Care Home: Eastholme

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What the care home does well This is a well run home with good staff support and committment. Eastholme provides the people who live there with a good fulfilling way of life. The quality of the care given is good and the caring staff give service users the support they need to help them to make decisions and choices that effect their everyday lives to make sure they have a varied social life. There is good rapport between service users and staff and healthcare needs are well met with other healthcare professionals fully involved. The care plans are well organised and contain good information and tell staff how they can meet all of the needs of the people living in the home. Risk assessments are detailed and make sure that risks taken by service users are minimised. The complaint procedure is written in picture format and helps service users to understand the contents. Staff are well trained and over fifty per cent of the staff team holds a care qualification. What has improved since the last inspection? Some refurbishment of the home has been completed, the bathroom has been decorated and new bathroom appliances have been installed. There is new furniture in the sitting room and the kitchen flooring has been replaced and two bedrooms redecorated. The home has acted on recommendations made at the last inspection and they have all been completed and one requirement made to provide CQC with the range of fees charged to service users to be published within their reports has now been addressed. What the care home could do better: The dining table and kitchen cupboards are damaged and the staircarpet is worn and stained and all need replacing. Other issues identified as needing attention with the environment are written within the report. The manager must receive one to one formal recorded supervision from her line manager on a regular basis Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Eastholme Denehouse Road Seaham Durham SR7 7BQ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Eileen Hulse     Date: 0 1 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 28 Information about the care home Name of care home: Address: Eastholme Denehouse Road Seaham Durham SR7 7BQ 01915812656 F/P01915812656 eastholme@swantoncare.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Autism North Limited care home 4 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 4 The maximum number of service users who can be accommodated is: 4 The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Learning Disability Code LD, maximum number of places: 4 Date of last inspection Brief description of the care home Eastholme is registered for four adults with learning disabilities between the ages of 18 and 65 years. It is a specialist service, which provides care for people with autism. Currently four young women live in the home, which is a spacious semi-detached house in a quiet cul-de-sac. The house has four single bedrooms, generous communal space and garden and it is close to Seaham town centre, the beach and train services to other towns. Eastholme is managed by Autism North, which though a separate company is closely related to the organisation now known as European Services for People with Autism Limited, which was established in 1987 and runs a range of services for younger adults with autism. Care Homes for Adults (18-65 years) Page 4 of 28 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 peterchart Concerns, complaints and protection Environment Staffing Conduct and management of the home Poor Adequate Good Excellent How we did our inspection: The last inspection on this service was completed on 6th June 2007 This is an overview of what the inspector found during this inspection The quality rating for this service is 2 STAR. This means that people who use this service experience GOOD quality outcomes. How the inspection was carried out. Before the visit we looked at information we have received since the last visit on 6th June 2007 How the service dealt with any complaints and concerns since the last visit. Care Homes for Adults (18-65 years) Page 5 of 28 Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service their relatives and staff. During the visit we observed staff practice and talked with people who use the service and looked at how well their needs are met. We looked at other records which must be kept. Checked that staff had the knowledge skills and training to meet the needs of the people they care for. We looked around the building to make sure it was safe clean and comfortable and checked if any improvements had been made. 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 set out 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 7 of 28 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 8 of 28 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. Good assessments are included within the plans of care for all service users that help to form the basis of the individual care plan, this ensures that before admission takes place the home is able to know if the care needs can be met by them. Evidence: All service users living in the house have had needs assessments carried out by a care manager and the manager of the service prior to their admission, all of the service users have lived in the home for between six and nine years. There have been no recent admissions into the service but the Manager was able to explain in detail the process that would be followed should a vacancy occur. The care manager would make a referral to the home and the prospective service user would then make several visits there either having a meal with the people who live there or spending some time in the house with them and accompanying them on activities to eventually being offered overnight stays. An assessment is carried out at this time to ensure the placement is suitable and the service can meet the care needs. This gives the person the time to decide if they would like to move in and ensures the Care Homes for Adults (18-65 years) Page 9 of 28 Evidence: correct equipment and care plans are made available prior to moving in. The organisation has comprehensive policies and procedures regarding the admission process and the admission procedure has recently been reviewed and updated. Care Homes for Adults (18-65 years) Page 10 of 28 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. The care plans are easy to understand and well maintained and therefore this helps staff to provide the care people can expect to receive on a daily basis with choices offered at all times. Evidence: All service users have an individual care plan that is completed by staff and gives the staff guidance on how the care needs of people living in the home will be met and during the visit some care plans were looked at. The care plans include personal details and pen picture, everyday care needs, healthcare needs and an activity organiser. The care plans are organised and provide good detailed information to help care staff to ensure that the individual care needs are met on a daily basis. Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: Service users living in this home have complex communication difficulties but through body language and facial expression they can make some choices in their everyday lives. The care plans include triggers that can help staff to identify if the service user is not happy about something. Staff were observed to understand people well and have a good knowledge of their likes and dislikes and although staff sometimes have to make choices for people, support is also given to try and help service users make their own decisions. The risk assessment records are completed in great detail and they are well maintained and include areas such as what the risk is, what risks are associated with it, the benefits of taking the risk and give step by step information so that they can be followed by staff in various situations. Risk assessments are completed and included within the care plans to make sure that any element of risk to the service user has been assessed and minimised where possible. The home has recently reviewed the care plan process and recently reviewed and changed the care plans used so that staff have the information and a good knowledge they need about people and the support that is needed by staff to help meet the needs on a daily basis. Service users completed questionnaires with staff support prior to the visit and they all stated that they are offered lots of choice with the best of care given. Care Homes for Adults (18-65 years) Page 12 of 28 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. There is a good range of social activities made available to all service users to fulfill lifestyles and this ensures people are able to choose how to spend their leisure time. The rights of people as individuals is recognised by support being given to maintain personal relationships and to maintain contact with their families and friends. Service users are offered nutritious and varied meals with good choices for everyone. Evidence: All daily routines of the house are centred on the preferences of the people who live there. Service users are frequently out and about and are very much part of the local community. They use the local shopping areas and enjoy having meals out, everyone has a cinema pass that they use regularly and service users also enjoy visiting the local swimming baths as well as visits to the local pubs and discos. Every friday service users visit the Activity Centre for Autism North where they have lunch and take part in Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: one to one or group activities depending on the needs and choices of each individual and one service user chooses to attend the local church service every sunday morning. All service users living in the home have at least one annual holiday to destinations of service users choosing. Staff access information from the local newspapers, local posters and information leaflets to help service users plan and choose what they want to do. Although the service have their own adapted vehicle, service users continue to also use public transport such as the local metro, trains and bus service and they all enjoy walking. People are encouraged to continue with relationships outside of the home and everyone has close contacts with their families. Service users are encouraged and supported by staff to help prepare meals, service users can make snacks and again are fully supported by staff to help them to do this and they also help with the weekly shopping. During the visit, a lunchtime meal was taken with service users who were at home for the day. Both staff and service users were sat around the dining table discussing what they would like to do for the rest of the day. The meal consisted of a snack type meal of sandwiches, crisps etc as their main meal is a hot meal in the evening when everyone has returned home from visits out or returning from day centres. There was good rapport between service users and staff and service users were given good support throughout the meal when they required it, it was evident everyone was comfortable with each other. Care Homes for Adults (18-65 years) Page 14 of 28 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. A number of specialist health professionals are used by the service and good systems are in place on the safe administration of medicines and this ensures that the healthcare needs of service users are identified and met. Evidence: Within the plans of care there was evidence to suggest that the healthcare needs of service users are addressed. Service users are escorted by staff to attend all healthcare appointments including hospital and GP visits and should a hospital stay be necessary, then staff will continually support the person twenty four hours a day whilst in hospital. Most appointments take place outside of the home but opticians and dental hygeneists make visits to the home. Staff work sensitively with the service users and obviously know people well, showing discretion when assisting with personal needs and demonstrating respect and sensitivity when interacting generally. The home has a policy and procedure on the administration of medication used in the home and the policy covers areas on the recording, administration, safekeeping and Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: disposal of unwanted or unused medicines. Although all staff working in the service complete the accredited Safer Handling of Medication training, only grade two staff or senior staff administer medication, four staff have recently completed NVQ Level three training. At this time no service users are able to administer their own medication and during the visit, observation was made of a member of staff administering the lunchtime medications in a safe and correct way. All medication is recorded on individual medication administration record sheets that are up to date and well maintained. A Psychiatrist attached to the service carries out regular reviews of all medications prescribed in the home. Care Homes for Adults (18-65 years) Page 16 of 28 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 home has a clear and easy to understand complaints policy and procedure that is accessible to service users and their representatives should they have a complaint or concern about the service and good safeguarding procedures help to protect people should