Inspection on 19/09/06 for Eynesbury House

This inspection was carried out on 19th September 2006.

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

Other inspections for this house

Eynesbury House 15/05/07

Eynesbury House 15/11/05

Eynesbury House 16/06/05

Eynesbury House 11/02/05

Eynesbury House 16/06/04

Similar services:

Chesham House

Argyll House

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

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

CARE HOME ADULTS 18-65 Eynesbury House Howitts Lane Eynesbury, St Neots Cambridgeshire PE19 2JA Lead Inspector Elaine Boismier Key Unannounced Inspection 19th September 2006 10:50 Eynesbury House DS0000048527.V312318.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 Eynesbury House DS0000048527.V312318.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. Eynesbury House DS0000048527.V312318.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Eynesbury House Address Howitts Lane Eynesbury, St Neots Cambridgeshire PE19 2JA 01480 218899 01480 218900 eynesbury@brookdalecare.co.uk na Brookdale Healthcare Limited 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 Nicola Caroline Grauwiler Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Eynesbury House DS0000048527.V312318.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th November 2005 Brief Description of the Service: Eynesbury House was established and registered in September 2003 to provide accommodation and support for six adults with a diagnosis of Autistic Spectrum disorder. The home is situated in its own grounds and the accommodation for service users comprises 6 bedrooms split into one unit with four bedrooms and two single bed sits all with ensuite facilities. There is a communal kitchen, dining room, lounge and one WC. The home is within walking distance of St Neots town centre and there are shops and facilities close by. An application to register the manager was approved in May 2006. Fees range between £2013.83 and £2525.04. Additional costs include payment for more than one holiday per year. A copy of the CSCI inspection report is available at the home or via the CSCI website. Eynesbury House DS0000048527.V312318.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the key inspection for Eynesbury House for 2006/7. The inspection was unannounced and carried out between 10:50 and 15:15 and took 4.5 hours to complete. At the time of the inspection there were 4 residents living at the home and these people were spoken to, as were staff, including the Registered Manager. A tour of the premises was made, documentation was examined and direct observation was carried out of both residents and staff. Six residents’ surveys were sent out and one of these six was returned. Information provided to the Commission prior to the inspection has been referred to in this report. Eynesbury House provides a good standard of specialist care for adults with autistic spectrum disorder. The service has the potential to become an excellent service should action be taken to meet the requirements and consider the recommendations made in this report, and by any other agency. Any improvements made should also be sustained for the service to be considered to be of an excellent standard. What the service does well: The service does well in the following areas: • The standard of care plan documentation is excellent, providing the reader with clear details of the residents’ personal preferences and interests and details of the residents’ needs and reviews of these needs. Residents are supported by staff in developing life skills such as shopping, cooking, cleaning, laundry and management of money. Residents are encouraged to be as independent as possible based on risk assessments. Staff receive one-to-one supervision regularly. Residents’ views have been obtained and included in the monthly reports sent to the Commission. These comments include, “Staff are available to me when I am anxious and know how to help me, “ and “I like my room and the lounge”. • • • • Eynesbury House DS0000048527.V312318.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: The home could improve in the following areas: • • • Medication must not be assembled by staff from the original containers into dispensing boxes. A requirement has been made about this. Air temperatures of the room where medication is stored should be checked. A recommendation has been made about this. The standard of decoration in bedrooms must be improved and floor coverings in shower/bathrooms must also be improved. A requirement has been made about these findings. The home should have 50 of care staff with NVQ level 2 or equivalent in care. A recommendation has been made about this. The Registered Manager should have a nationally recognised qualification in care. A recommendation has been made about this. Hot water temperatures provided in the bath and shower facilities must be close to 43 degrees centigrade. A requirement has been made about this. Hot water checks should be carried out in bathing and shower facilities. A recommendation has been made about this. Cleansing agents that are a hazard to health of residents must be stored in a safe way. An immediate requirement has been made about this. The names of people attending fire drills should be recorded. A recommendation has been made about this. • • • • • • Eynesbury House DS0000048527.V312318.R01.S.doc Version 5.2 Page 7 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. Eynesbury House DS0000048527.V312318.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 Eynesbury House DS0000048527.V312318.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The standard of preadmission information is good. EVIDENCE: Discussion with residents indicated that, prior to moving into the home, they were included in the decision where they were to live and had access to information about the home. This information included the CSCI inspection reports. The residents confirmed that the decision where they were to live also included the involvement of family, health care professionals and social work departments. Eynesbury House DS0000048527.V312318.