Inspection on 08/12/05 for Echo Square House

This inspection was carried out on 8th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Echo Square House 13/02/09

Echo Square House 06/02/07

Echo Square House 04/07/05

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 Announced Inspection 8th December 2005 10:00 Echo Square House DS0000023832.V261553.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Echo Square House DS0000023832.V261553.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Echo Square House DS0000023832.V261553.R01.S.doc Version 5.0 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 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) National Autistic Society Mrs Valerie Anne Barker Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Echo Square House DS0000023832.V261553.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th July 2005 Brief Description of the Service: Echo Square House is a care home providing personal care for three adults with Autistic Spectrum Disorders (ASD). The National Autistic Society (NAS) operate the service but Hyde House Corporation owns the property. 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 workshop 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 DS0000023832.V261553.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection took place over three hours on the 8 December 2005. Ground floor rooms were inspected. At the time of the inspection all three residents were out at their various workshops. In preparation of the inspection a visit was made on the 25 November 2005 to three of the NAS workshops in Gravesend – Robbie Centre, Artrack Centre and the Sands Centre. The three residents of Echo Square House were spoken with at the Sands Centre. Members of staff were also spoken with at the workshops. Some judgements about the quality of care, life and choices were taken from conversations with residents and staff, as well as direct and indirect observations. Some records were seen as part of case tracking and to assess work on the recommendations made at the last inspection. In response to the announcement of this inspection the Commission received a total of five comment cards from Relatives/Visitors (3) and Care Managers/Placement Officers (2). Some of their comments have been incorporated into this report. This is the second inspection of this home for the year 2005/06. Not all key standards have been inspected on this occasion, where they were met at the first visit. This report should therefore be read in conjunction with the inspection report dated 4 July 2005. The manager Mrs V Barker assisted throughout the inspection process. What the service does well: Although lifestyle standards were not re-inspected on this occasion, the visit to the Sands workshop on 25 November 2005 identified residents are supported in meaningful structured activities to meet their needs and preferences. The three residents were preparing to go swimming at a nearby leisure centre pool. Indeed one of the residents commented that he really enjoys this, as he likes to swim. Comment card respondents additional comments included “A beautifully run home – I always think it sets the standards for others to follow. Residents enjoy life greatly, despite their disabilities. Management and staff to be congratulated”; “Our [relative] is making good progress and is very happy with his placement. [We] too are very pleased with the home our [relative] resides in. Always happy to visit us and return to Echo Square”. The manager arranges input from community professionals when required. Indeed an environment assessment has recently been carried out by an Occupational Therapist with a view to improve the home’s bathing facilities for a particular resident. Echo Square House DS0000023832.V261553.R01.S.doc Version 5.0 Page 6 The décor and cleanliness of the home is maintained to a high standard and certainly benefits residents. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Echo Square House DS0000023832.V261553.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Echo Square House DS0000023832.V261553.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): N/I EVIDENCE: The three residents have lived at Echo Square House for over ten years and intend to continue to do so for the foreseeable future. No judgement has been made on these standards. Echo Square House DS0000023832.V261553.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 and 10 The health needs of residents are met with evidence of good multi disciplinary working taking place. EVIDENCE: All three residents have been provided with a care plan, risk assessments and other supporting documentation. The care plans inspected were in the main reflective of the residents’ current health and social needs and support. For a resident recently identified as having a behaviour problem, a risk assessment had been composed to monitor the problem and guide staff. The two returned comment cards from Care Managers/Placement Officers indicated staff demonstrate a clear understanding of their clients’ needs and their residents’ plan is being followed and reviewed regularly within the home. Two of the three comment cards returned from relatives/visitors indicated the respondents are satisfied with the overall care provided at the home. During conversations with the manager it transpired that the home provides much more support than is actually indicated in the care records. Although these matters were not health related, the information would be very useful if the resident was transferred to another home or indeed was supported by a worker not known to him. Echo Square House DS0000023832.V261553.R01.S.doc Version 5.0 Page 10 Details of residents’ medical and social needs and support are currently held in individual and communal files. The manager intends to sort out the current system and review all care files. This should allow for easier auditing as well as maximising residents’ confidentiality. Standard 41 also refers. Echo Square House DS0000023832.V261553.R01.S.doc Version 5.0 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): N/I EVIDENCE: All these standards were met at the last inspection. The standards have not been re-inspected on this occasion. Echo Square House DS0000023832.V261553.