Inspection on 21/11/08 for Eckett House

This inspection was carried out on 21st November 2008.

CSCI found this care home to be providing an Adequate service.

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

Eckett House 19/11/07

Eckett House 29/01/07

Eckett House 08/12/05

Eckett House 05/07/05

Eckett House 25/10/04

Eckett House 27/04/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 29/01/2009.

CARE HOME ADULTS 18-65 Eckett House 118 Dixon Street Swindon Wiltshire SN1 3PJ Lead Inspector Sally Walker Unannounced Inspection 21 November 2008 10:00 st Eckett House DS0000003214.V373125.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 Eckett House DS0000003214.V373125.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. Eckett House DS0000003214.V373125.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Eckett House Address 118 Dixon Street Swindon Wiltshire SN1 3PJ 01793 347929 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) Mrs Madeleine Thomas Miss Alicia Thomas Mrs Madeleine Thomas Miss Alicia Thomas Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Eckett House DS0000003214.V373125.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: 2. Learning disability (Code LD) The maximum number of service users who can be accommodated is 3 Date of last inspection 19th November 2007 Brief Description of the Service: Eckett House is a mid terraced house on the outskirts of Swindon town centre. On the ground floor there is one bedroom, a lounge and dining area plus a kitchen, bathroom and separate toilet. On the first floor are two more bedrooms and a staff sleep in room that also doubles as the office. At the back of the house there is a small garden. The home provides accommodation for men and women with learning disabilities. The model of care is based on the principles of ordinary living. The home is not staffed when people are at their daytime activities. There is at least one member of staff on duty when people are at home. There are no waking night staff. One member of staff sleeps in at night who assists if there is an emergency and meets any night time needs. Eckett House DS0000003214.V373125.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This inspection was announced so that we could have the opportunity to meet the people who use the service. It took place on 21st November 2008 between 10.00am and 3.00pm. We met with all three people who use the service before they went to their various day time activities. Both Mrs Thomas and Miss Thomas were present during the inspection. We looked at care plans, risk assessments, menus, medication and staff records. We made a tour of the building and some people showed us their bedrooms. We spoke with one of the staff. As part of the inspection process we sent survey forms to the home for people who use the service, staff and healthcare professionals to tell us about the service. Comments can be found in the relevant section of this report. We asked the providers to fill out an AQQA (their Annual Quality Assurance Assessment). It was not received on time. It was only received following our warning letter that we may take enforcement action for failing to return the AQQA. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. What the service does well: The statement of purpose and a service user guide is in easy read format with simple words and pictures. Although there were no new people admitted, people had had the opportunity to visit and meet the other people who lived there before they moved in. This meant that they had had enough information to decide whether the home could meet their needs. Their needs were assessed by a social worker before they moved in to make sure that their needs would be met. Each person had a statement of terms and conditions with the home so that they knew what to expect from the service. People had a care plan setting out how their needs are to be met and monitored. People make decisions about their lives with assistance as needed. They choose their meals, clothes, the décor of their rooms and their activities. People have access to advocates for more complex decision making. Eckett House DS0000003214.V373125.R01.S.doc Version 5.2 Page 6 Risk assessment focuses on promoting independence and keeping people safe. Risk assessment does not restrict people from having an independent lifestyle. People have opportunities for personal development. They attend church regularly, attend college, and leisure activities of their choice. People keep in contact with their family and friends. People are involved in some domestic tasks. People enjoyed the meals. People’s health care needs are being met and monitored. People have health action plans setting out their particular needs. People have good access to healthcare professionals when needed including the GP, community nurse, psychiatrist, dentist and optician. Medication is appropriately stored and recorded. Staff who assisted people to take medication receive training about medication. People are protected by the home’s medication practices. The complaints procedure is in an easy to read format and everyone had a copy. The home works to the local procedure about safeguarding from abuse and staff had received training about prevention of abuse. The accommodation is generally well maintained and well decorated. Each person has their own bedroom, which they liked. People benefit from homely, warm and clean accommodation. There is one member of staff on duty when people are at home and one member of staff who sleeps in at night. Although there were no new staff we have made judgements at previous inspections that people are supported and protected by the home’s recruitment practices. The managers have several years experience of managing the home. The quality assurance assessment seeks the views of people who live at the home, their relatives and anyone else involved in their care. Checks are made in relation to people’s and staff’s health and safety. What has improved since the last inspection? Improvements continue to be made to the care plans and personal files. A system for monthly review of key areas is being carried out. Miss Thomas has met with the manager from the local Skills for Care so that more training relevant to people’s needs can be provided. Staff had received updated training in medication, moving and handling, first aid, food hygiene, equality and diversity and training about prevention from abuse. One member of staff is registering for NVQ Level 4. The home continues to develop the quality assurance system. The managers continue to progress their aim to complete the required management training for registered managers. The managers are now clear about their different roles in managing the home. Eckett House DS0000003214.V373125.