Inspection on 10/12/08 for Eastleigh House

This inspection was carried out on 10th December 2008.

CSCI found this care home to be providing an Good 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

Eastleigh House 01/10/07

Eastleigh House 27/07/06

Eastleigh House 25/10/05

Eastleigh House 05/05/05

Eastleigh House 18/01/05

Eastleigh House 10/08/04

Eastleigh House 12/01/04

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

Extracts from inspection reports are licensed from CQC, this page was updated on 08/06/2011.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Eastleigh House First Drive Dawlish Road Teignmouth Devon TQ14 8TJ The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Judy Hill Date: 1 0 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to:  Put the people who use social care first  Improve services and stamp out bad practice  Be an expert voice on social care  Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 32 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: Eastleigh House First Drive Dawlish Road Teignmouth Devon TQ14 8TJ 01626776611 01626776611 eastleigh.house@craegmoor.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Park Care Homes (No 2) Ltd Name of registered manager (if applicable) Mrs Emma Mai Richards Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 10 1 0 0 care home 10 learning disability physical disability Additional conditions: The registered person may provide the following category of service only: Care home providing personal care only- Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Learning disability- Code LD- maximum of 10 places Physical disability- Code PD- maximum of 1 place The maximum number of service users who can be accommodated is 10. Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 32 A bit about the care home Eastleigh House is owned by Parkcare Homes Limited, which is a wholley owned trading subsidiary of Craegmoor Group Limited, one of the largest independent Social & Health Care providers in the UK. Eastleigh House is registered to provide accommodation and care for up to ten people who have learning disabilities and specialises in providing a service for adults with an Autistic Spectrum Disorder. The home is situated in a quiet residential area of Teignmouth but is within walking distance of the town centre, beach, train station and bus stops. Information about the service provided is available from the Home in a Statement of Purpose and Service Users Guide. Copies of inspection reports can be obtained from the Home or from the CQC Website. The current fees range from 786.94 to 3,123.72 pounds a week. Additional charges may be made for fixtures and fittings, curtains, furniture, breakages, mobility aids and items of a personal nature. Care Homes for Adults (18-65 years) Page 5 of 32 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: two star good 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 Care Homes for Adults (18-65 years) Page 6 of 32 How we did our inspection: This is what the inspector did when they were at the care home This unannounced key inspection was concluded on 10th December 2008 with a visit to the home. The information contained in this report was gained from information received about this service since the last key inspection, an Annual Quality Assurance Questionnaire that was completed by the registered manager, surveys competed and returned to the Commission by some of the people who work at the home and in conversations with the people who live at Eastleigh House, the registered manager and the staff. Additional information was gained from documents, including the homes Statement of Purpose and Service Users Guide, and from records including residents assessments, care plans and risk assessments and staff recruitment and training records. During the site visit we carried out an inspection of the premises and observed the interaction between the staff and the people who use the service. Care Homes for Adults (18-65 years) Page 7 of 32 What the care home does well Peoples individual needs assessments are detailed and well documented and provide a sound basis for individual care planning. Care planning is individually focussed and risk assessments and risk management plans are in place to ensure that peoples individual wishes and needs are known and can be met. The people who use the service are offered a choice of balanced meals and facilities are provided to enable them to make themselves drinks and snacks, with staff assistance if necessary. People are helped to maintain their personal hygiene and the physical and emotional health of the people who use the service is monitored. Some of the bedrooms very clearly reflect the tastes and preferences of the people who use them. The staff are well motivated and committed to providing a good quality of care for the people they work with. The premises are safely maintained and policies and procedures are in place to promote safe working practices. Care Homes for Adults (18-65 years) Page 8 of 32 What has got better from the last inspection Since the last inspection both the Statement of Purpose and the Service Users Guide have been updated and copies of the Service Users Guide are now being given to the people who live at the home. Significant improvements have been made to the care planning practices and the care planning system is now much more person centred, focussing on identifying the wishes and needs of each of the people using the service and how their needs can best be met. More is being done to ensure that the people who use the service are encouraged to engage more in activities within their home and in the wider community and further work is being done to improve the quality of life of the people who use the service. Improvements have been made to the premises and this is particularly noticeable in some of the residents bedrooms, which have developed a much more homely feel. Additional staff training is being provided, including training that is specific to the needs of the people who use the service. Care Homes for Adults (18-65 years) Page 9 of 32 What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Judy Hill 33 Greycoat Street London SW1P 2QF Care Homes for Adults (18-65 years) Page 10 of 32 02079792000 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.