Inspection on 15/09/08 for Sussex House

This inspection was carried out on 15th September 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Sussex House 14/09/09

Sussex House 03/07/07

Sussex House 04/07/06

Sussex House 08/02/06

Similar services:

Whiteley House

Tyndale Avenue

2-10 Norfolk Road

Bennfield House Nursing Home

Eastfield Residential Home

Sign Health

Springwood

Fairburn Mews

Extracts from inspection reports are licensed from CQC, this page was updated on 05/12/2008.

CARE HOME ADULTS 18-65 Sussex House 36 Princes Road Cleethorpes North East Lincs DN35 8AW Lead Inspector 15/09/08 Key Unannounced Inspection 15th September 2008 9:00 Sussex House DS0000064150.V372105.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 Sussex House DS0000064150.V372105.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. Sussex House DS0000064150.V372105.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sussex House Address 36 Princes Road Cleethorpes North East Lincs DN35 8AW 01472 694574 F/P 01472 694574 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) Amina Teja Mr Altaf Hirji, Mrs Nimet Hirji Mrs Anne Hanslip Care Home 24 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (12), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (24) Sussex House DS0000064150.V372105.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Staff receive the appropriate training to meet the needs of service users that have mental health problems that are under 65 and also traning to meet the mental health needs of over 65s 3rd July 2007 Date of last inspection Brief Description of the Service: Sussex House is a 24-bedded care home providing for the needs of people with mental health problems. The home does not offer nursing care. Individuals health needs are met with the assistance of other health care professionals for example general practitioners, community psychiatric nurses and district nurses. The home will take permanent residents and those needing short- term and respite care. The building is old and has been extended on several occasions. There is no scope for further development. The accommodation is provided over two floors. There is a passenger lift to the first floor. Sussex House is close to the centre of Cleethorpes and is within five minutes walk of the train station and the beach. Local amenities include shops, public houses, GP surgeries and parks. Regular public transport is easily accessible from the home and is also available to the adjoining town of Grimsby. Information about the home and its services can be found in the statement of purpose and service user guide, both these documents are available from the manager of the home. Information given by the manager at the visit on the 15th September 2008 indicates the home charges £361 per week. The home does not currently charge third party top-up fees. People that live at the home are expected to pay for hairdressing, private chiropody treatments, toiletries and newspapers/magazines for themselves. More up to date information on fees and charges can be obtained from the manager of the home. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations – but only Sussex House DS0000064150.V372105.R01.S.doc Version 5.2 Page 5 when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The quality rating for this service is 1* star. This means the people who use this service experience adequate quality outcomes. Sussex House DS0000064150.V372105.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The site visit took place over 1 day on the 15th September 2008. The Commissions visit to the service was unannounced and we were in the home for approximately seven hours. At the time of the visit there were twenty-one people living at the home. The site visit and other information gathered since the last inspection have contributed towards this report. This includes the homes Annual quality Assurance assessment, and the Commissions inspection record. During the visit to the home we also spoke with eleven people that use the service, the manager of the home, three care workers, the cook and one visiting relative to help to find out how the home was run and if the people who lived there were satisfied with the care that they received at Sussex House. We also case tracked three people that live at the home. This included looking at all of the written information in the home that was about them and their care. The Commission also looked around the home and the grounds to see what the environment was like for the people that live there. What the service does well: The health care needs of the people living in the home are well met and staff are provided with the right training to make sure that they understand the needs of the service users and makes sure that they can do their jobs well. The staff and the people that live at the home appear to have very good relationships with each other and the atmosphere between them is relaxed and friendly. This helps the people that live at Sussex House to feel very settled and this means that they can rely on the staff for any support that they may need. Individuals are provided with meals that they choose and like, however they are encouraged to follow a healthy diet including lots of fresh fruit and vegetables to try and maintain their health. The home was clean, tidy and comfortable and there were no unpleasant smells around the home. The people that live in the home say that they are ‘well looked after’ and they are happy to be living there. Sussex House DS0000064150.V372105.