Care Home: 368 The Ridge

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What the care home does well The care planning is focussed on the individual and staff are knowledgeable about individual`s needs, communication in particular. The home works hard to enable residents to have different experiences within the community. They also endeavour to involve residents in all aspects of the daily routines within the home. They do things with individuals, rather than for them. What has improved since the last inspection? The home responded to the three requirements from the previous inspection. One related to a maintenance issue and two related to staff recruitment procedures. CARE HOME ADULTS 18-65 368 The Ridge Hastings East Susex TN34 2RD Lead Inspector Christine Lawrence Unannounced Inspection 25 March 2008 13:00 368 The Ridge DS0000067861.V359110.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 368 The Ridge DS0000067861.V359110.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. 368 The Ridge DS0000067861.V359110.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 368 The Ridge Address Hastings East Susex TN34 2RD 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) 01424 754703 01424 854376 East View Housing Management Ltd Vacant Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 368 The Ridge DS0000067861.V359110.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is four (4). Service users must be aged between eighteen (18) and sixty-five (65) years on admission. 10 January 2007 Date of last inspection Brief Description of the Service: 368 The Ridge is a 4-bedroom detached house situated on a main road. The home is registered for 4 younger adults with learning disabilities, and at present all residents are young men. The home is a spacious residence, offering a large lounge, a further communal room/dining room and a wellequipped kitchen. All residents have their own bedrooms, which are en-suite. There is also a bathroom on the first floor. The house has a good front and very large back garden. There are local amenities within walking distance, and is a short journey to Hastings town centre. The current scales of fees range from £800 to £1200 per week. 368 The Ridge DS0000067861.V359110.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was notified to the home to ensure that there would be someone available and started at 13.00 and finished at 17.00. We (the Commission for Social Care Inspection, CSCI) looked at various records in the home and also used information sent to us by the manager before the visit. This was the Annual Quality Assurance Assessment (AQAA). Information from the previous inspection was also referred to. We observed the residents who live at the home, noting how they reacted to staff and how relaxed and comfortable they were within the home. A tour of the building was undertaken and this included residents’ rooms. We made observations of staff interacting with, and supporting residents. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. What the service does well: What has improved since the last inspection? What they could do better: There are no formal requirements from this inspection but the manager noted in AQAA that she intends to review the format of some of the record keeping to reduce staff time spent on this. Please contact the provider for advice of actions taken in response to this 368 The Ridge DS0000067861.V359110.R01.S.doc Version 5.2 Page 6 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. 368 The Ridge DS0000067861.V359110.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection 368 The Ridge DS0000067861.V359110.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Prospective residents’ individual aspirations and needs will be assessed. EVIDENCE: No new person has been admitted to the home since the last inspection but it is clear from the information provided in the AQAA, as well as discussions with the manager, that a detailed pre-admission assessment would be undertaken. She confirmed that an experienced and competent person would carry out this assessment. The care plans seen for this inspection indicate that any assessment would be centred on the individual’s wishes as well as their needs. 368 The Ridge DS0000067861.V359110.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents can be confident that their changing needs and their wishes will be noted in their individual plans and that they will be supported to make decisions and take risks to enable as independent lifestyle as possible. EVIDENCE: Two care plans were looked at for this inspection. The information within the care plans sets out clearly the needs of individuals, as well as their wishes. There is clear guidance to staff – protocols – which ensures that everyone is aware of how to support people. There are also summaries of the support plan. The key worker for each individual provides a monthly report and this, combined with input from all members of staff informs a monthly review of each persons care plan. An action plan is devised out of this and in this way care plans are kept up to date and relevant. The daily records maintained within the home are very comprehensive. 368 The Ridge DS0000067861.V359110.R01.S.doc Version 5.2 Page 10 The people living in the home are limited in their ability to communicate fully and staff were seen to encourage people to make decisions and choices. The daily records are particularly useful in reflecting what choices individuals have made. Risk assessments are in place and they showed that the emphasis is on empowerment and choice ie managing risks rather than avoiding things which are risky. Examples noted included going swimming and cooking. 368 The Ridge DS0000067861.V359110.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Activities and involvement in the local community, as well as support for personal relationships will be provided in an individual way for residents. They will benefit from having a healthy diet. EVIDENCE: The daily records and the care plans (life style plans) showed that residents are given opportunities to take part in a range of activities within the community. Some of this is formal, such as using a local college or day centre and some is informal such as outings, going to the pub, shopping, riding etc. The home has its own vehicle to support people using facilities in the community. Residents are also encouraged and supported to take part in routine things around the home such as housework and their own laundry. One person has been helping the gardener to plant bulbs in containers. With all activities it is clear from the care plans and the daily records that these are 368 The Ridge DS0000067861.V359110.R01.S.doc Version 5.2 Page 12 individual and relate to people’s likes and dislikes. The information within the care plans also is clear about how staff should support someone in an activity. Staff recognize some individual’s difficulties regarding things such as their attention span or need to have one to one support and this is reflected in what and how activities take place. It is clear from observing staff supporting residents within the house that they work hard to enable people to do things for themselves. Residents’ rooms are seen as private and staff were observed to knock before entering. People have music systems and/or televisions in their own rooms as well as in the lounge. The dining room is also used for activities such as games and crafts. Residents are supported to keep in touch with family and friends and their person centred plan has information about who is important to them. The menus are varied and the daily records reflect what people are eating. Residents are supported to take part in the preparation of meals as well as making choices about what to eat. 368 The Ridge DS0000067861.V359110.