CARE HOME ADULTS 18-65
Sussex Road, 15 15 Sussex Road Southport Merseyside PR9 0SS Lead Inspector
Mr Paul Kenyon Unannounced Inspection 24 February 2006 09:20
th Sussex Road, 15 DS0000005269.V284834.R01.S.doc Version 5.1 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 Road, 15 DS0000005269.V284834.R01.S.doc Version 5.1 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 Road, 15 DS0000005269.V284834.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Sussex Road, 15 Address 15 Sussex Road Southport Merseyside PR9 0SS 01704 537344 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) Speciality Care (Rest Homes) Limited Ms Samantha Jayne Faria Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Sussex Road, 15 DS0000005269.V284834.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Service users to include up to 3 in the category of LD. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection Brief Description of the Service: 15 Sussex Road is a small residential care home that offers support to up to three service users with learning disabilities. The home is owned by Arden College who are a subsidiary of Craigmoor Ltd. The home does not currently have a manager registered with the Commission for Social Care Inspection, however, Samantha Faria, who is currently acting as Manager has applied to the Commission For Social Care Inspection and is undergoing the registration process. The home is a domestic dwelling located in Southport. The home is close to local shops and transport links. Southport town centre is approximately ½ a mile away. The home is on two floors with one bedroom on the ground floor and two on the upper floor. Sussex Road, 15 DS0000005269.V284834.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the second inspection to be held this inspection year. The National Minimum Standards for Younger Adults was used to measured the quality of support provided to residents. The inspection was unannounced and lasted three and a half hours. The first part of the visit involved a general discussion with one residents although only limited information was provided given the nature of the disability of those who live at 15 Sussex Road. The other two residents preferred not to provide any information. The rest of the inspection involved a tour of the building, discussion with the Manager and examination of a number of records connected to the care provided to residents. This assisted with assessing the current standard of care as well as seeing if requirements at the last inspection had been addressed. What the service does well:
The service is good at enabling residents to maintain any employment they wish to pursue as well as maintain or create any educational opportunities. The service is good at ensuring that links with families and friends are maintained and that family members are involved in the review of any needs of any individuals. The service is good at providing a basis for individuals to be involved in tasks within the home as well as ensuring that individuals’ nutritional needs and preferences are met. The service is good at enabling residents to maintain their own personal hygiene and maintaining their independence in this area. The service is good at enabling the physical health of residents to be monitored but also the psychological health of individuals to be taken into account and met as far as possible. The service is good at providing complaint information to residents in an appropriate format as well as information to relatives. The service has a stable staff team who are experienced in supporting with the three individuals who use the service. Sussex Road, 15 DS0000005269.V284834.R01.S.doc Version 5.1 Page 6 The Manager has the experience and qualifications to run the service and has been registered with the Commission for Social Care Inspection since the last inspection in September 2005. The service assesses the quality of the support it provides both within the house and at an organisational level. This process involves all residents as well as their families. What has improved since the last inspection? What they could do better:
The service needs to provide evidence of infection control guidelines for staff given the location of laundry appliances within the home’s kitchen. The service
Sussex Road, 15 DS0000005269.V284834.R01.S.doc Version 5.1 Page 7 needs to broaden its training topics to include reference to training associated with learning disabilities. The service needs to provide evidence that the Manager has a job description. 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. Sussex Road, 15 DS0000005269.V284834.R01.S.doc Version 5.1 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 Road, 15 DS0000005269.V284834.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1. Standard 2 was not assessed given that all residents have been living at Sussex Road for some time. Residents are now provided with information about the home in a format that is more appropriate to their needs. EVIDENCE: A requirement at the last inspection highlighted the need for the statement of purpose and service user guide to be provided in a format that was more accessible to them. This visit noted that a service user guide in the form of a ‘talking book’ had been made available. This book is specific to the home and is accompanied by photographs and symbols accompanied by relevant text. One resident was seen using the book and clearly understood the main features of it and was able to use it independently. Some symbols were not available in all parts of the book. It is recommended that these are obtained. Sussex Road, 15 DS0000005269.V284834.R01.S.doc Version 5.1 Page 10 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 and 9. Standard 6 was measured at the last inspection and was met. Residents now benefit from increasing independence in managing their financial affairs. Residents are now supported to take risks in their daily lives and activities. EVIDENCE: A requirement at the last inspection highlighted