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Sussex House DS0000064150.V372105.R01.S.doc Version 5.2 Page 8 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 Sussex House DS0000064150.V372105.R01.S.doc Version 5.2 Page 9 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): 2,3 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This means that the service can meet the needs of the people living at the home, however there was not sufficient evidence to support that the service had assessed their needs before they had been admitted to the home. EVIDENCE: As part of the site visit the Commission case tracked three of the people that live at the home. This included talking to them and looking at all of the information that related to them in the home. At the time of the site visit there were twenty-one people living at the home. Two of the people had been living at the home for some time and one had recently been admitted for respite care. All of their care files included a copy of their care management assessment of need, and two of the people had been assessed by the home before they had been admitted to make sure that the home was able to support them and their needs. The other file that was observed was for a person that had been admitted for respite care. This person had previously been in the home for another period of respite care. There was no evidence to support that prior to their latest admission to the home that their needs had been fully re-assessed Sussex House DS0000064150.V372105.R01.S.doc Version 5.2 Page 10 to make sure that the home was still able to support them in a safe and appropriate manner. The home pre-admission assessments are completed by the manager of the home and care manager. The pre-admission assessments seen by the Commission only included very basic information and did not necessarily identify how individual needs affected their daily lives and the level of support that they would require to improve their quality of life. Since the last inspection the manager stated that the care manager has received training to provide her with the necessary skills to be able to safely and accurately asses the needs of individuals that are wanting to use the service. The people that live at the home that were spoken to by us stated that they were very happy with the care that was provided for them at Sussex House. One person said ‘I’ve been in a few other places, but this is the best’. The care manager is responsible for maintaining the training regime for the staff group. The training records, interviews with staff and observation of their interactions with the people that use the service all supported the evidence that they have the necessary skills and knowledge to be able to safely care for the people that are their responsibility. People that live at the home can have a choice of staff gender when deciding whom they would like to deliver their care, however this can be limited as the home only employs one male care worker. The manager stated that in the future representatives from the people that use the service will support the home in the interview process for new staff. Information included in the homes Annual Quality Assurance Assessment Questionnaire indicated that all the people living in the home are white/British. Interviews with the manager and the care staff identified that they were aware of where to get the correct information and support from if anyone was admitted to the home had a different religion or culture. The Commission spoke to several people that live at the home and they all supported that they were able to visit the home before they made a decision to move there on a more permanent basis. One person said ‘I came to look around when I was looking for somewhere to live and it was great’. Sussex House DS0000064150.V372105.R01.S.doc Version 5.2 Page 11 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 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This means that the care plans for the people that use the service are improving and are now much more person centred. EVIDENCE: The Commission looked case tracked three of the people that live at the home. This means that we looked at all of the information that was in the home that had been recorded in relation to their care, we spoke with the individuals involved and observed their interactions with the care staff. Since the last inspection new documentation to record peoples care needs (care plans) had been introduced. This included more person centred care plans detailing people’s individual needs and the support that they would need to improve their individual quality of life. The care plans had generally been evaluated on a regular basis to make sure that they were still appropriate and relevant to the people that they involved. Sussex House DS0000064150.V372105.R01.S.doc Version 5.2 Page 12 Where appropriate care plans had been supported with risk assessments. This included areas including budgeting and accessing the community. All the people spoken to by the Commission that they were aware of their care plans and risk assessments. One person said ‘I have been in a few different homes, but this is the best one for me’. Direct observations also helped to support the evidence that the people that use the service are encouraged to make decisions for themselves through the course of their daily lives. Sussex House DS0000064150.V372105.R01.S.doc Version 5.2 Page 13 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): 12,13,15,16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This means that the people that use the service are encouraged to maintain and develop their relationships with their families and friends that are in the community. EVIDENCE: Interviews with the care staff and management showed that they had a good and clear knowledge of individual resident’s needs, likes/ dislikes, family support, and religious beliefs and observances. Most people spoken to by the Commission were very positive in relation to how they lead their lives and the support that they receive through the services provided at Sussex House. This included how they wanted to spend their day, what clothes to wear and which visitors to receive. A visitor on the day of the site visit said that were made to feel very welcome when visiting the home. They also stated that their relative Sussex House DS0000064150.V372105.R01.S.doc Version 5.2 Page 14 ‘has never been so clean and tidy, they couldn’t look after themselves at home, but in here they have been well cared for and you see the difference’. The home employs a part