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are protected by the home’s policies and procedures regarding medication and their physical and emotional needs will be responded to. Their preferences and requirements for support are respected. EVIDENCE: The care plans contain clear information about how people prefer to be supported. Sometimes this ‘preference’ is based on staff’s observations of how residents react to different things. The manager confirmed that this process of observing and monitoring is part of the everyday interaction with people and helps to keep the care plan up to date and relevant. The daily records showed that there is some flexibility in peoples’ daily routines for getting up and going to bed etc but there is also the recognition of how important structure is for each person. The records show that residents’ health care needs are noted and responded to. Each person has a booklet called ‘My Health Plan’ which has been designed by the local learning disability partnership board, which has information about each individual’s health care needs. Examples were noted of the home being 368 The Ridge DS0000067861.V359110.R01.S.doc Version 5.2 Page 14 particularly responsive to individual needs such as swallowing difficulties and fears of medical interventions. Medication is stored and administered appropriately. Staff who administer medication have received training. 368 The Ridge DS0000067861.V359110.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are protected from abuse and their views are listened to or ascertained, and acted on. EVIDENCE: There is a complaints procedure for the home and the key worker system, as well as the person centred planning format is used to try and enable people to speak up about anything they are not happy with. All staff have received training/guidance with regard to the protection of vulnerable adults. There are procedures in place to safeguard residents’ finances as well as disclosure of abuse and bad practice (whistle blowing). Staff have also received training about how to deal with aggression and difficult behaviour. The organization has now started up a Residents’ Forum and residents from 368 The Ridge will be supported to take part. There is a newsletter to keep people informed and there is the opportunity to voice opinions at regular get-togethers. 368 The Ridge DS0000067861.V359110.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is clean, comfortable, safe and hygienic for the residents. EVIDENCE: The home is suitable for its purpose and during a tour of the building it was seen to be safe, comfortable, bright, spacious and clean. The home offers access to local amenities and to local transport if required. Furniture and fittings are satisfactory and maintenance is carried out as required. There is an attractive, well-maintained garden to the rear of the property. Access to local amenities is supported by staff and this is through the use of the home’s own transport. Residents’ bedrooms are individual and reflective of their personalities. Laundry facilities are satisfactory and all staff have received training in infection control. 368 The Ridge DS0000067861.V359110.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Sound recruitment procedures and training provided to staff will have a beneficial impact on residents. EVIDENCE: The training records show that there is a programme for mandatory training as well as opportunities for further training relating to the needs of the residents. Induction training is also provided. This was confirmed by one member of staff. Two members of staff are currently undertaking their national vocational qualifications at level two and one already has this. The manager explained that others will be doing NVQs in the future. Throughout this inspection visit staff were seen to engage with residents in a positive and respectful way. They responded to residents when approached by them and clearly made efforts with their communication skills. We looked at two individual staff records and they showed that the organization has a recruitment procedure which is thorough. Prospective staff members have a formal interview at the organization’s head office and a second interview at the home so they can meet the residents and other staff. 368 The Ridge DS0000067861.V359110.R01.S.doc Version 5.2 Page 18 The procedure includes seeking two references, using an application form to ascertain any gaps in employment history, terms and conditions of employment and undertaking criminal record bureau checks. 368 The Ridge DS0000067861.V359110.R01.S.doc Version 5.2 Page 19 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 and 42 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well run home and their health and safety is promoted and protected. EVIDENCE: The manager is experienced and is currently registered as the manager of another home within the organization. She is in the process of seeking registration as the manager of 368 The Ridge. She has a degree in health and social care, national vocational qualification in care at level 4 and the registered manager’s award. The manager works with an Operations Manager and a Resident Support and Development Manager to monitor all aspects of the running of the home and this includes regular audits within the home. As noted under Standard 22, the 368 The Ridge DS0000067861.V359110.R01.S.doc Version 5.2 Page 20 organization now has a Residents’ Forum which will be used to ensure that the homes within the organization know what residents’ opinions might be. A spot check on maintenance and service contracts showed them to be appropriate and up to date. One member of staff has delegated responsibilities for health and safety checks and also meets regularly with the organization’s health and safety officer who also undertakes audits within the home. The training records show that mandatory training relating to health and safety is part of the programme of training at 368 The Ridge. The fire safety checks and accident recordings were all satisfactory. 368 The Ridge DS0000067861.V359110.R01.S.doc Version 5.2 Page 21 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 3 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 4 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 368 The Ridge DS0000067861.V359110.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 368 The Ridge DS0000067861.V359110.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. 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