Care Home: 56 St Saviours Road

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What the care home does well The service excels with regard to ensuring residents receive a smooth transition into the service. The inspector saw evidence of comprehensive assessment documents for admission, and the Registered Manager tailors individual packages to suit each person and their families needs with regard to the transition into the home. The Registered Manager ensures that the home is run in the best interests of the residents, she provides excellent family support and contact. Service users independence is promoted and they are central to the provision of care in the home. What has improved since the last inspection? Following the last inspection three requirements and two good practice recommendations were made. These were in relation to the fire risk assessments in the home and general risk assessments for residents. It is evident that the home has completed these requirements. In July 2008 planning consent was given for the conversion of a second floor staff sleep in room to en suite bedroom accommodation for an additional, fourth service user. A final site visit on 8 July 2009, by the Building Inspector of Hastings Borough Council confirmed that all work had been completed in compliance with Building and Fire Safety Regulations. The service has therefore increased its numbers from three to four service users, this was careful planned for, with an additional full-time member of staff appointed to begin work, prior to the additional service users arrival. What the care home could do better: No requirements or recommendations were made as part of this inspection. The service is however planning to start work on the garden in the coming months and make the back part of the garden more accessible for residents to use. Key inspection report Care homes for adults (18-65 years) Name: Address: 56 St Saviours Road 56 St Saviours Road St Leonards-on-sea East Sussex TN38 0AR     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Alexis Reilly     Date: 0 9 0 2 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: 56 St Saviours Road 56 St Saviours Road St Leonards-on-sea East Sussex TN38 0AR 01424443657 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: jill.coker@sact.org.uk Sussex Autistic Community Trust (Care Services) Ltd care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 4. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home 56, St Saviours Road is a semi-detached property situated in a residential area of St Leonards-on-Sea. The town centre with its shops and railway station is approximately one mile away. Service user accommodation is on two floors with a lounge and dining room on the ground floor and bedroom accommodation situated on the first and second floors. The home is registered to accommodate four adults with a learning disability who have an Autistic Spectrum disorder. The home is one of four homes in East Sussex that are run by The Sussex Autistic Community Trust (care services) Ltd. Information about the home in respect of their Statement Of Purpose, Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 4 Brief description of the care home Service User Guide, current fees and copies of inspection reports can be obtained directly from the home upon request. Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The site visit to this service began on the 4th February, but due to the fact that the residents and staff were away from the service on that day the inspector returned on the 9th February to complete the inspection. As part of the inspection the inspector spoke with the Registered Manager and one care team member. The inspector also had the opportunity to speak with two residents in private in their rooms. A variety of documents were viewed as part of the evidence gathering for the inspection and these included; the plans of care for three residents and associated documents such as risk assessments, daily schedule plans, accident forms, and pre assessment documentation. The inspector also viewed complaint forms, quality assurance documents, recruitment files of two staff, team meetings minutes, supervision records, and the staff rota. The inspector visited all communal areas of the home and three of the bedrooms of the Care Homes for Adults (18-65 years) Page 6 of 26 residents involved in the case tracking. Care Homes for Adults (18-65 years) Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Registered Manager ensures that they carry out a comprehensive and detailed assessment with the service users prior to offering them a placement in the service. There is then a detailed and sensitive introduction into the home. The services assessment and introductory procedures into the home ensure they only offer services to people whos needs can be met. Evidence: As part of the inspection the inspector spent time with the Registered Manager of the service, and spoke to one staff member and two residents. The inspector looked at a variety of documents which included the admission documents of one resident and the care plans, risk assessments, activity and daily living plans for three residents placed in the home. The inspector viewed an initial assessment which was completed by the residents family, and saw evidence of a variety of admissions meetings which included key family members. A transition plan was then drawn up to ensure a smooth move into the service, this included a variety of day and overnight visits. Throughout these plans it was very evident that the Registered Manager was flexible in her approach to the new resident and the family. The move was tailored appropriately and in the best Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: interest of the resident. Care Homes for Adults (18-65 years) Page 11 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users in the home benefit from person centered care plans and activity schedules, these are detailed and supported by a comprehensive range of risk assessments. This ensures that service users in the home live in a supportive environment with a plan of care tailored to meet their needs. Evidence: As part of the inspection the inspector spent time with the Registered Manager of the service, and spoke to one staff member and two residents. The inspector looked at a variety of documents which included the admission documents of one resident and the care plans, risk assessments, activity and daily living plans for three residents placed in the home. The inspector viewed extremely detailed daily living plans and timetables for the residents placed in the service. Each resident has a 24 hour detailed plan and each activity is backed by a shift plan which details exactly how an activity will be carried out and at what time. Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: Residents have a varied week and evidence was supporting to confirm that the Registered Manager works hard to ensure that residents have choice in what they do and that they are involved in the service. It was clear that individuals religious and cultural beliefs are respected and promoted in the home. Daily living skills are worked on and residents are encouraged to be involved in the planning, purchasing and cooking of meals. The inspector saw evidence of very detailed risk assessments which were informative and provided good guidance for staff to follow. Care Homes for Adults (18-65 years) Page 13 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are supported by the staff in the home to be as independent as possible. They are involved in a variety of social, educational and work placed activities. Service users have a varied lifestyle which occurs within a planned framework with staff support. Evidence: As part of the inspection the inspector spent time with the Registered Manager of the service, and spoke to one staff member and two residents. The inspector looked at a variety of documents which included the admission documents of one resident and the care plans, risk assessments, activity and daily living plans for three residents placed in the home. Evidence was supporting to confirm that residents have a varied lifestyle. The Registered Manager and staff support residents to access the community and develop Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: independent living skills. Daily routines are very structured but this appears to suit the needs of the residents placed at the service. Evidence was supporting to confirm that the Registered Manager works hard to ensure that families are included in the care of their relatives and maintains good contact between them and the service. Meal times are flexible and the residents are involved in the buying, preparation and cooking of the meals if deemed as appropriate. On the day of the inspection one of the residents had been helping in the cafe that is run by SACT, others were involved in pursuits which included bike riding on a off road track. Residents started to return to the home from the early afternoon on wards and were involved in individual activities. All activities are reviewed six monthly in conjunction with the service users. Care Homes for Adults (18-65 years) Page 15 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service meets the health care needs of the residents placed and ensures that residents are treated with respect and dignity, thus ensuring that residents retain as much independence and control as possible. Evidence: As part of the inspection the inspector viewed documents in relation to accidents and incidents in the home. Evidence was supporting to confirm that residents access health care appropriately. Sexual health and well being is also discussed with service users in the home. At the time of the inspection only one resident had medication, this was administered appropriately and the inspector saw risk assessments and a plan of management in relation to the specific issue. Accidents were recorded appropriately. The service has the required policys in place with regard to administering medication. Evidence was supporting to confirm that residents are supported to remain as independence as possible with regard to personal care and again there is detailed guidance with regard to this in the shift plans. Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: All residents are registered with the local GP surgery and they attend a dentist which specialises in working with people with autism. Care Homes for Adults (18-65 years) Page 17 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service deals with complaints effectively and safeguards the interests of the residents placed. Evidence: The service has a complaints policy in place. Residents are given the number of the Responsible Individual of the home for their mobile phones if they wish to make a complaint directly to them. For residents who are unable to do this staff support residents to complete a sheet on a weekly bases which shows how they feel about things that have happened in the home. The home has a suggestions box in the entrance hall also. A complaint with regard to the organisation was sent directly to the CQC and this was referred back to the organisation to investigate. Evidence was supporting to confirm that staff have completed training in safeguarding vulnerable adults, and also that if staff or residents had any concerns they knew who to raise them with and felt confident that the problem would be addressed. Care Homes for Adults (18-65 years) Page 18 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well maintained and domestic in nature. Bedrooms are personalised and the home provides service users with a comfortable and well maintained home in which to live. Evidence: During the site visit to the service the inspector saw all areas of the home and spoke with two residents in their bedrooms. The home is well maintained with a domestic style kitchen. The home was clean and odour free on the day of the inspection. Pictures are displayed in the lounge and dining room. Since the last inspection the service has built a heated conservatory which is used as dining area and the original dining area is now used as an office. There are plans to deck or lawn the top area of the garden to make it more accessible to residents. The residents rooms seen were well decorated and full of personal belongings. Residents confirmed they were able to choose the colours of their bedroom walls. To meet the needs of one resident the service has installed a large shower room and walk in wardrobe in the original staff sleep in room upstairs. This has turned this room into a more self contained area. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff receive induction, training and supervision appropriate to enable them to carry out their role within the home. The home follows good procedures with regard to recruitment and retention of staff. Service users are supported by a competent staff group. Evidence: As part of the inspection the inspector spoke with one of the staff team on duty the Registered Manager and looked at a variety of documents. Included in these were two staff recruitment files, supervision notes, training certificates and team meeting minutes. The inspector saw evidence to confirm that staff receive a formal induction into the service and that they attend training, supervision and meetings as appropriate. The service runs various performance related and incentive schemes for staff which the Registered Manager informed the inspector are popular and effective. The service allocates staff time in relation to the service uses placed in the home, this means that normally there is one staff member of duty at any time. However the staff member has access to other staff in the event of an emergency. When the most Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: recent service user moved to the home this created a need for more staff hours, so therefore they have been provided and on set times a further staff member is on duty to enable one to one time and activities to be carried out with this particular resident. The service has one sleep in staff member at night and one on call staff. Personal care needs of female service users are supported by female staff. It was evident that the service follows its guidelines and procedures in relation to recruitment and if necessary disciplinary procedures with staff. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Registered Manager is competent and experienced in running the home and the service has effective quality assurance procedures in place. Residents are protected by the homes polices in relation to health and safety and the Registered Manager ensures an excellent service is provided for the service users placed. Evidence: As part of the inspection the inspector looked at a variety of documents and spoke with the Registered Manager and staff team member. The inspector was able to spend time with two residents individually also. The documents viewed included care plans, risk assessments, shift plans, accident forms and activity lists. Also viewed were the contact books for updating families and pre assessment documents. In relation to staffing the inspector looked at the recruitment, training and supervision of staff within the home and also at how they work with the residents placed in the service. All evidence was supporting to confirm that the Registered Manager runs a excellent Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: service for the residents placed there. The service is very structured and daily life is detailed however this appears to suit the needs of the residents in the home. The Registered Manager ensures that staff are well trained and supervised. The needs and choices of the individual residents are promoted and the Registered Manager ensures that residents are made to feel at home in the service and the transition into the home goes well. The Manager is extremely supportive to the parents of residents placed in the unit and has completed her NVQ level 4 and RMA award. Comments received by the inspector included; Approachable manager very effective in dealing with problems. Yes I like it here, I like my room, She is very good. Evidence was supporting to confirm that Regulation 26 visits are carried out on a regularly bases and that the home has quality assurance procedures in place. Information for the AQAA confirms that the service has the required policies and procedures in place with regard to health and safety in the home. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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