time an activity co-ordinator and this person is responsible for arranging the activity/ entertainment programme. Unfortunately on the day of the Commissions site visit they were not at work to explain the current state of the planned activities for the people that use the service. Care staff and people that use the service said that the activity programme includes bingo, quizzes, games, nail care and occasional outside entertainers. An outside singer was advertised in the home. We spoke with nine of the people that use the service and none of these had any concerns at the amount or range of activities that are provided. However several did say that they weren’t bothered about getting involved in activities, they just wanted to be left to their own interests. One person said ‘I don’t like activities I’d rather watch television or go out for a walk’. The manager confirmed some of these feelings when she stated that even with a great deal of encouragement and support many of the people that use the service lack the motivation to get involved in most things. However it is important to continue to at least make stimulating activities available. The home provides three meals a day and a light supper. A choice of food is not available at dinner, although the cook and staff said if someone did not like what was on the menu an alternative would be provided. The home keeps very little stocks of food except for frozen products as the cook buys most of the food fresh on a daily basis, this included fruit and vegetables. People that were spoken to by the Commission all said that they enjoyed their meals at the home. One person said ‘the food is good enough for me, I enjoy it, and another said ‘ the food is great’. People were observed during the lunch time meal and care staff were observed offering appropriate support to those that needed it to complete their meals. The lunch period was unrushed and there was a good and friendly atmosphere in the room. Since the last inspection new crockery has been supplied to the home. This has improved meal times as everyone one now has the same matching cups, plates and dishes At the last inspection it was observed that ‘residents had to ask for salt and pepper on their meals’. This matter was discussed with the manager, who stated said salt and pepper pots were not provided due to health reasons’. At this inspection salt and pepper was freely available on each table. There were no specialised diets required at the home at the time of the site visit. There were no diets required to meet any cultural of religious needs. The cook was aware of how to gain any information if she required it in relation to religious and cultural diets. Sussex House DS0000064150.V372105.R01.S.doc Version 5.2 Page 15 People were happy that the home helped them to remain as independent as possible and that they had freedom to go anywhere they wanted in line with their care plans and risk assessments. Since the last inspection most of the individual bedrooms had been fitted with new furniture and this involved somewhere that they could lock their valuables for safekeeping. Some people do not like going out of the home at all and so that they do not have to rely on other people to brings things for them the home have installed a chocolate and crisps dispenser in on the homes corridors. The manager stated that it had been moved to its present location following recommendations from the fire service. The home has a central garden area that is used by the people who want to smoke. Sussex House DS0000064150.V372105.R01.S.doc Version 5.2 Page 16 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 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This means that the people that use the service have all of the personal and healthcare needs met through the services provided at the home or though their healthcare and social care partners in the community EVIDENCE: We looked at the care files for three of the people that use the service. All of their care files clearly identified when they had any contact with healthcare professionals that are based in the community. This included General Practitioners, Psychiatrists, Chiropodists, Dentists, District nurses and Psychiatric Nurses. Where necessary people that use the service can be accompanied to attend outpatient’s appointments. Although some people prefer to attend by themselves. One person said ‘I go to the doctors on my own, but when I go to the hospital someone goes with me’. Sussex House DS0000064150.V372105.R01.S.doc Version 5.2 Page 17 There were no visiting healthcare professionals to the home on the day of the site visit, however individuals spoken to by the commission said that when they were seen at the home by a visiting healthcare professional they are always seen in private unless they asked for a member of staff to support them. The home uses a Monitored Dosage System for administering prescribed medication. The manager and care staff confirmed that only staff that had completed medication training administer medication to the people that use the service. The homes training records also supported this evidence. All of the recording on the Medication Administration Record sheets appeared to be up to date and had been accurately recorded. Any handwritten prescriptions had been double signed. To confirm that the information supplied was correct. When people had refused their medication this had been accurately and clearly recorded. There was list of the names of staff that are authorised to administer medication, and specimen signatures had been provided so that if required the person that administered the mediation could be identified at a later date. There were no controlled drugs in use at the home at the time of the site visit. Medication is being in a medication trolley in the dining area of the home. Staff are now monitoring the temperature of medication stored in this area. Others areas of medication management in relation to receipt, storage and stock control were appropriate and up to date. People spoken to by us, and direct