Inspection on 19/08/05 for Shakespeare House

This inspection was carried out on 19th August 2005.

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

Shakespeare House 28/06/07

Shakespeare House 09/01/06

Shakespeare House 08/09/04

Shakespeare House 13/05/04

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

CARE HOME ADULTS 18-65 Shakespeare House 34 Pier Road Littlehampton West Sussex BN17 5LW Lead Inspector Jennifer Wright Unannounced 19 August 2005, 20:30 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 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 Stationary 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. Shakespeare House H60-H11 S14712 Shakespeare House V244448 190805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Shakespeare House Address 34 Pier Road, Littlehampton, West Sussex, BN17 5LW Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Susan Elisabeth Howes 01903 723164 Mrs Susan Elisabeth Howes Care Home (CRH) 3 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia-over 65 years of age (MD(E)), (1) of places Mental Disorder, excluding learning disability or dementia (MD), (2) Shakespeare House H60-H11 S14712 Shakespeare House V244448 190805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 Only service users in MD (mental disorder, past or present) category under 65 years may be admitted to the home. Date of last inspection 8 September 2004 Brief Description of the Service: Shakespeare House is a care home registered to accommodate up to 3 residents in the category of younger adults, with an additional condition that 1 of the residents could be in the category of older persons. It is a 3 storied terraced property located in Littlehampton, near to the river and the sea. The service is owned and managed by Mrs. Susan Howes. The Manager has received a satisfactory enhanced Criminal Records Bureau check. Shakespeare House H60-H11 S14712 Shakespeare House V244448 190805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the first of a minimum of two statutory visits that an inspector must make to each care home during the course of a year. A second inspection, which will be announced, will be undertaken later in the year. During this inspection the Inspector toured all parts of the building used by the residents, including the resident’s bedrooms. All were found to be satisfactory. The inspector was able to speak to all the residents on the day of inspection and they all spoke very well of the care they were receiving from Shakespeare House. The Inspector examined records about care being provided to residents; as well as discussing any accidents or concerns or complaints, to make sure that the residents at Shakespeare House were being taken care of. All records examined were found to be in order and up to date. The Care Plans were well written and contained all the information needed to look after the residents. There was evidence of the necessary staff training, and records regarding training and supervision were up to date The building is in good decorative order, and was seen to be clean and welcoming. All Health and Safety issues were up to date, and no recommendations or requirements were made at this inspection. At this inspection Shakespeare House was audited against the National Minimum Standards for Younger Adults. All the elements in each of the standards assessed were met. Three were exceeded. The Inspector would like to thank everyone who co-operated with her on the day of this inspection. What the service does well: The home was seen to have a dedicated Manager, who runs the home with the support of an equally enthusiastic member of staff. It was evident that they both work hard to improve the quality of life of those in their care. Care Plans are satisfactory and contain all the information needed to care for the people who live at Shakespeare House. There is just one member of staff besides the Manager, which means that the residents always know the person on duty. The home is located in the town centre and residents attend a variety of activities and local community events. Residents are encouraged and supported to live as full a life as they are able. The Inspector was told that residents are regularly consulted about the daily running of the home. Records, including care plans were seen to be up to date, and safely stored. Shakespeare House H60-H11 S14712 Shakespeare House V244448 190805 Stage 4.doc Version 1.40 Page 6 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. Shakespeare House H60-H11 S14712 Shakespeare House V244448 190805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Shakespeare House H60-H11 S14712 Shakespeare House V244448 190805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4, 5 Residents and their families have the information they need to make an informed choice about Shakespeare House, and are suitably assessed before placement. EVIDENCE: The Manager informed the Inspector that each resident is given a Statement of Purpose and Service Users Guide and a Contract when they enter the home. The residents have family, or a solicitor, who act on their behalf. All residents are assessed before they join the home. The records of these assessments were seen by the Inspector, and found to be satisfactory. The Inspector was told that it is important that all residents fit in with others living in the home. Shakespeare House H60-H11 S14712 Shakespeare House V244448 190805 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8, 9, 10 Residents are encouraged to maintain independence whenever possible, and are fully involved in all aspects of their care planning. Resident’s needs are carefully monitored, and care plans are regularly reviewed by the Manager of Shakespeare House. EVIDENCE: Wherever possible residents take part in the running of the home, and are able to make their own decisions, supported by the Manager. Examples of this include activities, outings, and choice of menu. Residents are encouraged to maintain independence whenever possible, and are fully involved in all aspects of their care planning. The needs of residents are carefully monitored, and care plans were seen to be regularly reviewed by the Manager. Care plans were well detailed and were seen to reflect the needs of residents. All personal information with regard to residents was securely stored. Shakespeare House H60-H11 S14712 Shakespeare House V244448 190805 Stage 4.doc Version 1.40 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15, 16, 17 All the residents appeared extremely happy at Shakespeare House. The Manager informed the Inspector that all residents are encouraged to keep in contact with their family and friends and to have control over their daily tasks. The activities that residents attend are determined by their individual needs and care plans. Meals are well planned and provide a variety of choice. Fresh home cooked food is provided. EVIDENCE: The Manager informed the Inspector that residents have opportunities to meet people and join in activities outside of the home, and that risk assessments are undertaken to ensure the well being of the resident. These activities include clubs, outings, walking and watching videos. One resident is very involved with the local football team, and supports all their games. All the residents spoken to on the day of inspection praised the food at Shakespeare House, and