Inspection on 30/11/06 for Seagull

This inspection was carried out on 30th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Seagull 25/11/08

Seagull 29/09/05

Seagull 30/06/05

Seagull 14/10/04

Seagull 06/05/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Pinta

Kestrel House, St Anne`s Opportunity Centre,

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

CARE HOME ADULTS 18-65 Seagull 2 Witbank Gardens Shanklin Isle Of Wight PO37 7JE Lead Inspector Mark Sims Unannounced Inspection 30th November 2006 09:30 Seagull DS0000012532.V311292.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 Seagull DS0000012532.V311292.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. Seagull DS0000012532.V311292.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Seagull Address 2 Witbank Gardens Shanklin Isle Of Wight PO37 7JE 01983 864850 01983 864850 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) Islecare `97 Limited Mr Christopher Geoffrey Stewart Hyland Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Seagull DS0000012532.V311292.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th September 2005 Brief Description of the Service: Seagull is a home providing care and accommodation for up to six people with a learning disability. It is managed by Mr Christopher Hyland on behalf of Islecare ’97 Ltd. The home is a detached two-storey property set in its own reasonable sized grounds and situated in a quiet residential area of Shanklin. A convenience store is within walking distance from the home and the town of Shanklin with its shops, amenities and leisure facilities is approximately half a mile from the home. There is a large garden to the rear, which is available for residents’ use. Off-road parking is to the front of the building. There is no lift to the first floor and residents on that level are fully ambulant. Seagull DS0000012532.V311292.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the first ‘Key Inspection’ for Seagull, a ‘Key Inspection’ being part of the new inspection programme, which measures the service against the core and/or key National Minimum Standards. The fieldwork visit, the actual visit to the site of the home, was conducted over one day, where in addition to any paperwork that required reviewing the inspector met with service users and staff and undertook a tour of the premises to gauge its fitness for purpose. The inspection process also involved far more pre fieldwork visit activity, with the inspector gathering information from a variety of professional sources, the Commission’s database, pre-inspection information provided by the service and linking with previous inspectors who have visited the home. What the service does well: What has improved since the last inspection? What they could do better: The following is an indication of the areas where the service could perform better: • Seagull None DS0000012532.V311292.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. Seagull DS0000012532.V311292.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 Seagull DS0000012532.V311292.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standard 2: The needs of the service users are assessed and/or identified prior to admission to the home. EVIDENCE: Assessment: The evidence indicates that the needs, aspirations and wishes of the service users are considered prior to admission. • The last person to enter the home was admitted in 2002, the longest standing resident having lived in the home since 1985. With no new residents admitted to the home recently it is difficult to ascertain how effective the home’s current guidance and/or documentation would be in determining the needs, wishes and aspirations of the service user. However, based on the records available and observations involving the current residents group, it is possible say that people generally appear happy living at Seagull and that their lives seem full and to be meeting their immediate needs. Seagull DS0000012532.V311292.R01.S.doc Version 5.2 Page 9 One clear example of this being the holidays undertaken by the residents, several attending resorts in Butlins and The New Forest, which from the responses of the service users during discussions about their holiday experiences they enjoyed and took pleasure from. • Feedback from professional sources whilst scant, with only three professionals responding to comment cards sent out by the Commission, in the build up to the visit, indicate that overall the service is considered to provide satisfactory care, with one care manager, whose been more actively involved with the service confirming that: ‘staff have a clear understanding of the needs of the service users’ ‘there is a service user plan for the person that I placed in the home, this is followed and reviewed regularly’. • Four comment cards were also returned by the relatives of service users, the general consensus being again, that: ‘overall the levels of care were satisfactory’, one family remarking ‘we are very happy with all that goes on at Seagull, it is well run and has a happy atmosphere’. At the last inspection the inspector determined and reported that: ‘the home ensures that residents’ needs are met with the skills and experience of the staff, effective communications and access to specialist services’. • Seagull DS0000012532.V311292.