observations at medication times supported that the medication was administered in a manner that respected individual’s privacy and dignity. One person said ‘I used to get mixed up when I had my own medication, so it’s better for me now’. Sussex House DS0000064150.V372105.R01.S.doc Version 5.2 Page 18 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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This means that people that use the service can be sure that any concerns that they have will be listened to and thy will be protected from any possible abusive situations. EVIDENCE: The Commission had not received any complaints about the home since the last inspection of the service. The home has an appropriate and satisfactory complaints policy and procedure and individuals spoken to by us said that they knew how to make a complaint about the service if they had one and also said that they were confident that their views would be listened to and be acted on. One person said ‘I haven’t ever made a complaint but I know who to speak to if I have something to complain about. The homes records and the Commissions records showed that the home had no safeguarding adults referrals made about its services since the last inspection. However the home had policies and procedures to cover adult protection and the prevention of abuse and whistle blowing processes. The staff training records showed that the staff received safeguarding adults training including training provided through the local authority. Staff spoken to by the Commission were all aware of safeguarding issues and how to report any allegations or suspicions of abuse. Sussex House DS0000064150.V372105.R01.S.doc Version 5.2 Page 19 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): 24,25,27,29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. This means that the people that use the service are provided with a fairly comfortable environment, however there are areas of the home that need attention to support the health and safety of the people that use the home and to create a homely environment. EVIDENCE: As part of the site visit the Commission made a tour of the premises and the grounds. The home was free from any offensive odours. Two handy men are employed on a part-time basis to support the home with its general repairs and refurbishment Since the last inspection as already stated in this report most of the bedrooms had new furniture including wardrobes, drawers and bedside cabinets fitted. The fire doors in the smoking room and the lounge area had been replaced with new doors, the front door had also been replaced and a programme for Sussex House DS0000064150.V372105.R01.S.doc Version 5.2 Page 20 the replacement of many of the homes windows had been started. This will help to improve appearance to the exterior of the building, which currently needs a great deal of attention. It will also help to provide a more homely appearance and environment. The front and side wall of the home have also recently been replaced with a new brick wall. The manager stated that it her intention to then have this garden area made more accessible for the people that use the service. This will allow them to be able to access an outside area of the home that is free from smoking. In the communal and corridor areas of the home the décor was showing signs of wear and tear. It is important that these areas are improved to provide a homely and comfortable environment for the people that use the service. Whilst these matters do not pose a health and safety risk they do not ensure residents live in an attractive home. Three people invited the Commission to look around their individual rooms. All of the bedrooms that were seen were clean and tidy and had been furnished with a range of personal items, to reflect their own individual choice, taste and preferences. The homes fire risk assessment had recently been updated. And the recommendations from the assessment had been carried out. This included the renewal of a fire door and the strips in the door edgings (fire and smoke retardation) were replaced. All doors in the home were seen to be able to close properly. The manager of the home stated that the bath hoist was now working, care staff also supported this and direct observation by the Commission showed that the bath hoist was now working correctly and was being maintained and serviced. The service only has one mobile hoist to help to move and handling individuals with mobility problems. The care staff confirmed that this had not been available for several months. It is important that this piece of equipment is either repaired or replaced as soon as possible to make sure that if people need support with their mobility then this can be made available to them. The manager stated that there was only one person that should use a hoist for their needs, but they refused to use a hoist as it ‘scares them’. This was not supported through the persons care plans. The home has a very small shower room that has a large step to access it and therefore it is never used by the people that live at the home. It is also so small that a member of care staff could not go in to the room to offer support to individuals that are showering. The manager stated that because of this one of the homes bathrooms is going to be changed in to a wet room to provide individuals with the choice of either a shower or a bath. If this shower room is removed the home still has three bathrooms and the Commission’s registration Sussex House DS0000064150.V372105.R01.S.doc Version 5.2 Page 21 team confirmed that no application would be required to change the use of this room, however if any changes occur the Commission must be notified. The old shower room would then be converted to a room where staff can safely keep their coats and personal possessions. Currently the staff do not have anywhere to leave their possessions when they are at work. The home is built on two floors with flat walkways inside and out, providing safe and secure footing for people with limited mobility. Access to the