Care Home: Sea Gables

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What the care home does well From observing staff and residents it was clear that residents were happy living at the home and that staff and residents got on well together. Care plans were person centred and told staff what support was needed for each individual and how the service users wanted the support to be given. There was good evidence to show that residents are given every opportunity to make their own decisions and they are offered choice in all aspects of their life and staff are on hand to offer support when required. The residents are supported to participate in a range of activities that suit each individual and activities were arranged with consultation with each service user. Users of the service and are encouraged and supported to be involved as much as possible in the day to day running of the home and staff provides care and support to enable residents to live an independent lifestyle as much as possible. The routines in the home promote residents independence and they are encouraged to do as much as possible for themselves. The home has clear policies on equality and diversity and all residents` personal lifestyles are respected while personal image and dignity are maintained. The home has a dedicated and stable staff team and staff have been supported to obtain recognised qualifications. They are committed to their role and work well together as a team. The home has an effective training programme and staff said that the home provides training in all areas and this enables them to carry out their job effectively. What has improved since the last inspection? Since the last inspection one extra bedroom has been registered for use and a bathroom has been refurbished with a new shower fitted. The manager`s office has moved and a new activities room is nearing completion. What the care home could do better: CARE HOME ADULTS 18-65 Sea Gables 6 Northcliff Gardens Shanklin Isle Of Wight PO37 7ES Lead Inspector Mick Gough Unannounced Inspection 26th January 09:30 Sea Gables DS0000012587.V373264.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 Sea Gables DS0000012587.V373264.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. Sea Gables DS0000012587.V373264.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sea Gables Address 6 Northcliff Gardens Shanklin Isle Of Wight PO37 7ES 01983 861473 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) Mr Anthony James Delannoy Hannah Louise Delannoy Mr Anthony James Delannoy Hannah Louise Delannoy Care Home 7 Category(ies) of Learning disability (0) registration, with number of places Sea Gables DS0000012587.V373264.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Learning disability (LD). The maximum number of service users to be accommodated is 7. Date of last inspection 7th March 2007 Brief Description of the Service: Sea Gables is a three-storey house that has been converted to provide care and accommodation for up to seven younger adults with a learning disability. All bedrooms are for single occupancy and have en-suite facilities. The home provides pleasant communal facilities and gardens. The home is located in a residential area of Shanklin, close to shops and public transport. The home is owned by Mr and Mrs Delannoy and who are jointly registered managers of the service, however the day to day management of the service is carried out by Mrs Delannoy who is in the home on a daily basis. Weekly Fees: Fees at the home are dependent on the type and level of support each individual resident requires and details of current fess are available from the home. Sea Gables DS0000012587.V373264.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 the people who use this service experience Good quality outcomes. This report details the evaluation of the quality of the service provided at Sea Gables and takes into account the accumulated evidence of the activity at the home since the last key inspection, which was carried out in March 2007. The inspection also took into account the last annual service review which was carried out in February 2008. Included in this inspection was an unannounced site visit to the home, which took place on the 26 January 2009. Evidence for this report was obtained from reading and inspecting records, touring the home and from observing the interaction between staff and users of the service. It was possible to meet and talk with 2 of the residents, 2 members of staff and the homes managers who assisted the inspector during the visit. We also sent out surveys to interested parties prior to our visit to the home and responses were received back from all of the service users, 2 Health Care professionals and 7 Members of Staff. Comments received back included ”There is good communication between staff” “ The home puts the service users fists and provides good support to live as full lives as possible” “This is the most friendly and effective Staff team I have ever worked in” The home is registered to provide support for 7 residents and at the time of the inspection there were 6 people living at the home. What the service does well: From observing staff and residents it was clear that residents were happy living at the home and that staff and residents got on well together. Care plans were person centred and told staff what support was needed for each individual and how the service users wanted the support to be given. There was good evidence to show that residents are given every opportunity to make their own decisions and