Inspection on 03/08/05 for St Marks

This inspection was carried out on 3rd 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

St Marks 20/11/07

St Marks 17/01/07

St Marks 09/02/06

St Marks 24/11/04

St Marks 17/06/04

St Marks 26/02/04

Similar services:

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Southfields

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

CARE HOME ADULTS 18-65 St Marks 23 Collier Road Hastings East Sussex TN34 3JR Lead Inspector Caroline Johnson Announced 3 August 2005 09:30 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. St Marks H59-H10 s21225 St Marks v230451 030805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service St Marks Address 23 Collier Road Hastings East Sussex TN34 3JR 01424 200854 01424 200854 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) Mr Dominic Kennard Miss Fiona Macartney Care Home 6 Category(ies) of Learning Disability (LD) registration, with number of places St Marks H59-H10 s21225 St Marks v230451 030805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of residents to be accommodated is six (6) 2. Residents will be over the age of eighteen (18) on admission and below the age of sixty-five (65) 3. Residents will, on admission, be diagnosed as suffering from autism. Date of last inspection 24 November 2004 Brief Description of the Service: St Marks provides long term care for people over the age of eighteen who have been diagnosed as having an autistic spectrum disorder. This can include people with Asperger’s syndrome. Each residents needs in respect of education and leisure time are assessed and a programme of activities arranged.The property is situated in a residential area on the West Hill of Hastings and is within walking distance of Hastings. St Marks is a three-storey building. There is no lift so residents need to be able to use the stairs.St Marks is one of three homes owned by the proprietors Mr and Mrs Kennard. St Marks H59-H10 s21225 St Marks v230451 030805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, the first in the year running from April 1 2005 to March 31 2006. The inspection lasted from 9.30am until 3.00pm. During the inspection there was an opportunity to spend time with one of the residents in the lounge and to share lunch with another resident in the garden. Two members of staff were interviewed individually and there was also an opportunity to meet with another member of staff during the course of the inspection. A number of records were examined, along with the pre-admission documentation for a newly admitted resident and plans for the care to be provided for two residents. The majority of the building was seen on this inspection. The manager was on duty and she facilitated the inspection. What the service does well: What has improved since the last inspection? What they could do better: Two of the residents’ health care needs are currently unsettled. The home has been dealing appropriately with this and specialist advice and support has been sought. St Marks H59-H10 s21225 St Marks v230451 030805 Stage 4.doc Version 1.40 Page 6 The home needs to consider what arrangements could be put in place to assist staff should they require assistance in an emergency. The majority of the staff team has changed since the last inspection of the home. As stated above arrangements are being made for staff to receive training. However, at the time of inspection there was only one member of staff studying for NVQ level 3. Arrangements need to be made to enrol staff on an appropriate course so that the home can achieve 50 of the staff team being training to NVQ level two. The fan in the bathroom on the top floor was not working on the day of inspection and this needs to be repaired as soon as possible. As a result of comment cards received from two of the relatives of residents, the home needs to remind relatives of the home’s complaint procedure and advise about the accessibility of inspection reports. 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 Marks H59-H10 s21225 St Marks v230451 030805 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 Marks H59-H10 s21225 St Marks v230451 030805 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) 1,2,4,5 The home has a very good admission procedure. A thorough transition plan was put in place for a new resident and this assisted him in settling into the home very quickly. EVIDENCE: At the last inspection a good practice recommendation was made to redesign the service user guide to make it more applicable to the needs of the residents accommodated. One of the residents has expressed an interest in designing a web site highlighting the main aspects of the home. The manager advised that it is hoped that this recommendation can be achieved in the coming months. There has been one new admission to the home since the last inspection. The home completed an assessment of the prospective resident’s abilities and needs prior to admission and in addition the residents’ parents also completed an assessment form. Staff from the home spent a day at the resident’s school and residential unit and the resident and a few of his friends also visited the home. In addition the resident’s parents visited the home once on their own and once with their son. A detailed care plan was put in place prior to admission and there have been monthly reviews since the resident was admitted to the home. A copy of the home’s terms and conditions of residence has been given to the resident’s parents. St Marks H59-H10 s21225 St Marks v230451 030805 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 Care plans provide detailed information and this ensures that staff are clear about the extent of each residents abilities and needs and about the level of assistance they require. The home needs to consider what arrangements could be put in place to assist staff should they require assistance in an emergency. EVIDENCE: Two care plans were seen on this occasion. Both included