Inspection on 26/03/07 for Southside House

This inspection was carried out on 26th March 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 found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Southside House 28/01/09

Southside House 27/03/08

Southside House 15/12/05

Southside House 24/08/05

Southside House 18/03/05

Southside House 30/12/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Southside House 44 Severn Road Weston Super Mare North Somerset BS23 1DP Lead Inspector Catherine Hill Unannounced Inspection 26th March 2007 16:00 Southside House DS0000008091.V327409.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 Southside House DS0000008091.V327409.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. Southside House DS0000008091.V327409.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Southside House Address 44 Severn Road Weston Super Mare North Somerset BS23 1DP 01934 626540 NONE 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) Mr Lal Gunaratne Mrs Veronica Bishop Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Southside House DS0000008091.V327409.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. May accommodate up to 6 persons with learning difficulties, aged 18 64 years, requiring personal care only. The Manager to gain a formal LDAF qualification by June 2006 Date of last inspection Brief Description of the Service: Southside House provides support for up to six younger people with learning disabilities who spend most of their day away from the house. It contains two double bedrooms and two single ones. The emphasis of the service is on a homely approach, and it aims to provide opportunities for more able people to learn independence skills. The home is located close to the local shops, parks and seafront. It is about a mile away from the town centre. It is also located a short walk away from its sister home (Charlton House), with which it shares the manager. The current scale of charges ranges from £550 to £700. Southside House DS0000008091.V327409.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection consisted of visit to the home in the late afternoon and early evening. The manager was aware that this visit would be taking place several hours before it happened, because she was on duty at Charlton House when the inspector visited that home earlier in the day. Prior to this visit, the inspector spoke with some of the health and social care professionals in contact with the home. Last year, the inspector also visited a day centre attended by some of the residents, and spoke to residents and staff there about the home. Prior to visiting the home, the inspector had spoken earlier with four of the residents who were spending the day at Charlton House. During the early evening visit, the inspector also spoke to three other residents. The inspector spoke with the two staff on duty and the manager. Feedback from all sources was very positive. External professionals felt that any issues are dealt with promptly, care is good, and that the home liaises well with them. The inspector looked at all communal areas and some of the bedrooms. She also looked at a number of records, including: • information given to residents before they move into the home • documents relating to residents care • medications records • activities records • the maintenance log • staff rotas and task lists • staff recruitment and training records • accident records • fire precautions checks and training records. What the service does well: The staff interact very well with the residents, and treat them in an adult-toadult manner. They are offering choice wherever possible, and giving residents plenty of information so that they can make their own informed decisions. Residents seemed a lot more confident about their rights, and strong relationships are evidently developing. The atmosphere in the home was particularly vibrant, and each of the residents the inspector spoke with confirmed that they are feeling much happier. Southside House DS0000008091.V327409.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Southside House DS0000008091.V327409.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 Southside House DS0000008091.V327409.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): 1, 2, 3, 4, 5, 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective residents get good information about the service before moving into the home but their needs are not always assessed against the homes stated aims. EVIDENCE: The Statement of Purpose gives a good depth of information and is kept up-todate. This is very straightforward document in plain English with pictures, and is likely to be useful for residents. The pre-admission assessment not only looks at the persons needs but also gathers a lot of information about their preferences. However, two new residents have been admitted from the sister home without their needs being reassessed. One of these people has been diagnosed as having dementia, and both are older people. Both peoples needs fall outside the range of needs described in the homes Statement of Purpose. Southside House DS0000008091.V327409.R01.S.doc Version 5.2 Page 9 People are encouraged to make as many visits as they need to before deciding to move in for a trial period. The new residents and the existing resident group were fully consulted about the move before it took place. Each resident has a straightforward contract with clear information on the terms and conditions. Southside House DS0000008091.V327409.