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8 & 9 The standard of care plan documentation and residents participation in the home is excellent. Residents receive a good standard of support, and independence, to enable them on how they wish to live. EVIDENCE: Two residents’ care records were examined and these were of an excellent standard. Contained in the records were details about the resident, who they were and what they liked to do, including what they hoped to achieve. There was evidence that the residents were actively involved in the care planning process and the reviews of the care plans. Discussion with residents and review of documentation that included care records and minutes of residents’ meeting held in May 2006 indicated that residents are actively involved in participating in how the home is run. The returned resident’s survey stated that the person was allowed to make decisions about how they wished to live and that staff supported the person in carrying out these wishes. This was also confirmed during discussions with the residents and by observation of staff and residents during the inspection. Eynesbury House DS0000048527.V312318.R01.S.doc Version 5.2 Page 11 Care records that were examined indicated that the home allowed residents to be as independent as possible within a framework of risk assessment. Discussion with staff and residents confirmed that this was also the case. Eynesbury House DS0000048527.V312318.R01.S.doc Version 5.2 Page 12 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, 14, 15, 16 & 17 Residents live a good quality of life. EVIDENCE: According to staff, and confirmed by residents, educational courses had been attended by residents until recently. The courses had been completed and the home is actively seeking more appropriate educational courses that will meet the specialist needs of the residents. Eynesbury House is located close to leisure facilities, shops and pubs. Examination of residents’ care records and discussion with residents and staff indicated that the residents engage in the local community, including the use of shops and leisure facilities. On the office notice board it was noted that arrangements have been made for residents to go on holiday in October 2006, supported by staff. According to the Manager a holiday once a year is included in the fees; any additional holiday that the resident chooses to take is counted as an additional cost. Eynesbury House DS0000048527.V312318.R01.S.doc Version 5.2 Page 13 Residents confirmed that they maintained contact with their families. Residents’ care reviews recorded the presence of the residents’ family members. Staff were observed to request the residents’ permission before entering their bedrooms. Discussion with staff indicated that residents had keys to their own rooms and also keys to the front door; this was observed to be the case. Residents considered that staff treated them in a respectful way and this was also noted at the time of the inspection. Residents confirmed that they are encouraged to shop for food, with an allocated budget, and cook a meal one day a week, for the other residents, with support from staff. It was noted during a visit to the kitchen area that each resident has an allocated fridge and freezer space to store their food. Eynesbury House DS0000048527.V312318.R01.S.doc Version 5.2 Page 14 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 standard of health care is good although medication practices are adequate and could be improved upon. EVIDENCE: Residents were noted to be independent with their personal care and how and when they wanted to this for themselves. Residents’ care records, and discussion with both the residents and the Manager indicated that the residents have access to a range of specialist mental health services, general practitioners, dentists and opticians. Staff who are responsible for giving medication are trained by a local pharmacy and competencies checked by a registered nurse; evidence of this training was available in the two staff training files that were examined. Residents are risk assessed in self-medication practices and this evidence was located in the medication record file. Medication is stored in a locked cupboard located in the staff office. At the time of the inspection this room was very warm although there was no evidence to suggest the air temperature of this room was monitored to ensure that Eynesbury House DS0000048527.V312318.R01.S.doc Version 5.2 Page 15 medication was stored at temperatures as recommended by the manufacturer. A recommendation has been made about this. Discussion with staff and examination of medication administration records indicated that when a resident is on leave from the home, staff assemble medication from the original containers into a rudimentary dispensing box. This practice is not acceptable due to the risks posed to the health of residents. A requirement has been made about this. Eynesbury House DS0000048527.V312318.R01.S.doc Version 5.2 Page 16 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 There are good systems in place to listen to complaints/concerns and to protect residents from abuse. EVIDENCE: The one resident survey that was returned indicated that the person knew what to do, or who to speak to, if they were unhappy about something. In the same survey the person considered that staff treated the person well. Discussion with staff indicted that any concern the resident may have is managed before the concern becomes a complaint. Residents stated that they were able to speak to staff if they were not happy with something. The Manager reported that in house training has been attended by staff in adult protection awareness and she demonstrated knowledge of local contacts should there be any incident of abuse. Two residents’ monies were checked and both of these balances reconciled with the associated records. Eynesbury House DS0000048527.V312318.R01.S.doc Version 5.2 Page 17 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 & 30 The standard of the home’s decoration and furnishing is adequate but could be improved upon. EVIDENCE: Residents have access to a range of communal areas including an enclosed garden area to the rear of the home. During the tour of the premises it was noted that some of the residents’ bedroom walls were marked and stained. It was also noted that residents’ toilet/shower/bathroom flooring showed signs of staining and ageing. A requirement has been made about these findings. At the time of the inspection the home was clean and free of offensive odour. Laundry facilities do not encroach on kitchen areas where food is prepared. Eynesbury House DS0000048527.V312318.