Inspection on 07/09/09 for Eastcliffe

This inspection was carried out on 7th September 2009.

CQC found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Eastcliffe 08/03/07

Eastcliffe 19/01/06

Eastcliffe 09/09/05

Eastcliffe 08/03/05

Eastcliffe 12/10/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: Eastcliffe Eastcliffe Sidecliff Road Roker Sunderland SR6 9PX     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Eileen Hulse     Date: 1 7 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. that people have said are important to them: They reflect the things 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. Care Homes for Adults (18-65 years) Page 2 of 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 25 Information about the care home Name of care home: Address: Eastcliffe Eastcliffe Sidecliff Road Roker Sunderland SR6 9PX 01915484548 01915488678 ATTX11@dsl.pipex.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Autism North Limited care home 10 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Eastcliffe is a very large detached domestic house, which was built during the turn of the 20th century. The home had been registered as a care home for the elderly up until April 2002 at which time the registration ceased. Autism North has completed considerable refurbishment works to Eastcliffe prior to its registration in July 2004. Eastcliffe is registered to provide personal care for young adults who have an Autism Spectrum Disorder. All of the current residents pay fees of #2096 per week; however the amount the person pays will depend upon the financial assessment completed by social services. Each person?s social services department pays the majority of the weekly fee. The home has three floors. The nine bedrooms are located over the three floors, lounges, dining room, kitchen and laundry are located on the first two floors. The staff room, office, regional managers office, and facilities for visitors are located on the third floor. A sloped drive leads to the main entrance to the home and a large yard is at the rear. People with a physical disability could not be admitted to the home, as Care Homes for Adults (18-65 years) Page 4 of 25 Over 65 0 10 Brief description of the care home they cannot get to all of the communal rooms. Steps lead from the main entrance up to the dining room and lounge. A second lounge and toilet are adjacent to the front door and prior to these steps. A lift provides access to two floors but there are mezzanine landings throughout the home. Eastcliffe is located just up from the main road running along the sea front at Roker, Sunderland. It is opposite a large park and close to shops and local entertainment. Bus routes to Sunderland and South Shields are located on the main road close to the home. Care Homes for Adults (18-65 years) Page 5 of 25 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: three star excellent 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: The manager is qualified and has achieved the Registered Managers Award. He ensures that one to one staff supervision and staff meetings are held regularly and continues to attend futher training to make sure his practice is up to date. Autism North have developed a high quality assurance system to ensure the quality of care is audited on a regular basis. Observation showed that all staff throughout the day followed safe working practices at all times and records evidenced that staff receive regular training in fire safety. Care Homes for Adults (18-65 years) Page 6 of 25 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 25 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 8 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good assessments are included within the plans of care for all service users that help to form the basis of the individual care plan, this ensures that before admission takes place the home is able to know if the care needs can be met by them. Evidence: All service users living in the house have had needs assessments carried out by a care manager and the manager of the service prior to their admission. The Deputy Manager was able to explain in detail the process that is followed when a vacancy occurs and this includes the care manager making a referral to the home, the prospective service user would then make several visits there and either have a meal with the people who live there or spend some time in the house with them and accompany them on activities to eventually being offered overnight stays, this assessment period of time can take up to several weeks. An assessment is carried out at this time to ensure the placement is suitable and the service can meet the care needs of the person. This gives the person the time to decide if they would like to move in and ensures the correct equipment and care plans are made available prior to moving in. Care Homes for Adults (18-65 years) Page 9 of 25 Evidence: The organisation has comprehensive policies and procedures regarding the admission process and a sample of care plans looked at showed that when people move into the home, the assessment documentation is detailed and held within the plan of care. Care Homes for Adults (18-65 years) Page 10 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care plans are easy to understand and contain good information on the care required by service users, this ensures that staff are aware of any changes that may be required to the plans of care and that the care needs are being met. Evidence: All service users living in the home have an individual plans of care. Case tracking showed that they are organised and well laid out with person centred information and include good assessment details on the care that is required. Areas of the care plan include, personal details, significant people in my life, details of the personal care that is needed and where challenging behaviours are evident, staff are given good information on how they can be managed. Each care plan has a risk assessment attached that details what the risk is