Inspection on 29/01/07 for Eckett House

This inspection was carried out on 29th January 2007.

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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Eckett House 21/11/08

Eckett House 19/11/07

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 08/07/2008.

CARE HOME ADULTS 18-65 Eckett House 118 Dixon Street Swindon Wiltshire SN1 3PJ Lead Inspector Bernard McDonald Unannounced Inspection 29th January 2007 07:30 Eckett House DS0000003214.V315373.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.V315373.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.V315373.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.V315373.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th December 2005 Brief Description of the Service: Eckett House replicates the principles of ordinary living. The home is a mid terraced property on the outskirts of Swindon town centre. Accommodation is provided on two floors accessed by stairs. 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 further bedrooms and a staff sleep in room that also doubles as the office. To the rear of the property there is a small garden. The home provides accommodation for men and women with a learning disability. The home is not staffed when service users are at designated activities. Usually there is one person on duty. There is no waking night staff, instead staff undertake sleep in duties and are expected to assist in an emergency, should one arise and meet any night time needs. Eckett House DS0000003214.V315373.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over nine hours. A tour of the building was made and all areas of the home including all service users bedrooms were seen. We met with all service users to obtain their views on the service they receive. In addition two members of the care staff were spoken to in private. The two registered managers were also available to assist throughout the majority of our site visit. As part of our inspection, comment cards were sent to all service users, their representative’s, health care professionals and placing authorities. All care plans were examined in detail. In addition medication records, staff recruitment files, training records, health and safety documents and a sample of risk assessments were also examined. 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: What has improved since the last inspection? The home continues to explore new opportunities for service users. One service user has recently commenced a work experience programme. The service user commented they “really enjoyed going”. Work experience is also being considered for a second service user. In addition two service users have joined a ladies football team. Since the last inspection all staff have now completed a distance-learning course in medication administration training. Discussion with one member of staff confirmed they found this training useful. Eckett House DS0000003214.V315373.R01.S.doc Version 5.2 Page 6 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. Eckett House DS0000003214.V315373.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Eckett House DS0000003214.V315373.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2. There are clear admission procedures in place should they be required. The Quality rating in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: No service users have been admitted to the home since the last inspection. The procedures for admitting a service user if there was a vacancy was discussed with the manager. The manager stated that any person admitted to the home would be compatible with the service users who are currently resident. The service user would be invited to visit the home and stay for tea or a lunchtime meal. It would be anticipated that the service user would have opportunity to share in activities and be offered a weekend stay. This process is documented in the homes statement of purpose. Examination of the service users care records demonstrated each person has a copy of the service user guide, which has been developed using symbols and text. Eckett House DS0000003214.V315373.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9. The home is failing to ensure service users care plans accurately reflect their needs and are reviewed on a regular basis, however opportunities are provided to ensure service users make decisions about their life and are able to take responsible risks. The Quality rating in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The care records of all service users were examined in detail. The records were held in two separate files and it was difficult to evidence, which was the current care plan. Individual records would benefit from being reviewed in terms of the information being held in them. This would make the records more accessible to staff and service users and ensure records kept in the working file are clear and accurately reflect the current needs of service users. The placing authority has recently reviewed the care plan of one service user. Comments received from the care manager confirmed the service users needs are being met at the home. To ensure the specialist needs of one service user Eckett House DS0000003214.V315373.R01.S.doc Version 5.2 Page 10 are safely met a management plan has been developed in partnership with the Primary Health Care Trust. To ensure staff are aware of what action to take they have signed the management plan to confirm they have read and understood the contents. However two of the three care plans that were examined had not been reviewed in the past six months. One service user’s care plan had not been reviewed since September 2005. The manager stated that they are waiting for the placing authority to review the placement. The manager was advised that where the placing authority does not complete annual reviews then it is the responsibility of the home to ensure the service users care plan is updated and is an accurate reflection of their current care needs. One member of staff commenced work on updating this care plan during our site visit. Service users individual risk assessments have been developed. These assessments have been reviewed in the past year. Discussion with staff demonstrated an awareness of the risk associated with supporting service users at the home. In partnership with service users the home has developed a personal statement for each service user. This includes a statement of their involvement within the home. It highlights that service users are able to make decisions about the menu, join in the house meetings and have a say in what the home shops for. In addition it confirms each service user has a key to the front door and can decorate their bedroom to their individual taste. Information on advocacy services is also available in the home. There was opportunity to speak with each service user in private as well as in a group. One service user stated they liked living at the home. One service user said they had “everything they need”. All service users commented they were happy living at the home. Comment received the relatives of service users confirmed they were kept informed about important matters relating to the care of their relative. Two comment cards from relatives confirmed satisfaction with the overall care provided at the home. Eckett House DS0000003214.V315373.