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Eckett House DS0000003214.V373125.R01.S.doc Version 5.2 Page 8 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 Eckett House DS0000003214.V373125.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information is available about what people can expect from the home. People can visit the home, to decide whether the home can meet their needs. People had their needs assessed before they moved in to make sure that their needs would be met. Each person had a statement of terms and conditions with the home. EVIDENCE: The statement of purpose and service users guide provided detailed information about the service in easy read format with simple words and pictures. Each person had a copy of these documents in their file. There was also written confirmation that they had received the guide and it had been read to them. No new people had moved into the home since the last inspection. There was an admission procedure. People had had their needs assessed by their care managers prior to coming to live at the home. The standard about admissions was met at previous inspections. Eckett House DS0000003214.V373125.R01.S.doc Version 5.2 Page 10 Each person had a statement of their terms and conditions which they had signed. Two people also had a contract with Swindon Borough Council and the home. Eckett House DS0000003214.V373125.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have care plans describing how their needs are to be met and monitored. Care plans are regularly reviewed. People are encouraged to make decisions about their lives with assistance as needed. People are supported to take risks as part of an independent lifestyle. EVIDENCE: Action has been taken to address the requirement we made that care plans must be reviewed a minimum of every six months or earlier if the needs of the person changes. We saw that each person had had a recent care management review with their placing agency. The home has developed monthly monitoring forms, where staff report on any significant changes, areas of concern, family involvement, health and positive outcomes for people who use the service. Care plans reported on all aspects of people’s care and support needs. These included daily living, managing finances, family and relationships, access to work and leisure, physical and mental health, likes and Eckett House DS0000003214.V373125.R01.S.doc Version 5.2 Page 12 dislikes, communication, mobility and behaviour management. The plans detailed specific support needed. People’s social workers had reviewed their placement since the last inspection. We saw that people signed up to their care plans. There was information on file identifying details of those people who were important to them. We saw evidence that people made choices and decisions about their daily lives. People had access to advocates to support them with more complex decision making. Each person had a key to the front door and their room but usually were accompanied by staff when they went out. In the AQAA Mrs Thomas told us “all individual needs and choices are taken into account and acted upon”. Action has been taken to address the good practice recommendation we made that each person’s individual risk assessments should be kept separately in their individual file. We said that this is to help them to have easy access to their records and to keep their information confidential. Risk assessments were in place for all aspects of people’s lives both at the home and in the locality. Risk assessments included the benefits to the person of participating in activities which posed a risk. They also focused on promoting independence. The risk assessments were reviewed every six months and a record was kept. There were management plans for any particular behaviours which were reviewed every six months. Staff fill out daily diaries for each person. Staff report on what activities people have been involved in, daily chores, meals and mood. Eckett House DS0000003214.V373125.R01.S.doc Version 5.2 Page 13 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. 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. People have opportunities for personal development. People participate in their local community and keep in contact with family and friends. People are offered a varied diet and enjoyed their food. EVIDENCE: People have a full and varied activity programme each week. In the AQAA Mrs Thomas told us that the activities programme has been extended to include college courses in computers and ice skating. She told us “there are many other courses etc that can be found around Swindon district and will be explored.” One person showed us their pictorial plan for the week. This had photographs of the places they went to, including a day service and their parents’ home. Eckett House DS0000003214.V373125.R01.S.doc Version 5.2 Page 14 One person told us about their meeting with an advocate that day. They said they regularly met with the advocate to discuss different things over a cup of coffee. They also said they were looking forward to going home to their parents that weekend. They said they liked to go out for a coffee and to the swimming baths. They told us about a club they went to. They said they enjoyed the discos and raffles. They said they often went out for a pub lunch and enjoyed a beer. They showed