Inspection on 04/07/05 for Echo Square House

This inspection was carried out on 4th July 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 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

Echo Square House 13/02/09

Echo Square House 06/02/07

Echo Square House 08/12/05

Echo Square House 15/02/05

Echo Square House 21/07/04

Echo Square House 11/03/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Echo Square House 70 Parrock Road Gravesend Kent DA12 1QH Lead Inspector Elizabeth Baker Unannounced 4 July 2005 15:20 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. Echo Square House v234982 h56-h06 s23832 echo square v234982 040705 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Echo Square House Address 70 Parrock Road Gravesend Kent DA12 1QH 01474 332224 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) National Autistic Society Mrs Valerie Anne Barker CRH Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Echo Square House v234982 h56-h06 s23832 echo square v234982 040705 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15 February 2005 Brief Description of the Service: Echo Square House is a care home providing personal care for 3 Adults with Autistic Spectrum Disorders (ASD). The National Autistic Society (NAS) operate the service, but Hyde Housing Corporation owns the property. The service was first registered in February 1995. The home is a detached property situated about two miles from the centre of Gravesend. Gravesend has many amenities, including shops, pubs, main post office, banks, places of worship and an adult education centre. The home is also in close proximity to a number of local shops and public transport is easily accessible from the home. Resident accommodation comprises one sitting room, a separate dining room and three single bedrooms. None of the bedrooms have ensuite facilities. All bedrooms are situated on the first floor. The home does not have a stair or passenger lift. There is a garage and small-enclosed patio area at the rear of the property. The home blends into the surrounding area and there is nothing to suggest it is anything other than a family house. Free parking is available nearby. In addition to the residential accommodation the NAS provides day care activities in a variety of locations in the Gravesend area for residents from this home, as well as from the community and two other associated care homes. Echo Square House v234982 h56-h06 s23832 echo square v234982 040705 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over 2½ hours. Lead Inspector Elizabeth Baker carried out the inspection. A partial tour of the home took place. Of the three residents spoken with, one was also spoken with in private. The inspector also spoke with the member of staff on duty. Mrs V Barker, the Registered Manager, assisted in the inspection process. Some judgements about the quality of care, life and choices were taken from conversations with residents and direct observation. Some records were seen as part of case tracking and to assess work on the requirements and recommendations made at the last inspection. The inspector would like to thank all the residents for their time and assistance during this inspection visit, and for permission to visit their bedrooms. What the service does well: What has improved since the last inspection? What they could do better: For all residents to achieve their full goals and potentials with appropriate support from staff, care plans should be enhanced to allow for the setting and recording of discrete goals, where the residents’ assessed needs require such assistance. To maximise residents’ confidentiality, records relating to their care and support must be kept separately in their individual files. Echo Square House v234982 h56-h06 s23832 echo square v234982 040705 stage 4.doc Version 1.30 Page 6 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. Echo Square House v234982 h56-h06 s23832 echo square v234982 040705 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 Echo Square House v234982 h56-h06 s23832 echo square v234982 040705 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) N/I The home was registered ten years ago to accommodate the three residents who still live at the home. No judgement has therefore been made on these standards. EVIDENCE: Echo Square House v234982 h56-h06 s23832 echo square v234982 040705 stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 9 and 10 Residents are treated with genuine respect by staff who understand their needs. EVIDENCE: All residents have a care plan, which is reviewed twice a year, during multidisciplinary meetings. The manager said the content of the plans is to be expanded to include more precise information with regard to the level of support and guidance required where the assessed need requires this. The change of format will coincide with the next review scheduled for September 2005. Residents meet regularly to discuss their plans for the coming week, including arranging outings, menus and shopping. Details of the discussions are maintained in a book so each resident is aware of their actual responsibility. Assessments covering aspects of daily living have been undertaken on each resident. These identify any potential risks and the subsequent action to be taken to maintain their safety, whilst allowing them to be as independent as possible. The assessments are kept collectively in a large folder. The folder also contains general risk assessments. The manager said details of Echo Square House v234982 h56-h06 s23832 echo square v234982 040705 stage 4.doc Version 1.30 Page 10 assessments relevant to specific residents are also kept in their individual care records. The current arrangement of collectively maintaining individual residents’ records breaches their confidentiality. Echo Square House v234982 h56-h06 s23832 echo square v234982 040705 stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15, 16 and 17 Links with the community are good and support and enrich residents’ social, educational and development opportunities. Residents benefit from a wide variety of lifestyle choices with appropriate staff support where needed. EVIDENCE: Residents regularly attend day centres operated by the National Autistic Society. These centres provide opportunities for residents to develop life skills, including shopping and cleaning. Other activities include woodwork, art and computer studies. One resident will be demonstrating his art skills in London as part of a NAS initiative. Residents are supported in continuing their hobbies. A particular resident enjoys going to bus rallies with a friend in another town and has taken many photos of these trips as mementos. Where possible, residents are supported in making weekend home visits. All three residents and two members of staff are due to go on a rock and roll summer break shortly. One resident wished to visit Buckingham Palace and Clarence House. Such a trip has been arranged for August. Another resident spoke of his