Care Home: Edgecumbe House

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What the care home does well Edgecumbe House was overall well presented, clean and fresh smelling. Staff were knowledgeable about people`s individual needs and personalities. We observed good interaction between the staff and people living at the home. Staff took every opportunity to maintain people`s independence and enable them to exercise choice. People were helped to make use of local amenities. The manager encourages staff to train and extend their knowledge and skills. What has improved since the last inspection? The redecoration and refurbishment of the communal and bedroom areas had continued since the last inspection, this has created an attractive environment for people. What the care home could do better: Staff need extra training so that they know about the Mental Capacity Act 2007 this would make sure that they are able to fully protect vulnerable people. CARE HOME ADULTS 18-65 Edgecumbe House 7-8 The Crescent Doncaster Road Rotherham S65 1NL Lead Inspector Ian Hall Key Unannounced Inspection 28th January 2008 08:40 Edgecumbe House DS0000046545.V355705.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Edgecumbe House DS0000046545.V355705.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Edgecumbe House DS0000046545.V355705.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Edgecumbe House Address 7-8 The Crescent Doncaster Road Rotherham S65 1NL 01709 382 949 01709 382 587 wainwrighteh@tiscalli.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Voyage Ltd Ian Wainwright Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Edgecumbe House DS0000046545.V355705.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The registered manager attains the required level 4 NVQ (or its equivalent) management qualification by 2005. The basement staircase must not be used by residents. Date of last inspection 6th September 2006 Brief Description of the Service: Edgecumbe House is a care home for adults with learning disabilities, which is situated near the centre of Rotherham. The home is a converted building that consists of 3 floors used for people’s accommodation. The main office is located in the basement area. The home is situated in it’s own grounds which are securely fenced off. Information gained on the 28th January 2008 indicated the current fees vary from £1,110.00 to £3,142.00 per week with additional charges made for holidays and transport. These fees applied at the time of inspection, more up to date information may be obtained from the manager of the home. A copy of the home’s statement of purpose, service user guide and complaints procedure (available in appropriate formats) was available in the entrance hall. Edgecumbe House DS0000046545.V355705.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. The unannounced site visit undertaken as part of the inspection started at 08:40 and concluded at 13:40 on the 28th January 2008. The site visit included a tour of the building, reading records, discussions with staff and people who use the service and observation of the meals provided. We also met with the manager and other members of staff. In addition the inspection took account of information received about the service since the last key inspection on 6th September 2006. This included records of telephone conversations with staff, events notified to CSCI and records of management visits to the home. Prior to the site visit the home carried out a self-assessment of the service. This is called the annual quality assurance assessment (AQAA). People spoken with were happy to assist with the inspection. Comments were positive when describing the care and motivation of the staff, these included: “I like it at this home, I feel safe,” “they are good to me”, and “its lovely here they are smashing”. At the end of the site visit verbal feedback was given to the manager. What the service does well: What has improved since the last inspection? The redecoration and refurbishment of the communal and bedroom areas had continued since the last inspection, this has created an attractive environment for people. Edgecumbe House DS0000046545.V355705.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Edgecumbe House DS0000046545.V355705.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Edgecumbe House DS0000046545.V355705.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2. People who use the service experience good quality outcomes in this area. This judgment has been made using available evidence, including a visit to this service. The service provides people with detailed information to enable them to choose whether the home is the one for them. Detailed assessments ensure that people’s needs could be met prior to offering them a place. EVIDENCE: We checked three case files. Each contained a detailed needs assessment and covered such things as daily living, personal care, health care, social interests and areas of risk when appropriate. People said they had been able to discuss their wishes and the type of help they needed before they made the decision to live at Edgecumbe House. This was confirmed by written entries in the case files. Copies of contracts, social work referrals and assessments were available and kept in the case file. Edgecumbe House DS0000046545.V355705.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. People who use the service experience good quality outcomes in this area. This judgment has been made using available evidence, including a visit to this service. Staff ensure that people’s personal needs are met. People are facilitated to take risks, if they wish, in order to remain independent. Staff attitude and approach to care is based on respect for the person, this helps to safeguard and promote people’s rights and dignity. EVIDENCE: We checked three case files. Each contained individual needs assessments with plans of care for staff to follow to meet individual needs. These records were correctly maintained; they described how each person responded to the support/care provided and any necessary changes that were made. These records were monitored at regular intervals. Some plans have been amended in response to people’s changing needs. Areas of risk had been identified with detailed plans made to protect people. Care plans contained information detailing people’s physical and emotional needs. One care plan checked detailed the person’s needs in terms of anger management. A reactive plan was in place, this described the behaviour that the person would display when Edgecumbe House DS0000046545.V355705.R01.S.doc Version 5.2 Page 10 anxious, and