Inspection on 08/12/05 for Eckett 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 6 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 29/01/07

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 Announced Inspection 8th December 2005 09:15 Eckett House DS0000003214.V262455.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 Eckett House DS0000003214.V262455.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. Eckett House DS0000003214.V262455.R01.S.doc Version 5.0 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 Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Eckett House DS0000003214.V262455.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th July 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. Accomodation 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 day activites. 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 and meet any night time needs. Eckett House DS0000003214.V262455.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was given two weeks notice of the inspection, which was completed over seven and quarter hours by two inspectors. The inspector’s met with all service users both in private and in a group to obtain their views on the care they receive. The inspector’s met with two care staff. All areas of the home were seen including service users bedrooms. All care plans, risk assessments and staff recruitment records were examined. Since the last inspection the Commission has received two complaints about one of the registered managers. One complaint was not upheld and the second complaint is still being investigated. The joint registered managers who are also joint registered providers were available to answer questions and provide documentation during the inspection. Feedback on the preliminary findings of the inspection was given to the manager’s at the end of the inspection. What the service does well: What has improved since the last inspection? The home has made improvements to the care plans to ensure they reflect the needs of service users. Strategies for managing behaviour have been developed. Improvements to the statement of purpose and contracts mean service users are aware of the cost of their care and the service provided. Care plans are being reviewed a minimum of once every six months, which ensures service users needs are being kept under review. Improvements in care plans means that service users personal care needs and the way in which they wish to be supported are now clearly documented. General comments made by service users would indicate they are happy with the care they receive and feel safe at the home. Eckett House DS0000003214.V262455.R01.S.doc Version 5.0 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.V262455.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 Eckett House DS0000003214.V262455.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): 1, 5. Information is now of a sufficient standard and detail to enable prospective service users make a choice about the home. Contracts reflect the cost of care and terms and conditions between service users and the home. EVIDENCE: Since the last inspection the home has completed the service user guide in a format suited to the needs of service users. The inspector’s found the homes statement of purpose had not been amended to include the names and qualifications of the managers and staff. To fully comply with this requirement, the statement of purpose was amended during the inspection. The home had developed a personal statement on the services provided for each service user, which contained some personal information and could therefore not be shared with stakeholders. Following the last inspection the home has updated the service users contract to fully reflect the care and cost of living at the home and it included the financial contribution made by service users. The manager and the service users had signed the contracts. Eckett House DS0000003214.V262455.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, 9. The recent reviews held at the home have ensured service users care needs are reflected in their individual plan. The home is supporting service users to make decisions about their lives, but is failing to ensure risk assessments are sufficiently robust to safeguard service users who may be at risk from accidental scalding. EVIDENCE: Since the last inspection the home has implemented person centred plans and health action plans for all service users. Discussion with service users confirmed they had been involved in meetings about their care and had attended their recent review. Also attending the reviews were care managers, staff from the home and where relevant, family members. The outcome of the review confirmed the home was meeting the needs of the service users. The care plan of one service user has been updated to include strategies for managing difficult and or challenging behaviour. The inspector’s found the strategies that had been developed had reduced the number of incidents involving the service user. Discussion with staff confirmed they were aware of the needs of the service users. Eckett House DS0000003214.V262455.R01.S.doc Version 5.0 Page 10 There is evidence to demonstrate service users are able to be involved in the running of the home. Service users daily notes reflect participation in routines and involvement in decisions regarding where to go and what to do. One service users is involved in art advocacy, however not all service users have access to this service and it is recommended that advocacy services are made available for all service users. Following a requirement made at the last inspection the home has reviewed service users risk assessments. This review included behaviour management guidelines regarding any aggression and challenging behaviour. Risk assessments examined were generally satisfactory and known to staff. However risks related to scalding did not provided sufficient details on why service users were not likely to be injured or how this judgement had been made. This was discussed with the managers at the inspection and it is required that risk assessments relating to hot water or hot surfaces are sufficiently robust to evidence why no action has been taken to cover radiators or restrict hot water temperatures close to 43c. Eckett House DS0000003214.V262455.