Inspection on 26/07/05 for St Andrews House, Exmouth

This inspection was carried out on 26th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

St Andrews House, Exmouth 19/11/08

St Andrews House, Exmouth 01/08/06

St Andrews House, Exmouth 25/01/06

St Andrews House, Exmouth 10/01/05

St Andrews House, Exmouth 22/09/04

St Andrews House, Exmouth 25/03/04

Similar services:

Clouds House

Trevaylor Manor

Closereach

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

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

CARE HOME ADULTS 18-65 St Andrews House St Andrews Road Exmouth Devon EX8 1AS Lead Inspector Michelle Oliver Announced 26 July 2005 09:30hrs 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. St Andrews House D54 D06_s22035_standrewsexmouth_v231448_260705 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service St Andrews House Address St Andrews Road Exmouth Devon EX8 1AS 01395 223737 01395 223536 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) Christian Alliance Housing Association Mrs Ruth Brinsden Care Home 6 Category(ies) of A Alcohol depend past/present (6) registration, with number D Drug dependence pst/present (6) of places MD Mental Disorder St Andrews House D54 D06_s22035_standrewsexmouth_v231448_260705 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 10 January 2005 Brief Description of the Service: St. Andrews is one of more than 20 projects managed by Christian alliance Housing throughout the United Kingdom and is registered to care for up to six younger adults who may be suffering from past or present mental illness, drug or alcohol dependency and find themselves in a position where they can no longer live where they are and need a period of assessment or space to be able to grow. This sometimes necessitates going on to residential care but some can manage areas where they are supported to be independent.The property is a converted former church in a central residential area of Exmouth.The residential home is situated on the ground floor of the building. All rooms are for single occupancy. There is a communal smoking room, lounge, kitchen and dining room. There is also a small laundry for resident’s use. There is car parking facilities on site.Also managed on the same site, but physically separated, are two sheltered housing units -One on the first floor of the main building and one in an adjacent bungalow. St Andrews House D54 D06_s22035_standrewsexmouth_v231448_260705 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over four hours. The manager was present during the inspection. The inspector looked around parts of the building, a number of records were inspected and three comment cards from residents and two from relatives were received. Three staff and three residents were spoken to at the time of the visit. One resident was out at a Breakfast Club with Assertive Outreach. The home has not had as many admissions or discharges as 4 residents are waiting for supported accommodation to become available. What the service does well: What has improved since the last inspection? What they could do better: No requirements or recommendations were made at the last inspection. The manager aims to make St Andrews even more like home by achieving a position whereby residents are able to undertake activities without needing to tell staff where they are going or what they are doing. St Andrews House D54 D06_s22035_standrewsexmouth_v231448_260705 stage 4.doc Version 1.40 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. St Andrews House D54 D06_s22035_standrewsexmouth_v231448_260705 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 St Andrews House D54 D06_s22035_standrewsexmouth_v231448_260705 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) 2 All of the current service users have been admitted through the care management process. All residents are admitted to St Andrews only after a comprehensive assessment of care needs have been undertaken. EVIDENCE: All current residents have been placed by Social Services, and copies of their assessments are included in their individual files. All residents are admitted to St Andrews only after a comprehensive assessment of care needs have been assessed. Care staff spoken with confirmed their knowledge of service user’s needs and felt that the assessments and subsequent care plans provided them with good information and guidelines that help them understand service users’ needs. St Andrews House D54 D06_s22035_standrewsexmouth_v231448_260705 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) 7 & 9. Residents are encouraged and supported to make choices, decisions and to undertake risks to enable them to live an independent lifestyle. EVIDENCE: Residents told the Inspector that they are encouraged to be independent and are supported by staff to make informed decisions about their lives. Decisions made by residents are recorded in their individual care plans. Two residents spoke of the support they gain from other residents and how well they get on together. Staff enable residents to take responsible risks. Risk assessments are in place for each resident that are cross-referenced with the care plans. There was evidence that relatives and care managers are involved in regular care plan reviews and are kept up to date with any changes of need or care to the service users. The individual care plans include behavioural management guidelines for service users who are likely to become aggressive or self-harm. These have been compiled with consultation and advice from other professionals, such as psychologists and nurse specialists. St Andrews House D54 D06_s22035_standrewsexmouth_v231448_260705 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) 12, 13, & 15. Links with the community are good and support resident’s social and educational opportunities. EVIDENCE: Residents confirmed that they are encouraged and supported to take part in activities. Currently residents attend Quiet Mind Centre, Exmouth Adult Community College, Age Concern and Bell Industries. A computer is available at the home for residents use. The manager and service users confirmed that they have good relations with the local community. A notice board in the entrance hall displays local events. Residents spoke about using local facilities and local transport. Residents maintain contact with friends and family, and visitors are always made welcome, except where restrictions have been agreed. This would be recorded in a care plan. Two service users spoke about visiting family. St Andrews House D54 D06_s22035_standrewsexmouth_v231448_260705 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 The health needs of service users are well met with evidence of good multidisciplinary working taking place on a regular basis. EVIDENCE: The manager and three residents confirmed that there is complete flexibility in relation to daily routines at the home. Current residents do not require help with personal care. Records show that resident’s health is closely monitored. A resident told the Inspector that they have help from staff with medical appointments