Care Home: Maldon House

Similar services:

• Thorndene
• Insight - Eastchurch
• Southfields
• Magenta
• Seabourne House
• 33 St John`s Church Road
• Dovedale Court
• Lyncol House

What the care home does well People are happy with the care and support they receive. One commented `I like living here, I get on well with everyone and I`ve made friends with X, X, X & X (all residents)`. Relatives spoken with were very positive about the home. Their comments included `its amazing and fantastic, we looked at five and this stood out. The staff are really good`. `X is really good we have lots of contact and they keep us involved`. `We are very happy with X`s (family member) quality of life, we have had no down sides in four and half years since X has been here`. Staff are happy working at the home. When asked what the home does well comments included `its friendliness of staff and supports service users really well, theres good team work`. `Its a rewarding nice home`. `Promoting independence, ensuring all needs of residents are met. `I think the residents are all happy at the moment`. `Keeping the homes up keep. Maintain the welfare of residents`. `Very good orientation, many trips out. Staff is very supportive to the residents`. `Meet the residents needs and identify their individual rights e.g. meals, drinks, outings. I feel the service they get is OK and on asking the residents at their monthly meetings they appear satisfied with everything`. `The service puts the residents first and meets their needs, also promotes independence`. What has improved since the last inspection? There were no requirements or recommendations for good practise made at the previous inspection. What the care home could do better: No requirements have been made at this inspection. Areas where the home could improved are recorded in the text of this report. Key inspection report Care homes for adults (18-65 years) Name: Address: Maldon House 26 Belgrave Road Seaford East Sussex BN25 2EG     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Sally Gill     Date: 0 2 1 1 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 29 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 29 Information about the care home Name of care home: Address: Maldon House 26 Belgrave Road Seaford East Sussex BN25 2EG 01323491102 01323491124 colin.scott@achuk.com www.achuk.com Aitch Care Homes (London) Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Type of registration: Number of places registered: care home 10 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is ten (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 M/F Whose primary care needs on admission to the home are within the following categories: Learning Disabilities (LD) Date of last inspection Brief description of the care home Maldon House is registered to provide accommodation for up to 10 adults with a learning disability. There is a manager in day to day control although not yet registered with the Commission. The premise is a detached property in a quiet residential area. The property has a secure rear garden with lawn, flower borders, established shrubs, paved area with tables, chairs, sensory cabin and trampoline. To the front of the home there is a lawn Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 10 Brief description of the care home area and parking in addition to on street parking. Accommodation is on two floors. All bedrooms are singles and are situated on both floors. All rooms have ensuite bath or shower facilities. People also have the use of two bathrooms. The home has lounge/dining room, conservatory and separate quiet lounge. The home has a passenger lift. The home is approximately ten minutes walk from the town centre with all its amenities, shops and railway station. There is a bus stop approximately five minutes walk and beach and park approximately ten minutes walk. The staff compliment consists of a manager, senior support workers and support workers. Support workers work a rota that includes five staff on duty during the day and two on waking duty at night. At the time of the visit current fees charged ranged from £1199.81 to £2042.31 per week. Additional costs would include toiletries and newspapers and magazines. Previous inspection reports are available from the home or can be viewed and downloaded from www.cqc.org.uk Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The previous inspection took place on 28th November 2006. This inspection was carried out over a period of time and concluded with an unannounced visit to the home between 09.25am and 4pm. The manager was not present on the day and staff assisted during the visit. People that live in the home, staff and relatives were spoken with. Observations were made throughout the day. Ten people were living at the home on the day of the visit. The manager was briefly spoken with following the visit. Surveys taken to the home on the day for staff to distribute to residents and staff. Five were returned from services users, two were completed with staff support. Most were very positive and others were generally positive. Five were completed by staff although unfortunately they completed social care and health professional surveys not staff surveys and this was not noticed on the day, some information has been used. These Care Homes for Adults (18-65 years) Page 6 of 29 were very positive. The care of four people was tracked in parts to help gain evidence as to what its like to live at Maldon House. Various records were viewed during the inspection and a part tour of the home undertaken. The home sent their annual quality assurance assessment (AQAA) to the Commission within the required timescale. The AQAA is a