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): EVIDENCE: No standards were inspected. Eckett House DS0000003214.V262455.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): 18, 20. The home is providing support to service users in a way they prefer, but is failing to ensure staff are trained in the safe handling of medication and that certain service users medication is being kept under review. EVIDENCE: Service users care plans contain details on the way they wish to be supported and assisted with personal care. Discussion with service users confirmed they were happy living at the home and that they were satisfied with the care they receive. Service users confirmed they could get up and go to bed when they wanted and that they can choose what to wear. No aids or adaptations are required to support service users independence. The home is only holding a small amount of medication on behalf of service users. Examination of records demonstrated medication was being accurately recorded when administered. A separate record is kept of medication received and returned to the pharmacy. In addition records show that two service users attend the health centre to receive medication. Discussion with the manager focused on whether the reasons for this medication had been reviewed by the G.P. It is recommended that this action be taken to ensure service users are fully aware of the purpose of the medication and its continued use. Discussion with staff highlighted they had received no training in the safe administration of medication. Staff confirmed they had been shown “what to Eckett House DS0000003214.V262455.R01.S.doc Version 5.0 Page 13 do” and although only a small amount of medication is held in the home this practice is not sufficient to ensure the safety of service users. It is recommended that medication training be accessed for all staff responsible for administering medication to ensure they are competent in this procedure. Eckett House DS0000003214.V262455.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. The home is striving to ensure service users views are listened to and they are protected from abuse, but it needs to improve the way it records any money held on behalf of service users. EVIDENCE: Service users have been given a copy of the homes complaints procedure. To ensure service users fully understand the contents of the policy an abridged version has been developed using pictures and symbols. Since the last inspection the Commission has received two complaints about the values and attitudes of the manager. One complaint was not upheld and the second complaint is still being investigated. There have been no complaints made directly to the home. The inspectors were informed that two members of staff have still to complete abuse awareness training. Discussion with two care staff demonstrated a good understanding of what action they would take to report any concerns regarding the welfare of service users. The system adopted for recording money in the home does promote service users independence in that they keep their personal money and have access to it at all times. Once money has been given to service users the home was trying to keep a record of how and where money was spent. However by nature of this system the home cannot accurately record the money being held by service users. This does not mean the money held at the home was being mismanaged but the system adopted is confusing, as the home is not able to account for money once it is given to service users. Eckett House DS0000003214.V262455.R01.S.doc Version 5.0 Page 15 It is recommended that the home review the way it records service users money to ensure clear accounts are kept on money given to service users and money being held by the home. Eckett House DS0000003214.V262455.R01.S.doc Version 5.0 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, 26. The home was clean, tidy, well maintained and free from odour. EVIDENCE: The home is situated on a small terraced row close to Swindon town centre. Service users bedrooms are located on two floors. One bedroom is situated on the ground floor and two bedrooms on the first floor. In addition there is a staff sleep in room on the first floor. The inspectors viewed all areas of the home including all bedrooms, which were shown to the inspector’s by the service users. Service users bedrooms had been personalised to reflect individual taste and` discussion with service users confirmed they had everything they need in their rooms. One service user confirmed they liked their room because of its “outlook”. As identified earlier in this report radiators were not guarded and the reason for this omission was not clearly documented in the risk assessment. Eckett House DS0000003214.V262455.