enjoyment of watching the recent “Live 8” broadcast on TV as he Echo Square House v234982 h56-h06 s23832 echo square v234982 040705 stage 4.doc Version 1.30 Page 12 enjoys watching rock bands. A new television has been purchased, improving the quality of picture reception for residents. Staff support residents in preparing meals. An appetising smell was noticeable at the time of the inspection as the evening meal was being prepared. Menus have been devised in formats, which assist residents in making an informed choice. Residents are supported in attending services at the local church at festival times, if that is their wish. Echo Square House v234982 h56-h06 s23832 echo square v234982 040705 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, 20 and 21 Staff have a good understanding of residents personal and healthcare support needs. EVIDENCE: All residents are independent and require minimal support. However one resident has been identified as requiring additional support with his bathing arrangements. Although the home has obtained a bath aid as an interim measure, the manager is in discussion with Hyde Housing and Social Services with a request for the bathroom to be adapted to include a proper showering facility to be installed. This will enhance the washing facilities for the resident. Residents are supported in attending appointments and consultations with health professionals. A hospital form has been introduced, which will ensure pertinent information is recorded and is available to clinicians prior to residents receiving medical treatment in unfamiliar environments, thus minimising any anxieties they may have. A medication administration record chart was inspected. This had been appropriately completed as evidence of the resident receiving his regular prescribed eye drops. Echo Square House v234982 h56-h06 s23832 echo square v234982 040705 stage 4.doc Version 1.30 Page 14 Mrs Barker said details of residents’ wishes and preferences in respect of death and dying have now been obtained. This information is kept separately at the Society’s Gravesend locality office. The inspector suggested reference to this arrangement is referred to in the residents’ individual care plans, enabling easy access in the event of an emergency. Echo Square House v234982 h56-h06 s23832 echo square v234982 040705 stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 Arrangements for protecting residents are satisfactory. EVIDENCE: Where required the home notifies Social Services of incidents, which could be construed as Adult Protection issues. This ensures residents are protected from allegations of abuse. A resident said he likes living at the home and staff are kind. However the resident was unable to say what he would do if he were worried about something. The Provider has just published a new service user guide. This contains a section on how to make a complaint. The home is in the process of completing the documents for each individual resident. This will ensure residents know what to do if something is not right. Echo Square House v234982 h56-h06 s23832 echo square v234982 040705 stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28 and 30 The standard of décor, furnishings and cleanliness is very good, providing residents with a suitable place to live in. EVIDENCE: Staff ensure the home is kept in a good decorative order. Residents are involved in choosing colours for their bedrooms and communal areas. Bedrooms are furnished to meet the individual choices of residents. The home is situated in close proximity to a number of shops and in easy walking distance of the NAS day centres. The home is kept clean and odour free, thereby minimising any infection control risks to residents. The home was first registered in 1995. Until recently a Fire Safety Officer of Kent Fire Brigade had not inspected the home. The manager has completed and submitted a Fire Risk Assessment to the Inspecting Officer and is awaiting any comments he may have. An up to date fire risk assessment will assist staff in ensuring any fire safety risks are identified and appropriate is action taken, making the home a safe environment to live in for residents and staff. Echo Square House v234982 h56-h06 s23832 echo square v234982 040705 stage 4.doc Version 1.30 Page 17 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) N/I These standards were not examined at this visit. Therefore no judgement has been made. EVIDENCE: Echo Square House v234982 h56-h06 s23832 echo square v234982 040705 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 Residents benefit from a well run home. EVIDENCE: The manager has successfully completed a management qualification and has almost completed a relevant care course. This will provide the manager with the requisite qualifications to manage this care home. Residents have completed in-house “Talking to Staff” questionnaires. The information gathered is to be used during the multi-disciplinary reviews scheduled for September 2005. This will provide an opportunity for the residents and those associated with providing their care, to discuss any issues that may improve residents’ quality of life at the home. The organisation is committed to ensuring all staff are appropriately trained to carry out their duties appropriately. Information obtained from the Provider identifies staff having received recent training including Health and Safety, Management of Medications, Protection of Vulnerable Adults and Food Hygiene. Echo Square House v234982 h56-h06 s23832 echo square v234982 040705 stage 4.doc Version 1.30 Page 19 Echo Square House v234982 h56-h06 s23832 echo square v234982 040705 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 x x x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 2 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Echo Square House Score 3 3 3 2 Standard No 37 38 39 40 41 42 43 Score 2 x 3 x x 3 x v234982 h56-h06 s23832 echo square v234982 040705 stage 4.doc Version 1.30 Page 21 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 Regulation Requirement Timescale for action 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. Refer to Standard 10 37 21 Good Practice Recommendations All records containing residents information must be kept separately, to maximise confidentiality. The manager must successfully complete the care component to provide her with the necessary qualifications for the position of Registered Manager of this home. Details of residents wishes and preferences in respect of death and dying should be available at the home. Echo Square House v234982 h56-h06 s23832 echo square v234982 040705 stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection The Oast, Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 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 Echo Square House v234982 h56-h06 s23832 echo square v234982 040705 stage 4.doc Version 1.30 Page 23 - 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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