Inspection on 04/05/05 for The Seagulls

This inspection was carried out on 4th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Seagulls 24/07/07

The Seagulls 13/12/06

The Seagulls 15/11/05

The Seagulls 14/09/04

The Seagulls 01/06/04

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 Seagulls 6 Crowborough Road Saltdean East Sussex BN2 8EA Lead Inspector Glynis McLeod Unannounced 4 May 2005 10:15 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 Seagulls H59-H10 S21406 Seagulls V215848 040505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service The Seagulls Address 6 Crowborough Road Saltdean East Sussex BN2 8EA 01273 303713 01273 308672 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Driss Zemouli Ms Niki Clarke Ms Niki Clarke Care Home 6 Category(ies) of Learning Disability (LD) 6 registration, with number of places The Seagulls H59-H10 S21406 Seagulls V215848 040505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of service users to be accommodated is six (6). 2. Service users should be aged between eighteen (18) and sixty-five (65) years on admission. Date of last inspection 14 September 2004 Brief Description of the Service: The Seagulls is a well-appointed detached property situated in a residential area close to the main coast road and cliff tops at Saltdean. The home is registered to provide care for six adults with a learning disability; it does not provide nursing care. The owners have another home nearby and there are often joint activities between the two homes. Local shops and amenities are a short walk away and bus services to Brighton and other areas run close by the home. Parking is freely available in the street outside. Accommodation is provided on two floors, with two bedrooms on the ground floor and five rooms on the first floor. Communal areas include a comfortable lounge and a separate dining room, which is also used as an activity room. There is a smoking conservatory leading out to a pleasant garden situated at the rear of the property. The Seagulls H59-H10 S21406 Seagulls V215848 040505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection, which was unannounced, took place over five and a half hours and was one of two inspections required over the year. A tour of the premises took place and records relating to care, medication and maintenance were inspected. Four of the six residents, the staff member on duty, and the manager were spoken to. The inspector would like to thank the residents and staff for their hospitality and co-operation during the inspection. What the service does well: What has improved since the last inspection? What they could do better: Any changes that affect a resident must be recorded in their care plan so that staff are kept up-to-date with all new information. For the proper protection of residents, the home also needs to make sure that any concerns they have about residents’ health and safety must be passed on The Seagulls H59-H10 S21406 Seagulls V215848 040505 Stage 4.doc Version 1.20 Page 6 to the proper agencies such as the Social Work Department or the Commission for Social Care Inspection. The home must also check that any medicines that residents take only when they need it, and not every day, are labelled properly so that it is clear they don’t have to have them regularly. Old medicines must also be returned to the chemist. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Seagulls H59-H10 S21406 Seagulls V215848 040505 Stage 4.doc Version 1.20 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 Seagulls H59-H10 S21406 Seagulls V215848 040505 Stage 4.doc Version 1.20 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 and 4 The manager appropriately assesses prospective residents. Consultation with other professionals and families ensures that a clear picture of residents’ needs and wishes is available before admission. Prospective residents are given many opportunities to visit the home and meet with staff and other residents before moving in so that they become familiar with the home and can decide if they would like to live there. EVIDENCE: The manager, in conjunction with families and other professionals, completes a comprehensive assessment of all prospective residents. Any previous carers are consulted and a resident’s care plan is provided detailing current routines and lifestyle. Contact with families is encouraged by the staff who help residents make phone calls or write letters. The most recent resident was visited at his previous placement by the manager, and then visited The Seagulls on three occasions before moving in. Overnight stays are always offered but not always taken up. A three-month settling-in period is offered and reviews take place at four weeks and at the end of the settling-in period. The Seagulls H59-H10 S21406 Seagulls V215848 040505 Stage 4.doc Version 1.20 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9 Whilst the home does complete care plans and review them at six-monthly intervals, not all are updated regularly in between times. This means that important new information could be lost or not passed on to care workers, and that residents’ care plans do not reflect their current needs. Staff are good at assisting residents to make decisions and giving them opportunities to take control of their own lives. Staff also support residents to take responsible risks, such as going out alone, to enable them to live as independent a lifestyle as possible. EVIDENCE: All residents, bar one, had an individual care plan that contained the required information. Residents