they are offered choice in all aspects of their life and staff are on hand to offer support when required. The residents are supported to participate in a range of activities that suit each individual and activities were arranged with consultation with each service user. Users of the service and are encouraged and supported to be involved as much as possible in the day to day running of the home and staff provides care and support to enable residents to live an independent lifestyle as much as possible. Sea Gables DS0000012587.V373264.R01.S.doc Version 5.2 Page 6 The routines in the home promote residents independence and they are encouraged to do as much as possible for themselves. The home has clear policies on equality and diversity and all residents’ personal lifestyles are respected while personal image and dignity are maintained. The home has a dedicated and stable staff team and staff have been supported to obtain recognised qualifications. They are committed to their role and work well together as a team. The home has an effective training programme and staff said that the home provides training in all areas and this enables them to carry out their job effectively. What has improved since the last inspection? What they could do better: There were no requirements made as a result of this visit however points, which need to be addressed to help improve the service provided for residents are contained within the main body of the report. General observations were: Care plan folders would benefit from having old and irrelevant information removed and archived. The plans we saw were bulky and they contained some old information and this did not always make relevant information easy to find. One care plan seen was for a service user who had epilepsy and this plan required more information as it did not proved clear guidance for staff on what action they needed to take if the person had a seizure. Although there was evidence in care plans that reviews take place each month, this was normally just information such as “care plan reviewed” together with a date. There was no evaluation on how the care plan was working and this type of recording did not provide any evidence that service users were involved in the review process. Care plans contained risk assessment, however there were a number that were generic risk assessments for the home environment and these were duplicated for each resident. The home’s medication cabinet was checked and this was suitable for its current purpose, and the home does not currently hold any controlled drugs. However the law concerning the storage of controlled drugs has changed and the home was reminded that should there be a need for any controlled drugs Sea Gables DS0000012587.V373264.R01.S.doc Version 5.2 Page 7 to be held at the home, they must be stored in a proper Controlled Drugs Cupboard. A proper Controlled Drugs cupboard is one, which meets the standard set in the Misuse of Drugs (Safe Custody) Regulations 1973. Suppliers of CD cabinets can confirm that a cupboard meets the legal requirements. In brief, the requirements for CD storage are: • • • • Metal cupboard of specified gauge Specified double locking mechanism Fixed to a solid wall or a wall that has a steel plate mounted behind it Fixed with either Rawl or Rag bolts Suppliers of CD cabinets can confirm that a cupboard meets the legal requirements. We recommend that care homes request formal confirmation when purchasing a CD cabinet. 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. Sea Gables DS0000012587.V373264.R01.S.doc Version 5.2 Page 8 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 Sea Gables DS0000012587.V373264.R01.S.doc Version 5.2 Page 9 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective users of the service can be confidents that their needs would be fully assessed before they move into the home. EVIDENCE: Last inspection found that all residents had been in the home for some considerable time. There have not been any new admissions to the home. The homes completed AQAA told us that a full needs assessment would be carried out before anyone moved into the home and families and relevant professionals would be involved in the assessment process. We spoke with the manager and she confirmed that there is a policy and procedure to follow with regards to any prospective new service users and that Introductory visits to the home would be arranged to ensure suitability and the individual could then make a decision on whether to move in to the home or not, this would also give the home the opportunity to ensure that the service users needs could be met. Sea Gables DS0000012587.V373264.R01.S.doc Version 5.2 Page 10 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The assessed needs and personal goals of residents are reflected in an individual plan of care however plans would benefit from having old information removed to make relevant information easy to find. Care plans are reviewed monthly but the reviews do not provide evidence that service users are involved in the review process and care plans did not always provide staff with the information they need to provide the support that may be required. People who use the service are supported to make decision about their lives with assistance given by staff. Residents are supported to take responsible risks and this allows them to live an independent lifestyle as much as possible. EVIDENCE: Care and support plans were seen for 2 residents and care plans were kept secure in a cupboard on the first floor of the home. We