CARE HOME ADULTS 18-65
Eastholme Denehouse Road Seaham Durham SR7 7BQ Lead Inspector
Ms Kathy Bell Unannounced Inspection 29th November 2005 12:00 Eastholme DS0000007468.V257724.R01.S.doc Version 5.0 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 Eastholme DS0000007468.V257724.R01.S.doc Version 5.0 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. Eastholme DS0000007468.V257724.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Eastholme Address Denehouse Road Seaham Durham SR7 7BQ 0191 5812656 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 Denise Grufferty Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Eastholme DS0000007468.V257724.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 16th May 2005 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 DS0000007468.V257724.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was one of the two planned for each year. It was unannounced and took place during one afternoon in November 2005. All the residents were in the home during that day. The inspector, Kathy Bell, looked at some records, and talked with the manager and two staff. Residents have limited communication but the inspector spent the afternoon in one of the lounges and was able to see how they spent their time and the good relationships between them and the staff. One comment card was received from a relative who was satisfied with all aspects of the home. What the service does well:
The home has provided a stable setting where residents have been able to feel secure and develop their abilities, including greater communication. Residents seemed relaxed and confident with staff. Staff showed their awareness of individual needs and understanding of the reasons for behaviour. Autism North ,the organisation which runs the home, employs a worker to help staff find and develop activities which provide enjoyment for residents as well as developing their skills. It runs a day centre specially for people who use its services and the residents of this home are able to enjoy activities there. The building provides plenty of space for residents and a pleasant garden. Eastholme DS0000007468.V257724.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? 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 DS0000007468.V257724.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Eastholme DS0000007468.V257724.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were assessed. EVIDENCE: Eastholme DS0000007468.V257724.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were assessed. EVIDENCE: Eastholme DS0000007468.V257724.R01.S.doc Version 5.0 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 Staff respect residents rights and respond to their wishes. EVIDENCE: Residents have limited verbal communication but can let staff know what they want very effectively. Staff have become skilled in understanding what residents are saying, either by behaviour or gesture. This enables staff to respond to the choices residents are making. Staff try and involve residents in making choices about furnishings etc in the home. In discussion, the manager showed awareness of the rights of residents to make decisions as adults. Records in the home show that staff have acknowledged that their duty to provide care and supervision can conflict with a residents right to privacy. Eastholme DS0000007468.V257724.R01.S.doc Version 5.0 Page 11 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 The home looks after medication for residents in a safe way. EVIDENCE: The home has established systems for storing, giving out and recording medication for residents. Records seen on the day of inspection were kept properly. Staff who look after medication have done externally assessed training. Eastholme DS0000007468.V257724.R01.S.doc Version 5.0 Page 12 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 The home has taken reasonable steps to make it possible for residents or their representatives to complain . Staffs sensitivity to residents non-verbal communication should ensure that they respond if residents are not happy about anything. The home has satisfactory procedures and training to protect residents from abuse. EVIDENCE: Staff have tried to explain a simplified (pictorial and simple text) complaints procedure to residents and have recorded how much they believe each resident has understood. A satisfactory text version of the complaints procedure is also available. There have been no complaints in recent years. The home has a satisfactory adult protection procedure and training on prevention and identifying abuse is included in induction training. Staff receive training and refreshers in the use of restraint. These are provided by somebody who has met the standards of the British Institute for Learning Disabilities. As residents have become more settled in the home, restraint has become rare. The home keeps proper records of money handled for residents and the manager described how staff keep a check of these. Eastholme DS0000007468.V257724.R01.S.doc Version 5.0 Page 13 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed in full but see evidence below. EVIDENCE: During the inspection one lounge was noticeably cool. The manager explained that they had had problems with the heating system and now had a separate boiler for downstairs. They must monitor the temperature downstairs to make sure that it is warm enough for residents. Eastholme DS0000007468.V257724.R01.S.doc Version 5.0 Page 14 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35 There are enough staff on duty all the time to meet residents needs. There is always a more experienced senior on duty and staff have the necessary skills and training for their work. The home does the necessary checks on new staff to make sure that only suitable people are employed. EVIDENCE: Staffing levels are higher during weekdays so that residents can take part in activities which need a lot of support from staff to be safe. Three or four staff on duty is usual and this can rise to five or six on some shifts. During the evenings, which are seen as a time for relaxation, staffing reduces to two people: staff have said on previous inspections that this works well. At weekends for much of the time two staff are on duty. However the manager tries to make sure that for some part of the weekend three and sometimes for staff on duty so that residents can go out more easily. The demands upon staff can be less at times on weekends because some residents spend time with their families. One of the staff takes particular responsibility for the housekeeping role and prepares meals which ensures a consistently high standard. Eastholme DS0000007468.V257724.R01.S.doc Version 5.0 Page 15 Seven of the staff have now achieved NVQ 2 in care. New staff have been doing the LDAF-accredited induction training which is recommended for staff in homes for people with learning disabilities. There is a programme to make sure that all staff receive training in core areas such as food hygiene as well as in specialist areas such as understanding autism and restraint. The manager uses supervision sessions to deliver training on particular topics to all staff. The home has established procedures for recruitment which include obtaining references and doing CLB/POVA checks. Checks of personnel files showed that these procedures were followed. Eastholme DS0000007468.V257724.R01.S.doc Version 5.0 Page 16 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 42 There are satisfactory systems to make sure that everyone who uses the building is kept safe. EVIDENCE: The home makes sure that regular servicing of the boiler, fire safety and other equipment is carried out. The fire safety system is checked regularly and fire drills carried out. The manager does a regular health and safety check of the building and staff are responsible for daily checks. Eastholme DS0000007468.V257724.R01.S.doc Version 5.0 Page 17 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 X X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X X X Standard No 24 25 26 27 28 29 30
STAFFING Score x X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 4 3 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Eastholme Score X X 3 X Standard No 37 38 39 40 41 42 43 Score X X X X X 3 X DS0000007468.V257724.R01.S.doc Version 5.0 Page 18 No 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 Standard YA24 Regulation 23 Requirement Staff must monitor the temperature in the lounges to make sure that a satisfactory temperature is maintained . Timescale for action 29/11/05 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 YA37 Good Practice Recommendations The manager should achieve NVQ 4 in management and care in 2005. Eastholme DS0000007468.V257724.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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