detailed advice for staff to follow in order to meet the needs of the residents accommodated. Where risks are perceived, detailed risk assessments are carried out to minimise the risk of accidents and incidents occurring. In recent weeks two of the residents have shown signs of unsettled behaviour. Risk assessments for both men have been kept under continual review due to the changes in their health needs. It was recommended that the home carry out a risk assessment in relation to staff being able to call for assistance quickly in an emergency situation. At the last inspection of the home a good practice recommendation was made that the home should document the feedback given by residents as part of their involvement in staff recruitment. The manager advised that the home would be including resident feedback on their interview questionnaire. St Marks H59-H10 s21225 St Marks v230451 030805 Stage 4.doc Version 1.40 Page 10 Residents spoken with stated that they are very happy in their home and they enjoy all their activities. House meetings are held weekly and during these meetings residents discuss how they will spend their weekends. St Marks H59-H10 s21225 St Marks v230451 030805 Stage 4.doc Version 1.40 Page 11 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) 12,13,14,15, Each of the residents has a varied and interesting timetable of activities that they enjoy. Although there is structure built into the timetable, the timetable can and does change to fit in with the needs and wishes of the residents. EVIDENCE: Each resident has a programme of the activities that they are to participate in. Three residents attend a day centre one day a week. College courses have been booked for September. Activities through the week include bowling, swimming, badminton and gym. In addition the men all enjoy weekly trips to the cinema and pub. Two weekly aromatherapy sessions are arranged inhouse. There is also a two weekly social skills group where two of the men join with the residents from another home within the group to discuss various topics. Although there is a lot of structure within each resident’s week, where possible flexibility is also encouraged. An example of this was that on the day of inspection two residents chose to spend the afternoon in Battle. When staff advised a resident about a particular event that was occurring in a couple of weeks that he had been looking forward to, the resident showed keen interest but soon realised that his mum was meant to visit that weekend. St Marks H59-H10 s21225 St Marks v230451 030805 Stage 4.doc Version 1.40 Page 12 However, he then asked if his mum would also be able to join the activity. He was delighted that he was going to be able to participate in his activity but still see his mum at the same time. Records showed that residents have regular contact with their relatives and that the home works hard to maintain good relationships. At the time of inspection the home was planning their annual barbeque. Residents from each of the three homes in the area and their relatives are all invited to the barbeque, which is held annually at St Marks. St Marks H59-H10 s21225 St Marks v230451 030805 Stage 4.doc Version 1.40 Page 13 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) 19,20 EVIDENCE: Records seen in respect of medication administered to residents were in order. The home’s pharmacist visits the home periodically and provides training to staff on the medication in use in the home. In addition the home has an inhouse training exam, which all new staff need to complete prior to being assessed as competent to administer medication. Where appropriate the home obtains specialist advice and support to meet the individual needs of the residents accommodated. St Marks H59-H10 s21225 St Marks v230451 030805 Stage 4.doc Version 1.40 Page 14 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) The home deals with complaints made to them appropriately. EVIDENCE: Records showed that there had been one complaint since the last inspection of the home. The complaint had been handled appropriately and the proprietor had also checked with the complainant that they were satisfied with the outcome. All staff receive training on adult protection and prevention of abuse. The manager advised that she is due to attend a course on POVA in the coming weeks. St Marks H59-H10 s21225 St Marks v230451 030805 Stage 4.doc Version 1.40 Page 15 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) 24,25,26,27,28,30 The home is generally well maintained and the furniture provided is comfortable and homely. The fan in the bathroom on the top floor needs to be repaired. EVIDENCE: Since the last inspection of the home the external building has been repainted. In addition one of the bedrooms has been redecorated. The majority of residents enjoy cycling and have their own bikes. Recently a second staff bike was purchased so that residents can be supported when cycling. Nearly all areas of the home were seen on this occasion. The home is well decorated and has been personalised by the men. Hot water temperatures tested on the day of inspection were within agreed safety limits. The fan in the bathroom on the top floor was not working and it was noted that there was an odour in this room. St Marks H59-H10 s21225 St Marks v230451 030805 Stage 4.doc Version 1.40 Page 16 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) 32,33,34,35,36 Although there has been a big change in the staff team, the new staff team works well together and morale in the home on the day of inspection was very good. The owners and manager of the home are working hard to ensure that all staff receive appropriate training to carry out their duties effectively and to have a good understanding of autism. EVIDENCE: There has been a large turnover in the staff team since the last inspection. This was as a result of two staff relocating to other areas. In addition one member of staff moved on to manage another service and