self-assessment picture of how the manager thinks they are doing against the national minimum standards. This was completed by the previous manager who left in August 2009. Care Homes for Adults (18-65 years) Page 7 of 29 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 29 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 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service and their representatives have the information needed to ensure they are choosing the right service. People can be sure their needs based on their assessment will be met. Evidence: People have the full information they need to make an informed choice about whether this home is right for them. A copy of the statement of purpose, residents guide and an introduction to Maldon House was obtained. The statement of purpose is a written document and was last reviewed in November 2009. The residents guide was not dated and is produced in a user friendly format using photographs, pictures and words. This document requires review as the address of the Commission needs updating as does the photograph of the manager. Staff told us the residents guide is given to each individual as they move into the home. A copy of the residents guide and statement of purpose is available on the organisations website. In addition an introduction to Maldon House has been produced in a user friendly format using photographs, pictures and words. This is produced specifically for each individual as they show an interest in moving into Maldon House. At which point their name and Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: room number are inserted into the text and the photographs are changed to reflect their bedroom and ensuite. Staff told us this booklet is given to the individual when they visit the home prior to moving in. People surveyed indicated they were asked if they wanted to move into this home and felt they received enough information about the home before moving in. Relatives spoken with also confirmed they received enough information about the home before their family member moved in. Peoples needs are assessed prior to using the service. The organisation undertakes a thorough assessment of individuals needs prior to making a decision about them moving in. Staff told us that staff from the referrals team go out to visit individuals in their current setting and undertake the assessment. Copies of these assessments were seen to be held on files. Assessments were detailed and included information in relation to the individuals own skills and what assistance would be required by staff. Staff from the home also visit the individual in their own setting. Assessments covered independent living skills, communication and future aims and goals and information was updated as the planned moving in process got underway. In one case a transition meeting was held with the individual, their family, staff from the home and professionals. Notes were recorded and held on file. Assessments and care plans from professionals such as social workers and previous placements were also obtained and held on file. Staff surveyed felt the home always ensures accurate information is gathered and that the right service is planned for people. People have agreed rules of the house with the home. According to the statement of purpose a user friendly format contract is agreed with each individual. However these were not evident on the files examined. It was evident some individuals have agreed the rules of the house and a contract of activities with the home as some files contained these and some were seen displayed in bedrooms. Staff at the home agreed to send the Commission a copy of the contract in place. In discussion after the visit with the manager it was agreed that the rules of the house and fees will be detailed in the residents guide and individuals will then agree and sign this as their contract of terms and conditions. People have had the opportunity to visit and test drive the home. Staff told us about the process followed when the last person moved into the home. This involved a couple of visits to the home by the individual with their family and then proceeded onto two overnight stays. These visits ensure people are able to visit the home, meet staff and other people living there. Individuals and relatives spoken with confirmed they or their family member had had the opportunity to visit the home and look round, stay for a meal and also stay overnight. Care Homes for Adults (18-65 years) Page 11 of 29 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. Individuals are involved in decisions about their lives and play a role in planning the care and support they receive although this could be better evidenced. Evidence: Peoples skills and needs are reflected in their care plans. Four care plan folders were examined. Assessments provide information to staff on peoples skills and what support is required. Some folders contained an essential lifestyle plan but not all. From assessments the support needs of the individual are identified and guidelines of support are draw up. These would include how to manage any behaviours that may be difficult or challenging. All identified needs had been reviewed within recommended timescales. Individuals likes and dislikes that could cause distress are recorded including food, how the individual likes to spend their time and where they like to spend their time. Although one individual said they were aware of their care plan and had seen it this was not evidenced in the care folder. Only one folder viewed evidenced the individuals involvement in their care plan although this had been in January 2007 and April 2008. Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: Peoples agreed goals are identified within their care plan using a format of words and pictures. Most contained updates and action taken to date. All care plan folders contain a weekly activities timetable in a user friendly format using pictures and words. Staff told us reviews are held six monthly. However folders examined highlighted some slippage on this. One person who had moved in during February 2009 did not have any review paperwork on file and another was showing the last review as March 2009. Staff told us the key worker would work with the individual prior to the review meeting and discuss with them who they wanted to invite, where they want to hold their review and any goals they would like to achieve. However none of this planning is recorded or was evident in folders. Good practise would be to record this on a user friendly format. Review notes in place confirmed individuals, their relatives and professionals were involved in review meetings. People are able to make decision about their day to day life. It is evident people make decisions about what to eat, what to wear, how to spend their time and what activities they would like. Pictures, photographs and Makaton signs are all used to ensure people have real choices. One individual spoken with said there are some resident meetings. Staff told us these are usually monthly. Records confirmed considerable slippage on this. Staff told us a meeting had been held on 17/09/09 but as yet there were no minutes. Minutes on file showed only two other meetings had been held this year (January and April). Minutes in a user friendly format showed people are given feedback about previous items discussed, people are asked about the support they receive to ensure they receive privacy, dignity and respect, people are asked for ideas in relation to holidays and activities and feedback is given on trips taken and those planned. The minutes of the April meeting were displayed in the home. The meeting in January was also video recorded so people could watch it back. People surveyed were mixed about whether they are able to make decisions about what they do each day indicating always, usually and sometimes. Any limitations in place are in line with the homes duty of care and are recorded in the care plan. People are supported to take appropriate risks. Risk assessments for two people were examined. Risk assessments contained details of actions to reduce any risk and had been reviewed in line with good practise timescales of six months. It was also apparent where there had been changes or incidents risk assessments had been reviewed sooner. Care Homes for Adults (18-65 years) Page 13 of 29 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 excellent 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 able to make choices about their lifestyle, and are supported to maintain and develop their life skills. People have opportunities for a wide range of social, educational and recreational activities. Evidence: People are able to enjoy a full, active and stimulating lifestyle with a variety of activities and educational options to choose from. Records and discussions confirmed that people have lots of opportunities to get out into the community and undertake a wide variety of activities. Each individual has an activity planner produced in a user friendly format using signs, pictures and words. In addition some individuals have a communication board in their rooms where staff write down the planned activities. All individuals go to college for a variety of courses including creativity, business studies and IT skills. Records showed recent activities have included Seaford personal shopping, line dancing, swimming in Eastbourne, the pub, ballet and tap class, Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: aerobics, cinema, meal out, church, legs bums tums class, Witherspoons in Brighton, Pilates class, pier on rides, walk, Eastbourne shopping, shopping, bowling, pizza hut, walk, haircut, show at theatre in Brighton and eat out, drive into Eastbourne, Crumbles in Eastbourne, Bluebell railway and lunch out, pub meal in Seaford, Hampden Park walk and drink, bus to Friston Forest, swimming, Cuckmere walk along the lake and Eastbourne park and drink in cafe. On the the day of the visit the home was a hive of activity at times with most going out to a planned activity or to college. People use a photograph in/out system when coming in and going out. At the staff handover further activities were discussed which were planned for the evening. Staff told us the home has two vehicles to transport people, people also walk locally and use public transport such as trains and buses. Relatives confirmed their family member goes out lots. Records showed recent in house activities have included time on a laptop or computer, videos, music session, aromatherapy, television, music, DVD, music entertainer and board games. One the day of the visit people were involved in a cookery session, using the computer, watching television or just spending time as they wished. Free time is planned in to peoples timetable as is one to one time with their key worker and a house day when individuals do their chores such as room clean and laundry. This is so individuals can choose what to do rather than have all their time structured. It was apparent that people choose where they want to go on holiday and staff told us holidays this year had included Centre Parcs, Blackpool and France. People surveyed indicated they can do what they want in the day, evening and weekend. One person spoken with confirmed they can do what they want in the evenings and weekends. Staff surveyed indicated