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standard 6: The service users are at the centre of the home’s care planning system and actively involved in their development. Standard 7: The service users are appropriately supported when making their own decisions. Standard 8: The ethos of the home and the staff ensures that the residents are consulted on and participate in all aspects of daily communal living. EVIDENCE: Care planning: The evidence indicates that care planning is a progressive process within the home, with new client centred plans being introduced. • As indicated above the opinion of the care managers/professionals involved with the service and the residents is that the care is generally Seagull DS0000012532.V311292.R01.S.doc Version 5.2 Page 11 satisfactory and that care plans and assessments are both available and updated. • During the fieldwork visit the files of two service users were reviewed and noted to be informative documents, which contained historical information relating to the person, details of their current activities social pursuits, health care needs, work based activities, etc. The documents were also noted to be undergoing a transitional period with information being mapped out or transferred to newer client centred care plans. The newer documentation, whilst not yet fully implemented appears well structured and set out and is intended to reflect far more the needs and wishes of the client with regards to their life and longterm support goals. • The evidence from previous inspection visits and subsequent reports also indicate that the home’s care planning system has always been considered appropriate and effective, the last inspector reporting: ‘The home develops a comprehensive plan for each resident, which describes how individual health, social and personal needs will be met’. ‘The inspector viewed a selection of care plans and found them to be comprehensive in content, with individuals’ physical, emotional, social and medical needs identified. Instructions are provided for staff on how those needs should be met’. Decision Making: The evidence indicates that service users are both free to and well supported in making decisions. • Whilst it was not possible to explore in detail the opportunities the service users have on a day-to-day basis to exercise their rights to selfdetermination and freedom of choice, etc. The inspector was able to observe people, as they went about their daily routines, etc within the home and to gauge from these observations, that the level of freedom and/or self-direction experienced by the residents’ of Seagull is good. People observed returning from day services and either heading for the lounge to relax and unwind or coming into the kitchen to interact with other service users and staff. Some of the people residing at the home also opted to have drinks of various types, offered to them by the staff, on return from their days’ out before becoming involved in a range of activities, which included the completion of the decorating the home for Christmas. Seagull DS0000012532.V311292.R01.S.doc Version 5.2 Page 12 Throughout the evening spent at the home, the residents were observed to be interacting with the staff and to be choosing the type of activity they participated in, several residents utilising reading material (magazines) to occupy their time, others sitting with staff or watching television. As the evening progressed and following tea, the inspector noticed a large number of service users migrating to their bedrooms and later returning dressed ready for bed, the staff explaining that this is a common occurrence, several service users also requesting a bath before changing or settling down for the evening. • Feedback, via the relatives comment cards, indicates that families generally feel, where their next of kin is unable to make or reach a decision unaided, that they are involved in the decision-making process, all ticked ‘yes’, in response to the question ‘ if your relative is not able to make decisions are you consulted about their care’. Information gathered from the staff also supports the view that the service encourages people to be self-reliant and self-determining, staff questionnaires, returned prior to the visit containing statements like: ‘it is a very homely atmosphere to work in and be able to interact with the residents, helping their life’s be as happy as possible’. Staff also discussed how the home is a home in its truest sense, describing how people are encouraged to do what they wish, within reason, whilst in the building. The most graphic illustration of the fact that people are encouraged to view the property as home, comes when touring the premise and viewing some of the bedrooms, which clearly reflect the character of the person occupying the room, some being very sparse, as the person prefers not to spend time in the room unless sleeping, whilst others are brightly decorated and furnished in accordance with their wishes. Daily Living & Consultation: The evidence indicates that the home is run in the service users best interest and that staff consider and treat the property as the service users home. • The information above also provides evidence of the involvement of the service users in the daily activities of the home. Where people are unable to be involved in domestic activities, etc, risk assessments have been undertaken and the service users clearly understand and appreciate the restrictions these risk assessments place on, i.e. people are not permitted in the kitchen when food is being prepared, as some residents have limited appreciation of the dangers of hot devices, etc. • Seagull DS0000012532.V311292.R01.S.doc Version 5.2 Page 13 • The observations of the service users desire or wish to be involved in decorating the house for Christmas, as mentioned above, was discussed with the staff, as was the choices of holiday destinations for the service users. Seagull DS0000012532.V311292.