said, “there is always a choice, and plenty of it”. Shakespeare House H60-H11 S14712 Shakespeare House V244448 190805 Stage 4.doc Version 1.40 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 20, 21 The resident’s health, personal and social care needs are well met at Shakespeare House. All procedures for medication involve a thorough assessment of the resident. People administering medication to residents have been appropriately trained. EVIDENCE: Medication is stored safely and records were well kept with regard to the administering and disposing of all medication. The Manager informed the Inspector that both she, and the person in charge when she is absent from the home, has received appropriate training in medication. Shakespeare House has not had to deal with a death as yet. However, there are policies and procedures in place should such a thing happen. Shakespeare House H60-H11 S14712 Shakespeare House V244448 190805 Stage 4.doc Version 1.40 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22, 23 The Manager informed the Inspector that the staff member, and the residents and their families are aware of the complaint’s procedure, and know how to complain. The staff member is aware of the Adult Protection Procedures and of the policies and procedures with regard to Whistle Blowing. EVIDENCE: Residents told the Inspector that they would quite happily go to the Manager if they were unhappy with anything, and said that they “would be listened to”. The Manager confirmed that the staff member has access to a Whistle Blowing Policy and to the guidelines on how to refer any abuse, or suspicions of abuse. The staff member was not on duty at the time of the inspection. Shakespeare House H60-H11 S14712 Shakespeare House V244448 190805 Stage 4.doc Version 1.40 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28, 29, 30 On the day of inspection Shakespeare House appeared clean and well maintained, and there was evidence that residents choose what decor they would like in their bedroom. There is a lounge/diner upstairs, for the use of the residents. The location of the home is suitable for the residents who live there. The home does not have a garden for residents, and this information is included in Shakespeare House’s Statement of purpose and Service Users Guide, however Shakespeare House is situated extremely close to the river, the beach and a park, which, residents told the Inspector, they go to frequently. EVIDENCE: During the course of the inspection all parts of the home used by residents was inspected, to ensure that the environment was safe and comfortable for people who live there. The Inspector visited every bedroom, all of which were seen to clearly reflect the resident’s personality and interests. It was noted that the residents had brought personal possessions into the home, including televisions, videos, ornaments, photographs etc. The residents told the Inspector that they were very pleased with their rooms. Shakespeare House H60-H11 S14712 Shakespeare House V244448 190805 Stage 4.doc Version 1.40 Page 14 On the day of this unannounced inspection, Shakespeare House was seen to be clean and tidy and in good repair throughout. Records were available to show that the home is maintained to a satisfactory standard. On the day of inspection a door was seen to be wedged open, the Manager was made aware of the safety implications surrounding this. Shakespeare House H60-H11 S14712 Shakespeare House V244448 190805 Stage 4.doc Version 1.40 Page 15 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 34, 35, 36 There is only one member of staff currently employed at Shakespeare House. Shakespeare House has a satisfactory recruitment policy, where all required checks are made. The staff member was seen to have received the appropriate training and supervision. It was seen that policies and procedures are in place to ensure that residents are protected. EVIDENCE: Shakespeare House H60-H11 S14712 Shakespeare House V244448 190805 Stage 4.doc Version 1.40 Page 16 Staffing records were examined and it was seen that all necessary procedures had been followed, with regard to the recruitment of staff, including ensuring that the staff member currently employed has received a Criminal Records Bureau enhanced check, showing that they are safe to work with vulnerable people. Records are kept in a locked cabinet. The Manager informed the Inspector that the staff member has received all necessary training, and that supervision is being carried, out and notes kept. It was seen from the records that the member of staff had received supervision, however the inspector did not examine the individual supervision record as this could be an infringement of the rights of the individual, but it was clear that the supervision records meet the National Minimum Standards. One resident spoken to said that the staff member was “nice, part of the family”. Everybody who the Inspector talked with on the day of inspection spoke very highly of Shakespeare House. Shakespeare House H60-H11 S14712 Shakespeare House V244448 190805 Stage 4.doc Version 1.40 Page 17 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39, 42, Mrs. Howes is the owner/Manager of the home, and is experienced in working with this client group. Records needed for the safe running of a care home are kept up to date. Policies and procedures are available to refer to, to ensure the safety of the people who live and work at Shakespeare House. EVIDENCE: It is apparent that the needs of the residents are uppermost at Shakespeare House, and that the Manager and the staff member ensure that resident’s rights and best interests are safeguarded at all times. Reviews are held at regular intervals, and these are recorded. All records and policies and procedures are well maintained, and show that all Fire and Environmental Health requirements have been met, and that all equipment is serviced regularly, thus ensuring that Shakespeare House is a safe Shakespeare House H60-H11 S14712 Shakespeare House V244448 190805 Stage 4.doc Version 1.40 Page 18 environment for the people who live and work there. Policies and procedures ensure that the health, safety and welfare of residents are promoted. All the residents spoke very highly of the Manager, on the day of inspection, with one resident telling the Inspector “Sue’s all right”, a second resident saying that he liked living at Shakespeare House as he “felt part of one big family” and a third saying, “it is much better than the place I was in before”. Shakespeare House H60-H11 S14712 Shakespeare House V244448 190805 Stage 4.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 4 3 3 3 3 4 Standard No 31 32 33 34 35 36 Score 3 3 x 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Shakespeare House Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 4 x 3 x x 3 x H60-H11 S14712 Shakespeare House V244448 190805 Stage 4.doc Version 1.40 Page 20 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 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. 1. Refer to Standard Good Practice Recommendations Shakespeare House H60-H11 S14712 Shakespeare House V244448 190805 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 2nd Floor, Ridgeworth House, Liverpool Gardens Worthing West Sussex BN11 1RY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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