Inspection on 12/03/08 for Seabreezes

This inspection was carried out on 12th March 2008.

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

Other inspections for this house

Seabreezes 25/02/09

Seabreezes 07/06/06

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Seabreeze 61 Meehan Road Greatstone New Romney Kent TN28 8NZ Lead Inspector Sarah Montgomery Unannounced Inspection 12th March 2008 10:50 Seabreeze DS0000067549.V359436.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 Seabreeze DS0000067549.V359436.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. Seabreeze DS0000067549.V359436.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Seabreeze Address 61 Meehan Road Greatstone New Romney Kent TN28 8NZ 01905 459 800 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) seabreezes@craegmoor.co.uk Craegmore.co.uk Parkcare Homes Ltd Vacant Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Seabreeze DS0000067549.V359436.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Seabreezes provides residential care to up to 6 adults with a learning disability. The home is owned by Parkcare Homes Limited, which is a wholly owned trading subsidiary of Craigmore Group Limited, a major provider of services throughout the UK. The fees currently range from £1,058 - £1,713 per week. The Home is situated on the Kent coast within a short walk of the beach and local shops and some 20/30 minutes drive of the towns of Hythe, Rye and Ashford. Seabreezes is a detached two storey building which comprises individual bedrooms for each resident, all of which have en-suite facilities, a lounge/diner, kitchen/diner, laundry room and office. There is an enclosed level rear garden for the residents use, and there is a parking area to the front of the property. Staffing comprises the manager, who has applied for registration, and support staff. There is no staff sleeping in room but the home employs 2 awake night staff. Seabreeze DS0000067549.V359436.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Sarah Montgomery conducted this unannounced inspection on 12th March 2008. Evidence was gathered from reading documents, talking to staff and management, and speaking with service users. Several shortfalls were identified during the inspection. Outcomes for residents are in key areas of individual choice and lifestyle are adequate and improvements are needed. Outcomes in key areas of healthcare and complaints are good. Five requirements and one recommendation have been made. What the service does well: What has improved since the last inspection? What they could do better: Residents would benefit from a more robust and proactive approach to pre assessment, care planning, and activities. Staff need to be more aware of their role, particularly in the way they relate to residents. Residents would benefit from more consideration being given to creating a homely environment. Seabreeze DS0000067549.V359436.R01.S.doc Version 5.2 Page 6 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. Seabreeze DS0000067549.V359436.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 Seabreeze DS0000067549.V359436.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1 and 2. Quality in this outcome area is adequate. Prospective service users benefit from having their needs assessed prior to admission, but would benefit further from the home collating and researching previous history. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service user guide and statement of purpose were inspected. These documents give the reader sufficient information about the home necessary to make a judgement or choice about what it might be like to live there. They are in an easy to read and accessible format. Assessment documentation for two residents was inspected. Shortfalls were noted in both assessments. In particular, the assessments lacked sufficient information about the prospective resident. There were gaps and absences in historical information, particularly with regard to behavioural issues. There were no care management assessments, and a general lack of information gathering from other professionals. The assessments were not dated. Seabreeze DS0000067549.V359436.R01.S.doc Version 5.2 Page 9 Lack of information in the assessment stage can lead to poor care planning and risk assessments, as the true needs of the prospective service user remain unknown. It is critical for the home to develop a more robust and multidisciplinary approach to the assessment of prospective residents in order to ensure a individual needs-led service is developed, and that the home is able to meet the assessed needs of the prospective resident. Seabreeze DS0000067549.V359436.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9. Quality in this outcome area is adequate. Service users cannot be confident that their changing needs are reflected in their individual plan. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans and risk assessments of two residents were inspected. Care plans do not address residents changing needs, their aspirations, or goals. The care planning structure in this home is based around maintaining the status quo, with no proactive measures for achieving goals. The homes statement of purpose states they will; ‘provide an environment that supports service users to reach their full potential in daily living skills, thereby maximising their opportunity for independence’. In all the care plans inspected, no evidence could be found to support that statement. The home must consult with residents and their advocates about their changing needs and aspirations, and Seabreeze DS0000067549.V359436.R01.S.doc Version 5.2 Page 11 develop, in partnership with individual residents, care plans that are proactive, goal orientated and inclusive of aspirations. Risk assessments inspected were found to be adequate, and were supported by behavioural guidelines. Seabreeze DS0000067549.V359436.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14, 16 and 17. Quality in this outcome area is adequate. Service users cannot be sure their lifestyle choices will be supported or known by staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All residents have a day planner. This document outlines a range of individual activities and chores for residents Monday to Friday. Inspection of the day planners was cross-referenced with daily notes, discussion with staff and residents, and observation during inspection. Information gathered from the above, evidences that the residents currently experience an unstructured and haphazard service, and it is uncertain whether individual lifestyle choices are met or addressed with consistency. The home Seabreeze DS0000067549.V359436.R01.S.doc Version 5.2 Page 13 does not plan shifts, and one member of staff informed the inspector ‘we make it up as we go along’. Given the lack of clarity in individual care plans, coupled with the absence of any planning on a daily basis, it is unclear how the home is meeting or addressing the individual lifestyle choices of residents. On the day of inspection some residents had gone out to access community facilities, this included attending a day service and shopping. Staff and the manager stated that residents do have several opportunities to participate in activities both in house and community based. It was clear from discussion with residents and staff that residents are supported to maintain contact with their friends and family. Every effort is made to maintain important relationships, this includes providing support to write to relatives monthly, and providing transport and staff support on visits. The daily routines of the home do not evidence that service users rights are respected. Several incidents of poor interactions with residents were observed, including lack of respect or regard for individual’s feelings or confidentiality. Furthermore, there were a number of occasions where all the staff were in the kitchen talking with each other, with residents restricted access to this area by a baby gate. Since the inspection this gate has been removed. The fridge and kitchen cupboards were inspected. Temperature recordings for the fridge have been consistently high for months. The home was required to address this immediately. Following the inspection a new fridge was purchased. There was several open jars and covered food in the fridge. None had been labelled. The home was required to address this immediately. Seabreeze DS0000067549.V359436.