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standard 12: Service users are well supported when accessing appropriate age, peer and culturally based activities. Standard 13: The service users are active members of the local community. Standard 15: The service users are supported in the development of personal relationships/friendships and maintaining family contacts. Standard 16: The rights of service users are respected and their daily responsibilities acknowledged. Standard 17: All meals are freshly prepared, individually portioned and enjoyed by the service users. EVIDENCE: Seagull DS0000012532.V311292.R01.S.doc Version 5.2 Page 15 Activities: The evidence indicates that service users are involved with a wide variety of leisure activities. • The review of the care plans, during the fieldwork visit, confirmed that the service users are heavily involved with a number of social activities and/or day service. In addition to these records the home maintains a number of other records or documents, one such document displayed within the kitchen and identifying where the resident will be on given day. Apart from reading about the services people were involved with the inspector also observed residents returning to the home from various locations, noting that some transport is provided by the home, whilst other transport is provided by the local authority, which results in the service users being considerably later home than those residents’ picked up by the home. In conversations with the staff it was also established that the service users attend several voluntary clubs/organisations in the evenings, Johns Club and The Gateway Club notable favourites. The staff and the manager also discussed how the home does not specifically provided extra activities at the weekends for the service users, as it is felt that after a hard week at the day centres the residents’ might prefer to rest and relax, therefore any activity undertaken at the weekend is directed by the service users. One resident apparently very fond of walking and fresh air, although the distances travelled are less appealing to fellow service users and staff. • As mentioned previously the holidays attended by the service users are pertinent to the age of the client group, with the focus on fun, activity and enjoyment, according to the feedback gathered. When not involved with day services, etc, the residents’ have ‘home days’, which provide opportunities for some one-to-one time with staff and to focus on domestic jobs, etc, should the person wish. On the day of the fieldwork visit one of the clientele had been involved in helping the staff members bake mince pies for a house party, to which families had been invited and which according to the manager and staff was a great success last year. • The dataset information provided by the home includes details of the activities and/or recreational pursuits of the residents: Games Seagull DS0000012532.V311292.R01.S.doc Version 5.2 Page 16 • • • • Televisions DVD/Videos Music Parties Barbeques Pub visits Bowling Cinema Shopping trips Holidays Theatre Home visits. Local Community Contacts: The evidence again supports the view that service users are encouraged to participate in community-based activities. • As mentioned within the description of the service the home is located within a residual area of Shanklin and is only a short walk from the amenities of the town. Located to one end of the Witbank Gardens is a local convenience store and this provides the service users with ample opportunity to collect small grocery items and personal shopping, if required. • The voluntary organisations or clubs described above are another vehicle that promotes social cohesion and allows service users to network and interact with other members of the community, as are trips to the theatre, the manager discussing an outing to a premier of a local play/performance. Whilst it was recorded above that the service users are not expected to go out at weekends unless they wish, the care plans reviewed indicate that people’s outings, etc are documented. The home also maintain very detailed accounts of any visits to or involvement with medical/health services, which are vital communitybased institutions, although some often do not provide the support and understanding required to meet the needs of service users with learning disabilities. • As indicated the dataset includes information regarding the activities and/or recreational pursuits of the residents, some of which are community-based: Parties Barbeques Pub visits Seagull DS0000012532.V311292.R01.S.doc Version 5.2 Page 17 • Bowling Cinema Shopping Trips Theatre Meals Home Visits Families and Relatives: The evidence indicates that residents are generally involved with their families. • As indicated above the families of the service users are quite actively involved in the home, with most families having confirmed their attendance to the house party and mince pies. The comment cards completed by family members and returned in the build up to the visit, also provided evidence of the home’s commitment to ensuring families remain a vital part of the service users live, all four comment cards ticked ‘yes’ in response to the question ‘do staff welcome you in the home at all times’ and ‘can you visit your relative in private’. The care planning files also