Inspection on 26/11/08 for Beach View

This inspection was carried out on 26th November 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Sutton Lodge Nursing Home

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Beach View 28 Alleyne Way Middleton-on-Sea West Sussex PO22 6JZ     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lesley Webb     Date: 2 6 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Beach View 28 Alleyne Way Middleton-on-Sea West Sussex PO22 6JZ 02392251331 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Dolphin Homes Ltd care home 10 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: The maximum number of service users to be accommodated is 10. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) Physical disability (PD). Date of last inspection Brief description of the care home Beech View is located in a residential area, close to the sea. There is car parking at the front and a garden to the rear of the house. It comprises of ten single bedrooms all with en suite shower and toilet facilities. There is a large lounge/dining room, fitted kitchen, laundry and two communal bathrooms and seperate toilets. An activity room is located to the side of the main building. There is a power lift for access to the first floor. The decoration throughout communal areas is neutral, bright and airy with good natural light and is domestic in appearance. Fees charged for living at the home range from one thousand, one hundred and twenty four pounds to one thousand, six hundred and three pounds per week. Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 0 0 10 10 Care Homes for Adults (18-65 years) Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We undertook this site visit over one day, with the home being given no prior notice that we would be visiting. During the site visit time was spent talking to the Registered Manager, staff, a resident and people who were visiting the home. We also examined records, indirectly observed care practices and toured the premises before giving feedback about the inspection to the Registered Manager. The home completed its Annual Quality Assurance Assessment (AQAA) and sent this to us prior to our site visit. The contents of this were examined and tested for accuracy when we visited the home. It was also used when forming judgments of the standards of service provided and outcomes for residents. Care Homes for Adults (18-65 years) Page 6 of 31 Care Homes for Adults (18-65 years) Page 7 of 31 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 Care Homes for Adults (18-65 years) Page 8 of 31 240 7535. Care Homes for Adults (18-65 years) Page 9 of 31 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information is available to prospective residents that can help them decide if the home is suitable for them. In the main admission processes ensure the home can meet residents needs. People considering moving into this home can undertake a range of visits to help decide if it is suitable for them. Information is not available that allows the manager to monitor that residents contractual rights are upheld. Evidence: When we visited the home we saw the Statement of Purpose on display at the entrance to the building. The contents of the Statement of Purpose (which incorporates the Service User Guide) gives information that includes that of the qualifications of staff, the company that owns the home, assessment processes for new residents, the environment, health and safety and complaint processes. Colour pictures are included. These can help people who have difficulty understanding the written word. Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: The home sent us its Annual Quality Assurance Assessment (AQAA) prior to our inspection. With regard to assessment processes it states Initial assessment and Service User Plan undertaken by service manager and RHM as well as the individual and significant family and other professionals and specialists. Transition planning meetings. Detailed Transition Plan with opportunities for visits. At our site visit we looked at residents records and spoke to people, finding evidence that not all aspects of this information were accurate. For example residents files contained evidence of visiting the home before moving in and of other professionals involvement but not of detailed transition plans. The Registered Manager informed us that for one resident their transition to the home had been very difficult as all services were not put in place at the time they moved to the home. This information was confirmed by others that we spoke to. One informed us, The transition was reduced to about five weeks so not everything was in place in time. The manager has had to hit road running, we believe he has addressed everything in the best way possible. This is a newly registered home and at the time of our inspection there were eight vacancies for residents. There are currently two staff and the Registered Manager employed at the home, with all other vacancies covered by agency staff. We discussed this situation with the Registered Manager with regards to meeting needs, new residents moving to the home and recruiting staff. He informed us that his priority is to give a high quality service, stating, any new residents transition to the home needs to be assessed and decided on individual basis, hope would do on staggered basis. We agreed with his comments. No residents terms and conditions of residency were available for us to look at. We discussed this with the Registered Manager who informed us he thought they were held by the Director of the Company. The Registered Manager agreed with us that he needed to make himself familiar with the contents of these in order that he can ensure residents rights are being upheld. Care Homes for Adults (18-65 years) Page 12 of 31 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. In the main care planning and risk management systems ensure residents needs are met. Omissions mean people may not receive support is a consistent and safe way. Systems for promoting peoples rights to make decisions and to be supported to make choices need further development. This is needed to ensure no one is disadvantaged. Evidence: We examined the records of residents, observed practices and talked to people and found in the main care planning meets individual needs. For example files contained care plans for a range of needs including communication, mobility and health. People that we spoke to informed us that one resident has a need due to memory loss associated with dementia. One person explained, X is afraid of new faces, it takes time. Need to build trust, has short term memory. The Registered Manager confirmed there is no care plan in place explaining how this need will be met safely. He agreed this needs to be completed. Support plans detail peoples preferences. This helps people receive support in a person centered way. Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: Staff complete daily records for each resident. The form used for this allows for recording of general health, personal care, behaviour, communication, choice, activities, food and drink. We found some have been completed with more detail than others. For example under personal care some staff record all personal care given. Others describe what form of personal care has been given such as oral hygiene, whether bath or shower and hair care. We discussed this with the Registered Manager who agreed further work should be undertaken to ensure records can evidence a quality service for those residents with communication needs. Residents are allocated key workers. Staff that were spoken to demonstrated an understanding of this role. The people who live at this home have a range of needs, that for some have the potential to impact on them being involved in decision and choice making. Observations during our inspection confirm that efforts are being made to support some residents with some choices. For example staff were seen offering a choice of meal at lunch time. One residents care documentation states that objects of reference and cards can be used to aid communication. We did not see these being used during our visit. A resident that we spoke to did not have a key to lock their bedroom door. We found no information on their file demonstrating how this decision was arrived at. The Registered Manager produced two documents that he explained may be used for decision making and capacity assessments. He acknowledged work is needed to evidence compliance with the Mental Capacity Act and if decisions are being made on behalf of residents. Risk assessments were seen to be in place covering a range of personal risk issues for each resident. Examples being use of wheelchair, bathing, and medication. A risk assessment was not in place for a resident with short term memory lose associated with dementia. Care Homes for Adults (18-65 years) Page 14 of 31 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social, educational and recreational activities meet individuals expectations. Residents are supported to maintain contact with their families as per their needs and wishes. Residents are supported with their dietary needs. Evidence: The homes Annual Quality Assurance Assessment (AQAA) sent to us prior to our visit gives some information about how residents are supported to lead fulfilling lives. For example it states Support individuals to attend and engage in a wide range of lifestyle choices both within and outside the home e.g a wide range of daily activities offered including in house activities e.g cooking, painting, accessing community and shopping. We support those who need help at meal times. We promotes healthy and balance living, not rigid diets - for maintenance of well-being. We support an individual to access community shopping trips We discretely support individuals who need Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: assistance with eating. We examined the records of residents, observed practices and talked to people and found the information contained in the homes AQAA to accurately reflect practices within the home. For example one person informed us they were going out with staff to post advertisements in the surrounding area, inviting the local community to an open day that the home has arranged. The same person informed us, I go out shopping, walks, been to Bognor, do go out for lunch sometimes. We got a craft room where we do craft, make cards, pictures with glitter on, do different art pictures. Residents were seen moving freely around the home including the kitchen and were not seen to be restricted in any part of the home. The Registered Manager explained that they intend to support residents with regard to daily living skills. We were shown a room that is going to be converted to a kitchen area specifically for people to learn cooking skills. A resident that we spoke to said that staff cook their meals. When the home was registered with us for operation we were informed a multisensory stimulation room was going to be installed for residents to use. This has still to be provided. The Registered Manager informed us the home is currently raising funds for equipment. We were also informed by people at the home that the home is looking to arrange music therapy. During our visit to the home we spoke to relatives of a resident who expressed their satisfaction with the home. They stated, staff are magnificent, devoted to learning about people, manager outsourced additional training, they always ring us and keep us informed and send text. They altered our daughters feeding regime to encourage activities. They email photos doing activities A resident informed us that meals are really really good, really tasty. People requiring specialist intervention are supported as necessary. Staff were observed taking a resident to the privacy of their own bedroom to support with specialist dietary intervention. Care Homes for Adults (18-65 years) Page 16 of 31 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. In the main the principles of dignity and privacy are put into practice. The health and personal care that residents receive is based on their individual needs. Medication practices offer safeguards to residents. Evidence: Efforts are made to promote the dignity and privacy of residents but further consideration should be undertaken. For example a member of staff was observed taking a resident to their bedroom when an invasive procedure for eating was needed. When this occurred a listening monitor was left switched on in the lounge and we were able to hear staff talking to the resident when in the residents bedroom. We discussed this with the Registered Manager who agreed this should not happen as it encroaches on the individuals rights to privacy. We found evidence that residents are supported with their health needs. For example both of the residents files we examined contained evidence of external professionals involvement when necessary. Records include those for the dentist, doctor, physiotherapist and community learning disability nurse. Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: One residents file contained a weight chart detailing monitoring from February to May. We had been informed this person is being supported to manage their weight. The Registered Manager informed us the weighing scales were broke and that new were on order, stating, its important to weigh as this encourages the resident to manage their diet. When examining the the systems for storing and recording medication we found these to be in order and up to date. For example we found no gaps on medication administration records, stock for as and when required medication is recorded and competency assessments are completed for staff that administer medication. The Registered Manager informed us that no controlled drugs are currently used at the home, however facilities are in place should this arise. Care Homes for Adults (18-65 years) Page 18 of 31 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems are in place to support people to raise concerns. Staff understand their responsibilities to protect residents from harm. Evidence: The homes Annual Quality Assurance Assessment (AQAA) sent to us prior to the inspection states Home follows organisational procedure which complies with Standard 22 of National Minimum Standards (NMS). Homess complaints procedure displayed in accessible format of notice board. All complaints responded to within required time scale. Service User Guide - copy of which is in each individuals key file. All staff CRB enhanced checks- evidence kept on supervision files. At at visit we found parts of this information to be accurate. For example the homes complaints procedure was seen to be displayed and meet all aspects of the NMS and evidence was maintained on staff files that they have criminal records bureau disclosures. We did not find copies of the Service User Guide on residents key files. Some people that we spoke to demonstrated understanding of supporting people to raise concerns. For example one person explained, would ask, bring in room for private chat, report, speak to manager. Always seek advice and take higher. One person did not, stating dont know. A relative informed us they would feel happy to raise any concerns, should they arise. Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: The homes AQAA did not give evidence detailing how NMS standard 23 (protection) is met apart from explaining all staff have a CRB disclosure. We discussed this with the Registered Manager who agreed greater detail would be included when next completed. Everyone that we spoke was able to explain what they would do to protect residents from harm. For example one stated, look for unexplained marks, complete body maps, if saw anything use whistle blowing procedure and another watch other staff, make sure CRB, wouldnt let work alone, keep eye on. No qualms to to straight to manager, if manager go higher, to area manager. Care Homes for Adults (18-65 years) Page 20 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Not all parts of the home can be accessed safely by people who use wheelchairs. Bedrooms are spacious and have individual showering facilities that promote privacy. Specialist equipment is not available that allows all residents the choice of having a bath. The home is clean, promoting a comfortable place for residents to live. Evidence: The home is situated in a residential area, close to the sea and is in keeping with surrounding buildings. There is car parking at the front and an enclosed garden to the rear of the house. The Registered Manager escorted us around the building. Accommodation includes a fully fitted kitchen, a large lounge/dining room, laundry and staff office. We were shown a room that is currently used as a sleep in room for staff. The Registered Manager informed us this is going to be converted to a multi-sensory stimulation room. An outer building is used as an art room. The Registered Manager showed us a separate room at the rear of the art room explaining that this is going to be used as a kitchen for residents to develop their living skills. Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: When being escorted around the building we observed a steep incline to part of the first floor hallway. We discussed this with the Registered Manager questioning if the gradient would affect the safety of wheelchair users. The Registered Manager informed us that when an Occupational Therapist visited the home they had also questioned this. The home is registered to accommodate people with physical disabilities. People with a physical disability resulting in them using a wheelchair could not be accommodated in this part of the home safely. This information should be included in the Service User Guide. Each bedroom is large and airy with fully accessible shower en-suite facilities. Furniture includes a wardrobe, chest of drawers and bedside cabinets. Water damage was seen on the ceiling in one en suite bathroom. The Registered Manager instructed a member of staff to contact a plumber. A resident agreed that we could view their bedroom. This contained personal items including photographs and ornaments. The resident informed us they were happy with their bedroom. Communal toilets and bathrooms are wheelchair accessible. Water damage was seen on the ceiling in a communal bathroom. The Registered Manager was unsure if water was still leaking. We discussed the possible risks, as the water marks were around a light fitment. There are two bathrooms on the first floor. One with a fixed seating hoist. There is also a mobile hoist available for use. This is not compatible with the baths as they do not allow for the feet of the hoist to fit underneath and there is insufficient space for it to be used in one of the bathrooms. When the home was initially registered with us for operation we were informed a hoist would be fitted to the second bathroom. At the time of our inspection this had not happened. We were informed that one resident is not able to have a bath due to insufficient equipment. The Registered Manager stated that is going to be provided. The decoration throughout communal areas is neutral, bright and airy with good natural light and is domestic in appearance. The home has appropriately placed smoke detectors and emergency lighting. The home was seen to be clean and no odours detected. The laundry is sited in a room at the side of the building. There is a washing machine and dryer. There insufficient space for soiled and clean laundry to be stored separately. There is no hand wash basin. Infection control measures were discussed with the Registered Manager, who agreed that advice should be sought from the relevant agency regarding the laundry Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: facilities. The floor covering around the toilet basin in a ground floor toilet was seen to be damaged. We discussed the potential infection control issue with the Registered Manager as fluids can seep underneath. Paper towels and liquid soap were seen available for use in all communal toilets. Care Homes for Adults (18-65 years) Page 23 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to support residents living there. In the main recruitment practices safeguard residents. Evidence: Staff on duty at the time of our visit appeared to have built positive relationships with the residents