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Inspection on 30/07/07 for Searchlight Workshops - Webb House

Also see our care home review for Searchlight Workshops - Webb House for more information

This inspection was carried out on 30th July 2007.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The atmosphere in the home was comfortable with communication between residents and staff friendly and relaxed. Residents were very positive about the support provided, saying that `we decide what we want to do`, the `staff are friendly` and `look after us very well`. The acting manager and staff said Webb House is the residents home and they are encouraged to make choices about all aspects of their day to day lives, and be involved in decisions about developing the services at the home.

What has improved since the last inspection?

The acting manager confirmed that the requirements listed in the last inspection report have been addressed. The care plans have been reviewed and include risk assessments and daily records to reflect the support provided. The menu has been reviewed and changes made in line with residents preferences. Improvements have been made to the recording of accidents/incidents. Changes have been made to ensure the safety of residents who smoke. Regulation 37 report are forwarded to the Commission as requested.

What the care home could do better:

Some improvements for the safety of residents and staff were noted and have been highlighted in the body of the report. Requirements were not made for these because the acting manager advised that they are already being addressed. These include the appropriate use of the pre- admissions assessment form and training in adult protection for all staff.

CARE HOMES FOR OLDER PEOPLE Searchlight Workshops - Webb House Claremont Road Mount Pleasant Newhaven East Sussex BN9 0NQ Lead Inspector Kathy Flynn Unannounced Inspection 30th July 2007 09:30 X10015.doc Version 1.40 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 Searchlight Workshops - Webb House DS0000059528.V338828.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 Older People. 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. Searchlight Workshops - Webb House DS0000059528.V338828.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Searchlight Workshops - Webb House Address Claremont Road Mount Pleasant Newhaven East Sussex BN9 0NQ 01273 514007 01273 611289 Webb@search-light.org.uk 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) Searchlight Workshops Vacant Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (6), Physical disability (16) of places Searchlight Workshops - Webb House DS0000059528.V338828.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. That the maximum number of service users to be accommodated is twenty-two (22). That a maximum of six (6) service users accommodated must be older people, aged sixty-five (65) or over on admission. That a maximum of sixteen (16) service users accommodated will have a physical disability and be aged over fifty-five (55) on admission. That service users with a physical disability may also have a mild learning disability. 15.06.06 Date of last inspection Brief Description of the Service: Webb House is a care home registered to provide accommodation for a maximum of twenty-two (22) residents. Six (6) places are registered for older people, aged sixty-five (65) years or over on admission. Sixteen (16) places are registered for people with a physical disability who may also have a mild learning disability and must be aged fifty-five (55) years or over on admission. Webb House is one of three homes within the Searchlight Workshop group located at the one site. The home is situated on the top of a hill on the outskirts of Newhaven. There is a mini bus available at the home. There are local amenities and access to bus routes at the bottom of the hill. Unrestricted car parking is available in the adjacent streets. All rooms are for single occupancy and are located over two floors. There is a passenger shaft lift available to assist residents to access all areas of the home. Two of these rooms are provided with en suite facilities. There is a large dining area on the first floor and a good-sized lounge room on the lower floor. There are four bathrooms, of which two have shower facilities and five communal toilets located throughout the home. Some communal facilities and individual rooms have overhead hoist tracking. Grab rails are located throughout the home to assist individuals when mobilising. Any specialist equipment that may be required for an individual will be accessed by the home as the needs arise. There is a workshop on the site available to residents and others within the community. A variety of crafts/activities are offered at the workshop. A social club is run on site and this opens a couple of evenings a week. Searchlight Workshops - Webb House DS0000059528.V338828.R01.S.doc Version 5.2 Page 5 Weekly fees range from £600 through to £1000. There are additional costs for hairdressing (£5) and chiropody (£10). Depending on an individuals needs, there are additional cost for activities, papers, holidays, social transport and personalised toiletries. This information was provided to the CSCI on the 10/05/06. Prospective residents know about the home through social service referrals, word of mouth and from living in the Newhaven area. Information about the home can also be obtained from the CSCI website. Searchlight Workshops - Webb House DS0000059528.V338828.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place on the 30th and 31st July over a period of 10 hours. The inspection included a tour of the home, reviews of residents care plans including risk assessments, medication policies and procedures and medication administration charts, menus, activities, staff recruitment and staff training. Others such as supervision, health and safety checks, quality assurance and monitoring were discussed with the acting manager. There were 18 residents at the home during the inspection and 10 of the residents were spoken with. Those who expressed an opinion were positive about the support offered at the home. The acting manager, care staff, housekeeping staff, and administrators discussed the care and support provided at the home. The Annual Quality Assurance Assessment (AQAA) had been completed and sent to the Commission on the 5th May 2007. The information provided in this was reviewed as part of the inspection process. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulations 2001 use the terms ‘service user’ to describe those living in care home settings. However for the purposes of this report those living at Webb House will be referred to as ‘residents’. What the service does well: The atmosphere in the home was comfortable with communication between residents and staff friendly and relaxed. Residents were very positive about the support provided, saying that ‘we decide what we want to do’, the ‘staff are friendly’ and ‘look after us very well’. The acting manager and staff said Webb House is the residents home and they are encouraged to make choices about all aspects of their day to day lives, and be involved in decisions about developing the services at the home. Searchlight Workshops - Webb House DS0000059528.V338828.