Inspection on 05/05/05 for Eastleigh House

This inspection was carried out on 5th May 2005.

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 but made no statutory requirements on the home.

Other inspections for this house

Eastleigh House 10/12/08

Eastleigh House 01/10/07

Eastleigh House 27/07/06

Eastleigh House 25/10/05

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 TQ14 8TJ Lead Inspector Sam Sly Unannounced 5th 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. Eastleigh House D54-D07 S32594 Eastleigh House V214867 050505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Eastleigh House Address First Drive, Dawlish Road, Teignmouth, Devon, TQ14 8TJ 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) 01626 776611 01626 776611 info@craegmoor.co.uk Park Care Homes (No 2) Ltd Vacancy Care Home 8 Category(ies) of Learning disability (8), Physical disability (1) registration, with number of places Eastleigh House D54-D07 S32594 Eastleigh House V214867 050505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 18th January 2005 Brief Description of the Service: Eastleigh House provides care for up to 8 people with learning disabilities and additional autistic spectrum disorder. It is owned by a subsidary 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. Tehre is also additional toilet and bathroom facilities. There are several spacious communal rooms including a sensory room, training kitchen, activity room, lounge and dining room. There is also a large enclosed garden. Eastleigh House D54-D07 S32594 Eastleigh House V214867 050505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Inspection was unannounced, and took place over a weekday. Time was spent observing all the 8 residents, as many did not use speech to give their views. Lunch was also shared with residents. Judgements were based on observation of staff/resident interaction, written records, staff interviews, discussion with the Acting Manager Simon Trow and the Deputy Manager Phil Marshall and discussion with a visiting relative. A tour was also made of most of the building. What the service does well: What has improved since the last inspection? What they could do better: Eastleigh House D54-D07 S32594 Eastleigh House V214867 050505 Stage 4.doc Version 1.30 Page 6 A number of requirements remained from the previous 3 Inspections of Eastleigh House, some of which cannot be acted on without the Owners input. Only one care plan was comprehensive and reflective of the resident’s needs including assessed risks and information collected through accident and incident records, and even this care plan had not been reviewed since it had been written. Contracts were available but not signed or distributed, so residents were not aware of their terms and conditions. The Owners needed to make the changes agreed, so that resident’s money handled by them was protected and gave the best possible return. The present methods of monitoring quality needed to include the views of residents and others involved in the Home, and provide information so that the Owners, CSCI and other interested parties knew, overall, what Eastleigh House did well and still needed to improve. 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 D54-D07 S32594 Eastleigh House V214867 050505 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 Eastleigh House D54-D07 S32594 Eastleigh House V214867 050505 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) 1, 2 and 5 Clear information was available, for prospective residents, so informed choices could be made about where to live. However, information on resident’s terms and conditions had not been distributed or signed. An appropriate needs assessment was available for new residents ensuring that staff were aware of the initial care needs. Staff were getting some training on autistic spectrum disorder and communication methods, so that they could worked positively with residents. EVIDENCE: There was a Statement of Purpose and Service User Guide, which provided appropriate information for residents. Copies were given to CSCI at the Inspection. The Acting Manager said copies of the Service User Guide would be sent to all residents and their representatives. Although the Owners had developed a comprehensive contract format, so that residents and their representatives knew their terms and conditions, these contracts had not been distributed or signed. There was a comprehensive assessment format for new residents, although no new residents had been admitted for over a year. Present resident’s needs were being reassessed. Eastleigh House D54-D07 S32594 Eastleigh House V214867 050505 Stage 4.doc Version 1.30 Page 9 Some staff were getting training on working with people with autistic spectrum disorder during induction, and the Acting Manager had collected some books on the subject for staff. The Acting Manager said he thought the Owners were going to provide more specialist training, but did not know when. Eastleigh House D54-D07 S32594 Eastleigh House V214867 050505 Stage 4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 and 9 Not all care plans reflected the changing needs, including risks and personal goals of residents, nor had plans and information collected about residents been reviewed regularly, so staff could not be clear about the current care needs of residents. The way the Owners handled resident’s money did not give full protection or the best possible return on their