found that care plan folders were bulky and they contained some old information and this did not always make relevant information easy to find. Care plans gave information on individual, problems and needs and included information on morning and Sea Gables DS0000012587.V373264.R01.S.doc Version 5.2 Page 11 evening routines and these told staff what support the individual needed and also gave information on the persons own abilities. Both care plans seen reflected the person’s individuality and were specific to the person concerned, there was good information on the persons likes and dislikes. Care plans also had support plans, which identified the person’s goals and gave information on desired outcomes and provided an action plan to achieve this. However one care plan seen was for a service users who had epilepsy and this plan did not proved clear guidance for staff on what action they needed to take if the person had a seizure. The day to day manager told us that the service user was currently having their medication and epilepsy support reviewed and she told us a detailed care plan was in the process of being made up to give guidance to staff with regard to the persons support needs when having a seizure. The AQAA told us that all service users had key workers who meet with them regularly to review care plans. There was evidence in care plans that reviews take place each month, but these were normally just information such as “care plan reviewed” together with a date. There was no evaluation on how the care plan was working for the service user and this type of recording did not provide any evidence that service users were involved in the review process. Daily recording was carried out and this provided good evidence of care delivery and also provided information on what the service users had been doing and how they had been through the day. Residents are supported to make decisions about their day-to-day lives and care plans and recording gave good information on how staff involved residents in decision making. We observed staff supporting residents to make informed decisions throughout the visit and staff respected the resident’s choice and allowed them to do things for themselves as far as they were able. Care plans looked at contained risk assessments and these gave details of the assumed risk, the level of risk and also details of the risk. They detailed control measures to minimise the risk and they gave staff good information on any support that was required, however there were a number of generic risk assessments in residents care plans that were for the home environment and these were duplicated for each resident. Sea Gables DS0000012587.V373264.R01.S.doc Version 5.2 Page 12 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): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are supported to take part in appropriate activities and they access the local community on a regular basis. They have opportunities for personal development and are encouraged and supported to be part of the local community. The homes visiting policy supports residents to maintain family links and their rights are respected. Residents are offered support to plan their own menu and are provided with a balanced diet in pleasant surroundings. EVIDENCE: The homes completed AQAA told us that all residents are encouraged to be involved in social groups and that they support residents with college and to maintain appropriate jobs and interests and on the day of the visit we were able to confirm this. Each resident had an individual plan in place, which clearly promotes independence, positive risk taking and choice and the activities plans for each resident was in a picture format that residents could understand and the plan informed them what was taking place each day and who was supporting them with this. One resident is quite independent and is Sea Gables DS0000012587.V373264.R01.S.doc Version 5.2 Page 13 able to go out on her own but she is supported to go to college where she takes part in activities to improve her independent living skills, one service user works in a charity shop one morning a week and another residents works one morning a week at a local hotel in the holiday season. Another resident has worked in a local pet store and staff provide support for residents to gain employment but allow them to do as much as possible for themselves. 2 residents have been supported to obtain Duke of Edinburgh Bronze Awards and 2 residents take part in special Olympic events. The manager told us that one resident expressed a wish to learn to drive and they arranged for him to have some lessons on a private car park with a professional instructor. There are 6 residents who live at the home and on the day of the visit 4 were out with staff in the local community. The manager told us that they are well known in the local area and like visiting local pubs and cafes. Residents use local buses to get around and have travel cards and they are encouraged to use public transport although the home has 2 vehicles for residents use. The home arranges holidays for residents and we were told that they have a meeting to decide where they would like to go but they normally choose to go together to a local holiday centre. All of the residents have relatives who keep in touch, one service user phones her family every day, others have visitors who come 3 or 4 times a year, some residents go home for weekend stays and some exchange cards. The home has a visiting policy and there are no restrictions on visitors. Residents