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 & 36 Staff recruitment systems are good and staff training is adequate but could be better. EVIDENCE: The Manager reported that the home, due to trained staff leaving, has less than 50 of care staff with NVQ level 2 or equivalent. A recommendation has been made about this. Two staff files that were examined contained all the required information about the person and this information was satisfactory. Staff indicated that they had attended a number of training courses that included training in how to care for people with specialist mental health needs and evidence of this attendance was seen in two staff training files. Two staff files that were examined provided evidence that staff receive one-toone supervision almost every month and that the staff have had an appraisal of their standard of work and identification of training needs. Eynesbury House DS0000048527.V312318.R01.S.doc Version 5.2 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, 39 & 42 Management of the home is generally good although safe working practices are adequate and could be improved upon. EVIDENCE: A requirement was made following the inspection in November 2005 for an application to be made to register the home manager. This requirement has been met as an application has been made and this was approved in May 2006. The Registered Manager has two year experience caring for people with learning disability and was appointed as Acting Manager of Eynesbury House in November 2005. The Registered Manager reported that she has commenced the Registered Manager’s Award and is intending to complete this by December 2006. A recommendation has been made for the home to be managed by a person with this award, or equivalent. Eynesbury House DS0000048527.V312318.R01.S.doc Version 5.2 Page 20 Information is provided to the Commission on a monthly basis. This information details internal audits of staff training , information in staff files and comments made by residents. Discussion with staff and examination of records indicated that checks are carried out to test the temperature of hot water accessed in hand wash basins and in the kitchen area. However no checks had been carried out on hot water accessed by residents in their personal showers and bath. The temperature of hot water from one of the showers was checked and this was satisfactory. However, although the override facility in the bath was positioned at 40 degrees centigrade, the temperature this water was recorded at above 47 degrees centigrade. A requirement has been made for the temperature of hot water to be close to 43 degrees centigrade and a recommendation has been made for hot water temperature checks to be carried out. Although the majority of cleaning agents were safely locked away it was noted that cleaning agents were stored in an unlocked cupboard in the kitchen that can be accessed by residents. An immediate requirement has been made about this serious concern. Records of temperatures of fridges and freezers were seen and these were satisfactory. Food that was opened had been covered and labelled with the date of when this had been opened. Records for fire training, fire alarm and emergency lighting checks were satisfactory. Fire drills that had been carried out were duly recorded although there was no record of who was present during this training exercise. A recommendation has been made about this. Information provided to the Commission before the inspection notes that an inspection has been carried out by the fire safety officer in January 2006 and that this inspection was satisfactory. Eynesbury House DS0000048527.V312318.R01.S.doc Version 5.2 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 Standard No Score 1 x 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 2 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 2 33 x 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 4 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 2 x 2 x 3 x x 2 x Eynesbury House DS0000048527.V312318.R01.S.doc Version 5.2 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 YA20 Regulation 13(2) Requirement The Registered Person must ensure that medication is administered in an approved manner. The Registered Person must ensure that the décor and furnishings of the home are of a good standard. The Registered Person must ensure that hot water temperatures in bathing and shower facilities are close to 43 degrees centigrade. The Registered Person must ensure that hazardous substances are stored in a safe manner. Timescale for action 22/09/06 2 YA24 23(2)(d) 31/03/07 3 YA42 13(4)(c) 22/09/06 4 YA42 13(4)(a) 19/09/06 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 Refer to Standard YA20 Good Practice Recommendations The Registered Person should consider ways to ensure that medication is stored at the correct temperature. DS0000048527.V312318.R01.S.doc Version 5.2 Page 23 Eynesbury House 2 3 4 5 YA32 YA37 YA42 YA42 The Registered Person should consider ways to ensure that 50 care staff have NVQ level 2 or equivalent in care. The Registered Manager should have an NVQ level 4, or equivalent. The Registered Person should consider ways to ensure that hot water checks are carried out in all areas of the home. The Registered Manager should consider ways to demonstrate that all staff and residents have attended training in fire drill practices. Eynesbury House DS0000048527.V312318.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB1 5XE 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 Eynesbury House DS0000048527.V312318.R01.S.doc Version 5.2 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. 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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