Inspection on 16/05/05 for Eastholme

This inspection was carried out on 16th May 2005.

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 but made no statutory requirements on the home.

Other inspections for this house

Eastholme 06/06/07

Eastholme 29/11/05

Eastholme 10/08/04

Eastholme 20/05/04

Eastholme 03/12/03

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 Eastholme Denehouse Road Seaham Co. Durham SR7 7BQ Lead Inspector Kathy Bell Unannounced 16 May 2005 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 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 Stationary 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. Eastholme B54_S7468 Eastholme V227653 160506_stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Eastholme Address Denehouse Road Seaham Co Durham SR7 7BQ 0191 5812656 Telephone number Fax number Email 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 Ms Denice Grufferty Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Eastholme B54_S7468 Eastholme V227653 160506_stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 10th August 2004 Brief Description of the Service: Eastholme is registered for four adults with learning disabilities between the ages of 18 and 65 years. It is a specialist service which provides care for people with autism. Currently four young women live in the home, which is a spacious semi-detached house in a quiet cul-de-sac. The house has four single bedrooms, generous communal space and garden and it is close to Seaham town centre, the beach and train services to other towns. Eastholme is managed by Autism North, which though a separate company is closely related to the organisation now known as European Services for People with Autism Limited, which was established in 1987 and runs a range of services for younger adults with autism. Eastholme B54_S7468 Eastholme V227653 160506_stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place during one day in May 2005 and was one of the two routine inspections which have to be carried out each year. Two of the residents returned to the home after visits to their families during the day and the inspector, Kathy Bell talked to their mothers. All four residents are unable to comment directly on the care but seem to have good, affectionate relationships with the staff. Their relatives were very pleased with most things about the way residents were looked after. They had found that their daughters were happy to return to the home after visits to their families. One said she was absolutely delighted with the home. During the inspection Kathy Bell looked at records, looked around the building and spoke to staff. For most of the day, she shared the living space with residents and was able to see how they lived day-to-day and how they got on with staff. What the service does well: What has improved since the last inspection? Staff have continued to explore new activities for residents. Some work has been done on improving recording of restraint. Residents continue to develop their life skills and look more relaxed and happy. Eastholme B54_S7468 Eastholme V227653 160506_stage 4.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Eastholme B54_S7468 Eastholme V227653 160506_stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Eastholme B54_S7468 Eastholme V227653 160506_stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 All the residents have lived at the home for some time. A full assessment was done before they were admitted and they could have a number of long visits to the home before they moved in. In this way, the home made sure they only admitted people if they knew they could meet their needs. EVIDENCE: Records on residents included a full assessment by people such as a psychologist and a life history, covering peoples previous experience in care and education settings. Residents had spent time in the home before the final decision was made about moving in so that the home, relatives and care managers could see whether they liked it. This was also the final stage in the home making the decision on whether they could meet that residents needs properly. Eastholme B54_S7468 Eastholme V227653 160506_stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 & 9 The information staff need to meet each residents needs is written down and kept up-to-date. Residents can make some decisions about their day-to-day lives which increases their independence. Staff try and reduce the risks to residents while still supporting them to take part in activities they enjoy. EVIDENCE: Each resident has a plan which describes the care they need. These plans were very detailed and included all the information staff need to make sure they respond in a way suitable for each person. They include assessments by specialists such as a speech therapist. These are kept up-to-date and a member of staff with particular responsibility for each resident writes a monthly summary. Every six months a meeting is held about each resident to discuss whether the home is meeting all their needs and if they should be doing anything differently. Residents can choose where to spend time in the home, and have a choice at mealtimes. A relative described how she knew her daughter had chosen a present herself. Staff plan activities from their knowledge of what each person enjoys. Relatives said their daughters were able to show what they wanted, despite their limited speech and the staff agreed with this. Eastholme B54_S7468 Eastholme V227653 160506_stage 4.doc Version 1.30 Page 10 Staff have recorded their assessments of any activities, in and outside the home which may be a risk to residents. They have looked at the help residents need to prepare snacks