Inspection on 29/05/08 for 31 Hadlow Road

This is the latest available inspection report for this service, carried out on 29th May 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

31 Hadlow Road 19/09/06

31 Hadlow Road 09/12/05

31 Hadlow Road 30/08/05

31 Hadlow Road 01/03/05

31 Hadlow Road 04/11/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOME ADULTS 18-65 31 Hadlow Road Tonbridge Kent TN9 1LF Lead Inspector Wendy Mills Unannounced Inspection 29th May 2008 13:30 31 Hadlow Road DS0000023883.V361125.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 31 Hadlow Road DS0000023883.V361125.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. 31 Hadlow Road DS0000023883.V361125.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 31 Hadlow Road Address Tonbridge Kent TN9 1LF 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) 01732 770834 Hadlow.Road@theavenuestrust.co.uk glebe.house@theavenuestrust.co.uk The Avenues Trust Ltd Post vacant Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 31 Hadlow Road DS0000023883.V361125.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th May 2007 Brief Description of the Service: 31 Hadlow Road is a small home providing support and accommodation for up to five people with a learning disability. Currently there are only three residents living in the home. The registered provider is The Avenues Trust. This is a not for profit organisation that specialises in the provision of services for people with a learning disability, including those with very complex needs. The Avenues Trust lease 31 Hadlow Road from Kelsey Housing Association. The lease on is now up and The Avenues Trust is unlikely to continue to lease this property. Two of the residents have progressed and are now preparing to move on to more independent living arrangements. The third resident is currently being supported to consider other accommodation. The Commission for Social Care Inspection has been told that it is likely that this home will close within the next year. The home is a good-sized detached property situated on the outskirts of Tonbridge. There is a large lounge, pleasant dining room and newly fitted kitchen downstairs. There are five single bedrooms on ground and first floor levels and a staff sleepover room. Outside there is a large, safe and enclosed garden to the rear and side of the property and care parking to the front. The weekly fees range between £950 and £1500. The fees are dependent on the assessed level of care and support for each prospective service user. However, the home is not planning to take any new admissions due to the imminent end of the lease with the housing association. 31 Hadlow Road DS0000023883.V361125.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit took place on 29th May 2008 and took four hours. Twenty-four hours notice of this visit was given to make sure that the people who live in the home would be in. All the residents lead very busy lives and are frequently out and about so prior warning was necessary to make sure it was possible to spend time with them. The visit forms part of the inspection process of the Commission for Social Care Inspection (henceforth refereed to as, “The Commission”, in this report) under the Regulations of the Care Standards Act 2000. This report has been compiled using information gained during this visit and information supplied prior to the visit from a variety of sources, including notifications of incidents, the views of relatives and health and social care professionals. It also includes information from the home’s Annual Quality Assurance Assessment (AQAA) that is required by the Commission. The judgements made as a result of the information we gathered, both before and during this visit, will result in the home being given a star rating. The service users are referred to by their preferred term, “The residents”, throughout this report. The service manager assisted throughout the inspection. During the visit time was spent with the service users and staff. On the day of inspection there were three people resident in the home. Due to the nature of the service, it is difficult to reliably incorporate accurate reflections of their views in this report. Some judgements about quality of life and choices are made from direct conversation and physical responses with the people living in the home as well as direct observation followed by discussion with staff. Evidence from records and care plans held at the home was also used. A tour of the home was made in the company of the residents who were very pleased to be able to show their rooms and their interests and hobbies. The home meets the National Minimum Standards. All the requirements made at the last inspection have been met. The residents are very well cared for and are able to make appropriate choices. The service users, staff and manager are all thanked for the welcome they gave and their help throughout this visit. No requirements were placed as a result of this visit. The overall outcome for users of this service is good. This means that the rating for this service is 2 stars. 31 Hadlow Road DS0000023883.V361125.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 31 Hadlow Road DS0000023883.V361125.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 31 Hadlow Road DS0000023883.V361125.