and abuse situation arise or be suspected. Evidence: The complaints policy is written in a picture format that is suitable for the people living in the home to help service users understand. Although service users a not able to communicate, staff know the service users well and can usually identify any concerns or if people are obviously upset about something, body language and behaviour patterns also alert staff if something is wrong. Triggers about service users are well documented within the individual care plans. Staff confirmed they are aware of how to deal with a complaint should one be made whilst they are on duty and stated they had received training regarding complaints during their induction training and had also received Safeguarding of adults training from the companies training department. When looking at records regarding complaints, they were well documented and the last entry made for a complaint made in October 2008 showed the complaint had been dealt with satisfactorily. Safeguarding of vulnerable adults procedures are available in the home for staff guidance that also includes whistle blowing. Care Homes for Adults (18-65 years) Page 17 of 28 Care Homes for Adults (18-65 years) Page 18 of 28 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 clean, homely and well maintained, however, some furnishings need to be replaced and some maintenance issues need to be addressed to ensure the home is safe and comfortable for the people living there. Evidence: A maintenance person has recently been appointed to address issues the home identifies as needing to be addressed and the service has made some improvements to the interior of the building since the last inspection. The downstairs hallway and stairway has been redecorated and dining chairs have been purchased, they have been made to suit individual service users regarding their height and the support they need when sitting in the dining room. New lounge furniture and window blinds in the dining room and in two lounges have been replaced and a new toilet has been installed. However, a number of issues needing attention were identified. The dining table is worn and scratched and kitchen cupboards are worn and need replacing as some of the cupboard doors cannot be closed. The main lounge needs redecorating as the wallpaper is peeling off the walls and the staircarpet is worn and stained and needs to be replaced. The first floor passage ceiling and the bathroom ceiling both have cracks in them. Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: Service users bedrooms are homely and personalised to suit individual tastes and have a homely and comfortable feel to them and externally the home has lovely gardens with good access for service users. Care Homes for Adults (18-65 years) Page 20 of 28 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. Staffing levels within the home are good and sufficient in numbers to enable the needs of service users to be addressed and this helps to ensure that service users can lead fulfilling lives in a safe environment. Evidence: There are fourteen support staff employed in the home and over fifty per cent of the staff team now hold an NVQ qualification in care. There were four staff on duty and the numbers of staff were adequate to ensure the needs of service users could be met. The home has a low turnover of staff and most of the staff have worked in the home for up to nine years. The staff training matrix is well maintained and clearly shows courses the staff have completed over the year. The home has a recruitment policy and procedure in place when employing new staff and the manager was able to describe in detail the procedure that is used when the home have a staff vacancy. The personal files of two members of staff were looked at and showed references had been obtained, a Criminal Records Bureau check and an application form were completed and other records that are required to be kept were also in the individual files. Care Homes for Adults (18-65 years) Page 21 of 28 Care Homes for Adults (18-65 years) Page 22 of 28 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 managed by a competant person who shows leadership skills in managing the staff team and ensures risks to the health and safety of people are minimised. However, the manager needs to receive formal one to one recorded supervison on a regular basis. Evidence: The manager has worked at the home for a number of years in various posts that included support worker, activities co-ordinator and senior support worker. In 2006 she returned to the service as a trainee manager and in 2007 became the registered manager. She is well qualified to run the home and her qualifications include NVQ Level four, Registered Managers Award and she has a teaching certificate. The manager continues to update her knowledge and has completed Safeguarding for Managers training and has attended a course on epilepsy. Records evidenced all staff receive one to one supervisions and regular staff meetings take place, however, the manager does not receive formal recorded one to one Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: supervision from her line manager. Observation showed that all staff throughout the day followed safe working practices at all times and records evidenced that staff receive regular training in fire safety, moving and handling and infection control. Care Homes for Adults (18-65 years) Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 5 5b The home must provide information regarding the level of fees charged. 31/07/2007 Care Homes for Adults (18-65 years) Page 25 of 28 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 1 38 10 The manager must receive regular formal recorded supervison from the line manager This ensures knowledge is updated and benefits service users in the day ro day running of the service 28/09/2009 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 24 16 The Staircarpet is worn and stained and needs to be replaced This could become a hazard for anyone using the stairs 28/09/2009 2 24 15 There are cracks in the ceilings of the passageway and bathroom and need to be repaired This would prevent the issue becoming worse 28/09/2009 3 24 16 The dining table is worn and scratched and kitchen cupboards will not close. These need to be replaced. 28/09/2009 Care Homes for Adults (18-65 years) Page 26 of 28 These areas are used by service users and therefore must be kept in good state of repair 4 24 16 Wallpaper is peeling from 28/09/2009 the wall in lounge and needs redecorating The lounge must be comforatable for service users 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 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. 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