etc in the kitchen. Their aim is to provide enough supervision by staff so that residents can do more for themselves, but safely. They provide a range of stimulating activities, such as horse riding, which cannot be risk-free, but have considered how to reduce the risks. For example, they are alert to the signs that a resident may have a seizure soon and if they think there is a risk of this, they will not go ahead with the activity. Eastholme B54_S7468 Eastholme V227653 160506_stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15&17 Residents have an active enjoyable lifestyle although the home must make sure they have enough activities at weekends when staffing levels are lower. They use local community facilities which makes their lives as much like anyone elses as is possible. Staff have helped residents keep up contact with their families. The arrangements for providing meals make sure that a healthy diet is provided, suitable for each person, which they will enjoy. EVIDENCE: A range of activities is provided for residents during weekdays. The residents are quite young and staff try and provide an active lifestyle suitable for them. They enjoy horse riding, swimming, walking and cycling. They have also tried ice skating. Staff use facilities for skating and cycling which have special adaptations for people with physical disabilities so that all the residents can join in. Autism North is setting up a day centre for its residents which will increase the range of activities available. Within the house, residents have videos and music and activities such as crayoning-in . They work with staff on housework and cooking as far as they are able. Staffing levels during weekdays are high to make these activities possible but reduced during the evenings which are seen as times for relaxation. At Eastholme B54_S7468 Eastholme V227653 160506_stage 4.doc Version 1.30 Page 12 weekends two or three staff are on duty. All four residents are not always at home together at weekends because some spend time at home and others have visits from their families. However, staff cannot take residents out when all residents are in the building and only two staff are on duty and neither is able to drive the homes vehicle. The manager must check how often this happens and if residents are asking to go out at these times. This would help them make sure they are meeting residents needs and wishes and avoiding any behaviour problems. Staff described how they plan activities to occupy and interest residents at these times and residents can go in and out of the garden when they want to. One member of staff also said that they could ask for help from the senior staff on call if they felt residents really needed to get out. Residents use local facilities such as shops, cafes and restaurants and have been taken to the theatre. They use public transport as well as their own people carrier vehicle. All four residents have contact with their families, either spending time at home or with relatives visiting them and taking them out. Staff and relatives agreed they had been able to work together to respond consistently to residents. This has made it easier for some parents to care for their children on home visits, making more frequent visits possible. Relatives said staff keep them informed about things like visits to the doctor. Menus kept show a varied diet. Staff are aware of residents likes and dislikes and take these into account when planning meals. They have responded to special dietary needs and monitor residents weight. They provide low-fat but enjoyable meals for a resident who needs to control her weight. Eastholme B54_S7468 Eastholme V227653 160506_stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 & 19 Staff provide personal care in a way which meets each residents needs and helps them become more independent. They arrange routine medical checkups which is particularly important when residents may be unable to say what is wrong. They make sure that residents receive the health care they need . EVIDENCE: Care plans described in detail the help each person needs with personal care and how they like to be cared for. The plans showed that staff try and encourage residents to be as independent as possible. Staff described how they were going to try to improve a residents self-care skills in one area increase her independence and dignity. A relative confirmed that her daughter was able to do much more for herself now. Relatives had seen that residents always looked clean and well cared for. Good records are kept of regular medical checkups. A relative said that staff were very good at noting any problems which might show a need for medical treatment and made sure that they arranged treatment when necessary. Staff described how they had planned a hospital visit for dental treatment to reduce the stress for a resident as much as possible. A full assessment of health needs had been completed by staff on each resident. This helped them make sure that nothing had been missed. Eastholme B54_S7468 Eastholme V227653 160506_stage 4.doc Version 1.30 Page 14 Eastholme B54_S7468 Eastholme V227653 160506_stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not looked at during this inspection. EVIDENCE: Eastholme B54_S7468 Eastholme V227653 160506_stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 & 30 The building provides a comfortable place to live with plenty of space for residents so that they can choose who they want to sit with and safely burn off some energy walking within the house and garden. The owners of the home have made adaptations to it so that it is suitable for all the residents. There are systems to make sure the home is kept safe and clean