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 The outcomes in this area for people who use this service are good. This judgement has been made using available evidence including a visit to this service. People who use this service have good information about the home in order to make an informed decision about whether the service is right for them. EVIDENCE: The service user guide has been reviewed and a great deal of information is now provided in pictorial form. This means that the residents can understand their rights and responsibilities whilst living in the home. Observation showed that they are well supported and encouraged by the staff to make the most of life in the home. No new resident has joined the home for the past six years. Some of the residents have lived together since the home opened in 1988. There are sound admissions policies and procedures in place and the manager and staff have a good understanding of the referral and admission process. However, due to likelihood of the home closure, it is unlikely that the home will admit any new residents. 31 Hadlow Road DS0000023883.V361125.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 & 10 The outcomes in this area for people who use this service are excellent. This judgement has been made using available evidence including a visit to this service. The residents are supported to make informed choices and take appropriate risks. This means that they can gain as much independence as possible. EVIDENCE: From examination of all three care plans, records about activities and observation, it was clear that the residents are all supported to live fulfilling lives and encouraged to make informed choices and decisions. Appropriate risk taking is encouraged and risk assessments are made and recorded in the care plans. Observation showed that the residents are free to make decisions on a day-to-day basis about what they want to eat, the way they will participate in the running of the home and what hobbies and interests they will take part in. 31 Hadlow Road DS0000023883.V361125.R01.S.doc Version 5.2 Page 10 Two of the residents are in the process of preparing to move on to independent living using a scheme that allows them part ownership of their own homes. A great deal of time was spent in discussion with the manager as to how this schemes works and how the service is managing the process. This is a major decision for the residents concerned and it is imperative that the residents themselves, and their supporters are happy that the right decisions are being made. There is clear evidence that all interested parties, including care managers and relatives, but especially the residents, have been properly consulted. However, it was not possible to ascertain, during this visit, the depth of understanding that the residents have in respect of the implications the proposed changes will have on their lives. Photographic, pictorial and object referencing are used to aid communication. The residents took great pleasure in using these forms of communication during this visit. They showed clear familiarity with the communication systems and were confident in using the, particularly when it meant they wanted to make choices. One resident showed us his life book that described his family, interests and hobbies. Another showed the way he makes choices, particularly about what he chooses to do when he is at home. Personal money is kept securely in the home. Records are kept of the money put in and taken out. For additional security the cash tins are signed by staff after they have opened them and checked on each handover. Records seen were stored securely and the requirements of the Data protection Act are adhered to. 31 Hadlow Road DS0000023883.V361125.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 & 17 The outcomes in this area for people who use this service are excellent. This judgement has been made using available evidence including a visit to this service. The residents lead busy, interesting and fulfilling lives. This means that they can enjoy their lives and make a positive contribution to the community in which they live EVIDENCE: The care plans note individual needs, wishes and aspirations. Examination of the records of activities and from communicating with the residents it was clear that their lead full and fulfilling lives. Each resident has a pictorial life book that enables them to communicate information about their families, friends, interests and hobbies. All of the residents were confident in sharing these diaries and relating the pictorial and photographic information to the general conversation. 31 Hadlow Road DS0000023883.V361125.R01.S.doc Version 5.2 Page 12 Through their life books and use of photographs the residents were able to say that they keep in touch with their friends and family. Each resident has a weekly activities programme. Attendance at activities is recorded. The variety of activities in which the residents participate is very encouraging. Some take music lessons, one is an accomplished drummer and all contribute positively to the day-to day running of the home and to the local community. Other activities include sports, trips to cinema, discos and further education and work placements. The activities records show that each resident goes out for part, if not most, of each weekday. Interaction with the residents showed that they really enjoy their activities. Some enjoy the more gregarious pastimes such as drumming and discos and others prefer to spend time cooking and organising things in the kitchen and around the home. A camping trip is planned for the near future and the residents showed us the equipment they have bought in preparation for this trip. They indicated that they are really looking forward to this. The residents help to plan menus, shop for food and to prepare meals. On the day of inspection one resident had made a batch of small cakes and another was about to prepare pasta for the evening meal. The home has is a really good system that uses photographs to help the residents make food choices. There is an index system with photographs of a variety of food choices. Later in this visit, towards suppertime, it was possible to observe, discretely, the way this system worked. The residents went to the place where the pictures were kept and took out the picture of their chosen meal. Staff were seen to respect the choices made and support the residents in preparing their chosen meals. There was plenty of fresh produce in the home on the day of inspection. Staff said that food is purchased locally and that the residents all help with the food shopping. One resident is particularly enjoys this activity. 