Care Home: Beach View

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What the care home does well People who use the service are fully assessed prior to admission. Individual needs and choices are laid out clearly in people plans. Independence is encouraged and people have educational and employment opportunities if they wish. Opinions are sought and complaints are listened to. The home is managed in the best interests of the people who use the service. What has improved since the last inspection? Care planning has improved meeting the requirement of the last inspection. The requirements on bathing facilities and staff rota were also met. Activities have increased and a new kitchen off the art room allows people to have cooking sessions. A building programme has improved the premises, installing a new wet room, a larger laundry and improved ramps on the upstairs hallway. What the care home could do better: Clearer guidelines could be in place for the role of befrienders. Key inspection report Care homes for adults (18-65 years) Name: Address: Beach View 28 Alleyne Way Middleton-on-Sea West Sussex PO22 6JZ     The quality rating for this care home is:   two star good 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: Sheila Gawley     Date: 0 1 1 2 2 0 0 9 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: Beach View 28 Alleyne Way Middleton-on-Sea West Sussex PO22 6JZ 02392251331 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Dolphin Homes Ltd care home 10 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: The maximum number of service users to be accommodated is 10. 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) Physical disability (PD). Date of last inspection Brief description of the care home Beech View is located in a residential area, close to the sea. There is car parking at the front and a garden to the rear of the house. It comprises of ten single bedrooms all with en suite shower and toilet facilities. There is a large lounge/dining room, fitted kitchen, laundry and two communal bathrooms and seperate toilets. An activity room is located to the side of the main building. There is a power lift for access to the first floor. The decoration throughout communal areas is neutral, bright and airy with good natural light and is domestic in appearance. Fees charged for living at the home range from £1152 to £1689 per week. Care Homes for Adults (18-65 years) Page 4 of 26 2 6 1 1 2 0 0 8 10 10 Over 65 0 0 Brief description of the care home 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: two star good 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: This site visit as part of the inspection process was carried out on 01/12/09. It was undertaken by a lead inspector from the Commission for Social Care inspection. It was facilitated by the registered manager and two staff and one person who uses the service were involved in the inspecting process. Prior to the visit all files held by the commission, complaints and safeguarding issues were reviewed. The home had sent us their Annual Quality Assurance Assessment which gave us the information we needed. We were in receipt of three surveys from people who use the service, two from staff and one from a professional. The comments on the surveys were positive and a person using the service spoken with on the day expressed satisfaction with life in the home. Care Homes for Adults (18-65 years) Page 6 of 26 Satisfaction was expressed on the lifestyle and food in the home. Staff spoken to on the day stated that they were happy working in the home and that the management was supportive. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are assessed prior to admission. Evidence: People who use the service are fully assessed prior to admission to the home. All medical, nursing and personal care need is assessed and recorded. Mental, physical and behavioural need is recorded. Social need and carer and family involvement is recorded. People are invited to visit the home with their parents to help make an informed decision. Support plans for three people accomodated were inspected and their pre admission assessment was present. The AQAA stated that they continue to meet this standard on pre admission assessment. People and/or their representative are encouraged to visit the home prior to admission. An up to date statement of purpose and service user guide is available in an accessable format. The service user guide contains the complaints procedure. Care Homes for Adults (18-65 years) Page 10 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. People who use the service are involved in daily life in the home and are consulted on all aspects of life in the home. Evidence: The requirement on care plans made at the last inspection is met. Peoples support plans set out the support needed and independence is encouraged. The specialist equipment required to meet these needs is set out such as the provision of a track hoist or a high/low bed. The person who uses the service and their family are involved in drawing up the plan and all need is addressed in an individual way. People are encouraged to make decisions and attempts are made using prompt cards to elicit wishes from those with more limited communication. Staff complete daily records for each resident. The form used for this allows for recording of general health, personal care, behaviour, communication, choice, activities, food and drink. Those inspected were correctly completed. Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: Those able to can participate in the day to day running of the home and people are given the opportunity to have 1;1 cooking sessions. People in the home at present do not have the ability to undertake laundry tasks. People are supported to take risks as part of their individual lifestyle and risk assessment is in place in relation to travel, use of company bus and financial risks. There are also risk assessments in place for choking, scalds and burns, aspiration and skin breakdown. Care Homes for Adults (18-65 years) Page 12 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. Social, educational and recreational activities meet individuals expectations. Residents are supported to maintain contact with their families and the people living in the home enjoy the lifestyle on offer. Evidence: People living in the home are encouraged to be involved in a range of activities both inside and outside the home. The home is currently fund raising to provide a sensory room and has held community open days with this in mind. The registered manager reported a good response from the community. The home is a short walk from the beach and people can walk there or be taken by wheelchair. People in the home access range of community workshops, day centres, library and colleges. In the day centres there is a variety of activities on offer, arts, crafts and aerobics. One person has a placement in a workshop for which he is paid. One person Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: attends a hydrotherapy pool where she also has physiotherapy. It is hoped that this can be extended to other people. One person owns a personal computer. There are in house activities, art on Saturdays, evidence of this artwork was seen about the home, this is to be increased as a volunteer is to come in on Sundays and offer further artwork. There is an art room with an attached small kitchen where one to one cooking opportunities can be offered. Family and friends are encouraged to visit the home and are invited to be involved in decision making. the rights of people who use the service are respected and people can have keys to their rooms if they wish. People are treated with respect and are addressed by their preferred form of address. Throughout the visit staff were observed interacting with the people who use the service with respect and kindness. One person spoken with stated that she was very happy in the home, that she enjoyed the food. She knew who her key worker was and said the key worker would fix any problem she might have. Another person who has informed the home that she was bored having a bedroom upstairs was moved to a downstairs room. There is a variety of nutritious food on offer in the home and people are asked