document the service users family involvement and home visiting arrangements, one client not in the home during the fieldwork visit as he was on a home visit at the time. In discussion with the manager and his staff it was clear that they generally had good relationships with the families, meeting with them from time to time to ensure they remained satisfied with the service, which again the comment cards reflect people are. It was also apparent that the manager and his staff also understood and appreciated people’s arrangements for home visits, the staff able to discuss when and how often people go home, without reference to the care plans, etc. Meals and Mealtimes: The evidence establishes that meals are well presented and appetising. • Contact with the service users enabled the inspector to observe teatime and to establish that the meal provided was enjoyed. Being based in the kitchen for large periods also allowed the inspector to note that snacks and drinks are available throughout the day, service users returning from day centres coming in for drinks and then later returning for top-up or refreshers. Observations also indicate that mealtimes are social occasions, with service users and staff eating together in the dining area. Whilst meals are largely prepared by the staff, for reasons discussed earlier in the DS0000012532.V311292.R01.S.doc Version 5.2 Page 18 • • • • Seagull report, service users do help in the preparation of foods, such as the mince pies, when on home days, people are also expected to clear away their own plates or cups or at least return these to the kitchen. • During the last inspection it was reported: ‘Food served is varied and appealing to the residents. Although offered three times daily, there is flexibility to allow for residents who attend day services and other outside activities. The inspector saw a four-week menu guide, which showed food served to be varied and nutritious. Staff said they understand residents’ likes and dislikes which they take into account when planning meals, at the same time being mindful of the need for a healthy diet. On the day of the inspection they were trying out a new recipe, which seemed to meet the approval of those who ate it. Salads, fresh vegetables and fruit are always available. This year fresh vegetables have come from the garden, where one of the residents has had an input with staff. The inspector had an opportunity to sit with residents and staff over lunch. The atmosphere was relaxed and friendly. Residents seemed to enjoy the food, which was varied according to their preferences. The menu for the day showed that a cooked meal would be prepared for the evening’. • The dataset returned in the build up to the fieldwork visit, included a copy of the home’s menu, which again appeared to offer variety and choice and was created with a younger clientele in mind. Seagull DS0000012532.V311292.R01.S.doc Version 5.2 Page 19 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standard 18: Personal care and support is provided in accordance with the needs and wishes of the service users. Standard 19: Service users have access to both physical and emotional health care support. Standard 20: The home’s medication policies and procedures are adequate for the purpose of supporting the service users. EVIDENCE: Personal Care: The evidence indicates that the service users receive care in a manner and fashion that meets their needs and wishes. • As discussed earlier within the report the service users were observed taking themselves to their bedrooms to prepare to retire to bed and/or settle down for the evening/night in comfort. Seagull DS0000012532.V311292.R01.S.doc Version 5.2 Page 20 Several people, were also noted to enjoy baths before changing into their night attire, which according to staff is a common event, these individuals bring their own toiletries down to the bathroom and asking for assistance from staff, as appropriate. • At the last inspection it was reported that ‘All residents are independently mobile and require minimal physical support from staff. Guidance and support regarding personal hygiene is limited to encouragement and reassurance’. At this inspection it was determined that nothing has altered considerable and that the service user group, which has remained static and stable since, 2002 are largely independent and mobile, etc and therefore in need of support and prompting when addressing most personal care issues. • The service users’ care planning records also indicate that their personal care needs are delivered in accordance with their own abilities/needs, which mainly involves support and encouragement from the staff, as the service users are essentially able to manage the physical aspects of their own personal care. In discussion with staff it was felt or established that they perceive their roles as supporters of the residents and that this role is fulfilled via the keyworker system, which enables them to provide guidance and assistance, with purchasing of personal items, replacement of clothing, personal care, etc. Comments received via the staff surveys, returned prior to the fieldwork visit, also give some insight into how the staff perceive their roles, people adding remarks such as: ‘all staff work with the residents and their specific needs and abilities, so they are able to live within the community and have a comfortable home/family unit’. ‘The team works well together, which ensures the residents receive high quality support and care’. • All seven comment cards returned, the