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 and 21 The system for medication administration is good, but details of homely remedies need clarification for residents’ safety. EVIDENCE: Since the last inspection the home has obtained and recorded details of residents’ wishes in respect of death, dying and last rites. Having this information readily available should minimise any undue distress to relatives and or advocates at a sensitive time. Only one resident takes prescribed medicines. The resident’s medication administration chart was viewed and found to be in order. All residents have been provided with authorisation from their GP to take a number of “homely” remedies including Lemsip and simple linctus. The authorisation was dated 2002. As such preparations come in various compounds, specific types of Lemsip and linctus must be stated to prevent residents receiving medicines, which may adversely affect them. Echo Square House DS0000023832.V261553.R01.S.doc Version 5.0 Page 13 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): 23 The availability of two different versions of challenging behaviour policies and procedures may hinder the intervention of staff at a crucial time. EVIDENCE: A file is maintained containing policies and procedures for staff use, including one for challenging behaviours. This is a generic document and does not adequately reflect the individuality of this home and its residents. The manager was able to produce a separate but more comprehensive policy and procedure for this aspect of care. However having two separate documents may prevent staff accessing appropriate guidance when it is required quickly. The main policy manual did not inform the reader of the availability of the other information. Echo Square House DS0000023832.V261553.R01.S.doc Version 5.0 Page 14 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, 29 and 30 Residents benefit from living in a home, which is maintained to a very high standard. EVIDENCE: Areas of the home inspected were very clean, well decorated, tidy and comfortable, making it a homely place for residents to live. Following action taken by the manager, an occupational therapist has visited the home and inspected the one bathroom. The purpose of this was to establish the suitability of the current bathing arrangements in view of one of the residents being visually impaired. The new facilities would provide a “wet” room design, making showering arrangements safer, while retaining the bath, which the other residents prefer. Echo Square House DS0000023832.V261553.R01.S.doc Version 5.0 Page 15 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, 34, 35 and 36 Staff have a good understanding of residents support needs. Staff turnover is low ensuring residents receive consistent care and support. EVIDENCE: The pre inspection questionnaire form indicated 75 of staff are now trained to NVQ II care. The pre inspection questionnaire states some staff have received training in POVA, First Aid and Fire Safety since the last inspection. Future training is being arranged for medication, health and safety and further POVA training. However during discussions it transpired that staff have not received recent challenging behaviour training or indeed refresher training. As there has been a recent incident in the home where one resident was challenged by another this needs to be addressed. The manager reported that staff receive regular supervision, annual appraisals and details are recorded. This is good practice and helps to ensure residents are cared for by staff that feel appropriately supported. There have been no external staff appointments since the last inspection. Echo Square House DS0000023832.V261553.R01.S.doc Version 5.0 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 40, 41 and 42 Residents continue to benefit from a well run home. EVIDENCE: The manager has attained a Registered Manager’s Award and commenced on the care component. Unfortunately due to matters beyond her control the care course was cancelled. The manager is now awaiting further instruction from the organisation as to how the matter will be resolved. Since the last inspection Kent Fire Safety and Rescue Service has agreed the home’s fire risk assessment. Residents attend fire training sessions and watch fire safety videos and are encouraged to question staff about any fire safety concerns they may have. Safety checks of the home’s fire safety system are regularly carried out as is required. Echo Square House DS0000023832.V261553.R01.S.doc Version 5.0 Page 17 As previously identified the maintenance of care records does not provide a coherent picture of residents’ needs and wishes and in some cases may compromise their confidentiality. Echo Square House DS0000023832.V261553.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score X 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 2 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X 3 4 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 X X 2 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Echo Square House Score X X 2 3 Standard No 37 38 39 40 41 42 43 Score 2 X X X 2 3 X DS0000023832.V261553.R01.S.doc Version 5.0 Page 19 N/A 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 YA35 Regulation 18(i) Requirement Staff must receive training to reflect residents’ needs, including challenging behaviour. Timescale for action 15/03/06 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 5 Refer to Standard YA10 YA20 YA23 YA37 YA41 Good Practice Recommendations Resident information must be held individually to maximise confidentiality Homely remedies authorised by the GP must be specifically stated. A comprehensive policy and procedure in respect of challenging behaviour must be easily accessible. The manager must successfully complete the care component of her course. Residents’ care records should be maintained coherently to promote easy and quick auditing. Echo Square House DS0000023832.V261553.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone 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 DS0000023832.V261553.R01.S.doc Version 5.0 Page 21 - 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. 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