Inspection on 08/03/07 for Eastcliffe

This inspection was carried out on 8th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Eastcliffe 07/09/09

Eastcliffe 19/01/06

Eastcliffe 09/09/05

Eastcliffe 08/03/05

Eastcliffe 12/10/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Eastcliffe Eastcliffe Sidecliff Road Roker Sunderland SR6 9PX Lead Inspector Mrs Katie Tucker Key Unannounced Inspection 8 and 9th March 2007 10:00 th Eastcliffe DS0000061443.V332201.R02.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 Eastcliffe DS0000061443.V332201.R02.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. Eastcliffe DS0000061443.V332201.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Eastcliffe Address Eastcliffe Sidecliff Road Roker Sunderland SR6 9PX 0191 548 4548 0191 548 8678 ATTX11@dsl.pipex.com 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) Autism North Limited Michael Winter Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Eastcliffe DS0000061443.V332201.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th January 2006 Brief Description of the Service: 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 eight bedrooms, 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 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. Eastcliffe DS0000061443.V332201.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector carried out this unannounced visit. They spent two days at the home speaking to people using the service and staff. The inspector also looked around the houses and checked the standard of the record keeping. Eastcliffe cares for younger adults with an Autism Spectrum Disorder. The residents have difficulty understanding abstract thoughts. And, find changes in routine very difficult. Also they find it hard to understand other people’s needs and feelings. Some residents find meeting strangers extremely challenging and if given the option would not like to spend time talking to new people. These people’s wishes were respected. Prior to the visit the inspector looked at comment forms from people had been at the home. Several residents’ care was tracked through what people said and looking at the service user plans and other records. Residents found it very difficult to say what they thought of the service so judgements were made from comments relatives had made and what was seen. Staff practice, attitude and approach were also watched and judgements made on how well staff worked with people. During this inspection all of the key standards were checked. What the service does well: The manager and staff are very skilled. Staff have shown that they are able to successfully work with people who have Autism Spectrum Disorders. They understand people’s needs and care a great deal about the residents. Staff help people to join in an ever-increasing range of activities. And, have helped people to do more things either with staff help or on their own. Staff are good at working with people so they remain comfortable and willing to try something new. Residents no longer feel the need to become angry, as staff have found ways to understand what people want. This means that staff no longer need to use physical interventions for six months. Some residents are go to the local shops by themselves and really enjoy doing this. Relatives said ‘ Really friendly and supportive atmosphere. Staff are well trained and have responded to my relatives difficulties in a positive and professional manner’. The staffing levels at Eastcliffe are very good and this means that the people who find it very difficult being out of familiar places can still go out and join in activities they like because two staff go with them. Eastcliffe DS0000061443.V332201.R02.S.doc Version 5.2 Page 6 Autism North runs a day centre, Gorse House, which has rock climbing facilities, cinema, a swimming pool, cafe and craft workshops. This means that all the residents can try something new and experience things many take for granted. Also the owners have worked with a local college and now a lot of the residents go there and college staff stay with them at these times rather than the home staff. Residents have really enjoyed this experience. Autism North runs care services specifically for people who have an Autism Spectrum disorder and have an excellent understanding people’s needs. The owner always try to make the services better and that staff use up to date practice. They employ some health care professionals including a psychiatrist and they help staff find ways to meet residents’ needs. The manager makes sure staff have all the training they need to care for residents. 75 of the staff have NVQ Awards and the remaining staff have started this course. The home has a cook and she has made sure she knows all about people’s likes and dislikes as well as special diets. Thus she can make really interesting meals for people who cannot have wheat products or need to keep an eye on their weight. Eastcliffe is a converted private residence and the owners have made sure the room sizes are above those required in the standards. Thus all of the bedrooms are well in excess of 12m² and are equipped with an en suite bathroom. The lounges and dining rooms are large and roomy. Eastcliffe is decorated to a high standard and the manager makes sure it is redecorated when needed. What has improved since the last inspection? What they could do better: The manager needs to make sure he lets CSCI know about events that happen at the home. The psychiatrist needs to remember that this is a care home and not a treatment centre when looking at the medication people need. Eastcliffe DS0000061443.V332201.R02.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Eastcliffe DS0000061443.V332201.R02.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Eastcliffe DS0000061443.V332201.R02.