the service always support people to live the life they choose. People are supported to maintain contact with friends and family. Discussions and records confirmed people are able and encouraged to maintain contact and visit families. Several individuals visit their family at weekends, stay over or go home for holidays. Individuals are supported to have regular telephone contact with family. Staff told us one individual uses their computer and web cam to stay in touch with a relative. An individual told us they use email and face-book to stay in touch and also access the Internet. Relatives spoken with that visit regularly were entirely happy with the care and support their family member receives. They felt they were made welcome at the home and were quickly furnished with a cup of tea and also felt the home keeps them well informed. They said the family is always invited to partys and events. Peoples are supported to be independent and involved in all areas of daily living in the Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: home. Individuals confirmed routines are flexible. Discussions and records confirmed that people participate in the getting their own breakfast, helping or preparing and cooking meals, laundry and cleaning their rooms. One individual said Im learning to live independently, I do my own laundry, prepare my own meals there are things in the cupboard to cook. Staff were observed to interact well with individuals throughout the day of the visit. Relatives spoken with confirmed there are good interaction between staff and people living in the home which is very positive. Staff told us three individuals have keys to their rooms. People are involved in menu planning. Choice menus are in place with a four week menu rotation. Menus are produced in a user friendly format using pictures, Makaton signs and words. One individual is a vegetarian and has their own four week menu and does all the planning for the shopping of their meals. People spoken with confirmed they were happy with the food, one said it is very nice, you can have what you want. A relative also confirmed the food is good. Several individuals were observed to be in the kitchen preparing their own lunch and others had gone shopping at the supermarket. Staff spoken with told us people are involved with the food shopping which is done weekly. Breakfast is cereals and toast with cooked on Saturdays. Lunch is sandwiches or a light meal. The main meal is in the evening. Through the four weekly menus meals out and themed nights are incorporated. One staff member told us if people do not want to go out we sometimes get a take away its their choice. Care Homes for Adults (18-65 years) Page 16 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put in practise. Evidence: People receive support in a way that they prefer and require. A key worker system is in place and individuals were aware who their key worker is. A picture board of staff on duty today is in place. Staff are identified at hand overs to work with individuals for activities and/or personal care. Care plans and discussions confirmed people are encouraged to be as independent as possible with their personal care. Everyone has the luxury of an ensuite with shower or bath with shower over to ensure privacy. If individuals have a shower and wish to have a bath there are also communal bathrooms. Individual personal shopping time with key workers is incorporated to timetables so people are able to choose their own toiletries, clothing etc. Records confirm that individuals shop for their own clothes and have their hair cut as they choose. People were dressed individually reflecting personalities and one bedroom viewed had evidence of plenty of make up and cosmetics. During the visit people were treated with respect and their rights to privacy upheld. Staff surveyed indicated the care service always respects peoples privacy and dignity. Individuals confirmed they Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: are able to get up, go to bed, have a shower and their meals when they please. People have a health action plan in place. Details in the health action plan are updated and included information about health concerns. Appointments such as optician and dentist can be easily tracked with outcomes of appointment also recorded. Records and discussions confirmed people have access to their GP, dentists, opticians and attend hospital appointments as required. One individual confirmed if they are not well they are able to see the doctor. A relative talked positively about how the home had arranged counselling for their family member after a bereavement. They also said they family member had been supported well by staff to attend hospital out patients through to a hospital admission to have an operation. Staff surveyed indicated the care service always seek advice and act on it to meet peoples health care needs and improve their well-being. In the homes own quality survey health and social care professionals scored 3 or 4 out of 5 (highest) against providing good quality care and supporting people appropriately for appointments. People are protected by safe medication systems. The home has a medication policy in place. Storage for medication is safe and secure. Each individual has a Personal Medication Information sheet detailing their medication including dates it commenced and stopped. Medication Administration Records (MAR) charts were examined and had appropriate use of codes and signatures. Handwritten entries on the MAR charts were not signed, dated or witness which is good practise. There are specific instructions for medications given as required. Staff that administer medication