Inspection on 27/07/06 for Eastleigh House

This inspection was carried out on 27th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Eastleigh House 10/12/08

Eastleigh House 01/10/07

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 08/07/2008.

CARE HOME ADULTS 18-65 Eastleigh House First Drive Dawlish Road Teignmouth Devon TQ14 8TJ Lead Inspector Sam Sly Unannounced Inspection 27th July 2006 09:30 Eastleigh House DS0000032594.V289122.R01.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 Eastleigh House DS0000032594.V289122.R01.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. Eastleigh House DS0000032594.V289122.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Eastleigh House Address First Drive Dawlish Road Teignmouth Devon TQ14 8TJ 01626 776611 01626 776611 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) Park Care Homes (No 2) Ltd Vacancy Care Home 9 Category(ies) of Learning disability (9), Physical disability (1) registration, with number of places Eastleigh House DS0000032594.V289122.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th October 2005 Brief Description of the Service: Eastleigh House provides care for up to 9 people with learning disabilities and additional autistic spectrum disorder. It is owned by a subsidiary of Craegmoor Healthcare Limited. Eastleigh House is located in the town of Teignmouth within walking distance of the town centre, bus routes the train station. The ground floor is wheelchair accessible with stairs to the first floor and basement. Every bedroom is single and many have en-suite facilities. There is additional toilet and bathroom facilities. There are several spacious communal rooms including a sensory room, training kitchen, two lounges and dining room. Outside is a large enclosed garden. Eastleigh House DS0000032594.V289122.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit was unannounced and took place during a weekday in July. The visit included observation of the residents and their interaction with staff, discussion with the staff members on duty and Emma Richards the registered manager and Laura Bigland the deputy manager. Three resident’s care was partially case tracked. Care records and health and safety records were examined and a tour of the building, including all bedrooms was made. The Inspection process also included a review of contact the Commission has had with Eastleigh House over the past year and comment cards from four relatives/visitors, six staff, a Doctor and four professionals. The required preinspection information and data was also received from Emma Richards by the Commission, as was an action plan for requirements made at the last Inspection. What the service does well: What has improved since the last inspection? What they could do better: Eastleigh House DS0000032594.V289122.R01.S.doc Version 5.2 Page 6 The written plans that record what help resident’s need to be safe and lead interesting lives must be up to date Resident’s money that is looked after by the Owners must be kept safely. The Commission has also made some recommendations to make living at Eastleigh even better for residents. 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. Eastleigh House DS0000032594.V289122.R01.S.doc Version 5.2 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 Eastleigh House DS0000032594.V289122.R01.S.doc Version 5.2 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): 2&5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information on resident’s terms and conditions has been distributed to their representatives. New residents can be assured that their needs will be assessed prior to admission. EVIDENCE: The registered manager Emma Richards had ensured all resident’s representatives had contracts, which reflected the terms and conditions of residents stays. She said some representatives were not happy to sign them. Two new residents had been admitted since the last key inspection and both resident’s care was tracked during the Inspection process. The registered provider had developed a comprehensive assessment format, and it had been used, with additional information gathered from the placing authorities or last placements assessments and care plans. One resident had moved to Eastleigh House on an emergency placement and their needs had changed significantly since arrival, these changes were not reflected in an updated assessment or in the care plan, although a review meeting had been held. Eastleigh House DS0000032594.V289122.R01.S.doc Version 5.2 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): 6, 7 & 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans do not reflect the changing needs, including risks of residents and it could not be demonstrated that residents are always involved in the day-today decision making about their lives. The way the registered provider handles resident’s finances does not give full protection. EVIDENCE: Three residents care planning records were examined. In all cases residents had care plans, risk assessments, incident records and daily records. One resident was having monthly multi disciplinary meetings, and staff were working closely with a range of professionals to meet their needs. The Care Manager for this resident commented that ‘I have found this Home to be an excellent example of residential care’. Review meetings had been held for two residents, but plans and risk assessments had not been updated after these reviews. The risk assessment in one residents file was missing. Eastleigh House DS0000032594.V289122.R01.S.doc Version 5.2 Page 10 Discussion with the registered manager and deputy manager and examination of behavioural incident reports found that although detailed information was being recorded, and de-briefing sessions were taking place after incidents, this data was not being systematically reviewed to inform care plans. Also review meetings had been held and recorded but the care plans and risk assessments for residents had not been updated and were not reflective, particularly for one resident’s case, of their current needs. The deputy manager is trained, and trains staff in non-violent crisis intervention, including physical interventions for challenging behaviour. The training organisation is the Crisis Prevention Institute who is accredited by the British Institute for Learning Disabilities (BILD). Two of the three residents case tracked required plans for behaviours