upper floor is by use of a passenger lift and staircase. Entrances to the small sitting room and downstairs bedroom corridor are rather tight for people using larger wheelchairs. People spoken to by the Commission aid that the home was always clean and tidy. The manager of the home said that a domestic worker was employed by the home to help to maintain the environment. And the care staff supported that the majority of the domestic tasks in the home are completed by this worker and the night staff. Overall it was noted that the general environment of the home has improved, however there is much more required to create a homely environment for the people that use the service. Sussex House DS0000064150.V372105.R01.S.doc Version 5.2 Page 22 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): 31,32,34,35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This means that the staff have the necessary skills and knowledge to care for the people that use the service, however they are not all provided with the recommended supervision to make sure that they understand their roles and responsibilities and all of the appropriate safety checks are not always completed before people are employed to work at the home. EVIDENCE: All of the staff that were spoken to by the Commission were aware of their own roles and responsibilities and those of their colleagues. We looked at the staff personnel and training files for three of the care staff that work at the home. These all included their job descriptions and work specifications. The manager of the home confirmed that the Residential Forum Guidance is used to calculate the weekly staffing hours for the service. At the time of the site visit there were twenty-one people living at Sussex House and the staffing hours that were being provided were appropriate to the needs of the people involved with the service. One person said to the Commission ‘the staff are Sussex House DS0000064150.V372105.R01.S.doc Version 5.2 Page 23 great’ and ‘there’s always help you when you need it, some times you have to wait if they are with someone else, but you don’t have to wait long’. Another person said ‘the staff are friendly and always help me when they need to’, a visitor to the service said ‘ the staff are very good, they are friendly and they have made a big improvement to....quality of life’. The manager stated that there are three care staff on duty between 8am and 5pm, and that this is reduced to two care staff between 5pm and 8pm. Two staff are on duty at night. This would indicate that the home provides 299 hours. The staffing at the home is fairly consistent with very few people leaving the service and new people starting with. Care staff that were spoken to by the Commission said staffing levels in the home were generally satisfactory and that they had time to carry out their roles and responsibilities. The home remains committed to providing National Vocational Qualification training for staff. The homes Annual Quality Assurance Assessment identified tat 67 of the home care staff have achieved a minimum of National Vocational Qualification 2 in care. Staff also identified that the company pays them to attend all of their training and their uniforms are also supplied for them. The Annual Quality Assurance Assessment showed that the home spends 40 of its income on the staff wages. The Commission observed the employment records for three of the care staff. Two of these were in order, however the third file for a new member of staff showed that they had been employed to work at the home without a full Criminal Records Bureau checks (CRB). However they did have two references and a POVA first check. The manager stated that the staff team were depleted due to sickness and pregnancy leaves and the home needed someone in position quickly. The Commission stated to the manager that if this is the case then she should first consult with us to determine if it is appropriate for the person to be employed before their full CRB is received. This is to make sure that the people at the home are fully protected from any possible areas of abuse. New staff are provided with an induction that is tailored towards the needs of the service and the manager also had access to an induction programme which meets the Skills for Care Common Induction Standards specification. A new member of staff confirmed that they were undertaking a formal induction package through the home, however she did not have her portfolio with her on the day of the site visit. Staffing records also showed that pregnant workers are provided with a risk assessment for their pregnancy and their duties and responsibilities are redetermined following this assessment where changes that are identified are implemented. Sussex House DS0000064150.V372105.R01.S.doc Version 5.2 Page 24 Staff training record and interviews with staff showed that they were generally up to date with essential safe care training including moving and handling and health and safety training. Interviews with care staff and the manager of the service identified that they all had a clear understanding of the mental health needs of the people that use the service. A staff supervision programme was in place and all staff had a named supervisor and there was evidence that supervision that some of the staff had received the appropriate minimum levels of supervision, others had fallen far below this. One staff member’s records showed that they had only received supervision on two occurrences since January 2008. All of the staff had received an annual appraisal of their performances. It is important that all staff receive at least the recommended six formal recorded supervisions sessions (pro-rata) per year. This will help to identify any training or development needs that they may have and make sure that they have the skills and knowledge to be able to safely care for the people that use the service. Sussex House DS0000064150.V372105.R01.S.doc Version 5.2 Page 25 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): 37,39, 40 and 