Inspection on 30/08/05 for The Marshes

This inspection was carried out on 30th 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Marshes 26/01/07

The Marshes 24/01/06

The Marshes 24/01/05

The Marshes 06/09/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 The Marshes 3A Nursery Close Hailsham East Sussex BN27 2PX Lead Inspector Lucy Green Unannounced 30 August 2005 09:45 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. The Marshes H59-H10 S47638 The Marshes V234922 300805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Marshes Address 3A Nursery Close Hailsham East Sussex BN27 2PX 01323 440843 EX21 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) The Regard Partnership Limited Miss Teresa Kate Murphy Care Home 6 Category(ies) of Learning Disability (LD) 6 registration, with number of places The Marshes H59-H10 S47638 The Marshes V234922 300805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of service users to be accommodated is six (6). 2. Service users will be aged between eighteen (18) and sixty-five (65) years on admission. 3. Service users with a learning disability to be accommodated. Date of last inspection 24 January 2005 Brief Description of the Service: The Marshes is a purpose built bungalow, situated in a quiet residential area of Hailsham. The home shares the same site as Lynfords. Shops and public transport links are a short walk away. Resident accommodation provides six single bedrooms and a communal lounge. The bathrooms are fitted with the necessary adaptations. The grounds are secure and provide a well-maintained garden and ample parking.The home is registered to accommodate six younger adults with learning disabilities. The Marshes is owned by The Regard Partnership. This organisation owns a large number of homes across England and Wales. The Marshes H59-H10 S47638 The Marshes V234922 300805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulations 2001, uses the term ‘service user’ to describe those living in care home settings. For the purpose of this report, those living at The Marshes are referred to as ‘residents’. This short notice unannounced inspection took place over five hours on 30 August 2005. This is the first statutory inspection of this year. The purpose of this inspection was to meet with residents and staff and to generally monitor care practices at the home. A tour of the premises took place, rotas and care records were inspected. The Inspector joined five residents for their lunchtime meal and spoke with two residents individually. The three staff on duty and the Manager were spoken with throughout the inspection process. What the service does well: The home has an experienced team of staff who clearly enjoy their work at the home and have a good relationship with the residents. Residents were observed approaching staff and requesting support without hesitation. The home has a relaxed and friendly atmosphere and it is evident that the philosophy at The Marshes is to create a ‘home’ for the people who live there. Meals are varied, balanced and well presented offering both choice and variety. Residents access a range of activities, both inside and outside the home. Residents spoken with confirmed that they enjoyed trips out to town, swimming and meals out. Staff invest a lot of time in supporting residents to book meaningful holidays. Two residents have recently returned from a week’s holiday in Portugal and another two residents are due to go on a Coach holiday to Scotland in September. Residents are supported with their personal routines and this support was seen to be offered and carried out with dignity and respect. The home has a good system for managing medication safely. The Marshes H59-H10 S47638 The Marshes V234922 300805 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Marshes H59-H10 S47638 The Marshes V234922 300805 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 The Marshes H59-H10 S47638 The Marshes V234922 300805 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 & 5 Residents benefit from having accessible information which outlines the rights and responsibilities regarding their placement at The Marshes. EVIDENCE: The home has a comprehensive Statement of Purpose and Service User Guide in place. Both documents have recently been reviewed and updated. The Service User Guide has been produced in a pictorial format to make it as accessible as possible to the residents living at The Marshes. In line with a requirement at the last inspection, the Registered Manager has now produced a written contract outlining the terms and conditions attached to a placement at The Marshes. This document has been produced in plain English and made as easy as possible to understand. Copies of the Service User Guide and contract were found in resident care plans. The Manager stated that keyworkers had explained the purpose of both documents to the residents. The Inspector showed one resident a copy of the Service User Guide and he confirmed that he had seen it before. The Marshes H59-H10 S47638 The Marshes V234922 300805 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 & 9 Residents are both protected and enabled by the documentation in place to support them. EVIDENCE: The Inspector viewed the care plans for two residents, both were found to contain detailed information about how care should