are able to choose who they wish or do not wish to see and staff told us that they would respect their wishes. Daily routines in the home promote residents independence as much as possible and they are encouraged to participate in day to day routines in the home. During the visit staff were observed interacting with residents and they got on well together, staff used residents preferred form of address and those residents we saw appeared happy at the home. Staff were seen to knock on residents doors before entering and were asked their views on what they wanted to do. Resident’s rooms reflected their individual personalities and the manager told us that residents could be involved as much or as little as they want. Mail is given to residents unopened and staff support is available if required. Residents have all access to areas of the home and there were no restrictions. Menus at the home are made up with residents involvement, there is a residents meeting each week where staff support residents to make up the next weeks menu. Breakfast is normally a choice of cereals, toast or cooked items; lunch is normally a snack type meal or a packed lunch which residents make themselves with staff support. On the day of the visit we observed staff support both residents who were at home to make their own lunch, they were able to make their own decision on what to have and staff offered encouragement and advice but residents made their own lunch and were well Sea Gables DS0000012587.V373264.R01.S.doc Version 5.2 Page 14 supported with this task. The main meal of the day is in the evening and the menu for the evening meal is displayed in the kitchen and a record of all food consumed is kept. The manager told us that the menu is flexible to allow for meals out and take-away’s. The manager orders the weekly shopping online and this is then delivered to the home. Day to day shopping is carried out by service users supported by staff and we were told that service users are able to buy ingredients from the local shops and them go home and staff will support them to make their meal. Meals are normally taken in the dining room but residents can eat elsewhere if they wish. Sea Gables DS0000012587.V373264.R01.S.doc Version 5.2 Page 15 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): Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The health, personal and social care needs of residents are set out in an individual plan of care and residents have access to all relevant health care professionals and generally their health care needs are met, however not all plans seen gave staff all the information they need to provide effective support. Residents are protected by the homes policies and procedures regarding medication. EVIDENCE: The homes completed AQAA told us that personal care is carried out with the utmost dignity and support is only given when needed and this was evidenced by the individual plans of care for residents, the plans detail what support was needed for each individual resident and also how the resident wanted their support to be given. The home has a mix of both male and female service users and staff and there is a policy on staff members giving cross-gender personal care. The manager told us that resident’s requests on who provided them with support would be recorded and respected. All of the current residents are able to undertake some of their own personal care tasks and the support needed is detailed in their care plans. Some residents only need Sea Gables DS0000012587.V373264.R01.S.doc Version 5.2 Page 16 verbal prompts and encouragement while others need more staff input. All support is offered flexibly to suit resident’s needs. Residents are all registered at 2 local GP surgeries, however may have different GP’s. 3 service users are registered with a local NHS dentist and 3 have private dentists. Sight tests are obtained from local opticians in Newport and Shanklin and 1 service user is supported by a psychologist from Southampton Hospital. Community nurses are available from the GP surgery and residents are able to access other healthcare professionals through GP referral. 2 members of staff at the home have received training to enable them to cut residents nails and there was evidence that all female service users had access to a “well woman” clinic. The manager told us that she is trying to arrange check ups for the male residents. All residents were seen to have health care folders and these contained medical information and there were details of any health care appointments or visits recorded together with information on the visit and diagnosis. The files and the information in care plans provided evidence that resident’s health needs are monitored and generally met. However as stated in the Individual Needs and Choices section of this report, one care plan seen was for a service user who had epilepsy and this plan did not provide clear guidance for staff on what action they needed to take if the person had a seizure, there was no information on the types of seizure or the time the person would be expected to come out of the seizure nor was there any information to guide staff on what action they could be expected to take to support the person during the seizure. The day to day manager told us that the service user was currently having their medication and epilepsy support reviewed and she told us a detailed care plan was in the process of being made up to give guidance to staff with regard to the persons support needs when having a seizure The home has a clear medication