us the pictures they had made on the computer at college. They showed us some photographs of the different holidays they had with their parents. Staff supported two people to go to church and the other person went with their parents. One of the people showed us their photographs of their Christening and the party afterwards. People had regular contact with their family and went to stay with them some weekends. People were planning to spend Christmas with their family. There was information about the various different events in Swindon to be held over the Christmas period. Staff supported two people to have appropriate personal relationships. The three people went to a day service most days. One person worked in a fish and chip shop one day a week. They said that they enjoyed their job. Another person showed us photographs of them working in a local café. They said they enjoyed their work, cooking sausage rolls, chocolate mousse, apple pie and cakes and washing vegetables. Another person had a food hygiene certificate they had gained at college. People told us about their leisure activities. They went to a social club every week. One person liked dancing and was part of a dance group at the town hall and another group, which met at a school. Another person liked going to watch football. All of the people said they enjoyed going shopping for clothes and personal items, going out for meals and going to the pub. People had various trips out in the locality including Weston super Mare and different shows in London. Mrs Thomas told us that people had booked to attend a carol service in London. One of the people told us they had been to a pop concert in London. People choose where they go on holiday each year. Mrs Thomas told us they were considering going to Butlins because of the range of activities available and much of the meals and drinks were ‘all inclusive’. One of the people who use the service told us they enjoyed cooking, particularly sausages. They said they helped themselves to breakfast and made a packed lunch to take with them to day services. There was a varied menu based on people’s likes and dislikes. A balanced diet was encouraged although it was clear from the stores that people also enjoyed regular treats. In the AQAA Mrs Thomas told us “we ensure that their wishes on a rota system as to what they eat day to day. Could possibly be updated Eckett House DS0000003214.V373125.R01.S.doc Version 5.2 Page 15 with a more varied choice.” Mrs Thomas showed us a ‘cooked breakfast’ pack that people enjoyed on Saturday. Records were kept of what people ate each day. People went shopping at the local supermarket, with staff support, and chose what they wanted to buy. There was fresh fruit available for people to help themselves. A range of hot and cold drinks was available for people to help themselves and water from a water cooler. In a survey form, one of the people who use the service told us: “I go to Upham Road, I like it. I often go home. I like my room. I like the carers. I like living at Eckett House. I like my room and my television.” Another person told us: “I go swimming. I go home.” The other person told us: “I like everyone. I like living here.” Eckett House DS0000003214.V373125.R01.S.doc Version 5.2 Page 16 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. 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. People’s health care needs are being met. People are supported in the way they prefer. People are protected by the home’s medication practices. EVIDENCE: Healthcare needs were detailed in people’s care plans. Each person was registered with a GP. Miss Thomas told us that the GPs had particular skills in communicating with people with learning disabilities. Outcomes of appointments with health professionals were recorded. The records showed that people saw the GP, community nurse, psychiatrist, dentist and optician. One person attended the well men’s clinic. Each person had a health action plan, to ensure that their specific health care needs were met and monitored. Regular checks were documented on specific aspects of some people’s healthcare needs. We advised that negative comments such as ‘bad behaviour’ and ‘no problems to report’ should be avoided. We said that actions and observations should be written rather than judgements. Mrs Thomas supported one person to a GP appointment on the morning of the inspection. Eckett House DS0000003214.V373125.R01.S.doc Version 5.2 Page 17 One of the people showed us their new glasses. People were regularly weighed. Medication was kept in a locked cupboard. Staff supported people to take their medication. All staff give medication. Records were kept of medicines received into the home and administered. These were being appropriately recorded. Handwritten records were signed and dated when the entries were made. Staff had received training about the administration of medication. In a survey form one of the GPs told us: “Regular church attendance. Facilitating taking medication. They work with us very well. Raise any issue early and diligently of psychological or medical cause. Seem to provide happy, adjusted, healthy, kempt, stimulated environment for patient. Interfacing well between patient and all carers and family. I feel the carers should have more say over any difficulties/difference in treatment by themselves/families. I feel families and carers need to sign a common binding consistent/similar treatment” [re behaviours]. Another GP told us: “Always brought by carers to GP when required. Carers know well and act in their best interests. Given medicines in a pot and observed taking it. Enables [the person] to live a happy and fulfilled life.” Eckett House DS0000003214.V373125.R01.S.doc Version 5.2 Page 18 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. 