had clearly participated in drawing up the majority of care plans and had signed them where able. However, it was found that a care plan for the most recent resident (admitted two weeks previously) had not yet been drawn up and that the home was using the care plan from the previous placement in conjunction with the preadmission assessment. The usual practice in the home is to complete care plans after a two-week period when the staff know the resident better. Allowing the resident to participate in drawing up an initial care plan would The Seagulls H59-H10 S21406 Seagulls V215848 040505 Stage 4.doc Version 1.20 Page 10 help familiarise him or her with the home and provide staff with important information. It was also found that information and outcomes from a recent adult protection meeting had not been recorded in the appropriate care plans. A requirement was made that current care plans must be available for all residents and that they must be kept updated. A recommendation was made that a record of GP and other healthcare appointments should be kept separately so that staff can track more easily when appointments are next due. Staff try to involve residents in everyday decisions, such as what to have to eat or where to go for a walk, as well as talking through bigger decisions with them, such as which college course to attend. Individual choices are recorded in the day-to-day record and in review notes. General risk assessments, such as for the environment and moving and handling, are completed for all residents. Any particular risks, including the risk of smoking, are discussed with residents and any involved professionals and any restrictions agreed upon are written in the care plan. The Seagulls H59-H10 S21406 Seagulls V215848 040505 Stage 4.doc Version 1.20 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 13 Residents are encouraged to continue their education and participate in social activities both within the home and in the community, thus providing both lifelong learning opportunities and stimulating and creative activities. EVIDENCE: Four out of the six residents in the home attend college and two out of the four also attend a day centre. Two other residents participate in social and learning activities within the home. None of the residents are currently employed but the home may be exploring a work experience placement for one resident in the future. The home provides many recreational activities for residents including shopping trips, outings, pub lunches and cinema visits. A holiday for residents from both homes is arranged annually and is regarded by staff and residents alike as an enjoyable and rewarding experience. Residents spoken to during the inspection were eagerly looking forward to their forthcoming holiday in Bournemouth. The Seagulls H59-H10 S21406 Seagulls V215848 040505 Stage 4.doc Version 1.20 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) 20 Staff receive appropriate training in administering and recording medication, but it was found that there were two instances regarding labelling and the storage of medication where residents’ safety could be put at risk. EVIDENCE: Medication administered to residents was recorded properly and records of incoming medication were up to date. Staff receive training from a local pharmacy and from the home’s manager who is a qualified nurse. There were two particular instances where the home needs to take action. Firstly, the labelling on the medication record chart for one resident gave no indication of when one particular medication should be given; the manager advised that it was apparently only to be given when needed but this was not stated on the sheet. The correct dosage instructions need to be clarified with the pharmacy. Secondly, some old unused medication belonging to a resident who had left the home a year ago was also discovered in the medication cupboard. Both these instances could put residents at risk from either receiving the wrong dosage of medication or the wrong medication entirely. A requirement was made that medication records must be kept properly and any unused medication to be returned to the pharmacy. The Seagulls H59-H10 S21406 Seagulls V215848 040505 Stage 4.doc Version 1.20 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 and 23 A clear and simple complaints policy given to all residents encourages them to go to staff with any problems and makes it clear who they should complain to, and assures them that their complaints will be listened to and acted upon. To provide the strongest possible protection from abuse and harm for their residents, the home needs to improve its adult protection procedures and also ensure that all significant events are reported to the appropriate authorities without delay. It is not for the home to decide what is, or is not, an adult protection issue. EVIDENCE: In addition to the simple complaints policy for residents a more detailed one is available for their families. Residents spoken to said they felt able to talk to their keyworker or the manager if they were worried about anything – although none had ever had to make a complaint. Staff try to deal with concerns at an early stage and will talk to residents individually if they think they are upset about anything. Although all complaints and their outcomes are recorded, a recommendation was made that investigations are followed up with a written letter to the complainant. A number of concerns have been raised since the last inspection regarding the lack of notification of adult protection issues to the