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Searchlight Workshops - Webb House DS0000059528.V338828.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Searchlight Workshops - Webb House DS0000059528.V338828.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. A pre-admission assessment is completed for all prospective residents to ensure that the home can meet their individual needs. EVIDENCE: The acting manager explained that the pre-admission assessment has been reviewed and updated to include information about all aspects of the prospective residents needs. This includes medical history, current needs, medication, communication, diet, mobility, sensory and mental assessments. Searchlight Workshops - Webb House DS0000059528.V338828.R01.S.doc Version 5.2 Page 10 There have been no admissions to the home since the last inspection therefore it was not possible to assess this standard during this inspection. However a resident was transferred from another home on the site following discussions with the staff and resident. The pre-admission form was not used to record the assessments that identified this resident’s changing needs and the reasons for the transfer to Webb House. During feedback the acting manager agreed that the assessment form should be used to record the transfer of residents to the home. Searchlight Workshops - Webb House DS0000059528.V338828.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staff at the home provide residents with the support and care they need, and residents are protected by staff following the homes medication procedures. EVIDENCE: The acting manager explained that the care planning system has been reviewed and a number of changes have been made to the care plans, with an emphasis on the individual needs of each of the residents. A keyworker system has been introduced which identifies the senior support staff member, who works with each group of residents, to develop and write their care plans. The emphasis is on staff and residents working together to record individual care needs, risk assessments, daily records, as well as the residents aspirations and future goals. The acting manager advised that a rolling programme of training is in place to support staff and residents. Searchlight Workshops - Webb House DS0000059528.V338828.R01.S.doc Version 5.2 Page 12 Five care plans were examined and all had some information regarding the residents care needs. Risk assessments were in place in four care plans and these included falls, self-medication and smoking. Daily records were completed in all five to show the support and care provided, and there was evidence that they are reviewed monthly with the involvement of the residents. Two of the care plans were not complete and the staff spoken with explained that they were still updating these, although they were able to demonstrate an understanding of the residents individual needs and how these can be met. Residents who were spoken with said that the ‘staff are very good’ and ‘provide the help I need’. The acting manager explained that the basis for the support provided is to promote residents independence and ensure they feel valued, listened to and respected. Residents are registered with GP’s and appointments are made with allied health professionals when required, including District Nurses, chiropodists and opticians. The policies and procedure for medication at the home have been reviewed and the acting manger confirmed that training has been provided for staff to ensure they follow these. The medication administration record charts (MAR) were viewed and found to be complete. Communication between residents and staff was friendly, and the atmosphere in the home was relaxed and comfortable. Residents were treated with respect and their privacy was assured when personal care was provided. Searchlight Workshops - Webb House DS0000059528.V338828.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents make choices about how they spend their time at the home and the meals are good, meeting the specific dietary needs of the residents. EVIDENCE: A number of activities are available for residents, these are advertised on the residents notice board and staff also ask the residents if they would like to join in. A workshop offers residents and people from the community activities including painting and knitting, some residents repair chairs, and during the inspection a group were playing hangman with the staff. Three minibuses are available for staff to drive, a low floor bus stops nearby and a taxi is available if required. This ensures that the home can offer access to shops in Newhaven or Eastbourne and visits to the library, as well as trips to Searchlight Workshops - Webb House DS0000059528.V338828.R01.S.doc Version 5.2 Page 14 the theatre and local community events such as cricket matches. A client development manager is employed to make sure that residents are able to go on the trips and holidays that they choose. A group of residents and staff have arranged to go on a cruise in September. Friends and relatives are welcome at the home at any time, and some of the residents spoken with said that they see their family regularly. There were no visitors at the home to speak to during the inspection. Residents are encouraged to exercise choice and control over their lives, those spoken with choose how they spend their time and have decorated their rooms with personal possessions. All are responsible for their own money, and some use the safe in the administration department to keep their bank cards, although they also have lockable cabinets in their own rooms. Residents can also keep some cash in the safe, there are records to show the deposits and withdrawals are recorded and signed for, and these are checked weekly and an external audit is carried out yearly. The meals at the home ‘are good’, residents spoke positively about the food and the home meets the special dietary needs of the residents. A new kitchen has been installed and is used to serve the meals prepared at the main kitchen situated in a separate building. A chef and kitchen staff have not yet been employed to work in the kitchen at Webb House. Residents have a smaller kitchen that they can use to prepare drinks and snacks However there are some difficulties with residents who use wheelchairs accessing the units safely, the acting manager advised that they had recognised these difficulties and are going to address them. Searchlight Workshops - Webb House DS0000059528.V338828.