in their care. For example they were seen talking in a respectful way, assisting with patience and giving good eye contact to those with communication needs. Both staff employed at the home hold a National Vocational Qualification (NVQ). There are currently two people living at the home. The Registered Manager informed us that the home deploys two staff on each early and late shift and one during the night with a sleep in person. We asked the Registered Manager if his hours are supernumerary to those of care. He informed us that usually would be but at moment doing a mixture of care and management. The Registered Manager informed us that currently there are three people employed to work at the home (including himself). The home is using staff from other homes owned by the organisation and agency staff to cover the remaining positions. When asked how he ensures agency staff understand the needs of residents we were informed all have an induction that includes reading Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: residents files. Written documentation was seen that confirms this information. The Registered Manager informed us he intends to undertake night checks. He also informed us that where possible the same agency staff are used, for consistency of care. Records confirm this comment. We examined the recruitment records of the two people employed at the home and found them to be in good order and to contain the required information to protect residents. This information included verification that two references have been obtained, forms of identification and Criminal Records Bureau (CRB) disclosures. Original recruitment documentation is held centrally, with an agreed proforma in place for capturing all required information. This had not been signed by either the Registered Manager or Responsible Individual. We discussed this with the Registered Manager who confirmed this would happen to verify information is accurate. The Registered Manager informed us that confirmation that agency workers have the required recruitment checks is obtained from the agency that employs them. Records were in place for seven of the nine agency workers who undertook shifts during October and November. Records viewed and discussions with people evidence staff are suitably qualified to support people living at the home. For example staff have received training for gastric peg feeding, epilepsy and nutrition and diet. Both permanent members of staff have a Continuing Professional Development folder. Neither have been completed in full. Care Homes for Adults (18-65 years) Page 25 of 31 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is suitably qualified to run the home and people view is style to be open and communicative. Quality monitoring systems are not yet embedded. This means the home cannot measure if it is achieving its aims and objectives consistently. Not all records required by regulation for the protection of residents and for effective and efficient running of the home are maintained as required. Monitoring of health and safety takes place. Greater attention to detail would reduce potential risks to residents. Evidence: The Registered Manager holds a number of qualifications including the Registered Managers Award, NVQ level four and a Foundation Degree in Learning Disabilities. He has a number of years experience in care and management. Everyone that we spoke to during our inspection praised the Registered Manager. Comments include brilliant, he knows what he is doing, good at involving and good, knows his staff. Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: During our inspection the Registered Manager supplied us with a blank quality assurance checklist. This includes sections for recording choices, recreation and leisure, the environment, health and safety and training. As mentioned in other parts of this report the Registered Manager sent us the homes Annual Quality Assurance Assessment (AQAA) prior to our inspection. This in parts was brief and does not demonstrate how the home is meeting all key National Minimum Standards. We discussed this with the Registered Manager who confirmed greater detail would be included when next requested. Quality monitoring reports were in place for August and November. No others were available for us to examine, with the Registered Manager informing us visit had not taken place on a monthly basis. We examined the staff rota for the previous four weeks. Agency staff information is not included on the duty rota. A list of agency workers is maintained separately that includes the date and time of shift undertaken. Neither the Registered Managers care or management hours were included on the duty rota. Copies of certificates have been seen as part of the homes initial registration application for domestic electrical installations, emergency lighting, servicing of the fire detection alarm system and gas appliances. These are still valid at the point of our inspection. Risk assessments relating to equipment and safe home management are in place. As mentioned earlier in this report a corridor on the first floor has a steep incline that has the potential to place wheelchair users at risk of injury. A risk assessment is in place for hallways. This makes no reference to gradients and potential risks. A risk assessment is in place for the laundry. This makes no reference to the steep step at the entrance to this facility or to the restricted space within, both of which are potential risk areas. The floor covering around the toilet basin in a ground floor toilet was seen to be damaged. We instructed this be made safe during our visit due to the potential trip hazard. Records confirm staff have received training in health and safety, manual handling, first aid, food hygiene and fire. Training in these areas promotes the health and safety of residents. Care Homes for Adults (18-65 years) Page 27 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 6 12 In line with Regulation 12 (1) care plans must be implemented for all identified needs including dementia. This must happen to ensure the health and wellbeing of residents is maintained safely. 26/12/2008 2 29 23 In line with Regulation 23 26/02/2009 (2)(n) suitable equipment must be provided that allows all residents to have a bath. This must happen so that everyone in the home can have a bath safely, no matter what their needs. 3 41 17 In line with Regulation 17 (2) the duty rota must include details of all people who undertake shifts at the home. This must happen in order that records can be used to monitor residents are 26/12/2008 Care Homes for Adults (18-65 years) Page 29 of 31 supported by suitable numbers of qualified staff at all times. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). 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