four relative and three professional, support the view that people are generally well cared for within the home all seven ticked ‘yes’ in response to the question ‘are you satisfied with the overall care provided’. Additional comments including: ‘my son has been at Seagull for 17 years and he seems very happy to be there, I am told he is a popular adult in the home and from what I see he is cared for quite well’. • • Seagull DS0000012532.V311292.R01.S.doc Version 5.2 Page 21 ‘We are very happy with all that goes on at Seagull. It is well run and has a happy atmosphere’. Physical & Emotional Support: The evidence indicates that the service users are well supported when accessing appropriate health and social care services. • The seven comment cards returned by relatives and professional visitors, as identified above indicate that they are: ‘satisfied with the overall standard of care provided’, with the two professional comment cards returned by the care managers also documenting that: ‘There is a service user plan for the person(s) that I have placed in the home’ ‘The service user plan is being followed and reviewed regularly within the home’. • The general practitioner comment card provides us with further insight to how the home is performing when supporting the residents in accessing health care, the comment card indicating: ‘The staff demonstrate a clear understanding of the care needs of the service users’ ‘That specialist advice is incorporated into service users’ plans’ ‘That service users’ medications are appropriately managed’ • The opinions of other health professionals, namely community learning disability nurses and additional general practitioners were sought, however, those professionals have elected not to respond to the comment cards dispatched. The home appears, given the doctors’ comments, to have a good handle on the health care needs of the service users, a statement supported by the inclusion on the individual residents files of the ‘Health Assessment Plans’ (HAP), plans devised by the local authorities and designed to ascertain the residents’ own perspective of health care and health care services, i.e. likes and dislikes, phobias, etc. At previous inspections the health care needs of the service users have always been found to be well handled / managed with inspectors reporting: ‘Residents’ health care needs are regularly addressed’. • • Seagull DS0000012532.V311292.R01.S.doc Version 5.2 Page 22 ‘All health care needs of residents are identified in their care plans and all visits from medical/health care practitioners take place in the privacy of their own rooms. Plans contain a health action plan, which is set out in a person centred way. In circumstances where a resident requires a hospital visit the action plan goes with them to provide hospital staff with the information they need about someone with communication difficulties’. • During the fieldwork visit the manager discussed the current health care needs of one of the service users and showed the inspector the individuals care planning records, which clearly evidence the various contacts the person has had with a range of health care professionals, including general practitioners’, dieticians, learning disability nurses, etc. It was evident that the manager and the staff were also being proactive in ensuring that they followed any health plans devised and that they were prepared to follow-up or chase re-assessments, where they felt the plan and the care was not appropriate or effective. Medications: The evidence indicates that the service users medication requirements/needs are appropriately managed. • The dataset information, returned prior to the fieldwork visit, establishes that the home has a medication administration policy, which addresses, administration, self-administration, record keeping, safe-keeping – storage and disposal of medicines. It also establishes that this policy has not altered since the home was last inspected, when no mention to it not conforming to current guidelines was made. • The dataset also indicates that staff have received training in medication management, the manager indicating that staff have completed an ‘Advanced BTEC in Medication Administration’. At the last inspection it was reported that: ‘Residents are assessed as being unable to retain, administer and control their own medication. Medication for residents’ are held under secure conditions and appropriate records maintained’. This inspection visit reconfirmed the finds of the last inspection visit, with the client group unchanged since 2002, as reported and their care plans reflecting their inabilities to safely manage their own medication administration. • Seagull DS0000012532.V311292.R01.S.doc Version 5.2 Page 23 • It was also reported above, that the general practitioner who returned their comment card found: ‘That service users’ medications are appropriately managed’. Seagull DS0000012532.V311292.R01.S.doc Version 5.2 Page 24 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standard 22: The people who live at the home are able to make complaints that would be appropriately investigated and resolved. Standard 23: Service users are protected from abuse, neglect and harm. The home would respond appropriately to adult protection concerns. EVIDENCE: Complaints: The evidence indicates that peoples’ rights to complaint are acknowledged and self-expression encouraged. • At the last inspection visit it was reported that: ‘The home has a clear complaints policy and procedure in place’. ‘The manager and