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): 6, 7, 8, 9, 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents care needs are generally well documented and well met but are not always kept under review. EVIDENCE: The information contained in care plans is generally detailed and useful but most of the care plans sampled had not been reviewed for a year to eighteen months. One persons daily notes in summer of last year referred to him being prescribed glasses, but his care plan indicated that there were no issues relating to sight, and he was not wearing glasses during this visit nor in the photo on the front of his file. The staff member in charge had not been working at the home when his glasses were first prescribed so was unable to give any additional information about this. The inspector advised that all care-related records need to be checked when reviewing care plans to ensure that all significant information is followed up. Southside House DS0000008091.V327409.R01.S.doc Version 5.2 Page 11 Care plans for younger people need to be reviewed at least every six months, and monthly for older people. Care plans also need to be reviewed following any significant change. Southside House DS0000008091.V327409.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each person has a full timetable of social, leisure and vocational activities that suits their individual needs. The homes routines are very flexible and residents have a good deal of control over these. However, staffing levels do not allow the level of one-to-one support that the two newer residents might benefit from. EVIDENCE: Residents described full and interesting lives. Several people have some sort of work, and some go to college and day placements. Because most of the Southside House DS0000008091.V327409.R01.S.doc Version 5.2 Page 13 residents are fairly able people, they tend to arrange their own social lives with a minimum of support from staff. However, the two older men who were recently admitted require more support in this area. Residents felt that the home’s routines suit them. Staff were able to give examples of how routines are designed around residents preferences. Some of the residents go to the supermarket with staff to do the home’s shopping. The resident group plans menus every month with support from staff. The residents have agreed a chores list, and an easy-read rota has been put in the kitchen. Most residents do their own washing and ironing with support from staff as necessary. Most people buy their own clothing, but staff will give support with this if it is wanted. Contact with friends and family is actively supported. Several residents divide their time between their family homes and this one, and residents are welcome to invite their friends over. The home provides transport so that people can go to evening clubs and social events. A daily record is kept to afford each person has eaten, and this shows that a good variety of interesting in nutritional dishes is being offered. Southside House DS0000008091.V327409.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents health care needs are generally well met but the system for recording and monitoring these is not being well used and there is too much room for vital issues to be overlooked. EVIDENCE: A system has been set up for recording and monitoring residents health care checks, but this is not being well used at present. The monthly checks that staff are meant to carry out are not being completed. Information on health care is scattered throughout residents own files and other records. The manager intends giving staff further training on how to use this system, and monitoring it more closely to ensure its effectiveness. One person with a recent history of serious illness had no record on file of the date of their latest scans. This persons file mentioned that a cervical smear test was refused fourteen years ago but did not give any indication that this issue had been re-examined since. Another persons file mentioned a small lump found on their neck seven weeks before this inspection, but there was no Southside House DS0000008091.V327409.R01.S.doc Version 5.2 Page 15 further mention of this. However, a sore toe had been followed up for weeks until the problem was resolved. It appears that staff are losing track of some information, perhaps because the system is at present fragmented and not well used. Medications records were thorough and up-to-date. Residents are on very few medications. Southside House DS0000008091.V327409.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents wellbeing is protected by a culture in which their concerns and rights are taken seriously. EVIDENCE: The home has a written complaints procedure. Residents felt very comfortable raising any concerns with staff or the manager. Staff felt encouraged to raise any concerns on residents behalf. Conversation with staff and observation of their interactions with residents showed that they regard this as the residents home and are well aware of residents rights. No complaints had been received by CSCI since the last inspection. The home has recorded one complaint, which was really a minor grumble. This was quickly resolved, and the complaint book record shows that the response was very positive. Residents were praised for saying what they think, and were encouraged to talk to staff about any other issues that were bothering them. This response evidently had quite an effect on the residents, who are feeling very positive about how responsive staff are to them. Staff said they would report any concerns to the manager, and felt confident that these would be dealt with appropriately. Southside House DS0000008091.V327409.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 27, 28, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a very pleasant and welcoming environment that is generally well-suited to younger adults lifestyles. EVIDENCE: There is a large lounge and separate dining room, both of which have a TV and comfortable seating. There is an upstairs bathroom and a downstairs shower room. Some of the bedrooms are in the process of being redecorated. The dividing curtains in the double rooms will be replaced once the decoration is completed. Some bedrooms have locks that could prevent staff being able to reach the person in an emergency. These locks are gradually being changed over to safety locks. Residents are encouraged to hold their own keys. Southside House DS0000008091.V327409.R01.S.doc Version 5.2 Page 18 At the time of the last inspection, the manager and owner were discussing ways in which they might be able to reduce the