action staff should take to diffuse any situation. We had been appropriately notified of incidents that had occurred. Staff had acted to reduce risks of further incidents by reviewing care plans. People were supported to make decisions about their daily lives. Care plans contained a detailed weekly planner, which gave structure to the person’s week. Incorporated in the plan was time to clean their room and do their laundry. Staff said that some people were assisted to prepare their meals to promote choice and independence. Life storybooks were being developed for people to describe and reflect their lives. Staff said this helps to give them a better understanding of each person and their needs. Staff said people are encouraged to maintain their independence with people being assessed for their ability to travel to town, spend a prolonged period alone and return safely at the end of the day. Some of the people who live at the service have mobile phones to help them feel safe and to communicate with support staff as they wish. People spoken with stated they were happy living at Edgecumbe House and that staff were very good and always helped them. They were able to express their needs and choices in a non- judgemental environment. Advocates were available to help and support people who required this service. Edgecumbe House DS0000046545.V355705.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Visits from relatives and friends are encouraged to enable people to keep in touch with those who are important to them. Routines are minimal to promote people’s rights and dignity. People who live at the home are provided with choice and are encouraged to eat a healthy and varied diet. EVIDENCE: Three care files and care plans were checked. These showed that people were involved in a wide range of social and educational opportunities. Staff and people spoken to said most people attend day centres, educational or work placements during the week. Edgecumbe House DS0000046545.V355705.R01.S.doc Version 5.2 Page 12 Transport was provided for people who require help to attend placements. People visit local shops, gym and swimming pool in line with their daily living pattern. Some require assistance whilst others were self- sufficient. A number of people we spoke with said how much they had enjoyed their holidays. Some people discussed the holidays they were planning for next year. People confirmed that staff provided them with choice and all the support that they needed to choose and participate in holidays. People said their family and friends are always welcome as visitors and they went to visit friends and family whenever they wished. There were no visitors on the day of inspection. The meals provided both appeared and smelled appetising. People said they enjoy their meals and they can always choose other meals if they do not like the meal provided. People were seen and heard to exercise choice at mealtime. Staff were observed to encourage and help people with their meals as needed. People helped with household tasks such as setting the table and washing the pots after the meal. Mealtime was unhurried with extra portions available as required. People’s likes and dislikes were documented and known by staff. Special diets were available if required. Staff confirmed that they sought the dietician’s advice when necessary. Drinks and snacks were available throughout the twenty-four hour period. Some bedrooms had kitchenettes, these promoted independent living. One person said that they regularly shopped, prepared and cooked their own meals. Edgecumbe House DS0000046545.V355705.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. Care staff ensures people’s physical and emotional health care needs are met. Staff attitude and approach to care is based on respect for the person, this helps to safeguard and promote people’s rights and dignity. Staff work to the service’s policies for the administration of medication, this promotes the wellbeing of people who live at the home. EVIDENCE: We inspected three case records. People’s needs had been assessed. There were detailed care plans to inform staff how to meet peoples needs. These had been reviewed regularly. Health action plans were being developed for each person. Most people we spoke to know about their care plan. Records contained entries that showed relatives had been involved in drawing up care plans whenever possible. Edgecumbe House DS0000046545.V355705.R01.S.doc Version 5.2 Page 14 There were records of visits by the GP, community nurse, occupational therapist, dentist, opticians and chiropodist. People said staff helped them to go to the doctors when they needed to. All people who live at the home were registered with a family doctor. The manager said the home has good relationships with the doctors and the district nurses. People are able to manage their own medication if they wish. Several people had been assessed as capable of doing this safely. None were choosing to do this. Those spoken with said that they are happy for staff to manage their medication on their behalf. Ordering, storage, administration and disposal of medicines was checked and systems were safe. We observed medicines being given to people. They were helped and assisted to take them appropriately. Staff have received additional training for the administration and management of medicines to ensure safe practices are followed. We observed staff knocking upon bedroom doors and waiting to be invited before entering. Our observations were of mutual respect with warm relationships between staff and people living at the home. Edgecumbe House DS0000046545.V355705.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. The complaints procedure allows people to raise any concerns. There are policies and procedures to protect people form abuse and neglect. Staff has been trained in the recognition and reporting of abuse. Relevant checks are made prior to them starting work, this reduces the risk of harm to vulnerable people. EVIDENCE: The complaints procedure was displayed in the hallway so that people were aware how to make a complaint. People living at the home said they knew who to talk with if they felt unhappy or worried. There was an adult protection procedure in place. Staff had received training to enable them to recognise any signs of abuse, this reduces the risk of harm to people living at the home. We saw records of in-house complaints, there had been three; one had been substantiated and two substantiated in part. These had been dealt with promptly and involved domestic issues. People were satisfied with the outcome. Edgecumbe House DS0000046545.V355705.R01.S.doc Version 5.2 Page 16 Staff said their induction training included information about both the complaints policy and the adult protection policy. Staff were aware of their responsibilities in these areas. Edgecumbe House DS0000046545.V355705.