staff confirmed there had been no complaints from residents or representatives in the last year, but in the event of a complaint being made staff would make a record of the issue together with details of the outcome. Three positive comment cards were received from relatives, two expressing total satisfaction with the staff/service’. Seagull DS0000012532.V311292.R01.S.doc Version 5.2 Page 25 • As determined prior to visiting the home, the service users have limited capacity to understand written information, which makes a documented complaints process of little use to the residents. However, in discussion with the management and staff it was ascertained that they expect care manager’s to visit their clients and to read or share with them information of this type, ensuring they are aware in part of the processes available to them. • The dataset indicates that over the last twelve months no complaints had been received by the home, this statement confirmed by both the relative and professional comment cards, which establish that people both know of the home’s complaint process and confirmed no one had needed to evoke the procedure. It was also very evidence from the seven staff surveys returned that they both appreciate people’s rights to make complaints and understand their role in supporting people make a complaint should they wish. Staff making comments like: ‘listen and report the complaint to the manager, Record the complaint and follow the complaints process’. ‘Listen, try to deal with it, record and report as necessary’. • Protection: Again the evidence indicates that service users are protected from harm or abuse and their wellbeing promoted. • The dataset indicates that the home has access to an appropriate adult protection strategy and guidance document. At the last inspection the visiting inspector reported: ‘The home has a one-page adult protection summary guidance conspicuously displayed for staff, to ensure responses to suspicion or evidence of abuse are robust. However, the Company’s policy and procedure does not accord with the Department of Health Guidance ‘No Secrets’, or local policy produced by the Social Services’. At this visit it was established that steps to address this issue had been taken and appropriate guidance is now available to the staff team. • The dataset also confirms that staff receive training around the protection of vulnerable adults and that no referrals have been made to social services, regarding possible or potential abuses. It has also been reported extensively throughout this report that both relatives and visiting professionals are satisfied with the overall care provided at the home. DS0000012532.V311292.R01.S.doc Version 5.2 Page 26 • Seagull • During the fieldwork visit the inspector observed a particular incident, which evidences the appropriate measures taken by staff when protecting service users from potentially inappropriate and harmful situations. A resident, who likes physical contact was noted to place their arms around the next of a carer, the carer very nicely but firmly asked the client to remove her arms, as the situation was felt to be inappropriate, this did not stop the carer expressing fondness or warmth towards the service user bet established parameters of acceptable behaviour, which could aid the service user in future contact situations. Seagull DS0000012532.V311292.R01.S.doc Version 5.2 Page 27 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standard 24: The home is generally well maintained, with some areas redecorated since the previous inspection. Standard 30: The home is clean, tidy and free from odours. EVIDENCE: Environment: The evidence indicates that the home is well maintained and reasonably decorated throughout. • A tour of the premise, established that it is well maintained throughout and is both comfortable and homely. During the tour the manager, discussed how the residents had been involved in the decorating of their bedrooms, choosing colour schemes and furnishing, etc. Seagull DS0000012532.V311292.R01.S.doc Version 5.2 Page 28 The rooms visited clearly differing from each other both in layout and design, etc. • Within the dataset is information relating to those areas of the home, which have been improved since the last inspection, the manager listing: 1. The lounge 2. Kitchen 3. Lower Bathroom, ;as areas of the home, which had been redecorated and a new heating system, as the only substantial alteration/work. • Previous inspector’s had no concerns with regards to the suitability of the property or its maintenance, the last inspection reporting: ‘In relation to its structure and layout the home is suitable for its stated purpose, in that it is safe, well maintained and meets residents’ needs in a comfortable and homely way’. Cleanliness: The evidence indicates that the home is clean and tidy throughout. • No concerns with regards to the cleanliness of the property were noted during the tour of the premise, or at any other time during the fieldwork visit. The last inspection report indicates: ‘it was seen generally to be clean and hygienic with no unpleasant odours. Direct access to the laundry facilities is via the kitchen/dining area. An industrial grade washing machine enables washing to be carried out at appropriate temperatures. It was understood from the manager that soiled articles are taken to be washed only when the kitchen/dining areas are not in use’. Nothing has altered with the arrangements of the laundry area or the expectations of the manager or practices of the staff. • The