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff make sure assessments shows how they can work with residents. But information about fees and contracts are not available. So residents’ can be confident that staff know how to work with them but not what they pay. EVIDENCE: Blank contracts are included in the service user guide. But the signed copies, which have the fee levels or the local authority placing agreement, are kept at the home. The local authority placing agreements sometimes say how many staff they want for a person. Without contracts people cannot check that the service they are getting is what they expected and value for money. Autism North is working with local authorities to get the agreements. Case tracking showed that before anyone moves to this home a full assessment of their needs is carried out. The people involved in the assessment include health professionals, social workers/care managers, Autism North staff, the prospective resident and their representatives. In this way, everyone involved in the resident’s care can help decide if the service is right. The staff do work hard to produce detailed reports and show all of the residents needs and aspirations. The manager is currently looking at the format to see if still asks for the right information. Eastcliffe DS0000061443.V332201.R02.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Records clearly show how staff work with residents and meet any needs. The work the resident and relative to decide how best to meet people’s needs and goals. Therefore residents’ can be confident that their needs will be met. EVIDENCE: The manager and staff have made sure the care planning system shows the work they are doing. Case tracking showed that on the whole staff record all of the actions needed to take to meet someone’s needs, including managing challenging behaviours. Staff record where they restrict people’s choices and help them make positive decisions. Plus staff have written risk assessment plans for all of the residents. The risk assessment formats give detailed information about the presenting risk and actions staff have to take to reduce or work with the risk. Some of the records staff find complicated and repetitive so the manager is looking at how to improve them. Some residents knew about their plans and what they were doing with staff. Eastcliffe DS0000061443.V332201.R02.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. 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 helped to choose how they live but staff need to work with relatives to make sure residents desires are treated as the main goals. Residents can be confident that staff will help them live more independent lives and find fulfilling activities. EVIDENCE: Family are constantly involved in the care of their loved ones and are aware of how staff are working with people. 8 out of 9 relatives who sent in comment cards were very pleased with the service saying ‘it doesn’t matter who you speak to staff are always well informed and share information’ and ‘ all the staff are very helpful. I’m very pleased with everything’. Eastcliffe DS0000061443.V332201.R02.S.doc Version 5.2 Page 12 Case tracking showed that sometimes resident’s wanted to one thing such as going out by themselves or how they ate but their relative was a little worried about going with these changes. The staff tend to take on board relative’s views and not go with the changes. However, this means residents have restrictions on choices imposed and are not helped to become more independent. It was recognised that relatives want the best for the resident but with the introduction of the Mental Capacity Act staff must show that the actions they take on behalf on residents take account of what they want. Residents regularly write and visit their relatives. The staff accompany people on the home and return trips when relatives cannot pick people up. The way staff and Autism North promote the involvement of relatives helps to make sure everybody feel valued. People with Autism Spectrum Disorders find it difficult to form meaningful relationships, understand other people’s needs and prefer fixed routines. However staff have not become fixed in the way they work with people. Residents are helped by staff and specialists to learn about social skills and how to form relationships with others. A number of residents now go to a local college and need less support from staff at these times. This has been achieved because of the skilled ways staff have worked with residents to help them cope with change. Residents told me about the college and what they liked to do. Residents said ‘ I like it here’ and took the time to talk to me about what they were doing and asking me to join in activities with them. The cook is very competent and makes sure healthy, balanced diets are provided. Some service users require specialised diets such as gluten free and she is adept at making their meals interesting and appealing. Eastcliffe DS0000061443.V332201.R02.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. 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. Systems for making sure resident’s physical and emotional health needs are looked after work well. Thus residents can be confident that their health and emotional needs will be met by the service. EVIDENCE: The staff have an excellent understanding of Autism Spectrum disorder and how to meet people’s needs. Staff recognise changes in people’s health and help people to go to the local doctors. The owners employ health care professionals who help staff to meet residents’ needs. Staff have made sure the medication is stored and given out properly. The records were satisfactory. Resident’s are not able to look after their medication. The psychiatrist often makes changes to the medication in order to improve people’s well being. However he must bear in mind that if active treatment is being delivered at the home the registration may needs to change to a private and voluntary hospital. Eastcliffe DS0000061443.V332201.R02.