Inspection on 09/08/06 for 94 Eastern Road

This inspection was carried out on 9th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

94 Eastern Road 05/10/05

94 Eastern Road 11/04/05

Similar services:

Flint House

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

The Cotswold Home

Fairways

Treloar College

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

CARE HOME ADULTS 18-65 94 Eastern Road Portsmouth Hampshire PO3 5EW Lead Inspector Neil Kingman Unannounced Inspection 9 August 2006 14:30 94 Eastern Road DS0000061646.V299990.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 94 Eastern Road DS0000061646.V299990.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. 94 Eastern Road DS0000061646.V299990.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 94 Eastern Road Address Portsmouth Hampshire PO3 5EW 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) 023 9282 5182 www.c-i-c.co.uk. Community Integrated Care Mrs Karen Lisa Lee Care Home 3 Category(ies) of Learning disability (3), Physical disability (1) registration, with number of places 94 Eastern Road DS0000061646.V299990.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5 October 2005 Brief Description of the Service: 94 Eastern Road is a care home providing care, support and accommodation for up to three younger adults with learning disabilities. The home is a detached property situated at the junction of Eastern Road with Eastern Avenue, Portsmouth, close to some local shops. There are three good sized bedrooms, two with en-suite facilities. The ground floor bedroom has wheelchair access and is suitable for a person with mobility difficulties. The large lounge/dining room and kitchen are situated on the ground floor. A garden surrounds the home and provides seating for use by residents and staff. There is ample space for parking at the rear. The service is provided by Community Integrated Care (CIC), a Charitable Trust but does not currently have a registered manager in post. 94 Eastern Road DS0000061646.V299990.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report details the results of an evaluation of the quality of the service provided by 94 Eastern Road and brings together accumulated evidence of activity in the home since the last key inspection on 5 October 2005. Part of the process has been to consult with people who use the service; including telephone discussions with two social services care managers. All three residents completed a care homes survey with help from members of staff, and comment cards were received from visiting relatives. Included in the inspection was an unannounced site visit to the home by an inspector on 9 August 2006. During the visit the inspector toured the building, looked at a selection of records, spoke with care support workers on duty and spent time with all three residents. The responses from the consultations were generally very positive. What the service does well: What has improved since the last inspection? Equipment to meet the specific needs of one resident, which was lacking at the time of the last inspection, has now been installed. Improvements have been made to enable all residents to access the kitchen without the need for staff assistance. 94 Eastern Road DS0000061646.V299990.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. 94 Eastern Road DS0000061646.V299990.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 94 Eastern Road DS0000061646.V299990.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 94 Eastern Road is a relatively new service providing long-term care and support for three younger adults with learning disabilities. To ensure their care and support needs are met a proper assessment is undertaken before they move into the home. EVIDENCE: All three residents in the home have been referred through social services care management. A needs assessment was available with each of the personal plans seen by the inspector. The assessment process for the most recent admission to the home was looked at in more detail. In discussions with the individual’s care manager it was confirmed that the then manager of the home carried out a full assessment prior to his moving in. A personal plan was drawn up and developed when his needs and wishes were more fully understood. 94 Eastern Road DS0000061646.V299990.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service Opportunities for residents to make decisions and choices in their lives are determined by assessment and recorded in individually agreed personal plans, drawn up between the home and the residents. Residents are enabled to take control over their lives. Any limitations are identified in the assessment process and recorded in their personal plans. They are encouraged to be as independent as possible and to take sensible risks, which enhance their enjoyment of life. EVIDENCE: Each resident has a personal plan, which reflects their individual needs, aspirations and goals. At the site visit the inspector looked at the residents’ personal plans and was able to discuss one of them with the individual resident. Plans were seen to be very person centred in their approach to recording information. They cover all areas of daily living; identify skills, methods of 94 Eastern Road DS0000061646.V299990.R01.S.doc Version 5.2 Page 10 communication and social relationships. Comment cards from the residents’ families confirmed that they were consulted about their care and kept informed of important matters affecting the resident. Care managers spoken with were full of praise for the home’s approach to care planning, saying how person centred it was. A key element of CIC’s philosophy of care is that service users have a right to access information, that will enable them to make informed decisions in planning their future support and care needs. Care records and discussions with staff on duty provided evidence of them respecting residents’ rights to make decisions. No better example was a discussion that took place between a resident and his key worker about something he was saving up to buy. It was clear that the resident had made his own decision based on information he had been given. Since the last inspection the home has arranged for all residents to have their own bank account and to access their own monies when they wish. The inspector noted the current system for the handling of residents’ monies to be satisfactory. Care managers confirmed and the inspector noted from records that residents are supported to achieve their goals and aspirations. One in particular had for some time wanted to attend college. He was able to confirm the arrangements for him to start a college course in September. During the site visit the inspector noted clear and specific risk assessments on residents’ personal plans, with actions to be taken to minimise the identified risks. Included was a specific risk assessment relating to residents’ use of the minibus. There is a road safety programme to enable residents to go out from the home safely, either independently or with support. 