and how it can be minimised to keep service users and staff safe. The detail in the risk assessments show that any element of risk to the service user has been assessed and minimised where possible. The risk assessments are detailed and any elements of risk are known to staff. The individual care plans are monitored regularly and evaluated and this makes sure that all staff Care Homes for Adults (18-65 years) Page 11 of 25 Evidence: have the information they need so that the care needs are met on a day to day basis and any changes that are necessary are fully recorded. Care Homes for Adults (18-65 years) Page 12 of 25 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. There is a good range of social activities made available to all service users to fulfill lifestyles and this ensures people are able to make choices on how to spend their leisure time. The rights of people as individuals is recognised by support being given to maintain personal relationships and to maintain contact with their families and friends. Service users are offered nutritious and varied meals with good choices for everyone Evidence: All daily routines of the house are centred on the preferences of the people who live there. During the visit, three service users were attending college, one person was out with their family and another two were out walking along the beach that is close by and many were going to the evening disco. It is a very busy house with plenty going on. The home have recently acquired a garden allotment away from the home and people are clearly enjoying visiting and working on the allotment growing their own Care Homes for Adults (18-65 years) Page 13 of 25 Evidence: vegtables. Some service users are also doing voluntary work for the Voluntary Involvement team and this is also enjoyed by the people involved. Service users were very excited about a wedding they were going to the next week and all talked about where the wedding was and what would be happening while they were there. Service users were keen to discuss how they spend their leisure time and how they felt about living in the home. They also showed the many photographs they have in the home relating to past holidays and outings. Comments they made included, I am doing a numeracy course today I have lived here for five years and its ok here The staff help me a lot I like going for my dinner to the chip shop and going to the gym I like using my DJ equipment Staff access information about future events, local posters and information leaflets to help service users plan and choose what they want to do. The service have their own mini bus so that people can get out and about and the bus is used everyday to somewhere or other. People are encouraged to continue with relationships outside of the home and all service users currently living in the home have contact with someone outside of the service, families either visit the home or arrangements are made for the staff to accompany service users to visit home. During the visit, a lunchtime meal was taken with service users who were at home for the day or prior to going to college. Both staff and service users were sat around the table discussing what they would like to do for the rest of the day and what was happening during the week. The meal consisted of a variety of foods that service users had chosen to have for their lunch, in the evening people have a main meal when everyone has returned home. There was good rapport between service users and staff and it was evident everyone was comfortable with each other. Care Homes for Adults (18-65 years) Page 14 of 25 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. A number of specialist health professionals are used by the service and good systems are in place on the safe administration of medicines and this ensures that the healthcare needs of service users are identified and met. Evidence: Within the plans of care there was evidence to suggest that the healthcare needs of service users are addressed. Service users are supported sometimes by family when attending hospital appointments or GP visits but if this is not possible, then staff will provide this support. Staff work sensitively with the service users, showing discretion when assisting with personal needs and demonstrating respect and sensitivity when interacting generally. The home has a policy and procedure on the administration of medication used in the home and a monitored dosage system is used that is provided by the local pharmacist. The medication policy covers areas on the recording, administration, safekeeping and disposal of unwanted or unused medicines. At this time, no service users hold their own medication and during the visit, Care Homes for Adults (18-65 years) Page 15 of 25 Evidence: observation was made of a member of staff administering medications in a safe and correct way. All medication is recorded on individual medication administration record sheets that are up to date and well maintained and medication is administered only by senior support staff. Although all staff have received medication training, medication is administered by grade two support staff and grade two staff witness and sign as a second signature. Care Homes for Adults (18-65 years) Page 16 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a good clear and easy to understand complaints policy and procedure that is accessible to service users and they representatives should they have a complaint or concern about the service and good safeguarding procedures help to protect people should and abuse situation arise or be suspected. Evidence: The complaints policy is written in various formats to help people living in the home to understand and all service users have a copy of the complaints procedure within their care plans that is suitable to that person. Staff confirmed they are aware of how to deal with a complaint should one be made whilst they are on duty. However, when looking at records there were no entries made in the last twelve months and the acting manager explained