number of double bedrooms, as they realize these are in keeping with the home s aims to promote residents individuality and independence. The home is still looking at plans to turn the two double bedrooms into three single rooms. Given the wide range of needs currently being accommodated, it is even more important that individual residents have their own space within the home. Fire doors between the lounge, kitchen and dining room were wedged open. Given the layout of this home and the low staffing levels, this could be particularly dangerous. Southside House DS0000008091.V327409.R01.S.doc Version 5.2 Page 19 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): 31, 32, 33, 34, 35, 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are generally well protected by safe staffing practices but staffing levels need to be reviewed in the light of the current residents needs. EVIDENCE: The home is not usually staffed during the day when residents are out at work or at day placements, but cover is always promptly available should a resident need to stay at home. At other times of day, one member of staff is usually on duty. This was sufficient when residents were all younger and less dependent and the home aimed to equip people with the skills necessary for more independent living. However, it may not be adequate for older, frailer people with dementia, particularly in the event of an emergency. The two staff who mainly work in this home have some rostered time on duty together at the weekend. This helps to ensure adequate communication and provides an opportunity for staff to go out in small groups with residents. Southside House DS0000008091.V327409.R01.S.doc Version 5.2 Page 20 The job description for Support Workers covers their responsibilities regarding residents’ social and emotional wellbeing as well as their physical care and other tasks. The records relating to the newest staff member were checked and those seen were in good order. The home keeps a checklist of all documents requested and received. Criminal record checks are carried out on all staff before they start work in the home. New staff go through the home’s own induction training checklist but the home has recently asked a training organization to provide an induction training format. One of the two staff who mainly work in this home holds NVQ 3. She is hoping to do the NVQ Assessor award in the near future. Staff have recently had safeguarding adults refresher training, fire training, health and safety, first aid and challenging behaviour. Staff supervision has been patchy over the past couple of years: the system has been up and running more than once but then lapses again. Staff are not currently having formal supervision but the manager has recently advised them that this will be starting again soon. In practice, staff felt very well supported and regularly get to talk issues over with the manager. Southside House DS0000008091.V327409.R01.S.doc Version 5.2 Page 21 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): 37, 38, 39, 42, 43 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run and has an open culture in which a mutual respect has developed. EVIDENCE: Veronica Bishop is an experienced manager and holds the Registered Managers Award. She is registered as manager of both this home and Charlton House, which is round the corner. She spends most of the day in the sister home but visits Southside House each evening. The owner also visits regularly and spends time talking with residents and staff. Southside House DS0000008091.V327409.R01.S.doc Version 5.2 Page 22 Residents and staff described a very happy atmosphere with approachable management staff. Staff felt that they get a good combination of support and autonomy. Staff have a formal meeting every few months, and have regular opportunities to attend conferences or information-sharing events. Health and safety checks are done regularly. The maintenance book shows that any necessary repairs are carried out promptly. The member of staff in charge at the time of this inspection could not find the accident records. All staff need to know where this type of record is kept so that records can be completed promptly. Southside House DS0000008091.V327409.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 Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 2 3 2 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 2 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 x 3 3 3 X X 2 3 Southside House DS0000008091.V327409.R01.S.doc Version 5.2 Page 24 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 YA1 Regulation 4 Requirement Timescale for action 26/03/07 2. YA2 14 3. 4. YA6 YA19 15 12 Only those people whose needs fall within the range described in the homes Statement of Purpose must be admitted. New residents needs must be 26/03/07 assessed and compared against the homes stated aims before they move into the home. Residents care needs must be 26/04/07 fully documented and kept under review. Proper provision must be made 26/04/07 for residents health care needs. This refers to the lack of documentation and monitoring of residents routine health care checks. Adequate precautions must be 26/03/07 taken for containing fires. This refers to the practice of wedging open the downstairs fire doors. Specified records must be kept available for inspection. This refers to the need for staff in charge of the home to know where essential records are kept. 5. YA24 23 6. YA42 17 26/03/07 Southside House DS0000008091.V327409.R01.S.doc Version 5.2 Page 25 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. 2. Refer to Standard YA26 YA33 Good Practice Recommendations Residents should have the opportunity to have single bedrooms. Staffing levels should be reviewed in the light of the current residents dependence levels. Southside House DS0000008091.V327409.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Southside House DS0000008091.V327409.R01.S.doc Version 5.2 Page 27 - 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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