be delivered. There was evidence that residents had been consulted about how they receive support and individual likes and dislikes were recorded. Care plans are regularly reviewed and minutes of formal reviews were in situ. One resident was able to confirm that he had been able to participate in the reviewing process. The home has undertaken a range of risk assessments in respect of the residents, their environment and behaviours. The Marshes H59-H10 S47638 The Marshes V234922 300805 Stage 4.doc Version 1.40 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15 & 17 Residents are encouraged and supported to lead healthy and fulfilling lives EVIDENCE: The activity plans in the two care plans examined provided documentary evidence that residents participate in a range of appropriate activities. Both residents were able to confirm to the Inspector that these activities took place and were enjoyable. Residents access a range of community facilities, including regular trips into town, meals and drinks out, swimming and music sessions at a local church hall. Two residents have recently returned from a holiday in Portugal which was reported to have been a huge success. The residents stayed in a hotel for one week and were supported by three members of staff. During the inspection, the Inspector was shown photographs of the holiday and one resident expressed that he had thoroughly enjoyed himself. Two residents are due to go on a coach holiday to Scotland in September. The Marshes H59-H10 S47638 The Marshes V234922 300805 Stage 4.doc Version 1.40 Page 11 On the day of the inspection, it was observed that the routines of the home were reflective of the individual needs of the residents. It was evident that residents are enabled to choose when to get up and go to bed and make informed choices about their daily lives. Residents are encouraged and supported to maintain contact with their family and friends. There was evidence in the care plan that several of the residents have regular family contact and staff support service users to maintain contact and arrange meetings with families. The home is currently in the process of trying to arrange for one resident to go on holiday and visit a relative at the same time. The Inspector joined the residents for their lunchtime meal. The meal was bacon, brie and tomato baguettes. The food was appetising and well presented. Staff and residents ate together and the mealtime was relaxed and friendly. A six-week rotating menu is in place which has been approved by a dietician. The Manager and staff confirmed that the menu was however flexible and that if residents wished to eat out, have a takeaway or have something different, then this would be accommodated. The Marshes H59-H10 S47638 The Marshes V234922 300805 Stage 4.doc Version 1.40 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 & 20 Staff have the knowledge, information and experience to ensure health and personal care needs are fully met. Medication is managed appropriately. EVIDENCE: It was observed during the inspection that personal care is provided with dignity and respect. The two care plans viewed contained detailed support plans to guide staff in the delivery of care. Residents are able to make choices about how they are supported and who assists them. At the time of the inspection, one service user requested that a member of staff support him with his personal care and this was responded to without hesitation. Staff support residents to ensure their health needs are met. Care plans contain a record of any visits or contact with healthcare professionals. There was evidence of current involvement from General Practitioner, Dentist, Chiropodists and Opticians. Medication is stored, dispensed and administered appropriately. The Manager confirmed that only staff who had received relevant training and supervision were permitted to administer medication. The Marshes H59-H10 S47638 The Marshes V234922 300805 Stage 4.doc Version 1.40 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 Residents and their opinions are valued by both staff and management. Adequate systems are in place to protect residents from abuse. EVIDENCE: The complaints policy has been updated in line with the requirement from the last inspection. Neither the home, nor the Commission for Social care Inspection has received any complaints about the service in the last twelve months. Residents’ views are sought and whilst they have limited verbal communication, it was observed that residents were able to air their views in other ways. It was clear that staff understood people’s communication systems and responded accordingly. Various systems are in place to protect clients from abuse. The two recruitment files inspected showed that new staff are employed subject to the required checks by the Criminal Records Bureau. It is however, required that the adult protection policy is updated to include details of the Protection of Vulnerable Adults register which was introduced on 26 July 2004. Employment and disciplinary policies should also be updated to reflect the correct procedures to be followed in the event of an adult protection allegation being made against a staff member. The Marshes H59-H10 S47638 The Marshes V234922 300805 Stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 & 30 Residents benefit from a