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17. Service users are supported to access their local community. Visitors and friends of service users are welcomed. Routines are flexible though meals served could offer more variety. The Quality rating in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Each service users attends a structured day care service. One service user attends five days a week but at a recent care review a decisions was made to explore work placement opportunities on their behalf. The service users said they were looking forward to finding some work. Since the last inspection one service user has obtained work experience at a local fish and chip shop. The service users commented they “really enjoy going” and spoke at length about the work they did. A feature of this service is the strong emphasis of involving service users in their local community. For example service users regularly go out for meals, visit the local pub, attend a weekly club and two service users have recently joined a ladies football team. This is in addition to regular trips into Swindon Eckett House DS0000003214.V315373.R01.S.doc Version 5.2 Page 12 and assisting with the weekly shop. Service users commented about a recent ‘short break’ that they all had with the manager and staff from the home. Each service user is supported to maintain contact with people who are important to them. For example one service user is supported to visit an elderly relative; one service user has regular visits home. Comments received from relatives confirmed they could visit the home whenever they wished. One service user commented they could telephone their relative when they want. Service users commented they are able to invite personal friends to the home if they wished. This is a small family style home where routines are flexible and responsive to the needs of service users. The personal statements contained in service users records confirm they are consulted on the weekly menu. This practice was reflected in the records of meals served with each service user having responsibility for planning the menu a week at a time. Two members of staff confirmed that if a service user was to refuse a meal than an alternative would be offered. One service users commented the “meals are good” another service users commented about a particular member of staff being a “good cook”. The manager was advised of the need to monitor the menu to ensure the meals are nutritious and varied. Eckett House DS0000003214.V315373.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20. The home is making every effort to ensure service users health and personal care needs are met. Medication is being safely managed. The Quality rating in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Each service user has a health action plan. Records examined demonstrated service users health care needs are being met in the home. Records showed service users attending the local health centre for medication reviews. In addition the home enables service users to access the chiropodist and optician. The manager stated that staff provide support to enable service users to attend hospital or specialist appointments. Service users who require assistance with personal care have this support documented in their care plan. However service users do not have a choice of which staff provides them with support in meeting their personal care needs. Normally there is only one member of staff on duty and no male members of staff are employed at the home. While this does limit service users choice on who provides them with support no service user expressed any concern regarding the support they receive. Eckett House DS0000003214.V315373.R01.S.doc Version 5.2 Page 14 Since the last inspection all staff have now completed a distance-learning course in medication administration training. Discussion with one member of staff confirmed they found this training useful. Only a small amount of medication was held at the home. Records examined showed medication was being recorded when administered to service users. As required medication is recorded separately. Records relating to medication received at the home were not available. The manager was advised these records should be kept in the home at all times. Eckett House DS0000003214.V315373.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23. The home is making every effort to ensure service users views are listened to and they are protected from abuse. The Quality rating in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: An abridged version of the homes complaint procedures is on display at the entrance to the home. The policy states any complaint would be responded to within 21 days. Examination of the complaints log showed no complaints have been received since the last inspection. Discussion with service users confirmed they would “tell staff” if they were unhappy. The home was supporting service users to manage their personal money. As a result no money was being held by the home on behalf of service users. One service users finances are managed by their relative. The remaining service users manage their money with minimum support. A copy of Wiltshire and Swindon’s “no secrets” guidance was on display in the home. Discussion with staff confirmed they had attended abuse awareness training and certificates to confirm attendance are held at the home. One member of staff confirmed they would have no hesitation in reporting any concerns about the welfare of service users to the police or to the Commission. Eckett House DS0000003214.V315373.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 30. The home provides service users with a comfortable, clean and safe standard of accommodation. The Quality rating in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The home is a mid terraced property close to the centre of Swindon. The home provides service users with single bedroom accommodation. One bedroom is on the ground floor and two service users bedrooms and the staff sleep in room are on the first floor. On ground floor there is a small sitting room with dining area. The bathroom and toilet facilities are also on the ground floor. A tour of the building was made. The home was clean and tidy and maintained to a good standard. Discussion with service users confirmed they were happy with their accommodation and had everything they need. Service users had personalised their room with pictures and small ornaments to reflect their individual taste. Eckett House DS0000003214.V315373.R01.S.doc Version 5.2 Page 17 The laundry facilities are domestic in style and are situated in the kitchen area. A risk assessment has been completed to identify and reduce the risk of infection. Staff have completed infection control training. Eckett House DS0000003214.V315373.