the relative. The home has written policies covering adult protection and whistle blowing. These make clear the vulnerability of people in residential care, and the duty of staff to report any concerns they may have to a responsible authority for investigation. Staff consulted confirmed that they had attended training in the protection of vulnerable adults and demonstrated that they had a clear understanding of their roles and responsibilities in this area. A health care professional consulted felt that “Incidents and concerns are raised correctly to my knowledge” 7 Princes Crescent DS0000014159.V324370.R01.S.doc Version 5.2 Page 17 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): 24 26 27 28 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Tenants live in an environment which suites their needs and tolerances and which is well maintained, tidy and hygienic. EVIDENCE: The home is located near Hove seafront and within walking distance of Hove town centre and the amenities that this offers. The home is presented across three floors with the top floor used only as supervised quiet space for individual tenants. The environment within the home is based upon the needs and tolerances of current tenants. The environment continues to improve with staff continuing to look at creative ways of introducing a more homely environment, which can be tolerated by the tenants. The home is reasonable maintained. 7 Princes Crescent DS0000014159.V324370.R01.S.doc Version 5.2 Page 18 There is a rear secure garden, which can be easily accessed by tenants and has a patio and grassed area, making this an attractive area for all to use. Tenants bedrooms are highly individualised, and are furnished in accordance with tenants preferences, and needs. This in some cases results in minimum furnishing and decorations. It was clear that much effort is made to promote tenants individual choices while ensuring that they are comfortable and safe. Locks are provided on all bedroom doors but are not used by most tenants. One tenant has a keypad on their door to prevent access by other tenants. There are sufficient number of toilets and bathrooms located around the building that meet the needs of tenants. One bedroom has its own ensuite facilities. In line with a previous requirement the flooring in one of the communal bathrooms has been replaced. Currently there is no need for any specialist equipment or mobility aids as all tenants are fully ambulant. The home was found to be reasonable clean and hygienic. Staff undertake the domestic chores of the home as part of their general duties. The laundry facilities were adequate for the needs of the tenants. The standard of laundering was variable, which the manager was aware of. 7 Princes Crescent DS0000014159.V324370.R01.S.doc Version 5.2 Page 19 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): 31 32 33 34 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. An enthusiastic, knowledgeable and skilled staff team provide good quality care to understand and meet the needs of tenants. Good supervision and support enable staff to provide consistent and caring support. EVIDENCE: Staff showed a sound understanding of the purpose and function of the service, and how their individual roles contributed to the achievements of this in terms of the goals of the home and of individual tenants. The manager reported that currently four of the twelve support workers have obtained a National vocational Qualification (NVQ). It is the organisations policy that staff must have been in service for a year to be able to apply for NVQ training and therefore new staff are not able to undertake this as yet. Although most staff do not currently have a formal care qualification many have qualifications in other areas. 7 Princes Crescent DS0000014159.V324370.R01.S.doc Version 5.2 Page 20 A health care professional spoke positively about their experience of working with the staff team saying: “The staff team have recently worked very well with the Behaviour Support Team and day service staff to work out the best way of supporting a tenant through active support. They are open to ideas as they are keen to get it right and this has paid off”. The minimum staffing levels is for three staff to be on duty throughout the waking day. Staff felt that this was sufficient to meet the individual needs of tenants. There is often periods when there is one member of staff in the building supporting the remaining tenants. All staff consulted felt that there was sufficient management on call support in the event of an emergency in these circumstances. The manager and staff said that there is much flexibility in the staffing arrangements depending upon what activities and events are being planned. Staff felt that they were kept informed of changes in needs and practices and that there was a good standard of communication across the team, with regular team meetings. Relief staff are used regularly to cover shifts, the manager said that the same relief staff are used in order to maintain continuity. Recruitment files are held outside of the home and it was therefore not possible for these to be inspected on this occasion. There needs to be some mechanism in place for the manager to be able to satisfy themselves that all of the necessary recruitment checks have been undertaken. This should include Criminal record Bureaus checks on staff prior to them commencing at the home and evidence maintained in the home that these checks have been undertaken. The organisations policy is that new staff received induction training within the first six weeks and foundation training within six months of them working in the home. A staff member who has recently undergone induction training felt that this was sufficient to enable them to undertake their role effectively. A minimum of eight days of training are set-aside for each staff member per year. Individual training records for each staff member highlighting what training has been undertaken and is booked. These showed that staff undergo mandatory training as well as some specialist training in the broader aspects of people who have learning disabilities. The majority of the training is undertaken by the organisation, the manager said that there is the opportunity to also access external courses. There is an organisation training and development plan for the year ahead, which identifies available courses in autism, active support and challenging behaviour. Staff said that they receive regular supervision with the manager or deputy regarding their performance, conduct and training needs. All staff consulted said that they felt well supported by the management team to undertake their roles and felt able to approach them for advice and guidance. 