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. This means that the manager of the home is competent and bases her practice on openness and respect, however there are some areas of management including quality assurance that need addressing to support the health and safety of the people that use the service. EVIDENCE: The manager of the service is a qualified nurse and has many years experience of working in the home. She has not yet completed the Registered Managers Award. The manager attributed the delay in achieving the award to the time taken up by administration duties at the home and because of problems with the training provider. She said that she is currently in discussions with a third Sussex House DS0000064150.V372105.R01.S.doc Version 5.2 Page 26 training provider after being ‘let down’ by the two previous training providers in relation to the award. The owners of the home meet with the manager every month and record any outcomes of the visits. There was no evidence to support that they offer supervision and management guidance to the manager of the home. As stated it the last report it remains ‘ important that the owner addresses these matters more formally with the manager. This will ensure the managers personal development and support needs are clearly identified and ensure plans are in place to address any identified needs’. Care Staff spoken to by the Commission confirmed that moral in the home was very good and said that there was a good team approach to the care delivery at the home. People that use the service were very positive in relation to the abilities of the manager and the staff and the manager was observed communicating with individuals in a supportive and professional manner. The home had a bought in procedure for quality assurance and monitoring. This consisted of a self-assessment tick box system. However there was no evidence to support that the management of the service had recently consulted outside professionals, family’s friends, or people that use the service to see how they believe that the service is providing care. The Commission reaffirmed to the manager of the service the importance of the home having an effective quality assurance system to help with the identification of any improvements that are needed to improve the quality of life for the people that are living in the home. Records showed staff randomly monitored water temperatures form outlets at regular intervals, however there were no records to show that the water was tested or treated for Legionella. Current certificates were in place for the fire, gas, portable electrical appliances, passenger lift and fixed electrical systems. Sussex House DS0000064150.V372105.R01.S.doc Version 5.2 Page 27 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 X 2 2 3 3 4 3 5 X 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 3 27 3 28 X 29 2 30 2 STAFFING Standard No Score 31 3 32 3 33 X 34 2 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 2 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 2 3 X 3 X Sussex House DS0000064150.V372105.R01.S.doc Version 5.2 Page 28 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 YA3 Regulation 14 (1a,b,c,d) (2a,b) Requirement The registered person must make sure that all individuals that are admitted to the home have had a full and comprehensive assessment of their needs completed. This will make sure that the service has the ability to support all of their needs. The registered person must either repair or replace the remaining windows in the home that haven’t already received attention to provide a more homely and safe environment. The registered person must make sure that a mobile hoist is made available at the home to support the moving and handing needs of anyone who may have mobility problems. The registered person must make sure that all prospective staff for the service have received a full safety check before they are employed to work at the home. This will help to safeguard the people that use DS0000064150.V372105.R01.S.doc Timescale for action 30/09/08 2. YA24 23 (2b) 30/12/08 3. YA29 13 (5) 13/10/08 4. YA34 19 (1a) 5(a,b,d) 30/09/08 Sussex House Version 5.2 Page 29 the service from harm or abuse. 5. YA39 24 The registered person must 30/01/09 (1),(2),(3) develop and maintain an effective quality assurance and monitoring system for the service. This will help the service to see how other people view the service and identify any areas of practice that need to be improved to support the health and safety of the people that use the service. 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 YA14 Good Practice Recommendations The management and care staff should make sure that stimulating and interesting activities are made available to the people that use the service to offer them things of interest to them. The registered person should make sure that the refurbishment to the home is completed to make the service a more homely and comfortable environment for the people that live and work there. This includes the general decoration of the corridor area of the home The registered person should make sure that the water systems in the home are tested for Legionella on a minimum of an annual basis. This will help to support the health and safety of the people that use the service. The registered person should make sure that all of the care staff receive the recommended minimum of 6 formal recorded supervision periods per year (pro-rata) to make sure that they understand their roles and responsibilities and to identify any support that they require to carry out their roles including training needs. DS0000064150.V372105.R01.S.doc Version 5.2 Page 30 2. YA24 3. YA30 4. YA36 Sussex House 5. YA37 The registered person must ensure that the manager of the home has achieved the registered managers award or equivalent. Sussex House DS0000064150.V372105.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Sussex House DS0000064150.V372105.R01.S.doc Version 5.2 Page 32 - 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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