appropriate authorities. The manager and staff are capable and experienced but must ensure that they do not try to deal with all issues themselves. Any incident involving residents being put at risk of harm, no matter how minor, must be reported to the social worker and to the commission. It is up to the appropriate authorities to then make a decision as to whether an adult protection investigation is warranted. A requirement was made that all incidents must be reported to the commission without delay and that the adult protection policy and procedures must state The Seagulls H59-H10 S21406 Seagulls V215848 040505 Stage 4.doc Version 1.20 Page 14 clearly that incidents must be reported and give clear details of whom to contact. Additional training has been arranged by the social worker for later in May 2005. The Seagulls H59-H10 S21406 Seagulls V215848 040505 Stage 4.doc Version 1.20 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of the above standards was assessed. EVIDENCE: The Seagulls H59-H10 S21406 Seagulls V215848 040505 Stage 4.doc Version 1.20 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 35 Residents benefit from an experienced and stable staff team, many of whom have worked at the home for four or more years and know the residents very well. Staff have the training and the personal skills to enable them to work effectively with residents. EVIDENCE: The staff group, although small, is capable and experienced. The manager has high standards for employees and would rather not recruit at all than take on someone she was not completely satisfied with. She is happy to re-employ workers who have been off for a while doing other things, such as travelling. Both male and female care workers are employed, reflecting the mixed residents group, and some are from different cultures and countries. There is a low sickness and turnover rate, and the staff member spoken to said that the rota system worked well. All staff receive appropriate training through their NVQ courses and additional training is arranged in-house by the manager. Staff are encouraged to study for their NVQ certificates; the deputy manager has nearly completed her NVQ 3 and two others, who have completed their level 2, are hoping to start their level 3 when funding has been agreed. One member of staff has completed her foundation training and two others are waiting to do theirs. Each member of staff receives an appropriate induction to the job, and has their future training needs identified through the supervision and appraisal system. The The Seagulls H59-H10 S21406 Seagulls V215848 040505 Stage 4.doc Version 1.20 Page 17 home now has two residents with dementia and a recommendation was made that specific training in equal opportunities and dementia awareness should be arranged in order that their particular needs can be fully understood and met. The Seagulls H59-H10 S21406 Seagulls V215848 040505 Stage 4.doc Version 1.20 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 Staff training, along with regular checks of the environment and systems in the premises, and the relevant policies and procedures, ensures that the home is safe and secure for residents, staff and visitors. EVIDENCE: Records inspected relating to gas, electric and plumbing systems showed that all equipment had been inspected and tested within the given time limits. Risk assessments had been carried out and were readily available for staff in the kitchen area. Accidents and injuries had been recorded properly and safety posters were displayed in relevant positions. Regular fire safety drills and tests had been carried out, and staff had undertaken food hygiene and first aid training. It had been recorded that one resident had refused to leave the building during a fire drill and the manager was in the process of completing a risk assessment and plan of action to deal with this if it happened again. The Seagulls H59-H10 S21406 Seagulls V215848 040505 Stage 4.doc Version 1.20 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 The Seagulls x 3 3 x x Standard No 31 32 33 34 35 36 Score x x 3 x 3 x Version 1.20 Page 20 H59-H10 S21406 Seagulls V215848 040505 Stage 4.doc 16 17 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x The Seagulls H59-H10 S21406 Seagulls V215848 040505 Stage 4.doc Version 1.20 Page 21 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. 2. Standard 6 20 Regulation 15 (1 & 2) 13 (2) Requirement Timescale for action Immediate 3. 4. 23 23 37 13 (6) Service user plans must be available for all service users and must be kept updated. Medication records must be kept Immediate properly and old unused medication must be returned to the pharmacy. All significant incidents must be Immediate reported to the commission without delay. Adult protection policies and 30.6.05 procedures must state clearly that all significant incidents must be reported and give details of whom to report to. 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. 2. 3. Refer to Standard 6 22 35 Good Practice Recommendations A separate record should be kept of all GP and other healthcare appointments and inteventions. All complaint investigations should be followed up with a written letter to the complainant. Training in equal opportunities and dementia awareness should be arranged. H59-H10 S21406 Seagulls V215848 040505 Stage 4.doc Version 1.20 Page 22 The Seagulls The Seagulls H59-H10 S21406 Seagulls V215848 040505 Stage 4.doc Version 1.20 Page 23 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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