savings. EVIDENCE: Only one of the four care plans examined was comprehensive, and had been agreed with the resident’s family. Discussion with a resident’s relative revealed that they agreed with the plan but that it had not been reviewed since it was written. Other plans were in varying degrees of completion. Staff could not demonstrate that they were using the plans to inform what they did with residents, and written incident reports being kept on resident’s behaviour were not informing the risk assessments and plans. That residents had comprehensive, reviewed plans, which included identified risks and were informed by incident reports, had been an outstanding requirement from the previous four Inspections. The relative said that daily Eastleigh House D54-D07 S32594 Eastleigh House V214867 050505 Stage 4.doc Version 1.30 Page 11 records were not always being kept accurately either. The Acting Manager acknowledged this. A senior staff member was in charge of developing activities and daily living skills with residents, and the system looked good, in that it would enable residents to make choices and decisions about what they wanted to do, and improve their independence. It was not yet fully implemented. CSCI were aware that the Owners were working on a new system for handling resident’s money, which had not yet been implemented. Eastleigh House D54-D07 S32594 Eastleigh House V214867 050505 Stage 4.doc Version 1.30 Page 12 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) 17 Meals were varied and the residents were given choices about what to eat, and where to eat it, so meals were healthy and enjoyable. EVIDENCE: A meal was shared with the residents that was tasty and was enjoyed by the residents. The mealtime was an enjoyable experience. There was a choice of menu, and the cook was aware of resident’s dietary needs. The dining room had recently been redecorated and refurbished and residents could chose to eat together or alone. The new activities co-ordinator had developed independence skills programmes for all residents to start planning, shopping for, and cooking their own meals in the future. The relative spoken to had some specific issues about the meals that were shared with the Acting Manager to resolve. Eastleigh House D54-D07 S32594 Eastleigh House V214867 050505 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 and 20 The resident’s personal and health needs were documented and understood by staff, so support could be given in their preferred way. Suitable procedures were in place, and being followed, for the storage, administration and recording of medication, so it was given safely. These procedures enabled residents, where appropriate, to retain, administer and control their own medication, although none were. EVIDENCE: Information in those care plans examined detailed how residents liked to be supported with personal and health care, and any health checks they had received. Staff said they were key workers for individual residents and this helped them get to know residents well. The daily routine was flexible to the residents needs. One resident was resting after illness; another was having a quiet day after going out the day before. Several residents went out during the day. The local learning disability health team and Consultant supported some of the residents. Eastleigh House D54-D07 S32594 Eastleigh House V214867 050505 Stage 4.doc Version 1.30 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 Arrangements for protecting residents and responding to their concerns were appropriate. EVIDENCE: Staff had either attended, or were booked to attend adult protection training given by Devon County Council. Staff that had attended training were able to demonstrate what they would do if they came across an abusive situation. The complaints procedure was clear and had been made as understandable as possible for residents. Eastleigh House or CSCI had received no complaints since the last Inspection. Eastleigh House D54-D07 S32594 Eastleigh House V214867 050505 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 29 and 30 The premises were on the whole suitably adapted, maintained and furnished for its stated purpose, with a programme in place to meet identified deficits. The premises were clean, hygienic and free from odour so residents were generally protected from the spread of infection. EVIDENCE: A major redecoration and refurbishment programme has taken place, and the home was now decorated and furnished to a high standard. Communal rooms were comfortable, homely and relaxing. Staff said the improved environment had boosted morale. A programme was in place to remedy outstanding environmental issues, one of which is an outstanding requirement from previous inspections. The laundry facilities now had washable walls and an impermeable floor, and a separate entrance was in the process of being made to the food store. It was recommended that advice e was sort about the pipe work in the laundry in relation to the spread of infection. Eastleigh House D54-D07 S32594 Eastleigh House V214867 050505 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34 and 35 There were enough staff and they received a range of training tailored to their needs and the needs of residents. Recruitment procedures had been followed consistently so all staff had been properly interviewed, vetted and appointed. This meant the residents using the service were protected. EVIDENCE: The