clean, comfortable and well maintained home. The physical adaptations enable service users to move safely and independently around their home. EVIDENCE: The Marshes is a large purpose built bungalow which is situated in a quiet residential area of Hailsham. The home is well maintained and provides residents with sufficient private and communal space to meet their needs. Level access is provided both internally and externally. At the time of the inspection, the home was found to be clean and tidy throughout. Resident accommodation is provided in six single bedrooms which have been decorated and furnished to reflect the individual. Communal space comprises of a large lounge and a kitchen / dining area. The external grounds offer a garden and patio area. The home has two assisted bathroom facilities and a separate toilet. Since the last inspection, a new kitchen has been fitted and the area is due to be painted in the near future. The kitchen provides residents with a spacious and safe environment where they can assist staff with the preparation of their meals. The Marshes H59-H10 S47638 The Marshes V234922 300805 Stage 4.doc Version 1.40 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34 & 35 Residents benefit from a dedicated and competent team of staff. Staff have the skills and support to perform their roles effectively. EVIDENCE: At the time of the inspection, the Manager stated that the home was in the process of recruiting to vacant posts. Vacancies have been covered through overtime and the use of relief staff. The rota indicated that staffing levels were flexible and respondent to the number of residents at home and activities going on. The Manager reported that minimum staffing levels provide three staff in the morning, three staff in the afternoon/evening and an additional middle shift, one waking and one sleep-in person at night. The atmosphere in the home was observed to be calm and relaxed on the day of the inspection and there were sufficient staff on duty to meet the needs of the residents. Staff training is ongoing at The Marshes and at the time of the inspection, four staff members had completed National Vocational Level (NVQ) 2 or above, two staff are Registered Nurses and therefore not required to undertake NVQ training. All other staff are currently working towards NVQ’s. New staff to The Marshes undertake appropriate induction training, including the Learning Disability Award Framework (LDAF) course, where staff are new to supporting The Marshes H59-H10 S47638 The Marshes V234922 300805 Stage 4.doc Version 1.40 Page 16 people with learning disabilities. It is required that the home also introduce an appropriately accredited foundation course to follow-on from the induction. The recruitment files for two new staff were viewed and found to contain the required information and checks. The Marshes H59-H10 S47638 The Marshes V234922 300805 Stage 4.doc Version 1.40 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 & 42 Residents benefit from a well managed and safely run home. EVIDENCE: The Manager at The Marshes has recently been registered with the Commission for Social Care Inspection. She is a highly motivated and skilled practitioner who promotes the well-being of the residents at all times. During the inspection, it was observed that the Manager was liked and respected by staff and residents. Whilst management hours are supernumerary to the rota, it was evidenced both on the rota and at the time of the inspection, that the Manager is very ‘hands on’ in her approach. Various systems are in place to ensure the Health and Safety of the home are maintained. Several safety audits were viewed and found to be accurately maintained. It is however, required that the recording of fire drills be expanded to include details such as length of time to evacuate, names of staff and clients involved, time of drill and any other significant information. It was also noted that not all staff had received fire training at least twice per year. The Marshes H59-H10 S47638 The Marshes V234922 300805 Stage 4.doc Version 1.40 Page 18 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 3 x x x 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 x 3 Standard No 31 32 33 34 35 36 Score x 2 3 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Marshes Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x x x x 2 x H59-H10 S47638 The Marshes V234922 300805 Stage 4.doc Version 1.40 Page 19 YES 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 23 Regulation 14 & 13(6) Requirement Policies and Procedures to reflect current guidance on the Protection of Vulnerable Adults. (Previous timescale of 01 December 2004 not met) All staff to receive training in the prevention of abuse. All new staff undertake foundation training which is in line with Skills for Care specification. The recording of fire drills to be expanded. All staff to receive the appropriate level of fire training. Timescale for action 01 October 2005 2. 3. 23 32 13(6) 18(1)(c) 01 Dcember 2005 01 October 2005 01 October 2005 01 October 2005 4. 5. 42 42 23(4) 23(4) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations The Marshes H59-H10 S47638 The Marshes V234922 300805 Stage 4.doc Version 1.40 Page 20 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. 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