94 Eastern Road DS0000061646.V299990.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 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. Residents are encouraged and supported to take part in a range of activities inside and outside the home, including opportunities for personal development, life skills and leisure. They maintain family links and outside friendships where desired. Routines in the home promote independence for the residents who have unrestricted access around the home. They are offered meals they enjoy, which are varied and healthy. EVIDENCE: Residents’ interests and hobbies are varied, and clearly identified in their personal plans. Staff employ a range of communication techniques including symbols, videos and photographs to gain a better understanding of their wishes. The inspector had discussions with two of the residents about their 94 Eastern Road DS0000061646.V299990.R01.S.doc Version 5.2 Page 12 individual interests. It was clear from their comments that the home enables them to further those interests. Bedrooms were seen to be well personalised and reflected residents’ different interests and preferences. Residents access a wide range of community facilities including pubs, cafes, sports and leisure facilities, football stadiums and shops. They generally have set programmes for visiting family, all of whom enjoy a good relationship with the home. Residents engage in a weekly programme of activities throughout the week involving college, ‘Creative Advances’ and day services. A comment from one response to the relatives survey highlighted a lack of drivers amongst the staff team, which restricted use of the home’s minibus. This was raised with the acting manager who said he had been made aware of the concern, and had resolved the situation by changing the staff rota to create a more even spread of drivers. There was evidence from records and staff during the site visit that holidays are arranged according to residents’ individual preferences. This was confirmed in discussions with two of the residents. Rooms have lockable doors and residents have their own keys. During the site visit one resident showed an interest in the menu for the day, which was on display in the kitchen. He pointed out to the inspector what was planned for the evening meal. It was clear during the conversation that he and the other residents appreciate the food in the home and are involved in choosing what is included in the menu. Menus showed that food is varied and nutritious, and while occasionally fast food and take-aways are an option the menus contain healthy options, where vegetables and fruit are included. 94 Eastern Road DS0000061646.V299990.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents at 94 Eastern Road are assessed as needing varying amounts of support for them to maximise the control they have over their lives. Aids and equipment help staff to provide flexible support according to their needs. Residents’ healthcare needs are assessed and key workers enable and support them to receive healthcare checks at appropriate intervals. Medication is securely held and appropriate records maintained. EVIDENCE: At the time of the site visit all residents were generally in good health. Staff confirmed, and care records showed that their health care needs are regularly addressed. They receive checks from the GP, dentist, optician and specialist health care professionals. All health care needs of the residents are identified in their personal plans. 94 Eastern Road DS0000061646.V299990.R01.S.doc Version 5.2 Page 14 Records showed that medication is administered by staff who have completed training in the safe handling of medicines. At the time of the site visit medication for residents was securely held in appropriate metal cabinets, and records relating to its safekeeping and administration were found to be in good order. The inspector noted the home had satisfactorily addressed the issue of the medication key security identified at the last key inspection. The inspector gave advice to staff, and later the acting manager regarding the separation of external ointments from internal medication. 94 Eastern Road DS0000061646.V299990.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ complaints are treated seriously and given an appropriate response. The home’s policies, procedures and practices ensure that residents are safeguarded from abuse. Procedures for responding to suspicion or evidence of abuse are robust. EVIDENCE: While the home has a formal complaints policy and procedure a copy of which is included with the residents’ personal plan, the inspector focused on whether or not residents and their representatives knew how to complain if they had any concerns about the service. The responses from the relatives/visitors survey indicated that they were aware of the home’s complaints procedure. One of the care managers spoken with said they had used the procedure to raise an issue and was satisfied with the home’s response. One resident who was able to express a view said he would speak with staff if he had a complaint. The inspector noted that relations between the residents and staff appeared open, friendly and genuine. Monthly residents’ meetings give them an opportunity to be listened to and have their difficulties resolved. In a telephone discussion with the acting manager after the site visit it was understood that the complaint about the lack of drivers had been addressed. 94 Eastern Road DS0000061646.V299990.R01.S.doc Version 5.2 Page 16 The pre-inspection information sent to the Commission confirmed that an adult protection policy and procedure is in place. In discussions with staff during the site visit it was clear that they take part in Protection of Vulnerable Adults (POVA) training and have POVA manuals. They showed a good understanding of what constitutes abuse and the importance of reporting issues of concern without delay. 94 Eastern Road DS0000061646.V299990.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s premises is suitable for its stated purpose. It is comfortable, safe and well maintained. On the day of the site visit the home was clean, hygienic and free from unpleasant odours. EVIDENCE: Residents have very different needs, skills and abilities. One has mobility difficulties and uses a wheelchair. The way in which support is given is a key issue for this resident and following a referral to the occupational therapist the home has introduced aids and equipment to his bedroom, which have enhanced his independence. An issue at the last key inspection was access to the kitchen. The inspector noted the positive measures that had been taken to permit access for all residents without the assistance of staff. One of the care support workers said that further improvements to the kitchen were planned. 