ratio of staff to resident was determined by their needs; many received one-to-one staffing or higher levels. Staff spoken to said staffing numbers had increased and this meant they could do more with residents in and out of the home. The Owners oversaw recruitment with the acting manager involved with interviews. Several staff files, including two new staff, were examined and found to be comprehensive thereby protecting residents. Staff commented positively on the amount of training being provided which included induction, equal opportunities, communication methods and health and safety courses. Staff felt happy to now have a stable management team, who were described as ‘approachable’. Staff felt that now that staffing Eastleigh House D54-D07 S32594 Eastleigh House V214867 050505 Stage 4.doc Version 1.30 Page 17 numbers had increased there was beginning to be a real sense of ‘team’ in the Home. Eastleigh House D54-D07 S32594 Eastleigh House V214867 050505 Stage 4.doc Version 1.30 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 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, 39 and 42 There was a stable management team and residents were beginning to benefit from a well run home. The Owners methods for monitoring quality were not underpinned by resident’s views, and did not enable them to identify, overall, what they were doing well and what needed to be improved, or inform CSCI and other interested parties. The resident’s health, safety and welfare was protected and promoted by the Owner and acting manager. EVIDENCE: The Owner was aware that its quality assurance system needed work as requirements had been made at the last 3 Inspections. There were some monitoring methods in place: Eastleigh House was visited monthly by the Owners, there were regular environmental and risk checks and training was monitored, but residents views and those of other interested parties were not gathered and there was no overall quality audit which showed what the home was doing well, and what needed improving. The acting manager did not know Eastleigh House D54-D07 S32594 Eastleigh House V214867 050505 Stage 4.doc Version 1.30 Page 19 how the Owners were progressing with meeting the CSCI requirement in connection with this issue. An application had been lodged with CSCI to register Simon Trow as manager. Staff spoken to felt they now benefited from a stable management team and residents were beginning to see the benefits. Records showed that staff had received a range of health and safety training, and health and safety checks were being carried out systematically, so that the environment was safe for residents. Eastleigh House D54-D07 S32594 Eastleigh House V214867 050505 Stage 4.doc Version 1.30 Page 20 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 3 3 x x 2 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x 2 2 Standard No 11 12 13 14 15 16 17 x x x x x x 3 Standard No 31 32 33 34 35 36 Score x x 3 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Eastleigh House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 2 x x 3 x D54-D07 S32594 Eastleigh House V214867 050505 Stage 4.doc Version 1.30 Page 21 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 5 Regulation 5 (c) Timescale for action Contracts must be signed by 20th July residents or their representatives 2005 and distributed. (Previous timescale of 25th February 2005 not met). 20th July Each resident must have a care plan that details their assessed 2005 needs. Plans must be completed with residents and their representatives and reviewed regularly. (Previous timescale of 31st March 2005 not met). The Owners should put into place 20th the banking arrangements for September residents that have been 2005 proposed. (Previous timescale of 31st March 2005 not met). Detailed risk assessments must 20th July be carried out for each residents 2005 and reflected in care plans. Information collected through accident and incident reports must be reflected in care plans. (Previous timescale of 31st March 2005 not met). The Owners must make sure 20th July rails are provided on steps out of 2005 the house. (Previous timescale of 31st March 2005 not met). There must be a complete D54-D07 S32594 Eastleigh House V214867 050505 Stage 4.doc Requirement 2. 6 15 3. 7 20 4. 9 13 (4) (b) (c) 5. 29 13 6. 7. 39 24 20th Version 1.30 Page 22 Eastleigh House Quality Assurance system in place which captures the views of the residnets and stakeholders. An annual report must be produced, with a copy available for CSCI and other interested people. (Previous timescale of 16th March 2005 not met). September 2005. 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. 3. 4. Refer to Standard 32 and 3 6 17 30 Good Practice Recommendations Staff should receive the Autism traininig that the Owners have said they would provide, The daily records should be complete. The acting manager should investigate the relatives food issues discussed at the Inspection. The Owners should contact the relevant health regulators to advise on how to control the potential spread of infection, from the unboxed pipework, in the laundry facilities. The acting manager should ensure that discussion anout issues of staff suitability are recorded. 5. 34 Eastleigh House D54-D07 S32594 Eastleigh House V214867 050505 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 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. 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