have received training. Since the last visit there have been incidents reported of medication errors. Staff told us action has been taken. Medication administration is now planned so only one individual is in the medication room at any one time. Care Homes for Adults (18-65 years) Page 18 of 29 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. People who use the service have opportunities to express their concerns, and have access to a complaints procedure, and are protected from abuse. Evidence: People have opportunities to express concerns. Staff told us people are given a residents guide which is in a user friendly format and does contain a complaints procedure although details in this require updating. The AQAA stated seven complaints have been received by the home which was confirmed by complaints folder. All complaints were logged including the outcomes and individual more detailed records are maintained. It is acknowledge that some people would require assistance to make a complaint. People surveyed indicated they know who to speak to if they are not happy and how to make a complaint. An individual confirmed who they would speak to if they were not happy and felt comfortable to do this. They told us they had previously complained and this had been resolved. Most people surveyed indicated that staff and managers always listen and act on what they say, one indicated sometimes. People surveyed indicated staff always treat them well. Minutes of resident meetings held showed people are asked about the support they receive and any concerns. Staff surveyed indicated the service always responds appropriately if they or a person using the service have raised concerns. Relatives spoken with said they had not had the need to complain, they would complain to X (deputy) as we feel we can talk to X. They were confident anything would be resolved. They said there was an anonymous complaint to the home which shocked them but it was Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: investigated. People feel safe living in the home and are protected from abuse. The AQAA states that polices and procedures are in place to safeguard people. There have been a number of referrals and safeguarding investigations all of which have been managed appropriately. Records confirmed that staff undertake safeguarding training during induction. Staff spoken with were clear about the routes to report any abuse within the organisation. Staff this year have undertaken an additional safeguarding workshop to ensure they are clear about safeguarding procedures. Detailed behavioural guidelines are in place for those individuals who may display aggressive behaviour to ensure staff deal with this in a consistent way. Records show staff are trained in preventing and managing challenging behaviour. Any incidents are recorded to try and identify any triggers. Care Homes for Adults (18-65 years) Page 20 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home, which is comfortable, clean and homely. Evidence: People live in a homely, comfortable and safe home. A part tour of the home was undertaken with a member of staff and only one concerns was highlighted. There was an unpleasant odour on the stairs which was probably coming from the carpet. A staff member told us a new stair carpet has already been requested to head office. The home is a modern and decorated to a high standard. People are involved in choosing colours for the decor and also furniture. All rooms have a homely and comfortable feel and are fully accessible. A passenger lift is installed. One individual felt the position of the home was good they said best thing about living here was its a nice seaside place, nice shops and I like Eastbourne. Peoples bedrooms are individual, personalised, very homely and promote their independence. All bedrooms viewed reflected peoples personalities, interests and hobbies. Individuals spoken with confirmed they are happy with their room and everything is in working order. One confirmed there is plenty of hot water for a shower although the bathroom (ensuite) is a bit small. One individual confirmed they had chosen the colour of their room when they moved in and they kept their room clean and tidy. Another confirmed they had been able to choose which room they Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: wanted. The homes own quality assurance survey confirmed all individuals liked their rooms. Bedrooms are lockable and three people hold keys to their rooms. Peoples bathrooms provide privacy and meet individual needs. In addition to every bedroom having an ensuite there are two bathrooms, one on each floor. There are also three other toilets. One toilet was out of action but all staff spoken with confirmed any problems once highlighted are quickly put right. People have access to good shared space which compliments their own room. The homely dining room, lounge and conservatory are three separate rooms with large archways connecting them. The conservatory has a pool table and doors to the enclosed garden which is accessed by steps. The garden is well maintained with lawn and established flowers, shrubs and trees. In the garden there is a large trampoline, barbecue, swing, tables and chairs. The garden now also has a cabin/large summer house which is equipped and used as a sensory room. There is also a quiet lounge, a well equipped kitchen and small laundry. The home was clean and tidy throughout. Most people surveyed indicated the home is always clean and fresh, one indicated usually and another sometimes. Liquid soap and paper towels are supplied as necessary to avoid infections. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to support the people in the service and to support the smooth running of the service. Evidence: People benefit from staff who are qualified. Staff told us eight staff have obtained a National Vocational Qualification (NVQ) level 2 or above and four are currently undertaking the qualification. When completed this will more than meet the recommended 50 for good practise. People surveyed indicated that both staff and managers always treat them well. There is a team of seventeen permanent and two flexi staff in the home in addition to the manager. The team is male and female. Staff told us there are a minimum of five staff on duty during the day. Two members of staff are on a wake night duty at night. Staff told us at weekends staffing can be reduced as several people do go home. Staffing at this time is would be based on individuals needs but there would be a minimum of three staff on duty during the day and two at night. One staff member spoken with confirmed the staff team is stable. Time is planned into the rota to enable a shift hand over. A hand over was observed. Information regarding individuals was discussed to bring staff up to date. This time is also use to allocate staff to work with individuals either for activities or personal care. A shift planner is in place for each Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: shift. Recruitment records must be strengthened to fully protect people. Staff have been recruited in the last twelve months and these files were examined. Application forms, references, Criminal Records Bureau (CRB) and Protection Of Vulnerable Adults (POVA) checks were in place. However all application forms showed gaps in employment history and there was no record of an explanation as required. One file had two references addressed to to whom it may concern which is not good practise. One file had a reference from a previous employer in retail but not from the two most recent employers which were both care providers. Peoples needs are met by appropriately trained staff. Staff told us new staff always undertake an induction. Staff spoken with confirmed this included shadowing existing staff and for a period and would be over and above normal staffing numbers. Staff also undertake induction training to Skills for Care specification in the form of a workbook within six months. Although two staff have had this timescale extended. Good practise guidance recommends induction is completed within three months. A copy of the training matrix was viewed although staff told us this was not up to date. Staff agreed to send the Commission a copy of the up to date matrix. In discussion with the manager after the visit they told us that all staff have undertaken mandatory training such as fire, first aid, food hygiene, infection control, moving and handling, medication and safeguarding adults in early 2008 or since. Some staff have received refresher training although a lot is outside of the organisations own refresher timescales and the home now intends to work to meet those. Staff told us training for essential lifestyle planning is planned for January 2010. Staff surveyed indicated they always have the right skills and experience to support people social and health care needs. People benefit from a staff team which feel supported. Supervision records were examined for three staff who started in March 2009. Records showed one had received monthly supervision. The others had only received two supervision sessions in that time although these were in August and October. Two staff spoken with confirmed they receive monthly supervision and feel well supported. Care Homes for Adults (18-65 years) Page 24 of 29 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 management of the home creates an open, positive and inclusive atmosphere and is run in the best interests of people living there. Evidence: People benefit from a well run home. Since the last visit the manager has left and a new manager is in post. However there is no evidence the Commission has been informed of this change which is required under legislation. The home must inform the Commission in writing. Staff told us the new manager started in August 2009. According to the residents guide the manager is a registered social worker and has an NVQ level 4 in management. They are also an A1 assessor and have completed mandatory training. Staff told us the manager is in the process of submitting an application to register with the Commission. A relative told us the previous manager was good but we have not had a lot of dealings with the current manager. People have opportunities to express their views on the home. People are asked to complete an annual questionnaire to gain feedback on the home. The last survey was completed in November 2008. Results were sent to the Commission. Parents/carers Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: indicated they were pleased with the service by scoring 4 or 5 out of 5 (highest). Residents meetings are in place but as previously mentioned these have not been that frequent. People also spend one to one time with their key worker. Regulation 26 visits required by legislation have taken place to check the quality of care provided and a report is produced. However records show these have not been monthly as required by legislation. There have been five this year to date. The previous manager submitted the AQAA. Information was comprehensive and gave a good picture of the home. The AQAA indicated that health and safety checks and maintenance is carried appropriately. Care Homes for Adults (18-65 years) Page 26 of 29 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 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!