that any issues are dealt with immediately. All complaints or concerns however minor should be recorded within the complaints book and advice was given to ensure this happens. Complaints or concerns are received by the service are acted upon and service users spoken with clearly knew how to make a complaint and stated if they were unhappy it was always sorted out by the staff. One complaint the home are currently dealing with is very detailed and the service is waiting for acknowledgement from the complainant on the outcome of the investigation to state if they are satisfied on how it has been dealt with. Safeguarding of vulnerable adults procedures are available in the home for staff Care Homes for Adults (18-65 years) Page 17 of 25 Evidence: guidance that also includes whistle blowing. Staff records confirmed all staff have received training on safeguarding of people. There have been no safeguarding issues in the home since the last inspection and plans are in place to discuss the protection of service users within staff supervisions. Care Homes for Adults (18-65 years) Page 18 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean, homely and well maintained and a number of improvements have been made to ensure the home is safe and comfortable for the people living there. Evidence: The home is spacious, homely and well maintained. All bedrooms have en-suite facilities and they have been made very personal to the people occupying the rooms with the help of staff. Since the last inspection, a large number of improvements have been made to the communal areas of the home. Furnishings and flooring have been replaced in a number of areas, some kitchen appliances have been renewed, skylite windows have been put into the lounge roof to allow more natural light into the home and some windows throughout the home have been replaced. A maintenance manual has been introduced that includes check lists to identify any repairs or replacements that need to be addressed. Care Homes for Adults (18-65 years) Page 19 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels within the home are good and sufficient in numbers to enable the needs of service users to be addressed and this helps to ensure that service users can live the lifestyle they prefer. Evidence: On the day of the visit, there were six support staff on duty to meet the needs of the people living in the home some of whom have very complex needs. The good staffing levels ensure that the range of activities offered to the service users living in the home can take place everyday. There are twenty eight support staff in total employed in the home and over eighty per cent of the staff team now hold an NVQ Level two qualification in care. Three of the staff have attained NVQ Level three and one member of staff has almost completed Level four which also includes a management course running at the same time. The staff training matrix is on the wall and shows all the training that has been completed by staff, it was up to date and well maintained. Recent training that staff have completed included all mandatory training and some specialist training such as, Physical and Psychological intervention, Epilepsy, Medazelam training and Autism Awareness. Care Homes for Adults (18-65 years) Page 20 of 25 Evidence: The home has a low turnover of staff and most of the staff have worked in the home for a number of years. If staff do leave the service it is usually within the organisation for promotion opportunities. Staff on duty were spoken with during the visit and they made the following comments, I really enjoy working here and recently have completed my Pova training We get very good support from the Manager and senior staff, they support us with anything I have no concerns at all about the service We have regular supervisions and staff meetings Staff get spot on support, quite happy how the home is run as its very person centred run Service users have a lot of input into decisions and choices everyday I love working here its a lovely home, lovely service users and great staff team The home has a recruitment policy and procedure in place that is used when employing new staff. All new staff are required to complete the Common Induction Standards as well as mandatory training and the in house induction training prior to commencing employment. Two staff personal files were looked at that included a range of appropriate information. They are organised and well maintained and the records that were looked at included a personal file checklist, identity documents, two references, application form and certificates obtained, Criminal Records Bureau checks had been completed. Interview notes are not always held on personal files by the service as some interviews are held centrally by the company. Care Homes for Adults (18-65 years) Page 21 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is currently well managed by a person who is qualified and shows good leadership skills, this helps to ensure a good quality service. Evidence: The manager is qualified and has achieved the Registered Managers Award. He ensures that one to one staff supervision and staff meetings are held regularly and continues to attend futher training to make sure his practice is up to date. Autism North have developed a high quality assurance system to ensure the quality of care is audited on a regular basis. Observation showed that all staff throughout the day followed safe working practices at all times and records evidenced that staff receive regular training in fire safety. Care Homes for Adults (18-65 years) Page 22 of 25 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 23 of 25 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 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 24 of 25 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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 © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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. 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