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. People’s views are listened to and acted upon. Systems are in place to ensure people are protected from abuse. EVIDENCE: A summary of the home’s complaint procedures was on display at the entrance to the home. The complaints procedure was also included in the easy read service user guide and each person had a copy in their personal file. The policy stated any complaint would be responded to within 21 days. The complaints log showed that no complaints had been received since the last inspection. People told us they would speak to staff if they were unhappy. In the AQAA Mrs Thomas told us “we keep records of all concerns by service users on any matter. No complaints have been made by them or their families. We have regular meetings to talk about any concerns.” People are supported to manage their personal money. Two people kept their own money and managed it with minimum support. One person told us that their relative managed their finances. People have their own named savings accounts. Records were kept of people’s contributions to travelling using the travel element of their allowances. People had signed these forms. A copy of Wiltshire and Swindon’s “No Secrets” guidance about the local multiagency safeguarding adults procedures was available to staff. Staff had Eckett House DS0000003214.V373125.R01.S.doc Version 5.2 Page 19 attended abuse awareness training and there were certificates to confirm attendance. There had been no allegations of abuse. Eckett House DS0000003214.V373125.R01.S.doc Version 5.2 Page 20 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. 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. People live in an environment that is generally well maintained and well decorated. People have their own bedroom which they like. People benefit from homely, clean accommodation. EVIDENCE: The home is a mid terraced house close to the centre of Swindon. Each person had a single bedroom. One bedroom is on the ground floor. Two more bedrooms and the staff sleep in room are on the first floor. On the ground floor there is a small sitting room with a dining area. The bathroom and toilet facilities are also on the ground floor. The home was clean and tidy and maintained to a good standard. People said that they liked their rooms. Two people showed us their bedrooms. They were individually decorated and furnished to suit the person’s personality. In the AQAA Mrs Thomas told us “we have put new flooring and new furniture into one of the service user’s Eckett House DS0000003214.V373125.R01.S.doc Version 5.2 Page 21 rooms. We are looking into redecorating the home and the service users’ bedrooms.” One of the people who use the service told us they did some vacuuming and that staff did their laundry. There was a domestic washing machine in the kitchen area. A risk assessment had been completed to identify and reduce the risk of infection. Staff had completed infection control training. Two of the tiles in the kitchen doorway which were broken at the last inspection had been replaced. Mrs Thomas told us that the flat roof to the rear of the property was due to be replaced. Eckett House DS0000003214.V373125.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People are supported by sufficient staff who are on duty when they are at home. People would benefit from staff undertaking relevant training and induction that is specific to their needs. A sound recruitment process is in place. EVIDENCE: The rota showed that there is one member of staff on duty when people are at home and one member of staff sleeping in at night. At the time of the inspection there was one full time member of staff, a member of bank staff and the two managers. There was a recruitment procedure. No staff had been employed since the last inspection. At the last inspection we saw that all the documents and information required by regulation had been obtained as part of the recruitment process. No one commenced duties without checks on their suitability to work with vulnerable people on the Protection of Vulnerable Adults list. Eckett House DS0000003214.V373125.R01.S.doc Version 5.2 Page 23 Some action has been taken to address the good practice recommendation we made that the induction training meets the Skills for Care induction standards and the Learning Disability Induction Award for new staff is introduced. Miss Thomas told us that she had recently met with the local Skills for Care manager to set up a programme of induction and training. Some action has been taken to address the good practice recommendation we made that more training should be introduced that is specific to the needs of people with learning disability. Miss Thomas talked about her meeting with Skills for Care and setting up more relevant training for staff. Each staff has a record of all training undertaken. All staff and managers had recently attended a course on epilepsy. One member of staff had a certificate for moving and handling training dated September 2008. Staff had recently undertaken training in the principles of care, safeguarding vulnerable people, the Mental Capacity Act 2005 and occupational health and safety. The managers had attended the Skills for Care equality and diversity seminar. Action has been taken to address the good practice recommendation we made that more staff are enrolled for NVQ training. We said that this is to ensure that at least 50 of permanent staff are appropriately qualified. In the AQAA Mrs Thomas told us that two members of staff now had NVQ Level 2. One member of staff told us they were registering for NVQ Level 4 as they had now returned from maternity leave. We were shown the policy for staff supervision. Staff supervision notes were on file and related mainly to tasks rather than the home’s philosophy and development needs. There was no evidence that staff had regular supervision. Miss Thomas told us that staff meetings were held every two months and most development work was discussed as a group. In a survey form one of the staff told us: “The home provides a very clean homely atmosphere. The service users are happy and contented and feel safe. All staff are offered training to suit the needs of the service users. Due to the service users busy lives it is not always possible for the staff to meet up for meetings.” Another