the need to increase the financial independence of residents through the opening of post office accounts. This has been done and all books were available providing evidence that the accounts were now in use. A further requirement at the last inspection noted that risk assessments relating to residents had not always been dated or reviewed. All risk assessments were examined and found that dates had been included and that reviews had now occurred at appropriate intervals. Sussex Road, 15 DS0000005269.V284834.R01.S.doc Version 5.1 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 the following standard(s): 12,15,16 and 17. Standard 13 was measured at the last inspection and was met Residents benefit from a service that encourages them to pursue occupations and education. Residents are encouraged to maintain links to family and friends. Residents are encouraged to be involved with the running of the home. Residents are provided with a healthy diet. EVIDENCE: Evidence was available that suggested that all residents have had the opportunity to pursue employment with staff support and to continue their education. Two residents attend a work placement during the week and this has continued for some time. Staff support is provided with this. Photographs were available evidencing these placements and showing each individual undertaking an active role. Two residents attend college placements. One resident could not continue with a college placement yet another course elsewhere was identified and is now actively pursued. Records suggested that all residents are able to maintain family links. All are able to maintain contact by telephone or to visit their respective families on an occasional basis. Evidence was available that suggested that a family member had been actively encouraged to take part in a multi disciplinary process when
Sussex Road, 15 DS0000005269.V284834.R01.S.doc Version 5.1 Page 12 the needs of their relation were being reviewed. One resident maintains a close relationship with a friend. This is a longstanding relationship and is supported by the staff team. All residents have been offered keys to their rooms although this offer has not always been taken up. All residents are able to access all areas of the home but there are reminders that they should respect the privacy of others. This is included in an appropriate format in the ‘talking’ service user guide. The staff team provides a key point of reference for residents to refer to and there was a great deal of evidence during the inspection of staff interacting with residents. There is an expectation that residents should become involved in household tasks such as shopping, laundry and general housekeeping. A pictorial rota is available that provides a general guide as to when residents will become involved in such tasks. This involvement is encouraged rather than enforced. Meals are provided within a domestic setting. A menu is available which offers choice and a good selection of preferred meals. Occasionally residents go out for meals. Care plans suggested that diet was down to preference rather than any dietary need. The kitchen is domestic in scale and a small dining room also available for meals. The inspection coincided with the morning period. Two residents had already eaten yet the third was having breakfast in the dining room. This suggested a degree of flexibility for residents when having meals as well as the option to eat on their own. All foods are purchased from local shops. Again care plans suggested that residents are involved in this process and that levels of supervision are used when residents participate in preparing meals. Sussex Road, 15 DS0000005269.V284834.R01.S.doc Version 5.1 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 the following standard(s): 18,19 and 20 Residents receive support in a manner appropriate to their needs. The health and emotional needs of residents are met. Medication training has now been identified for staff. EVIDENCE: A requirement at the last inspection highlighted the need for staff to undertake medication training. A date for this has been identified and staff will attend this in April 2006. Care plans noted that no resident requires direct personal care. In all cases, residents are able to either maintain their own personal hygiene needs or require prompting. The prompting for service users was indirectly observed during the visit with a member of staff prompting one individual that her bath was ready. Health records are maintained. These indicated that residents attend appointments with medical agencies with staff support in all cases. At present such appointments tend to be for routine issues and involve visits to Doctors, dentists and chiropodists. Health needs are not exclusively limited to the physical health of individuals. In addition to these, there is an emphasis on dealing with the emotional needs of residents also. This is particularly true for one person at present. Many agencies have been involved to ensure that the
Sussex Road, 15 DS0000005269.V284834.R01.S.doc Version 5.1 Page 14 emotional needs of this individual can be met and there is evidence of many strategies being in place to meet these needs. Sussex Road, 15 DS0000005269.V284834.R01.S.doc Version 5.1 Page 15 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 the following standard(s): 22 and 23 Residents benefit from having information about how a complaint can be made in a format appropriate to their needs. Relatives also have the same information provided to them. Residents are now better protected from abuse. EVIDENCE: A requirement at the last inspection highlighted the need for staff to attend training on abuse awareness. The organisation now provides staff with the opportunity to attend this and the topic is included within the training schedule. A complaints procedure is available and comes in two forms. One is included within the ‘talking’ service user guide and includes reference to the Commission for Social Care Inspection. The policy