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18 and 19. Quality in this outcome area is good. Service users benefit from being supported with their personal and healthcare needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Health care plans of two residents were inspected. These documents contain detailed information regarding meeting individual’s healthcare needs, including recording individuals wishes regarding how they like to be supported with personal care. Healthcare appointments including outcomes of these appointments are recorded. It is suggested that the home adopts a proactive approach with regard to preventative healthcare, and encourage residents to have health screening (ie; breast screening) and lead a healthy lifestyle. Seabreeze DS0000067549.V359436.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23. Quality in this outcome area is good. Service users can be confident their views will be listened to, and will be protected from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Seabreeze has an accessible complaints procedure. All service users are supplied with a copy of this. In addition, service users have regular ‘your voice’ meetings with support staff. Service users are encouraged to talk about their feelings, including any concerns or complaints they may have. The inspector spoke with a service user about making a complaint. Although he seemed unsure of the complaints procedure and process, he was clear about his rights in making a complaint, and knew a selection of appropriate people he could talk to if necessary. The staff team have all received adult protection training. The manager spoke knowledgably about his responsibilities in ensuring that service users are protected from harm. Seabreeze DS0000067549.V359436.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30. Quality in this outcome area is adequate. Service users would benefit if the communal areas were more homely. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All communal areas and a selection of bedrooms were inspected. The bedrooms were personalised and comfortable, and clearly a lot of effort had gone into making these rooms individual and reflective of the individual personalities of residents. However, communal areas presented as functional rather than homely. Furnishings and décor was shabby and worn. Walls were stained and require repainting. An empty bookcase in the lounge looked out of place. Seabreeze DS0000067549.V359436.R01.S.doc Version 5.2 Page 17 The outside of the house has been rendered but not painted. This gives an unfinished look to the home and it is recommended that the house is painted. All areas of the home were clean and hygienic. Seabreeze DS0000067549.V359436.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34 and 35. Quality in this outcome area is adequate. Service users cannot be sure they will be supported by competent or effective staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: As stated in the ‘Lifestyle’ section of this report, some examples of negative and disrespectful language and communication was observed from staff to residents was observed. This is unacceptable. The inspector and manager spoke at length regarding this, and the manager assured the inspector that all issues would be addressed. Observations of staff throughout the inspection were generally positive, and it was clear that the majority of staff were motivated and enthusiastic, and interacted well with residents. Seabreeze DS0000067549.V359436.R01.S.doc Version 5.2 Page 19 However, lack of planning (as noted in the ‘Lifestyle’ section) was evident. Several times staff were observed as being unsure of what to do, and when asked what was happening that afternoon the inspector was told ‘don’t know yet’. Staff were not focussed on activities or on residents, and were waiting to be told what to do. Residents were asking about activities and could not be told what was happening. There was a general air of confusion. Staff files inspected were adequate and contained all relevant information. Training certificates in staff files evidence regular training in key areas. Seabreeze DS0000067549.V359436.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37 and 38. Quality in this outcome area is adequate. Service users would benefit from a more robust management approach. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The theme running through this inspection report is lack of planning. From assessing prospective residents, to care planning, supporting residents with lifestyle choices, and shift planning. This results in a service, which is operating reactively rather than proactively, and the needs of residents cannot be fully met in this way. Seabreeze DS0000067549.V359436.R01.S.doc Version 5.2 Page 21 Discussion with the manager evidenced he has insight into the shortfalls, and he spoke of strategies to overcome the current difficulties and improve the outcomes for residents. Seabreeze DS0000067549.V359436.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 2 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 2 STAFFING Standard No Score 31 X 32 2 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 2 X X LIFESTYLES Standard No Score 11 X 12 2 13 3 14 2 15 3 16 2 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X 2 2 X X X X x Seabreeze DS0000067549.V359436.R01.S.doc Version 5.2 Page 23 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 YA2 Regulation 14(1)(a) 14(1)(b) 14(1)(c) 14(1)(d) Requirement Timescale for action 30/04/08 2. YA6 15(1) 3 YA16 12(4)(a) 12(5)(a) 12(5)(b) The registered person shall ensure that a robust assessment of all prospective service users is undertaken, and this will include gathering all relevant information from other professionals, and a care management assessment. The registered person shall 30/04/08 ensure that individual care plans are proactive documents which reflect the current and changing needs of the resident, and include aspirations and goals. The registered person shall make 30/04/08 suitable arrangements to ensure the care home is conducted in a manner which respects the privacy and dignity of service users. The registered manager and registered provider shall, in relation to the conduct of the care home – Maintain good personal and professional relationships with each other and with service users and staff; and Encourage and assist staff to maintain good personal and DS0000067549.V359436.R01.S.doc Version 5.2 Seabreeze Page 24 4 YA12 16(2)(m) 16(2)(n) 5 YA17 16(2)(j) professional relationships with service users. The registered manager must ensure that service users have a structured and planned day service which takes into account their choices and aspirations regarding lifestyle. The registered manager must ensure that the health of service users is protected by labelling all food items in the fridge. 30/04/08 13/03/08 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 YA24 Good Practice Recommendations The registered manager gives consideration to improving the communal areas, making them more homely and comfortable for residents. The registered manager to arrange for the outside of the house to be painted. 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