if they want or need it; otherwise they arrange their own appointments. Healthcare visits take place at the GP surgery. This was also confirmed during discussion with a resident and staff. The home has close links with Community Psychiatric Nurses and GP’s. St Andrews House D54 D06_s22035_standrewsexmouth_v231448_260705 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 home has a good complaints system. The home has good systems in place to protect service users from abuse, neglect and self-harm. EVIDENCE: The manager told the inspector that complaints or concern are taken seriously and acted upon. The home keeps excellent detailed records of complaints and concerns raised by residents. The records include details of the issue, the investigation process and a detailed record of the outcomes. The complaints policy had good information on each stage of the complaints procedure. Residents are given a handbook on admission, and the complaints procedure is included in this. Recently, a Christian alliance Support worker gave the residents a talk A resident told the Inspector that they felt secure in the knowledge that if they had a complaint it would not be ignored. They were aware of how to complain and were happy with how concerns are dealt with. There is no evidence to suggest that residents are any other than safe and properly protected from undue risk. There are records in the training files of training in the prevention of abuse. Residents are also included in watching a video during this training. The home has adult protection procedures that include the Department of Health Guidance “No Secrets”. POVA checks are currently being undertaken at the home’s central office. Staff recruitment files confirmed this. St Andrews House D54 D06_s22035_standrewsexmouth_v231448_260705 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 & 30. Residents live in a comfortable, clean well maintained home. EVIDENCE: St. Andrews is well located, close to shops, beach, and local facilities. It consists of two separate units having a sheltered housing unit on the first floor. Residents accommodated in the registered unit downstairs can visit the unit upstairs for leisure activities such as pool or art if they wish. However, the occupants of the upstairs unit may only visit the ground floor if they are invited. All areas were bright clean and well and tastefully decorated. The decor, furnishings and fittings create a warm, friendly and homely atmosphere. The home has a good budget for cyclical maintenance and decoration. A record is kept confirming that all routine maintenance has been carried out as required. Level access is provided throughout the ground floor. There is a CCTV outside the main door only. St. Andrews does not employ a cleaner; all residents, assisted by staff as necessary are responsible for cleaning the home. All areas of the home were St Andrews House D54 D06_s22035_standrewsexmouth_v231448_260705 stage 4.doc Version 1.40 Page 14 bright, clean and free from odour at the time of the visit, which is commendable. There is a small laundry, which has impermeable flooring and washable walls and is fitted with a domestic washing machine and domestic tumble drier. The home does not require a sluice. The home has a detailed infection control policy. St Andrews House D54 D06_s22035_standrewsexmouth_v231448_260705 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) 34, 35 & 36 Service users are supported by an effective, competent and experienced staff team with recruitment practices that protect service users. EVIDENCE: The home’s recruitment procedure and practices ensures that the necessary checks are carried out for the protection of residents. The home provides a minimum of three staff per day shift, two each evening and one staff sleeping in at night. The home has a stable team that uses minimum agency and bank workers. A resident confirmed that there is always enough staff on duty to meet their needs. The staff compliment covers the St Andrew project therefore the hours available to the care unit are flexible. Residents are encouraged to develop activities away from the unit. Regular staff meetings are held at St Andrews. Staff confirmed that there is a good induction programme provided by Christian Alliance. The manager told the inspector that she has been told the induction programme meets the Sector Skills Council specifications. St Andrews House D54 D06_s22035_standrewsexmouth_v231448_260705 stage 4.doc Version 1.40 Page 16 The home has a dedicated training budget that provides staff with at least 5 paid days training per year. Staff spoken with confirmed that there are excellent training opportunities. This was also evident in staff files. The inspector was told that staff training needs are assessed as a whole, through regular staff and management meetings, and individually, through supervision. St Andrews House D54 D06_s22035_standrewsexmouth_v231448_260705 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 The home is managed effectively, efficiently safely and for the benefit of residents. The home regularly reviews aspects of its performance through a good programme of review that includes seeking the views of relatives. EVIDENCE: The registered manager has many years of experience working as a manager in the care setting and has achieved NVQ level 4 in management and care and the Registered Managers Award. She attends all training sessions as staff undertake. The manager ensures that the home’s budget is properly managed, that the staff reads Policies and Procedures compiled by Christian Alliance and that each resident has a written contract in place. The home has quality assurance systems in place that are based on a systematic cycle of planning, reviewing and setting targets. The pre-inspection questionnaire provided evidence that St Andrews complies with health and safety legislation in relation to maintenance of equipment, storage of hazardous St Andrews House D54 D06_s22035_standrewsexmouth_v231448_260705 stage 4.doc Version 1.40 Page 18 substances, health and safety checks and risk assessments. The fire logbook, record of fire safety training and the accident and incident records were found to be accurate and up to date. Christian Alliance has a written statement of the policy, organisation and arrangements for maintaining safe working practices. St Andrews House D54 D06_s22035_standrewsexmouth_v231448_260705 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 x 3 x x x Standard No 22 23 ENVIRONMENT Score 4 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x x Standard No 31 32 33 34 35 36 Score x x x 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 St Andrews House Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x 3 x Version 1.40 Page 20 D54 D06_s22035_standrewsexmouth_v231448_260705 stage 4.doc 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 St Andrews House D54 D06_s22035_standrewsexmouth_v231448_260705 stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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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