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has a complaints procedure and residents are encouraged to raise any concerns they have, and staff have a good understanding of protecting vulnerable people. EVIDENCE: There have been no complaints to the home or to the Commission since the last inspection. The acting manager confirmed that appropriate policies and procedures are in place. Residents have opportunities to discuss any concerns they may have on a daily basis and during the residents meetings, which are held monthly. Advocacy services are available if required. Residents spoken with said that they did not have anything to complain about and if they did they would ‘talk to the staff to get it fixed’. Searchlight Workshops - Webb House DS0000059528.V338828.R01.S.doc Version 5.2 Page 16 Staff spoken with were able to demonstrate a good understanding of adult protection. They were knowledgeable about abuse and what action they would take if they had any concerns. However training in the protection vulnerable adults has not been provided for staff for some time and new member of staff have not attended any training. The acting manager and training organiser are aware that this training is a mandatory requirement and they are currently organising training for all the staff. Searchlight Workshops - Webb House DS0000059528.V338828.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use this service experience good outcomes in this area. This judgement has been made using available evidence and a visit to this service Webb House offers residents a comfortable and homely environment in which to live. Staff protect residents by following the homes procedures for the control of infection. EVIDENCE: Webb House is an older building that offers spacious and comfortable single and communal rooms that are accessible to wheelchair users. There is a large lounge on the lower floor, with a smoking room attached, that has access to a large balcony and the garden to the rear. There is a large dining room on the Searchlight Workshops - Webb House DS0000059528.V338828.R01.S.doc Version 5.2 Page 18 ground floor, next to the main kitchen, and a smaller residents kitchen near the entrance. There are 21 single rooms at the home and residents are encouraged to personalise their rooms and many have with furniture, pictures and ornaments. A shaft lift enables residents to have access to all parts of the home, assisted baths and toilets are in place and hoists are available for staff to assist residents. There is an ongoing maintenance programme at the home, with repairs carried out when the need arises. A budget to ensure that regular checks are completed, including hot water and call bells, is in place. Training in the control of infection is provided for staff and the acting manager confirmed that there are policies and procedures for staff to follow. Staff were noted to use gloves and aprons appropriately. Searchlight Workshops - Webb House DS0000059528.V338828.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. A robust recruitment procedure is used by the home to protect residents, and training is provided for all staff to ensure they are aware of their roles and responsibilities. EVIDENCE: The acting manager advised that there are sufficient staff working in the home to ensure that the residents receive the support and care they need. Staff spoken with said they have the time to assist residents to be independent and make choices about what they do. An induction programme is provided for all new staff, they are required to complete it and the expectation is that they will then do the National Vocational Qualification (NVQ). 24 of staff at the home have completed an NVQ course, and the acting manager is aware that this is below the 50 Searchlight Workshops - Webb House DS0000059528.V338828.R01.S.doc Version 5.2 Page 20 target expected, a number of staff are now working towards this qualification and others will be over the next year. There are robust recruitment procedures in place at the home with the human resources department at Searchlight responsible for the recruitment of staff with regard to sending out application forms, collecting references and completing checks, including the Protection of Vulnerable Adults (POVA) and Criminal Records Bureau (CRB) check. When these have been completed the manager of the home interviews prospective employees with another senior member of staff, and the expectation is that residents will be part of the interview panel in the future. Searchlight Workshops - Webb House DS0000059528.V338828.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 People who use this service experience good outcomes in this area. This judgement is made using available evidence including a visit to this service. The management of the home is appropriate and meets the needs of the residents, systems are in place to protect the welfare, health and safety of residents, staff and visitors. EVIDENCE: The acting manager has been in place for two years and has completed the NVQ Level 4 in care. She has considerable experience in providing care for Searchlight Workshops - Webb House DS0000059528.V338828.R01.S.doc Version 5.2 Page 22 people with learning difficulties and disabilities and has applied to the Commission to register as the manager of Webb House. The management approach at Webb House is open and inclusive. Residents, relatives and staff are encouraged to participate in discussions about the services provided at the home. There are regular meetings that they can attend if they wish, and the acting manager confirmed that feedback is sought from all groups and individuals who have any contact with the home, as part of the quality assurance system. The results are analysed and the acting manager and responsible individual confirmed that changes are made if any concerns are identified. The comments from residents and relatives during the inspection were very positive, and there were no suggestions as to how they service could be improved from anyone, including staff. A designated health and safety officer has been appointed in the home who is a member of the Health and Safety Group, which has produced a robust Health and Safety Policy. The group meets weekly to address any concerns identified, they carry out fire tests and if required address any accidents or incidents, and assess any new concerns with appropriate risk assessments completed if required. The acting manager advised that hot water pipes are now covered although radiators in residents toilets are not, these should be assessed to ensure that they do not place residents at risk of injury. Training required by legislation, including moving and handling, fire training, health and safety, food hygiene, first aid and infection control is provided for all staff to protect the health and safety of residents, staff and visitors. Searchlight Workshops - Webb House DS0000059528.V338828.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Searchlight Workshops - Webb House DS0000059528.V338828.R01.S.doc Version 5.2 Page 24 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 Searchlight Workshops - Webb House DS0000059528.V338828.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Searchlight Workshops - Webb House DS0000059528.V338828.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!