94 Eastern Road DS0000061646.V299990.R01.S.doc Version 5.2 Page 18 The inspector toured the building during the site visit. Residents were happy to show the inspector their rooms and seemed proud of them. Rooms were seen generally to be spacious, well decorated and personalised. Communal areas are also spacious and comfortable. All areas were noted to be clean, tidy and free from unpleasant odours. One resident indicated a small area of carpet in his room that was badly worn. While it was not considered a hazard it is recommended that consideration be given to replacing the carpet in the near future. 94 Eastern Road DS0000061646.V299990.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff in the home are deployed in adequate numbers and have the necessary skills and experience to meet the needs of the people who live there. A robust recruitment procedure ensures residents are protected. EVIDENCE: The home currently employs seven care support staff, and is actively seeking a new manager. On the day of the site visit there were two care support workers in the home. The inspector was told that the acting manager would normally have been on duty with them but was attending training on the day. Staff rosters showed that typically there is a minimum of three staff on duty during the day and one overnight. These staffing levels are considered adequate for the current needs and numbers of residents in the home. On the day of the site visit the inspector was unable to look at the staff files. Due to the confidential nature of the files it was understandable, since the acting manager was away. At the last inspection the standard relating to staff recruitment was met and a robust recruitment procedure was seen to be operating. It was confirmed from the pre-inspection information, and discussions with staff and the service manager that two care support workers 94 Eastern Road DS0000061646.V299990.R01.S.doc Version 5.2 Page 20 had been recruited since the standard was last assessed. Arrangements were later made for the inspector to view the security checks carried out on these new staff, which were found to be in order. During the site visit the inspector looked at a copy of the staff training plan, which gave details of training completed and scheduled. Staff confirmed the content of the training programme, which includes health and safety, first aid, manual handling, food hygiene, fire training and understanding challenging behaviour. New staff are placed on an ‘Induction Training and Foundation Course’. After three months probationary period they undertake the mandatory training, which CIC provide in-house. Both care managers spoken with were very complimentary about the skills of the staff. One said that after some initial teething troubles significant progress had been noted in recent months. 94 Eastern Road DS0000061646.V299990.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 - Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is currently without a registered manager. An acting manager is in charge of the day-to-day running of the home, with support from the organisation’s service manager. The home has developed effective quality assurance systems for measuring its performance based on seeking the views of residents, representatives and stakeholders. While the home’s policies, procedures and staff training ensure as far as is reasonably practicable, the health and safety of the residents and staff, it is important that self-closing fire doors are not wedged open. 94 Eastern Road DS0000061646.V299990.R01.S.doc Version 5.2 Page 22 EVIDENCE: There has been no registered manager in post since June 2006. This was raised as a concern in one of the responses to the relatives/visitors survey. Both the acting manager and the CIC service manager have confirmed that the process of recruiting a new manager is well under way and should be resolved in the very near future. The home is small and domestic in nature with only three long-term residents. Consequently satisfaction surveys, anonymous or otherwise are not carried out. Information about the service held by the Commission shows that systems are in place to assure quality, including: • • • • • • • Service user charter Written service standards Person centred planning Key worker system Monthly home meetings Audit visits by the service manager Quality assurance (Business excellence model) Key to obtaining the views of service users are the monthly residents’ meetings, at which family are encouraged to attend. Conversations with care managers showed them to be very positive about the home’s ability to develop each resident in line with their personal plan. There were very positive responses from residents in the care homes survey, which were filled in with support from staff. The overriding view was that living at 94 Eastern Road had brought them a good deal of happiness. All care support staff undertake statutory training, which includes health and safety awareness, basic food hygiene, manual handling and fire training. The home’s pre-inspection information confirmed that policies and procedures were in place to ensure safe working practices in the home. The inspector dip-sampled fire and maintenance logs, accidents and risk assessments, all of which were in order. During the tour of the building it was noted the self-closing fire door to one resident’s room was wedged open. The home is advised to consult with the Fire Safety Officer, as fire doors must only be held open with an approved mechanism. 94 Eastern Road DS0000061646.V299990.R01.S.doc Version 5.2 Page 23 94 Eastern Road DS0000061646.V299990.R01.S.doc Version 5.2 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 Standard No Score 1 x 2 3 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 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 2 x 3 x x 2 x 94 Eastern Road DS0000061646.V299990.R01.S.doc Version 5.2 Page 25 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 YA42 Regulation 13 Requirement Self-closing fire doors must only be held open with mechanism approved by the Fire Safety Officer. Timescale for action 30/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA24 Good Practice Recommendations To replace the carpet in the resident’s room identified during the inspection. 94 Eastern Road DS0000061646.V299990.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Southampton, Portsmouth and Isle of Wight Ground Floor Mill Court Furrlongs Newport, IOW PO30 2AA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 94 Eastern Road DS0000061646.V299990.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. 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