policy and procedure and all staff have received training in the administration of medication. There was information for the receipt, storage, disposal and administration of medication. The home uses a monitored dose system for medication and records were inspected and found to be accurate and up to date. We found that the medication administration records were kept loosely in the medication cupboard and it was recommend that these are kept together in a folder together with the procedure to be followed when administering medication at the home. The home’s medication cabinet was checked and this was suitable for its current purpose and the home does not currently hold any controlled drugs. However the law concerning the storage of controlled drugs has recently changed and the home was reminded that should there be a need for any controlled drugs to be held at the home, they must be stored in a proper Controlled Drugs Cupboard. A proper Controlled Drugs cupboard is one, which meets the standard set in the Misuse of Drugs (Safe Custody) Regulations 1973. Suppliers of CD cabinets can confirm that a cupboard meets the legal requirements. In brief, the requirements for CD storage are: Sea Gables DS0000012587.V373264.R01.S.doc Version 5.2 Page 17 • • • • Metal cupboard of specified gauge Specified double locking mechanism Fixed to a solid wall or a wall that has a steel plate mounted behind it Fixed with either Rawl or Rag bolts Suppliers of CD cabinets can confirm that a cupboard meets the legal requirements. We recommend that care homes request formal confirmation when purchasing a CD cabinet. Sea Gables DS0000012587.V373264.R01.S.doc Version 5.2 Page 18 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a clear and accessible complaints procedure and service users can be confident that their views would be listened to and acted upon, any complaints are logged and responded to appropriately. The homes policies and procedures help to protect service users from any form of abuse. EVIDENCE: The home has a clear and accessible complaints procedure and the manager told us that this is made available to service users and their representatives. The home has a complaints book and this showed that there had been no complaints made to the home since the last inspection and the homes completed AQAA also confirmed this. Staff spoken with on the day of the visit were aware of the homes complaint procedure and told us that they would help and support any resident who wished to make a complaint. In returned comment cards from staff and service users there was evidence that they were aware of the homes complaint procedure. The homes completed AQAA told us that all staff receive adult protection training and that there had recently been a Safeguarding training day and that the homes policy has been reviewed and updated. We saw that the home has an adult protection policy which links to the Isle of Wight Adult Protection policy and there are also appropriate policies for whistle blowing and gifts to staff. A summary of these policies are detailed in the staff handbook, which is issued to all staff. Staff members and also the manager who we spoke with were aware of their responsibilities and knew who any concerns should be reported to and what procedures should be followed. Sea Gables DS0000012587.V373264.R01.S.doc Version 5.2 Page 19 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a homely and comfortable environment and the home is clean and hygienic and free from offensive odours. EVIDENCE: We walked around the home with the manager and saw all communal areas and bedrooms and we found that the home is well maintained and pleasantly decorated and contains all the appropriate furniture, fixtures and fittings. All bedrooms were single and had en-suite facilities and we were told that residents have been involved in choosing the decoration. Bedrooms contained personal items and reflected the individual’s personal tastes and choices. The home has had an additional bedroom registered with CSCI but the manager informed us that at present the intention is to use the new room to move residents so that their bedrooms can be re-decorated. The manager told us that residents would be fully involved in choosing the colours and deciding how their room would be decoration. The completed AQAA told us that the home is well maintained and residents are involved in all aspects and are supported to re-arrange their rooms when they want to. Residents were seen to have Sea Gables DS0000012587.V373264.R01.S.doc Version 5.2 Page 20 individual timetables for cleaning and tidying their bedrooms and undertaking personal laundry and staff support was available for them to do this. The home has a spacious lounge/dining room, and an additional sitting room equipped with TV and games console. There is a large kitchen, which is well equipped and this has a small dining area. There is a utility room, which has 2 washing machines and 2 tumble driers. We were told that residents are encouraged to do their own laundry and staff are on hand to provide support if required. Residents have specified days for doing their laundry but can also use the machines at other times if required. Staff confirmed that they are provided with protective clothing and the home has policies and procedures on infection control and staff confirmed that they receive training in this area. Sea Gables DS0000012587.V373264.R01.S.doc Version 5.2 Page 21 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): Quality in this outcome area is Excellent. This