7 Princes Crescent DS0000014159.V324370.R01.S.doc Version 5.2 Page 21 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): 37 38 39 42 and 43 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager ensures a clear ethos and values of the home enable staff to provide good quality care to tenants. A range of regular health and safety checks helps to ensure the health and welfare of tenants and staff, this should be further supported by confirmation of an electrical systems check. EVIDENCE: The registered manager has managed the home since 1999 and has obtained qualifications in management. The Manager said they undertake training to enable them to keep up to date with best practice issues in the care of people who have a learning disability. 7 Princes Crescent DS0000014159.V324370.R01.S.doc Version 5.2 Page 22 There was clear evidence available that the home is managed effectively with a strong sense of leadership and direction being provided. Comments regarding the manager included: “Jon fantastic very clear of his boundaries, absolutely time for everyone” and “good manager”. A relative said that they found it difficult to communicate directly with the manager and therefore raised any concerns in writing. Relationships between tenants, staff and the manager was observed to be friendly and informal and the general atmosphere of the home was relaxed and open. There are some stand-alone quality assurance practices in place. This includes: placement reviews, regular individual consultations, a monitoring tool used to record the level and type of services a tenant receives and a formal audit of tenants personal monies by a representative of the organisation. The manager spoke about a monitoring day, which was held with senior management to audit the homes practices and procedure. This identified any areas where service development was needed. The home would now benefit from merging these stand-alone practices into a formal integrated approach to quality assurance to ensure that regular self-assessment across its range of services and facilities is being undertaken. Written guidance is available for staff on issues related to health and safety. Records submitted by the manager prior to the inspection stated that with the exception of an electrical wiring certificate, all of the necessary servicing and testing of health and safety equipment had been undertaken. The manager has been asked to confirm that an electrical check has been undertaken to ensure that residents are safeguarded by the homes electrical system. Good systems are in place to support fire safety, this includes: regular fire alarms and emergency lighting checks, maintenance of fire equipment, fire safety training and fire drills. A fire risk assessment has been undertaken which records the actions to be taken to ensure adequate fire safety precautions in the home. The manager acts as the home’s budget manager and the organisation manages the financial viability of the home. There are clear lines of accountability between the home and the organisation. 7 Princes Crescent DS0000014159.V324370.R01.S.doc Version 5.2 Page 23 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 3 3 3 4 X 5 3 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 2 25 X 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 2 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 3 3 X X 2 3 7 Princes Crescent DS0000014159.V324370.R01.S.doc Version 5.2 Page 24 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 YA6 Regulation 15(2)(b) Requirement Timescale for action 28/02/07 2 YA9 3 YA20 4 YA34 5 YA43 That care plans be reviewed regularly to reflect changes in the needs and preferences of service users and recorded as having been reviewed. 13(4)(c) That service users individual risk assessments provide clear guidance for staff on how to manage or reduce risks, are reviewed frequently and recorded as having been reviewed. 13(2) That instructions are provided for staff on the administration of “As required” or “PRN” medication, which make clear the individual requirements for when this medications are to be administered. 19(1)(b)(i) That employment and recruitment documentation as listed in Sch 2 (1Schedules 2 (as amended) & 4 be 4) obtained prior to employment commencing and that copies are retained in accordance with the National Minimum Standard That confirmation of adequate 13(4)(a) electrical wiring check has been undertaken is provided to the CSCI. 28/02/07 28/02/07 28/02/07 28/02/07 7 Princes Crescent DS0000014159.V324370.R01.S.doc Version 5.2 Page 25 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 YA20 YA20 Good Practice Recommendations That a record is maintained of all medicines received into the home. That hand written medication administration records be checked and countersigned for accuracy by a second member of staff. 7 Princes Crescent DS0000014159.V324370.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 7 Princes Crescent DS0000014159.V324370.R01.S.doc Version 5.2 Page 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!