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 11 of 32 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 12 of 32 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 . People considering moving into the home and their carers have the information they need to make an informed decision about whether or not the service will be able to meet their needs. Evidence: The home has a written Statement of Purpose and a copy of this was made available to us on request. A copy of the Service Users Guide was also made available to us on request. The registered manager told us that all but one of the people who use the service had been given their own Service Users Guide, which they keep in their bedrooms. The Service Users Guide is illustrated to make it easier for people to understand. Since the last inspection two new people have moved into the home. One of the new residents had moved from another residential care service and extensive records had transferred with him. The other new resident had moved from his family home. Records seen at the home indicated that both new admissions had been carefully and Care Homes for Adults (18-65 years) Page 13 of 32 Evidence: sensitively planned. Care Homes for Adults (18-65 years) Page 14 of 32 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Person centered care planning is being developed to enable the people who use the service to become more independent. Evidence: The two recently admitted residents case files were inspected and these contained detailed care plans, risk assessments, behavioral support plans and daily records. Since the last inspection care planning has become more person centered and the registered manager said that the number of incidents of behaviors that challenge had reduced. We spoke with staff that act as key workers to individual residents and found them to be committed to developing the independent living skills of the people they work with. The people who use the service are being encouraged to make choices for themselves and picture cards and illustrations are being as one method for enabling them to do so. Care Homes for Adults (18-65 years) Page 15 of 32 Evidence: Money is held at the home for some of the residents. Records are kept of money coming in and money spent by or on behalf of each resident. It was observed that the residents personal spending money is sometimes used inappropriately to pay for items such as furniture, soft furnishings and breakages, which should be paid for from their fees. Care Homes for Adults (18-65 years) Page 16 of 32 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 . Although there is still work to be done, considerable improvements have been made to enable the people who use the service to lead active lives and develop their life skills. Evidence: The social, occupational and recreational interests of the people who use the service are recorded in their care plans. The staff were seen to interact well with the residents within their home environment. Some of the staff spoken with said that they worked with the residents to help them develop their independent living skills by helping them to keep their bedrooms tidy and use the training kitchen. The home has transport facilities to take the residents out and the registered manager said that she was looking for more activities outside the home that the residents could participate in. She said that she was particularly interested in finding adventurous Care Homes for Adults (18-65 years) Page 17 of 32 Evidence: activities, which the residents can enjoy. Some of the questionnaires completed and returned by the staff suggested that more funding could be made available for activities outside the home. The registered manager said that continued family contact is actively encouraged and that a newsletter is produced to enable families that cannot visit to keep up to date with life at the home. The meals for the day are displayed on a notice board in the kitchen and the residents are asked to make a choice of at least two different dishes at every meal time. The Cook was spoken with and she said that she could provide suitable meals for people with specific dietary needs. Care Homes for Adults (18-65 years) Page 18 of 32 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 . The people who use the service are helped to maintain their personal hygiene and their physical health is monitore Evidence: The people who use the service are given the help they need to maintain their personal hygiene and to exercise choice in what they wear and how they present themselves. The physical health and mental well being of the residents is monitored and professional help is usually sought in a timely manner as and when necessary. The home has a Behavioural Management Officer who has worked closely with the staff and residents to help the staff to gain a better understanding of the people who use the service. The registered manager told us that this has lead to a significant decrease in the number of incidents of challenging behaviour display by the people who use the service. The home also uses the Specialist Support Services provided by the NHS and Social Services for advice and guidance. Care Homes for Adults (18-65 years) Page 19 of 32 Evidence: The service users medication is stored appropriately in a locked cabinet in a designated room. The Boots pharmacy controlled system is being used to record and administer medicines and the staff administering medication had received training. We checked the medication administration records and found them to be in good order. Care Homes for Adults (18-65 years) Page 20 of 32 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . A complaints procedure is available and policies, procedures and staff training have been provided to protect the service users from the threat of abuse. Evidence: A complaints procedure is available at Eastleigh House. Two complaints have been made to the Commission about this service in the past twelve months. Neither indicated that any breaches of regulations had occurred but both suggested that communication with relatives and others had not been handled as sensitively as they could have been. Both of these complaints were subsequently resolved to the complainants satisfaction. The staff