dataset makes clear that the staff are provided with access to infection control guidelines, policies and procedures, and that staff are receiving training around health & hygiene and Infection control. • Seagull DS0000012532.V311292.R01.S.doc Version 5.2 Page 29 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standard 32: Arrangements for staff training are appropriate. Standard 34: The home’s recruitment and selection procedures are robust and thorough. Standard 35: Arrangements for staff training are appropriate. EVIDENCE: Training, Development & deployment: The evidence indicates that staff have access to sufficient training and development opportunities and are employed in sufficient numbers to meet the needs of the service users. • Observations evidence the fact that adequate staff are available to meet people’s health and social care needs, the staff on duty comprising: 1. The manager & three care staff, although the manager is not based at the home permanently, as he manages two services, these are in close proximity to one another. Seagull DS0000012532.V311292.R01.S.doc Version 5.2 Page 30 • Feedback from the staff is that they consider the staff team to be very united and working in the best interest of the service users, the staff surveys containing statements such as: ‘the home runs extremely well and all staff work very well together and residents needs are always met’. ‘The home is run like a family unit and staff, residents seen very happy’. ‘I feel the staff group work well as a team’. • The positive feedback from the staff could well be attributed to the low turnover in staff experienced by the home, no employed at the home since 07th September 2006. Professional comments would generally appear to support the fact that sufficient and appropriate staffing levels are maintained, people’s testimonies indicating that: ‘there is always a senior member of staff to confer with’ and that people are ‘satisfied with the overall care provided to the service users’. However, one relative comment card does state: ‘at times more staff could be useful’, however, nothing specific is cited and the remaining evidence would appear to suggest the deployment of sufficient staff. • • The evidence indicates that the training opportunities for the staff are good. As part of the dataset information the manager included copies of the home’s forthcoming teaching session as well as those completed: Completed: Food Hygiene Fire safety Manual Handling Health and Safety Appointed persons National Vocational Qualifications (NVQ) at levels 2,3 & 4 Register Managers Award Learning Disabilities Award Framework (LDAF) BTEC Medication BTEC Infection Control Signs/Symptoms Down Syndrome Autism Team Leader. Scheduled: Seagull DS0000012532.V311292.R01.S.doc Version 5.2 Page 31 Mandatory Training Palliative Care BTEC Infection Control Team Leader NVQ 3. • In discussion with staff it was quickly established that training opportunities are continuously made available at Seagull, the surveys also documenting many of the courses attended. 1. 2. 3. 4. 5. 6. 7. 8. 9. • LDAF NVQ’s Sexual Awareness Down Syndrome Autism PCP Facilitator Manual Handling Food Hygiene Fire Safety. It was also clear, given the dataset information and feedback from staff during the visit, that they are also being supported when accessing National Vocational Qualifications (NVQ) level 2 & 3 courses or equivalent. The evidence within the dataset indicating that the home has met and surpassed the 50 ratio recommended within the National Minimum Standards, the actual percentage holding an NVQ 2 or above being 75 . Recruitment: The home’s recruitment and selection process has at previous inspections always been found to be satisfactory and has been considered therefore to support and protect service users. • The last inspection report indicating: ‘One support worker had been recruited since the last inspection. All recruitment records were in order’. • At this visit no one new had been recruited, the last employee recruited back in the September of 2005, as previously reported. However, experience of inspecting other home’s under the same company umbrella as Seagull, has resulted in the inspectors finding a comprehensive and robust system to have been introduced and to include: 1. Application forms Seagull DS0000012532.V311292.R01.S.doc Version 5.2 Page 32 2. 3. 4. 5. 6. 7. 8. 9. • Details of interview Contracts Induction information Employment correspondents Two references Protection of Vulnerable Adults clearance Criminal Records Check outcome Supporting identification and documents. Information provided by the staff via the staff surveys, also confirms a robust recruitment and induction procedure was adhered to, all seven staff confirming that they had: 1. 2. 3. 4. 