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35. Staff employed at the home have been safely recruited but more attention needs to be given to ensure staff receive training appropriate for the work they perform. The Quality rating in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Examination of staff recruitment records demonstrated all staff working at the home had received a satisfactory Criminal Records Bureau (CRB) check. There is a small staff team, which has worked together for a number of years. A requirement was made at the last inspection regarding the recruitment practices at the home. Although no new staff have commenced work since the last inspection the manager was reminded of the need to ensure safe recruitment practices are followed for any future member of staff that may be employed. Since our last inspection there has been some improvements to the amount of training provided to staff. This is a small care home with a total of four staff, which includes the two registered managers. The two care staff continue working towards completing their National Vocational Qualification in care (NVQ). Though progress is slow in achieving this award the two members of Eckett House DS0000003214.V315373.R01.S.doc Version 5.2 Page 19 staff remain committed to completing the qualification. Additional training specific to learning disability services is beginning to be addressed. In the absence of any new staff commencing work, induction training that meets the “skills for care” standards was not in place. It is recommended the managers ensure any future induction training meets the required standards. Eckett House DS0000003214.V315373.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42. Managers need to be clear on their roles and responsibility to ensure the home is better organised. Quality assurance is progressing slowly. The Quality rating in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: There was opportunity to meet with both registered managers. Both managers are working towards completing the registered managers but this training has been ongoing for over two years and needs to be completed. A recommendation was made at the last inspection that the managers must provide details of the hours worked and areas of responsibility for each person. This was not received although the managers stated that they had agreed to this. Although this is a small family run business there is a need for the managers to fully grasp the responsibility of running a care home. Eckett House DS0000003214.V315373.R01.S.doc Version 5.2 Page 21 More attention needs to be given to maintaining an appropriate standard of documentation and they need to consider better ways of how to organise the overall running of the business. The home still needs to make further progress on developing a quality assurance system. Previous inspections found a number of complimentary letters from the relatives of service users confirming satisfaction with the care provided. The home has recently sent questionnaires to service users to seek their views on the service they receive. However there were only five questions on the survey and the home needs to look at ways of extending the scope of the questionnaire. In addition the views of service users families and relevant stakeholders need to be obtained. All staff have completed health and safety training. In addition staff have now completed training in first aid, food hygiene and infection control. Certificates were available to demonstrate successful completion of the training. Risk assessments on safe working practices are in place and had been reviewed in the past month. Eckett House DS0000003214.V315373.R01.S.doc Version 5.2 Page 22 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 X 5 X 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 3 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 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.V315373.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 15(1)(2)(b) Requirement Timescale for action 01/04/07 2. YA35 18(1)(c)(i) 3. YA39 24 The registered person must prepare a written plan as to how the service users needs are to be met and ensure the plan is kept under review. The care plan must be reviewed a minimum of every six months or earlier if the needs of the service user changes. The registered person must 01/04/07 having regard for the care home ensure staff receive training appropriate for the work they perform and ensure each member of staff has a training and development plan which includes training specific to the needs of service users. The registered person must 01/05/07 establish and maintain a system for evaluating the quality of services and extend the scope of the quality assurance survey to include service users families, staff working at the home and relevant stakeholders. Eckett House DS0000003214.V315373.R01.S.doc Version 5.2 Page 24 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. Refer to Standard YA6 Good Practice Recommendations The registered person should audit the information contained in the service users care records to ensure the information held is accurate and easily accessible to staff and service users. The registered person should ensure staff receive the time and support to complete their NVQ training. The registered person should ensure the induction training meets the “skills for care” induction standards. The registered managers should write to the Commission to confirm the date when the registered manager that has been absent from the home, recommences work at the home and the numbered hours they intend to work. This is outstanding from the last inspection The registered managers should provide the Commission with a copy of the legal agreement they intend to draw up and also provide the Commission with a copy of each manager’s job description and defined areas of responsibility. This is outstanding from the last inspection The registered managers should ensure they have the necessary qualification to manage the care home and should complete the Registered Managers Award. The registered person should review the questionnaires sent to service users as to how it can be improved to ensure service users views are fully reflected in the quality survey. 2. 3. 4. YA32 YA35 YA37 5. YA37 6. 7. YA37 YA39 Eckett House DS0000003214.V315373.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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 Eckett House DS0000003214.V315373.R01.S.doc Version 5.2 Page 26 - 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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