another member of staff wanted a career change. Four new staff have been employed and they are each working their way through their induction/foundation training. Due to the current needs of two of the residents staffing levels have been increased at key times. The home is aware that they need to enrol staff on NVQ training once they have completed their foundation training. One staff member is at least half way through the course but further arrangements need to be made so that the course can be completed. Recruitment records were seen in respect of two staff members. Recruitment procedures had been thorough and all necessary checks had been obtained. Records also showed that staff receive regular formal supervision sessions. St Marks H59-H10 s21225 St Marks v230451 030805 Stage 4.doc Version 1.40 Page 17 Two staff were interviewed in private and another staff member was spoken with generally. Each staff member stated that they were `well supported’. In addition to their regular supervision they stated that they could go to the manager at any time if they had a problem. Staff meetings are held every two to three weeks and all staff are encouraged to participate in the meeting. All of the staff team have received training in fire safety and food hygiene, and first aid training has been planned for August. The owner, with support from each of the managers in the three care homes, is working on developing a training programme for all new staff which will involve staff receiving training on a wide range of subjects relating to working with people with autistic spectrum disorders. These training courses will be held over the coming months. St Marks H59-H10 s21225 St Marks v230451 030805 Stage 4.doc Version 1.40 Page 18 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) 37,38,39, The manager is well-qualified and competent to carry out her duties and as a result the home is well run. Overall comment cards received from residents, their relatives and a visiting professional were very positive. The manager needs to remind relatives of the complaint procedure and how to access inspection reports. EVIDENCE: The registered manager has completed NVQ level four in management. In addition she has completed the NVQ Assessor’s award. She has managed the home for a number of years and has attended numerous training courses to update her knowledge and skills. She has recently completed a two-day management training course. She is currently studying for a Bachelors of Philosophy degree in autism. As stated previously staff advised that they are `well supported’. They also stated that the home is `run well ‘and feel that their `individual contributions and skills are acknowledged’. As part of the inspection process, comment cards were sent to the home for distribution to residents and their representatives. St Marks H59-H10 s21225 St Marks v230451 030805 Stage 4.doc Version 1.40 Page 19 Responses were either sent to the Commission or to the home. Four comment cards were completed by residents. All were positive in their comments. However, one resident ticked sometimes for the questions relating to being more involved in decision making and the provision of suitable activities. A visiting professional had completed one comment card. This was wholly positive and stated that the resident whom they visit `has received very good support to enable him to become more independent’. Four comment cards were completed by relatives of residents. Comments were generally very positive. However two relatives stated that they were not aware of the home’s complaint procedure and one relative stated that they did not think that there were always sufficient staff on duty. They also stated that they did not have access to inspection reports. As required at the last inspection of the home monthly regulation 26 reports are now being sent to the Commission. St Marks H59-H10 s21225 St Marks v230451 030805 Stage 4.doc Version 1.40 Page 20 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 2 3 x 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 2 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 x x Standard No 31 32 33 34 35 36 Score x 2 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 St Marks Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 2 x x x x H59-H10 s21225 St Marks v230451 030805 Stage 4.doc Version 1.40 Page 21 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 9 Regulation 13(4) Requirement A risk assessment must be carried out in relation to safety implications in respect of staff calling for help in an emergency sitaution. The fan in the bathroom on the top floor must be repaired. Timescale for action 30 September 2005 2. 3. 24 32 23(2)(b) 18(1)(a) 15 September 2005 Arrangements must be made to 30 enrol at least 50 of the staff September team on an NVQ level two course 2005 or its equivilant. 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 1 Good Practice Recommendations The service user guide should be redesigned to make it more applicable to the needs of the residents accommodated. Residents should be involved in the process. (This was a recommendation of the previous inspection). The home should document the feedback given by residents as part of their involvement in staff recruitment.(This was a recommendation of the previous inspection). H59-H10 s21225 St Marks v230451 030805 Stage 4.doc Version 1.40 Page 22 2. 8 St Marks 3. 39 The home should remind relatives of residents of the homes complaint procedure and provide information about how to gain access to inspection reports. St Marks H59-H10 s21225 St Marks v230451 030805 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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. Extracts may not be used or reproduced without the express permission of CSCI St Marks H59-H10 s21225 St Marks v230451 030805 Stage 4.doc Version 1.40 Page 24 - 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. 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