5. Attended for interview Provided references Provided Photographs Provided Work Permits (where applicable) Submitted to Protection of Vulnerable Adults and Criminal Records Bureau checks 6. Completed and Induction 7. Been supplied with a contract 8. Been supplied with a job description. • The dataset also confirms the existence of a recruitment and selection strategy and procedure. Seagull DS0000012532.V311292.R01.S.doc Version 5.2 Page 33 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standard 37: The manager is both appropriately qualified and experienced to operate the home. Standard 39: The service users can feel confident that views are a listen to and the future direction of the service takes this into consideration. Standard 42: The health, safety and welfare of the service users are not being appropriately promoted of protected. EVIDENCE: Management: The evidence indicates that the home is well run and managed and that the service users, their relatives and staff are appropriately protected from harm and injury. Seagull DS0000012532.V311292.R01.S.doc Version 5.2 Page 34 • Information contained within previous inspection reports indicate that the manager possesses both the Registered Manager’s Award (RMA) and has also completed the National Vocational Qualification (NVQ) level 4 in Care. This information confirmed via the dataset, where both of these courses are listed as having been completed. • Evidence gleaned from the dataset and other documentation provided prior to the fieldwork visit, suggests that the manager also regularly accesses additional courses, alongside his staff and other senior managers, to maintain his own skills and knowledge, those courses listed above. In addition to the registered manager, the home also employs a senior support worker, the post currently being covered on a temporary basis, the latter individual was available to speak with during the fieldwork visit, senior support worker the assistant overseeing some operational issues and running of shifts. Comments received from the relatives of service users general indicate that the manager is considered to be both approachable and supportive. The relatives’ comments providing further evidence of the manager’s professionalism and standing within the home, one person remarking: ‘We are very happy with all that goes on at Seagull it is well run and has a happy atmosphere’. • • • The professional comment cards also addressed the management of the home, all three cards indicating that they believe the management would ‘take appropriate decisions when they can no longer manage the care needs of the service users’. Service User Involvement: The evidence indicates that service users are encouraged to participate in care reviews and the development of their care plans, as well as activities/entertainment and changes within the home. • As mentioned previously the service users were actively encouraged to participate within the decoration and furnishing of their bedrooms, some people embracing this opportunity more than others, based on the attachment placed on the room they accommodate. It was also clear that service users do participate with case and/or care reviews, records on the service users plans establishing that people are asked to attend both in house and professional reviews. • Seagull DS0000012532.V311292.R01.S.doc Version 5.2 Page 35 In addition to the service user, their keyworker and the care manager, family members may be asked/invited to attend, as often the service user may require additional support and advocacy. • Professional advocates are also involved with the service users and are known, from a conversation with the manager to attend the home regularly to ensure the views and opinions of the service users are heard and listened to appropriately. It is considered that the advocacy service has no concerns over how the home responds to requests made on behalf of the service users, as no contact between this service or the Commission is documented on file. • It was also established through contact with residents and staff that the holidays attended this year, were mutually agreed, all of the service users required to have a say before a decision was reached. The final choice would appear to have been a popular success given people’s reaction when discussed. Health & safety: The evidence indicates that the health and safety of the service users and staff is being appropriately managed. • • • No immediate health and safety concerns were identified with regards to the fabric of the premises during the tour of the premises. The dataset establishes that full health and safety policies/guidance documents are made available to the staff. Health and safety training is clearly made available to staff, with the dataset evidencing that staff complete first aid, fire safety, moving and handling, infection control and food hygiene. Access to paper towels and liquid soaps within bathrooms and toilets are indicators of attention to infection control, as is the availability of a specific infection control policy, as listed within the dataset and the training opportunities, as planned and delivered. At the last inspection it was also reported: ‘there are comprehensive policies and procedures in place to ensure safe working practices in the home and all care staff undertake statutory training, which includes health and safety, food hygiene, first aid, manual handling and infection control’. ‘The home’s pre-inspection self-assessment signed by the manager confirmed that all policies and procedures, maintenance and associated • • Seagull DS0000012532.V311292.R01.S.doc Version 5.2 Page 36 records were in place to ensure compliance with regulations and relevant legislation’. Seagull DS0000012532.V311292.R01.S.doc Version 5.2 Page 37 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 x Seagull DS0000012532.V311292.R01.S.doc Version 5.2 Page 38 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Seagull DS0000012532.V311292.R01.S.doc Version 5.2 Page 39 Commission for Social Care Inspection Southampton, Portsmouth and Isle of Wight 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Seagull DS0000012532.V311292.R01.S.doc Version 5.2 Page 40 - 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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