that challenge, and plans were in place, but were not comprehensive. It was recommended that the deputy manager attend some training on behavioural support planning. Although very active in the community and at home, the activity programmes in resident’s files were not up to date or being followed, and as yet decisionmaking within these activity programmes had not been fully explored, which meant records did not always demonstrate that residents had chosen, or been given alternatives to what they were doing each day. Emma Richards said the registered provider had agreed to an activities co-ordinator being employed so that activities could be developed to include choice. The registered provider’s practice at Eastleigh House for handling residents money include banking arrangements that incorporate the finances of residents from other Homes that the registered provider owns in the same account, as well as money for a resident who no longer lives at Eastleigh House. It is also difficult for residents to access money outside of office hours, if they want more than is held in petty cash. CSCI are aware that the registered provider are continuing to work on an improved system for handling resident’s money, but there is no date for completion. Eastleigh House DS0000032594.V289122.R01.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents lead active, interesting lives and activities make full use of community facilities and amenities. Family involvement is encouraged and supported. EVIDENCE: There was evidence in daily records and through talking with staff that residents spent a lot of time accessing activities in the community, or doing activities in the home. The registered manager Emma Richards said the registered provider had recently agreed to an activities co-ordinator being employed, so that the element of choice could then be explored, as resident’s abilities to communicate meant making choices was not always straightforward. Eastleigh House had cooking staff and a menu was followed, with special dietary needs catered for. Contact with relatives was promoted, and four relatives sent comment cards to the Commission that said that they were made welcome, they could meet their relative in private, they were kept Eastleigh House DS0000032594.V289122.R01.S.doc Version 5.2 Page 12 informed of events, knew the complaints procedure and consulted about the care of their relative and that they felt their was sufficient staff on duty. Three of the four relatives said overall care provided was satisfactory. The Commission is aware that the registered manager is working with the relative that was dissatisfied. Additional comments from relatives were: ‘I feel my [relative] is week cared for and that staff keep a very homely atmosphere around him. I am always made welcome by staff. I can turn up without notice and [my relative] is always clean and happy’. ‘When Eastleigh was taken over by Craegmoor we initially had concerns research: staffing, activities, facilities etc. for our [relative]. We are pleased to say things have improved and the premises seem to be a pleasant place for [them] to live’. ‘I had cause to complain when Eastleigh changed ownership but conditions have improved tremendously since then and my relative is quite happy there now’. Staff were observed to be interacting at all times with the residents, and were approachable and looked and talked like they genuinely cared about the residents. Daily routines were relaxed and fitted around the needs of residents. Some residents were going on an annual holiday this year; others would take day trips out. Eastleigh House DS0000032594.V289122.R01.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s personal care and healthcare needs are met, and medication procedures protect them. EVIDENCE: Staff were observed to be supporting residents in ways that maximised privacy and dignity. Learning about resident’s rights, confidentiality and privacy make up part of staff induction at Eastleigh House. Residents were all dressed to reflect their ages, the time of year and their personalities. Staff worked closely with health and social care professionals, and referrals were made appropriately. Four professionals and a Doctor sent the Commission comment cards which reflected that in their opinions staff at Eastleigh demonstrated a clear understanding of the residents needs, plans were in place, there was always a senior available to talk to, they were informed of significant events and were satisfied with the overall care at Eastleigh. Additional comments were: ‘I have worked closely with staff and management to ensure the needs of my client are met, [they] have very complex needs and we have a very good working relationship’. ‘My client receives a very good service and has improved since being at Eastleigh and the provision is very self-centred around the client’. Eastleigh House DS0000032594.V289122.R01.S.doc Version 5.2 Page 14 Healthcare is monitored closely and records showed regular medication, and health checks take place. Staff due to the needs of residents administers all medication. Medication is stored in suitable metal cabinet, and procedures for the administration, handling, recording and disposal of medication were examined and found to be appropriate. Only trained staff administer medication. Eastleigh House DS0000032594.V289122.R01.S.doc Version 5.2 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 the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their representatives can feel assured that their concerns are listened to and acted on. Procedures at Eastleigh House ensure that residents should be protected from abuse. EVIDENCE: Eastleigh House has had several incidents since the last key inspection when the protection of vulnerable adults procedures have had to be implemented. Staff, the registered provider and registered manager have acted swiftly and professionally and worked with other Agencies to ensure residents are protected. Staff spoken with during the site visit were clear about Adult Protection procedures. Eastleigh House has a sufficient complaints procedure, and the relatives (who act as representatives for residents) that sent back comment cards indicated that they were aware of the process. The Commission is aware that the registered provider has dealt with complaints in the past swiftly and professionally. Eastleigh House DS0000032594.V289122.R01.S.doc