have received training in the protection of vulnerable adults and policies and procedures are in place to ensure that the manager and staff have access to information about the procedures to follow if they suspect that a situation could be regarded as abusive. One safeguarding referral has been made concerning the use of physical restraint. This was investigated under the Adult Protection procedures. A number of meetings were held around this issue including best practice meetings, meetings with outside therapists and a best interests meeting. Professional support and advice given to Eastleigh House on restraint techniques and paperwork and a positive outcome was Care Homes for Adults (18-65 years) Page 21 of 32 Evidence: reported to us by the service provider. Care Homes for Adults (18-65 years) Page 22 of 32 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . On-going maintenance is helping to make this a comfortable home for people to live in. Evidence: There is a large communal lounge and new sofas, designed for use by people with complex needs, had recently been purchased. This room is well used by the residents and has a homely feel. The dining room is also spacious and this room doubles up as an arts and crafts room. There is a sensory room for people to relax in. The residents do not use the main kitchen but have a training kitchen where they can make themselves drinks and snacks, with the help they need from the staff. Some of the bedrooms have been very highly personalised by the people who use them. During our last inspection we noted that some of the bedrooms were very poorly Care Homes for Adults (18-65 years) Page 23 of 32 Evidence: presented and sparsely furnished and were told that this was the residents choice. During this site visit we noted that significant improvements had been made to the presentation of these rooms were told that these improvements had been achieved by working closely with the residents and gradually introducing change. The bathrooms and toilets are adequate for the needs of the residents. Eastleigh House has a very large garden, which provides a safe outdoor area for the residents. The laundry facilities are in the basement, which is accessible to service users who are able to assist with their laundry. Care Homes for Adults (18-65 years) Page 24 of 32 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The staff are committed to providing a good service for the residents. Evidence: We looked at a sample of staff recruitment records and saw that safe recruitment practices are being used. Induction and foundation training is provided and the staff receive regular one to one supervision and performance appraisals. The Annual Quality Assurance Assessment tells us that the staff turnover is not high and the staff that we spoke with told us that they enjoy working at the home. Some of the staff said that they found their role as a key worker particularly rewarding. The provision of specialist staff training has improved since the last inspection but some of the staff told us that they would appreciate more autism specific training and more communication training, including Maketon to enable them to gain a better understanding of the needs of the people they are working with. Most of the staff have gained a National Vocational Qualification in Care at Level 2 and some have completed Level 3. Care Homes for Adults (18-65 years) Page 25 of 32 Evidence: Feedback from the staff tells us that there are not always enough staff on duty to meet the needs of the people who use the service and so the staffing levels do need to be reviewed regularly. Care Homes for Adults (18-65 years) Page 26 of 32 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The people who use the service benefit from living in a well managed home. Evidence: The manager, Emma Mai Richards, was registered in July 2006. She has completed her Registered Managers Award and holds an NVQ in Care at Level 4. Very positive comments were received the staff about the support provided by the manager. The registered providers have developed a Quality Assurance system, which audits different parts of the service provision during a year, and also includes a monthly audit of practices in the Home. Views are sought from representatives of residents and health care professionals using questionnaires. The registered provider also monitors the Home during monthly checks. The Annual Quality Assurance Assessment completed by the registered manager tells us that all of the required and recommended policies and procedures are in place. And up to date. Care Homes for Adults (18-65 years) Page 27 of 32 Evidence: Equipment and appliances are serviced regularly and kept in good repair. Care Homes for Adults (18-65 years) Page 28 of 32 Are there any outstanding requirements from the last inspection? Yes  No  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 29 of 32 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 Description 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 Description Timescale for action 1 7 16 The registered persons should provide in rooms occupied by residents adequate furniture, bedding and other furnishings, including curtains and floor coverings, and equipment suitable to the needs of the residents. 16/05/2009 This is to ensure that the residents do not use their personal spending money to pay for items that should be paid for through their fees. 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 1 2 13 22 Continued efforts should be made to enable the people who use the service to spend more time out of their home. Complaints could be handled more sensitively to prevent Page 30 of 32 Care Homes for Adults (18-65 years) them from escalating. 3 33 The staffing levels need to be continually monitored to ensure that there are always enough staff on duty to meet the social, occupational and recreational needs of the people who use the service. More training specific to meeting the needs of people with an autistic spectrum disorder could be provided. 4 35 Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: Telephone: 03000 616161 or Textphone : or 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) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 32 of 32 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!