for residents. EVIDENCE: The building is a large semi-detached house which has two large living rooms, a separate dining room, four single bedrooms and a garden. There are two bathrooms and a number of toilets around the building. The house is decorated and furnished in a domestic style. It provides plenty of space for residents so that they can choose whether to spend time alone or with others and is particularly suitable for this active group of residents. A stair lift and ramps have been provided so that all residents can use the first floor and go easily into the garden. The manager described plans for maintenance of the building and redecoration of some bedrooms which have not been redecorated recently. Eastholme B54_S7468 Eastholme V227653 160506_stage 4.doc Version 1.30 Page 17 The only disadvantage of the home is the lack of a separate office. This means that it is difficult for staff to talk in private with anyone and if anyone is working on records, residents tend to join in the activity. Staff respect the rights of residents to use all their living space when they wish but this arrangement is not ideal. The home seemed clean on the day of inspection and relatives said it always did seem clean when they visited. Records in the home showed that the staff carried out checks of hot water temperatures to make sure residents were protected from accidental scalding and followed a cleaning schedule to make sure that all of the home was cleaned regularly. Eastholme B54_S7468 Eastholme V227653 160506_stage 4.doc Version 1.30 Page 18 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 Staffing levels are generally good and so that residents can enjoy an active lifestyle and receive the personal care they need but the manager must make sure that residents needs for activity are met at weekends when staffing levels are lower. EVIDENCE: Staffing levels are high during weekdays so that residents can take part in activities which need a lot of support from staff to be safe. During the evenings, which are seen as a time for relaxation, staffing reduces to two people: staff says this works well. At weekends two or three staff are on duty. Although sometimes only three residents may be in the building if another is with her family, this can limit whether staff can take residents out, particularly if none of them can drive the homes vehicle. One of the staff takes particular responsibility for the housekeeping role and prepares meals which ensures a consistently high standard. Eastholme B54_S7468 Eastholme V227653 160506_stage 4.doc Version 1.30 Page 19 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 & 41 Although she has not yet achieved the recommended qualifications, the manager seems to be running the home well. However she needs to spend more time doing the management part of her job to make sure that she has time to supervise and train staff properly. Record-keeping is generally good and helps the staff provide a good standard of care. Some records of restraint were not written clearly enough to describe what exactly had happened which is important for the protection of resident and staff. EVIDENCE: The current manager has been registered as manager since December 2004 although she was the deputy and taking major responsibility for managing the home before this. She is working towards the recommended qualifications for managers. She has made sure that records in the home are kept up-to-date and that there are systems to make sure regular health and safety checks etc are done. However she admits that when there are difficulties covering shifts, for example when staff are off sick, she often covers them herself so that she is Eastholme B54_S7468 Eastholme V227653 160506_stage 4.doc Version 1.30 Page 20 working as a support worker rather than as the manager. This has reduced the hours that she is working as manager to well below the 19 hours a week which CSCI would expect for a home of this size. This is a problem because she will find it difficult to set aside time for training and supervising staff and for her own professional development. Records seen were kept up-to-date and generally to a good standard. In the last inspection, Kathy Bell found that some records of restraint were not as detailed as they should be. It is important that staff write down exactly what happened to help them find out what had caused difficult behaviour and the best way to respond to it, and also as a protection for them and residents . Records have improved but the staff need to continue to work at how they record incidents. Eastholme B54_S7468 Eastholme V227653 160506_stage 4.doc Version 1.30 Page 21 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 4 x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 4 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 4 4 x 3 x 3 Standard No 31 32 33 34 35 36 Score x x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Eastholme Score 4 4 x x Standard No 37 38 39 40 41 42 43 Score 2 x x x 3 x x B54_S7468 Eastholme V227653 160506_stage 4.doc Version 1.30 Page 22 Yes Are there any outstanding requirements from the last inspection? 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. 2. 3. Standard 41 33 37 Regulation 17 18 8 Requirement Records of restraints and incidents must be more precise. Staffing levels at weekends must be reviewed to make sure residents needs are met. The manager must spend at least half her working week on management duties . Timescale for action 30.6.05 30.6.05 31.7.05 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 37 Good Practice Recommendations The manager should achieve NVQ 4 in management and care in 2005. 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