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 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): 33, 34, 35. The home is providing staff with appropriate training to meet the needs of service users but is failing to ensure safe recruitment practices are followed. EVIDENCE: Examination of the rota demonstrates there is only one member of staff on duty at one time. The manager stated that she is on call Monday to Friday when service users attend day care. Since the last inspection the manager’s hours are now being recorded on the rota. One member of staff provides sleep in cover at night. The inspector’s examined the recruitment records in the home. Following a requirement at the last inspection the home had applied for a Criminal Records Bureau (CRB) check for one member of staff. However the application was returned as incomplete. It needs to be resubmitted. Further examination of the records highlighted additional deficits in the recruitment records. There were no written references for one member of staff and only one reference for a second member of staff. The manager stated they have had difficulties obtaining written references for the staff members, however these concerns had not been raised with the Commission, as good practice would dictate. The inspector’s were concerned to find such major deficits in the recruitment practices at the home. These concerns were discussed with managers during Eckett House DS0000003214.V262455.R01.S.doc Version 5.0 Page 18 the inspection. Action to address these deficits must be taken to prevent the Commission taking enforcement action. Discussion with one member of staff confirmed they had commenced National Vocational Qualification (NVQ) level 2 in care and hopes to complete the award on the coming year. Additional training has been completed in abuse awareness, induction standards, health and safety and disability and equality. Eckett House DS0000003214.V262455.R01.S.doc Version 5.0 Page 19 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, 42. While improvements have been noted, until both managers are working as a cohesive partnership serious concerns remain over the management of the home. The home is striving to ensure the health and welfare of service users is promoted but deficits in risk assessments continue to put service users at risk. EVIDENCE: The fire logbook contains fire prevention information regarding smoke alarms, policy on smoking and frequency of monthly checks. It did not contain a fire risk assessment and it is a requirement that one is completed to ensure the safety of service users. The use of the bedroom window on the first floor being used as a fire escape was discussed with the manager. According to the manager the fire officer suggested using this window as a last resort. It is clear that this is not designed as a fire escape and it would be inadvisable to continue to routinely practice exits via this route due to the danger of falling. Eckett House DS0000003214.V262455.R01.S.doc Version 5.0 Page 20 Training records highlighted the need for staff to update their training in food hygiene. Water temperatures are not regulated and concerns have been highlighted earlier in the report. The Commission is concerned about the current management arrangements at the home. Following the last inspection the joint registered managers who are also joint registered owners attended a meeting to discuss their dispute and the impact it was having on service users. Both registered persons were present during the inspection and confirmed the dispute has now been resolved. The inspectors were informed that the joint management arrangements would recommence in January 2006. It is recommended that the joint managers write to confirm these arrangements have taken place. In addition the managers to said they intended draw up a legal agreement on their joint responsibilities. A copy of this agreement should be provided to the Commission. Eckett House DS0000003214.V262455.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 X X X 3 Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 X X X X 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 X 3 1 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Eckett House Score 3 X 2 X Standard No 37 38 39 40 41 42 43 Score 1 X X X X 2 X DS0000003214.V262455.R01.S.doc Version 5.0 Page 22 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA42YA9 Regulation 13(4)(c) Requirement Timescale for action 2 YA42YA9 13(4)(c) 3 YA34 19(1)(a) (b)(i) The registered person must ensure risk assessments relating 01/02/06 to hot water temperatures include details on why service users are not at risk from scalding. If following this review a risk is identified then action must be taken to reduce the risk. The registered person must 01/02/06 ensure risk assessments relating to hot surfaces include details on why service users are not at risk from injury. If following this review a risk is identified then action must be taken to reduce the risk. The registered person must 01/02/06 ensure the following documents are obtained for all staff working at the home and are available for inspection. A satisfactory criminal records bureau check, two written references, proof of identity, evidence of the person’s qualifications, evidence that the person is medically fit to work in a care home. Eckett House DS0000003214.V262455.R01.S.doc Version 5.0 Page 23 4 YA42 23(4)(a) The registered person must complete a fire risk assessment. 01/02/06 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 6 Refer to Standard YA6 YA20 YA20 YA23 YA42 YA37 Good Practice Recommendations The registered person should ensure service users have access to advocacy services. The registered person should ensure all relevant staff receive training in the safe handling of medication. The registered person should ensure service users medication is reviewed by their G.P. The registered person should review the way it keeps records of service users money and ensure any system adopted is transparent and robust. The registered person should ensure staff update their training in basic food hygiene. 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. 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. The registered person should review the use of the first floor window as a fire escape. 7 YA37 8 YA42 Eckett House DS0000003214.V262455.R01.S.doc Version 5.0 Page 24 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.V262455.R01.S.doc Version 5.0 Page 25 - 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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