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The owners have shown that they will check that the service is working well, help people to raise concern and take all actions necessary to resolve issues. Thus, residents can expect that poor practice will not be tolerated. EVIDENCE: The complaints procedure is made available to residents and relatives through the service user guide as well as being sent out separately as a reminder. Relatives said ‘we are very satisfied and our relative is very happy’. Case tracking showed that when people had raised concerns such as not always being given all of the information they need staff treated these seriously and took action to resolve the issue. Eastcliffe has an appropriate protection of vulnerable adults policy and follow Sunderland Social Services Department guidance. Staff do not have experience of using the procedures, as allegations of abuse have never been made but staff receive regular training and up dates. Senior managers are aware that if residents or staff behave abusively that this must be looked under the POVA guidance, and CSCI need to be alerted. Eastcliffe DS0000061443.V332201.R02.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Eastcliffe is well maintained and has been thoughtfully up graded and refurbished to meet the needs of this resident group. EVIDENCE: Prior to opening Eastcliffe had a lot of work done to it. It has eight bedrooms, which all are in excess of 12m² and one bedrooms layout makes it ideal to use almost as a bed-sit. All of the bedrooms have en suite bathrooms. The home has mezzanine landings including one on the ground floor and a lift, which does not go to all of these landings. An access officer confirmed that Eastcliffe met the Disability Discrimination Act 1995 for visitors. Case tracking showed residents found the home a good size and met their need for space. The home is decorated to a very high standard and well maintained. Staff receive infection control and health and safety training. Eastcliffe DS0000061443.V332201.R02.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The high staffing levels and good range of training means residents can be confident that their needs are met. EVIDENCE: At least 6 staff and often 8 staff are on duty during the day and waking night staff are employed. Many of the residents have very complex needs and without these good staffing levels would not be able to join in the range of activities they do. Some residents need to have two staff accompany them when they go out so that they remain safe when navigating traffic and in crowded areas. Eastcliffe employs a housekeeper, who prepares the meals. She is very knowledgeable about people’s needs and has makes sure the menu is tailored to each person’s nutritional requirements. The manager is supernumerary. Eastcliffe DS0000061443.V332201.R02.S.doc Version 5.2 Page 17 The staff files include a range of appropriate information. The manager told about new legislation related to age, diversity and protection of staff from harassment that will need to be incorporated into the recruitment practices and management policies. The manager now is in control of the training programme and makes sure staff get the training they need and in a timely fashion. 75 of staff have completed NVQ level 2 with remaining staff completing this award. Some of the staff have also completed level 3 awards and are looking at completing level 4 in care as well as the registered managers award. Staff have been going training about how to make sure people’s equality and diversity needs are met plus insight into the Mental Capacity Act. Eastcliffe DS0000061443.V332201.R02.S.doc Version 5.2 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The management systems on the whole meet the needs of residents living at Eastcliffe. EVIDENCE: The manager is a very competent. He recently finished the registered managers award and constantly makes sure his practices are up to date. Autism North has developed a robust quality assurance system. The operational manager completes different audits of the service and uses this improve the service. Case tracking showed that recently the manager forgot to let CSCI know about a recent event. He has always done this before but it was an unusual situation and this led to the oversight. Eastcliffe DS0000061443.V332201.R02.S.doc Version 5.2 Page 19 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 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 3 16 2 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 3 X X 4 X Eastcliffe DS0000061443.V332201.R02.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? YES 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 YA1 Regulation 5 (3) Requirement The owner must provide a copy of the local authority placing agreements to service users or their representative and should keep a copy in the home. (Requirement made at previous inspections timescale for action 15.02.05) The manager must follow the guidance outlined in regulation 37 and submit notifications when service users well being is affected. Timescale for action 13/07/07 2. YA39 37 13/07/07 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 YA18 Good Practice Recommendations The employed healthcare professionals should not use the service in a manner that would suggest clinical and nursing treatment is being delivered by the owners and residential care staff. If it is a service to be offered the owners should DS0000061443.V332201.R02.S.doc Version 5.2 Page 21 Eastcliffe re-register as a private hospital. Eastcliffe DS0000061443.V332201.R02.S.doc Version 5.2 Page 22 Commission for Social Care Inspection South Shields Area Office 4th Floor St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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