staff told us: “Gives personal support and care to all service users. Gives opportunity and choice to all to further their education and provide skills for living. Keeps service users in contact with their families. They all live in a clean, happy home with caring staff. Provide transport for all service users activities. All service users needs are already met health wise. They have excellent care.” Eckett House DS0000003214.V373125.R01.S.doc Version 5.2 Page 24 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The managers need to have the appropriate qualification for registered managers. The managers explained their different roles to ensure that people benefit from a well run home. People’s views are being reflected in the quality assurance process. People health, safety and welfare are promoted. EVIDENCE: Mrs and Miss Thomas have a number of year’s experience of running the home. They both share the registered managers’ role. We talked about the recommendation made at previous inspections, that they should provide us with a copy of the legal agreement they intend to draw up and also provide us with a copy of each manager’s job description and defined areas of responsibility. Miss Thomas told us that this related to a period of time that Eckett House DS0000003214.V373125.R01.S.doc Version 5.2 Page 25 she was away from the home. She told us she was now back full time as one of the managers and the recommendation did not now apply. She told us that she and her mother had clearly defined roles; she oversees the care and support of the people and her mother has responsibility for the financial management and staffing. Some action has been taken to address the requirement we made that the registered managers should ensure they have the necessary qualification to manage the care home and should complete the Registered Managers Award (RMA). In the AQAA Mrs Thomas told us about plans for improvement, “for one or both managers to complete the manager course”. Miss Thomas told us she was commencing the new Leadership and Management for Care Services Award. Mrs Thomas told us she was completing the Registered Managers Award. Miss Thomas had attended training in behaviour management and epilepsy. In the AQAA Mrs Thomas told us “we have attended various course to improve our understanding of paperwork and medications.” Some action has been taken to address the requirement we made that a system for evaluating the quality of services should be in place. We said that the scope of the quality assurance survey should include people’s families, staff working at the home and relevant stakeholders. In the AQAA Mrs Thomas told us “we have instigated a quality control system to give us an understanding of how various people close to our service users see us and our home.” Questionnaires had been sent to people who use the services and all those involved in their care in July 2008. We said that in order to fully meet this requirement, the responses should be reviewed and a report and action plan must be compiled to show details of necessary improvements to the service following this consultation. The managers had purchased a format for developing relevant policies and procedures. The home keeps a file on all the health and safety checks of services and any equipment. Staff were trained in moving and handling. There was guidance on infection control good practice available to staff. Mrs Thomas told us that the battery in the smoke alarm that was ‘beeping’ would be replaced that day. There were no accidents recorded since the last inspection. Miss Thomas told us that accidents were very rare. Risk assessments were recorded with regard to the environment and tasks that staff were involved in. Windows were restricted so people would not fall out. The radiators were not covered but people were mobile and were judged not to be at risk from hot surfaces. Records were kept of regular testing of the hot water supplies to the bath. We saw that liquid correction fluid was being used on some of the records. We advised that if a mistake is made in any record, a line should be drawn through it and the record completed afresh. Eckett House DS0000003214.V373125.R01.S.doc Version 5.2 Page 26 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 3 2 3 3 X 4 3 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 X 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 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 2 X 2 X X 3 X Eckett House DS0000003214.V373125.R01.S.doc Version 5.2 Page 27 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 YA39 Regulation 24 Requirement The registered person must complete the quality assurance process by writing a report of the findings from the questionnaires and producing a development plan. (This is outstanding since 19th November 2007). The registered managers must ensure they have the necessary qualification to manage the care home and must complete the Registered Managers Award. This is outstanding from the end of 2005. Timescale for action 31/01/09 2. YA37 9(2)(b)(i) 31/05/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Eckett House DS0000003214.V373125.R01.S.doc Version 5.2 Page 28 No. 1 2 3 4 Refer to Standard YA41 YA41 YA41 YA36 Good Practice Recommendations The care planning files should be rationalised to ensure only current information is readily accessible. Comments such as “bad behaviour” and “no problems” should be avoided. Correction fluid should not be used in any record. Staff should receive regular supervision at least six times a year. The focus should be away from task. The meetings should cover the home’s philosophy and aims together with personal training and development needs. More training should be introduced which is specific to the needs of those people with a learning disability. 5 YA35 Eckett House DS0000003214.V373125.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Eckett House DS0000003214.V373125.R01.S.doc Version 5.2 Page 30 - 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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