also makes reference to bullying and harassment and how these incidents can be dealt with. The main complaints procedure for families and others also includes reference to the Commission for Social Care Inspection and a reference to a timescale for investigation should a complaint arise. The service maintains complaints records although no complaints have been received for some time and the Commission For Social Care Inspection has received no complaints. Sussex Road, 15 DS0000005269.V284834.R01.S.doc Version 5.1 Page 16 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 the following standard(s): 30. Standard 24 was measured at the last inspection and was met. Residents do not completely benefit from practices that control infection. EVIDENCE: The home was noted to be clean and hygienic during the visit with no offensive odours present. There is no need to provide clinical waste facilities since the needs of residents at present do not reflect the need for this. Laundry facilities are included within the kitchen in the form of a domestic appliance. This reflects the aims of the service to provide an ordinary domestic feel to the house. As a result, clothes that require laundering are brought into areas that are used for food preparation. There needs to be written guidance for staff to refer to taking infection control into account in this area. This is raised as a requirement in this report. It was noted that the washing machine was not working during the visit and a repair had been identified as being needed. Alternative and temporary arrangements were in place until a repair could be effected. Sussex Road, 15 DS0000005269.V284834.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 and 35. Standard 34 was measured at the last inspection and was met. Residents benefit from a staff team who are experienced in supporting them and identifying their needs. The staff team need to have their training expanded to include reference to topics specific to the needs of residents. EVIDENCE: Observations during the visit noted that staff follow care practices that are centred on the needs and preferences of residents. Staff provide a key point of reference for residents and as a result the service is geared to their needs with staff interacting regularly with residents and not just between themselves. Linked to this, a training schedule is available. This is limited to mandatory topics and does not make reference to training that includes the needs of residents. Staff have the experience of supporting those with learning disabilities but have not had any recent training on learning disability awareness. In addition to this, a health need that one person has and a condition that another displays have not been provided as training for the staff team. As a result, the awareness staff have of these conditions have not been formalised. It is required that staff receive learning disability training as well as training in the areas identified during the inspection. Sussex Road, 15 DS0000005269.V284834.R01.S.doc Version 5.1 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Residents benefit from a service that is run by an individual experienced qualified in dealing with the needs of residents. Residents benefit form a service that reviews the quality of support it provides. Residents have their health and safe better promoted. EVIDENCE: A requirement at the last inspection highlighted the need for general risk assessments to be reviewed as well as one member of staff to attain a Food Hygiene certificate. Both of these requirements have now been addressed. The Manager has been approved by the Commission for Social Care Inspection since the last inspection to become the registered person for this service. The Manager has the experience and qualifications to perform this role. Initially a copy of her job description was not available. This has been provided subsequent to the visit. The service looks at the quality of the service provided in a number of ways. Residents’ meetings are held and these provide an opportunity for residents to
Sussex Road, 15 DS0000005269.V284834.R01.S.doc Version 5.1 Page 19 comment on the aspect of the support they receive. In addition to this, the head of residential service will visit on a regular basis in order to assess all aspects of the facilities, records, building and gain the views of residents. Copies of these were made available to the Inspector during the visit. Evidence was also provided that where shortfalls in the service are identified, an action plan is drawn up in order to address these issues. Evidence was also available to suggest that the organisation that runs the service gains the views of relatives to assess the standard of support provided. A copy of a relative questionnaire form 2005 was examined. This asked for views on a whole range of aspects of the support provided. Sussex Road, 15 DS0000005269.V284834.R01.S.doc Version 5.1 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 Standard No Score 1 3 2 N/A 3 X 4 X 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 X 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 2 33 X 34 X 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Sussex Road, 15 DS0000005269.V284834.R01.S.doc Version 5.1 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 YA30 Regulation 13 Requirement Guidelines must be produced to outline infection control arrangements for the use of the laundry facilities within the kitchen Staff training must be extended to include reference to learning disability awareness as well as the two conditions identified during the inspection Timescale for action 15/03/06 2 YA35YA32 12 30/04/06 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 YA1 Good Practice Recommendations Symbols in the service user guide to reinforce information directed to residents should be provided for all parts of the guide Sussex Road, 15 DS0000005269.V284834.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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