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27, 28 and 30. People who use the service experience good quality outcomes in this area. This judgement has been made using a range of available evidence, including a visit to this service. Edgecumbe House is clean, tidy and well maintained ensuring that people live in pleasant and safe surroundings. Bedrooms are clean, comfortable, well decorated and furnished to meet people’s needs. Good hygiene standards are maintained and this helps with the control of infection and makes the home more pleasant. EVIDENCE: We toured the building accompanied by a member of staff. There were no unpleasant odours. All rooms entered were clean, tidy and well maintained. The company has continued their programme of updating and refurbishing the home. The décor was, overall, a good standard. Some decorating had taken place since the last inspection and some new furniture and carpets purchased. Edgecumbe House DS0000046545.V355705.R01.S.doc Version 5.2 Page 18 The dining room required redecoration. Furniture in the lounge appeared tired and worn. This would provide comfortable and homely surroundings for people living at the home. A number of bedrooms we visited reflected the choice and personality of the person who lived there. Some people said staff helped them to choose things for their rooms, these included televisions, pictures and items of furniture. People said they were happy with their rooms. They were able to have a key and lock them as they wished. They said they could make their own beds if they wanted to; but they didn’t have to because staff gave them as much help as they needed. Toilets and bathrooms were readily accessible and provided with aids and adaptations as needed. Sufficient laundry facilities were provided. People were allocated laundry days to clean their linen/clothing with the assistance of staff. Radiators were guarded and window openings restricted to provide a safe environment and reduce risk of injury to people. Annual servicing of equipment had been planned and undertaken as required i.e. the gas and electrical equipment. Limited provision of homes handyman/gardener requires the home’s manager to be both assertive and proactive to ensure people continue to enjoy a safe and pleasant home and grounds Edgecumbe House DS0000046545.V355705.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence, including a visit to the service. Staff have received training to enable them to meet people’s general and specific needs. Appropriate support and guidance is provided to new staff, enabling them to safely care for people living at the home. The service operates a recruitment policy that protects vulnerable people. EVIDENCE: Milbury Voyager provides staff induction, updates and a range of training opportunities. These include fire prevention, moving and handling, health and safety at work, food hygiene, challenging behaviour, makaton, recognition and prevention of abuse and accredited medication training. This ensures that staff are trained to meet people’s needs. Staff recruitment had improved since the last inspection. There was one staff vacancy at the time of the site visit. Edgecumbe House DS0000046545.V355705.R01.S.doc Version 5.2 Page 20 Staff appeared well motivated and enthusiastic about their work. They said they were well supported with their work and actively encouraged to develop personally by the manager. Staff files and discussions with staff confirmed that they receive regular supervision from the manager or his senior staff. This ensures that people are provided with a high standard of care and service. Five members of staff including the manager were spoken to during the course of this inspection, they were observed working with people, and there was an atmosphere of mutual respect between staff and the people who use the service. People’s comments included: “staff are smashing”, “they’re always helpful”, “staff are always very busy”, and “ they help me to go out to town or the shop”. Edgecumbe House DS0000046545.V355705.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is generally well organised and managed ensuring that people’s health; safety and welfare needs were promoted and protected. The manager is supportive and approachable and there is a well-established system of professional supervision. People are involved in making decisions about their care and have control over issues that affect their lives. Checks are made on the major systems in the home such as fire and gas installations to ensure the home is safe for people. Edgecumbe House DS0000046545.V355705.R01.S.doc Version 5.2 Page 22 EVIDENCE: People and staff said the manager was approachable and they felt confident in him. We saw that there is always a senior member of staff on duty at the home with advice and support readily available. Responsibilities for the day-to- day operation were shared between senior members of the team. A quality assurance system is used to seek the views of people and relatives. Regular meetings are held; minutes are kept and were available. Changes had been made to meals and activities at people’s suggestion. People said that their views and opinions were taken into account by staff. Staff receives management supervision at regular intervals. This is required to ensure individual staff development and monitor care practices. Staff had received training on moving and handling, fire prevention, food safety and infection control. No fire exits were obstructed and hazardous substances were securely stored. Statutory servicing and checks of equipment were complete. This is needed to maintain safety of people who live at the home. Staff had not received training in the Mental Capacity Act 2007. This would ensure staff were aware of the changes needed to fully protect vulnerable people living at the home. Edgecumbe House DS0000046545.V355705.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 X Edgecumbe House DS0000046545.V355705.R01.S.doc Version 5.2 Page 24 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA42 Good Practice Recommendations Staff should receive training in the Mental Capacity Act 2007. Edgecumbe House DS0000046545.V355705.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Edgecumbe House DS0000046545.V355705.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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