judgement has been made using available evidence including a visit to this service. Competent, qualified and appropriately trained staff supports residents and meet their needs. The homes recruitment policy and practice protect residents. EVIDENCE: There is a good staff mix at the home and all staff are encouraged and supported to undertake National Vocational Training. Currently the home employs 17 care staff and of these 17 three staff members hold NVQ3, four staff hold NVQ2 and 4 staff are currently undertaking NVQ2 and the home completed AQAA told us that there is a strong commitment to training and all staff are encouraged to undertake NVQ qualifications. We looked at the staff rota and this is made up to reflect the support needs of the service users. Some service users require 2 – 1 support when the go out into the community and the rota along with the residents support programme reflect the staffing levels required. The manager told us that there is a minimum of 3 staff on duty between 0700 and 2300 with additional staff coming in to provide support to residents. At times there can be 6 or 7 staff members on duty who are supporting residents in the home or out in the community we found that the manager deploys her staff effectively to ensure Sea Gables DS0000012587.V373264.R01.S.doc Version 5.2 Page 22 the resident’s needs are met. At night one member of staff sleeps in between 2300 and 0700 and this staff member is back up by an on call member of staff who is able to come in and give extra support if required. Comments received back from staff that completed surveys and those staff we spoke with on the day of the visit felt that staffing levels were sufficient to meet resident’s needs. We were told by the manager that the home has robust recruitment practices and that new staff only start at the home after all employment checks have taken place. Recruitment records were seen for 2 members of staff and these contained all of the required information including application form, 2 x references, Criminal Record Bureau and Protection of Vulnerable Adults Checks, Passport, driving licence, health declaration, interview notes, photo and qualifications. Staff spoken with told us that their recruitment was thorough. The manager told us that staff undertake induction training, which is linked to skills for care and NVQ, and this is completed within the first 6 weeks of employment. Training is provided through Video training and also through training organisations and staff receive a certificate when training has taken place. We saw training records for staff and this showed that training had taken place in; moving and handling, fire safety, adult protection, medication, first aid, health and safety, food hygiene and infection control. Specialist training is also made available to meet the needs of residents and this includes; learning disability, person centred planning and managing challenging behaviour. Staff members spoken with confirmed that they had received a good induction and said that there was regular training provided at the home. Sea Gables DS0000012587.V373264.R01.S.doc Version 5.2 Page 23 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from a well run home and the views of residents and other interested parties are sought on how the home is meeting needs. The health, safety and welfare of residents and staff are promoted and protected. EVIDENCE: The manager is also one of the registered providers and has been running the home for over 6 years and has completed the registered managers award and has NVQ 4 in Care, she is an experienced manager who manages the home effectively. The manager is supported by a good staff team who went about their work confidently and efficiently and were seen providing good support to residents. During the visit the manager was able to answer any questions asked of her and all records and documents were up to date and readily available. The manager works well with her team and the residents, and she operates an open door policy. The manager completed the homes AQAA in detail and this gave us good clear information about the service. Sea Gables DS0000012587.V373264.R01.S.doc Version 5.2 Page 24 The organisation sends out questionnaires to residents and other stakeholders to seek their views on how the service is operating and the manager informed us that she would be sending out surveys again shortly. Staff told us that there are regular staff meeting and residents have menu meetings once per week and also monthly meetings and this gives them the opportunity to discuss any issues they may have about how the home is run. The fire logbook was inspected and all appropriate testing and checks have been recorded. Appropriate certificates were in date for gas safety, fire alarms systems and equipment, private electrical equipment and fixed wiring. There is an in date fire risk assessment for the building and regular health and safety monitoring takes place. Sea Gables DS0000012587.V373264.R01.S.doc Version 5.2 Page 25 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 X 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 4 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 4 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 4 X 3 X X 3 X Sea Gables DS0000012587.V373264.R01.S.doc Version 5.2 Page 26 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. Refer to Standard Good Practice Recommendations Sea Gables DS0000012587.V373264.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. 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