Version 5.2 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 the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The premises are suitably adapted, maintained and furnished for its stated purpose, with a system in place to meet identified deficits. EVIDENCE: The site visit involved a tour of the premises, which were clean, well furnished and well decorated. One resident had stripped their bedroom of everything; carpet, radiator, decoration, bedding and furniture and it is recommended that this behaviour be investigated as part of their behavioural plan. There were no outstanding requirements from either the fire service or the environmental health department. Each resident has his or her own bedroom, most of which are en-suite. There are two lounges, one being refurbished at present, a sensory room and additional bathrooms. Residents have access to a large enclosed garden, which was observed to be used by residents. The laundry facilities were in the basement, which also housed the boiler and the food storage room. The registered provider had worked hard to try to find a way to ensure access to the food store was not through the laundry, however, the Home’s maintenance man said after seeking advise from the Eastleigh House DS0000032594.V289122.R01.S.doc Version 5.2 Page 17 boiler engineers, it would be impossible to put in a hallway as it would dangerously restrict ventilation to the boiler. Therefore it is recommended that a policy to ensure cross-infection does not occur should be written, and the door to the food storage is tight fitting. Eastleigh House DS0000032594.V289122.R01.S.doc Version 5.2 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 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from a staff team that are fit to work with them, approachable, interested, committed and that receive a range of training tailored to their needs. EVIDENCE: Two staff files recruitment and training files were examined. Recruitment is initially done through the registered provider head office, with interviews being carried out by the registered manager. The files examined contained all the appropriate checks and records to ensure the safety of residents. Six staff questionnaires were returned to the Commission and confirmed that appropriate recruitment practices were carried out. All six said they felt supported by the registered manager. Staff felt the staff team worked well together and this was good for residents as it: ‘gives consistency of care to them’. Staff also felt they were ‘committed to their work’. Staff spoken with said they were often a good range of training that helped them meet the needs of residents and included health and safety training, Adult Protection training and positive interaction training and NVQ training. Each staff member had a training and development file. There were regular staff meetings and supervision sessions. Eastleigh House DS0000032594.V289122.R01.S.doc Version 5.2 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 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): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a Home run by a competent manager, with the quality of the service being monitored and improved by the registered provider. EVIDENCE: Eastleigh House now has a registered manager who staff described as ‘supportive’ and who had the appropriate skills, qualifications and qualities. One staff member commented that: ‘the management that we have now tell us about what is going on, if it’s something that we should know, which makes us feel and work more like a team’. The registered manager has acted appropriately in informing the Commission and acting on any issues that have arisen since the last Key Inspection. The registered provider 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 sort from representatives of residents, and the registered provider monitors the Home during monthly Eastleigh House DS0000032594.V289122.R01.S.doc Version 5.2 Page 20 checks. The only missing element was an annual development plan and feedback to participants. The Pre-inspection questionnaire showed all the necessary safety checks on appliances and heating systems took place, and fire safety records were examined and found to be up to date and appropriate. There was a monthly health and safety meeting and the environment was regularly monitored. Accidents were recorded appropriately. Eastleigh House DS0000032594.V289122.R01.S.doc Version 5.2 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 Standard No Score 1 X 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Eastleigh House DS0000032594.V289122.R01.S.doc Version 5.2 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. Standard YA6 Regulation 15 Timescale for action Care plans must be reviewed and 04/11/06 updated so that they reflect the current needs of residents. (Timescale 10/03/06 – not met). Risk assessments must be up to date. Care plans for residents whose behaviour challenges must have comprehensive behaviour support plans. 04/11/06 Requirement 2. YA9 13 (4) 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. 2. Refer to Standard YA2 YA6 Good Practice Recommendations A resident’s assessment should reflect any changes to their needs, and if a resident is admitted in an emergency needs should be reassessed once they are settled. Behavioural incident reports should be reviewed, with outcomes informing the resident’s care plan and risk assessment. The staff member whose role it is to develop behavioural DS0000032594.V289122.R01.S.doc Version 5.2 Page 23 Eastleigh House 3. 4. 5. 6. YA7 YA24 YA30 YA39 plans should have some training. The Owners should put into place the banking arrangements for residents that have been proposed. The resident who has stripped their bedroom should have the behaviour investigated as part of a behavioural plan. A policy to ensure cross-infection does not occur should be written, and the door to the food storage should be tight fitting. The Quality Assurance system should include an annual development plan and feedback to participants. Eastleigh House DS0000032594.V289122.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 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. Extracts may not be used or reproduced without the express permission of CSCI Eastleigh House DS0000032594.V289122.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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