what their choice is on a daily basis. They have choice in when and where to eat. People using the service today went out to lunch at a local pub. People are encouraged to get involved in food preparation both in the main kitchen and in a smaller kitchen off the art room. Care Homes for Adults (18-65 years) Page 14 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. Personal care is offered in a person centered way with privacy and dignity respected. Evidence: People who use the service are supported in their health and personal care needs in the way they wish, which is recorded in their plans. The plans indicate a person centred approach. Care plans are specific, for instance in the administration of medicines, monitoring and treatment of epilepsy, weight and oral hygiene. There is ongoing review and daily records. All care is offered in private and this was confirmed on a survey received from a professional commented I think that the care at Beech View is excellent. People are treated as an individual and needs are well catered for. A community matron spoken to on the day stated that communication was very good between the home and the community team. There is access to local national health services with support from the local general practitioner surgery and the community nurse team. A chiropodist visits regularly and people are taken to the opticians and the dentist. People have had seasonal influenza Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: vaccines. Medicines are received and recorded in the home according to policy. There are policies and procedures in place to support staff. The Medicine Administration Charts (MAR)were up to date. and care plans were in place for as required medication and the use of Buccal midazolam. Controlled drugs were recorded correctly and there was a suitable cupboard in place but the cupboard is not fitted to a solid wall. The registered manager stated that he already had plans to reorganise this room to utilise space better and this will involve moving the controlled drug cupboard to a solid wall. This will be a requirement of this inspection. Care Homes for Adults (18-65 years) Page 16 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. Peoples complaints are listened to and they are safeguarded from abuse. Evidence: There is an accessible complaints procedure in place and complaints are recorded. One complaint had been logged and resolved since the last inspection. The opinions of people who use the service are sought in meetings and are acted. Two out of three surveys received from people who use the service responded that they knew how to make a complaint, the other one did not respond to this question. A person with on the day indicated that the key worker would be told of problems and the problems would be fixed. There are safeguarding policies, procedures and training in place. The home is cooperating with a recent safeguarding allegation regarding the conduct of an ex staff member from a sister home which is still ongoing and the organisation may have to consider a referral to the Independent Safeguarding Authority when this is concluded. Care Homes for Adults (18-65 years) Page 17 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. People who use the service live in a comfortable and safe environment. Evidence: The home is situated in a quiet residential area, close to the sea and is in keeping with surrounding buildings. There is car parking at the front and an enclosed garden to the rear of the house. The accommodation comprises of a fully fitted kitchen, a large communal sitting/dining room, There is a staff office and a room for which funds are still being raised to convert it to a sensory room. There is an accessible outer building used as an art room. This now has a small kitten addition at the end which allows for one to one cooking sessions for people to develop their living skills. The laundry has been extended. The grounds are well maintained. There has been some recent building work upstairs which has meant the addition of a wet room, the extension of a bedroom and the gradient of the ramp on the upstairs hall being reduced. Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: The home has a homely domestic feel to it whilst having all the aids and equipment needed to meet assessed need such as, hoists, track hoists, ramps, grabrails and assisted bath. The requirement of the last inspection on people being able to have a bath has been met. 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. Peoples need are met by a suitably qualified staff team. Evidence: There are currently six people accommodated in the home. there are nine care staff employed in the home and staff rota show sufficient staff to meet the need of people living in the home, with four staff on from seven am to seven pm, two waking evening/night staff and one sleeping night staff. Staff are suitably qualified to meet the need of the people who live there. Three staff have National Vocational Qualification (NVQ)Level 2 in care and two staff have NVQ Level 3. Three staff are doing a medication course with Chichester college. Staff recruitment procedures and practises ensure the safety of people living in the home. Staff files inspected contained all the documentation required to ensure their suitability. This meets the requirement on staff documentation made at the last inspection. There was evidence of identification, work history, criminal records bureau clearance and two references. The home may need to put in place some guidance on visitors to the home as the recent safeguarding investigation related to a visitor/befriender to the home who was an ex staff member of another home in the organisation. The appropriateness of that visitors behaviour in relation to a person Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: using the service was questioned. There is a staff training and development programme in place which covers fire, safeguarding, first aid, infection control, moving and handling,and health and safety. There is further training on epilepsy, coping with aggression,, supported interventions and the administration of medicines. 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 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 run and managed in the best interests of the people who use the service Evidence: There is a registered manager in place who has met the criteria to register with the Commission. He has sixteen years in care, holds a foundation degree in learning disabilities,an NVQ Level 4 in care and the Registered Managers award. He has been employed in the home since it opened and has been slowly admitting people who fulfil the category requirements. Quality assurance systems are in place. There are staff and resident meetings in place, minutes were available. The home supplied us with their AQAA when asked for it and it contained the information we needed. On the visit we got more clarity on the quality assurances systems that are in place. Surveys are currently being sent out to people who use the service and their relatives. One was seen from one persons parents who commented They were happy their daughter had moved into the home. The organisation does an audit which covers client choice and possessions, staffing, Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: medicines, environment and maintenance issues, daily records, fire maintenance and drills and meetings. The requirements of the last inspection have been met. A monthly hazard check is carried out which includes a building assessment, a check for obstructions and for loose or damaged fixtures and fittings. The registered manager ensures the health and safety of people who use the service by the provision of policies and procedures and staff training in health and safety and by adherence with the above practises. 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 1 20 13 Controlled Drugs, including 17/04/2010 Temazepam, must be stored in a Controlled Drugs cupboard complying with the Misuse of Drugs (Safe Custody) Regulations 1973 The cupboard to be secured to a solid wall to ensure the safe storage of medicines. 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). 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