31 Hadlow Road DS0000023883.V361125.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 The outcomes in this area for people who use this service are good. This judgement has been made using available evidence including a visit to this service. The residents lead healthy lifestyles and the home positively promotes their health and well-being. EVIDENCE: All the residents are registered with local healthcare services including General Practitioners (GPs) and dentists. Other health and social care visits are arranged when indicated. Records show that appropriate appointments are made and kept. Care plans show that any advice given by health and social care professionals is followed diligently. The care plans are up-to-date and in order. Care plans are important documents. This is because they form one of the means by which the residents and their supporters can tell that they will receive their care in the manner of their choice. Also, the plans are a source of reference information for the care workers who need to ensure that they assist people in a consistent and appropriate manner. 31 Hadlow Road DS0000023883.V361125.R01.S.doc Version 5.2 Page 14 The care plans clearly note the needs of the residents and there is good evidence that their health is monitored on a regular basis. The residents are encouraged to eat healthily and to take plenty of exercise. Their nutrition is monitored and they are weighed regularly. The home uses a form, common to other homes in The Avenues Trust, to record weight. This form only records date and weight. It could be greatly improved by adding goals, ideal weight and a column to note any action taken if there is either significant weight loss or weight gain. 31 Hadlow Road DS0000023883.V361125.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 The outcomes in this area for the people who use this service are good. This judgement has been made using available evidence including a visit to this service. There are sound policies for managing complaints, concerns and the Protection of Vulnerable Adults (POVA). This means that the home listens to, and acts upon, any concerns expressed and does all in its power to protect the residents from all forms of harm EVIDENCE: The Avenues Trust has clear policies for complaints and concerns and for the Protection of Vulnerable Adults (POVA). Observation showed that the residents are very well able to express their wishes and indicate if they are not happy about anything. There is a formal complaints procedure but concerns are mostly dealt with on a day-to-day basis as they arise. Just before the last inspection there were some concerns raised in respect of POVA. The home is clearly able to demonstrate that they have learned lessons from the concerns and have taken robust measures to prevent any further occurrence. Staff spoken to were all clear about the procedures they must follow should there be any concerns brought to their notice. They have received POVA training and were clear that they would report any colleague who they believed might contravene POVA guideline 31 Hadlow Road DS0000023883.V361125.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26 & 30 The outcomes in this area for the people who use this service are good. This judgement has been made using available evidence including a visit to this service. The environment is spacious, well-maintained, clean and welcoming. This means that the residents have a safe, pleasant and homely place in which to live. EVIDENCE: There is plenty of communal space in the home and each resident has his own bedroom. Since the last inspection a new kitchen has been fitted and some rooms have been re-decorated. This gives the home a bright and welcoming feel. There is a relaxed and friendly atmosphere in the home. The residents help to keep the home clean and tidy and on the day of inspection it was pleasant smelling and clean. 31 Hadlow Road DS0000023883.V361125.R01.S.doc Version 5.2 Page 17 Outside there is a safe and enclosed garden where the residents can enjoy a game of football with staff, have barbeques and generally enjoy the fresh air. Two resident took us on a tour of the home. They showed us their rooms. These rooms had been personalised and reflected their personalities, families and interests. No health and safety hazards were noted during the tour of the home. 31 Hadlow Road DS0000023883.V361125.R01.S.doc Version 5.2 Page 18 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): 31, 32, 33, 34, 35 & 36 The outcomes in this area for the people who use this service are good. This judgement has been made using available evidence including a visit to this service. Staffing levels are sufficient to meet the needs of the residents. Staff training and morale are good. This means that the residents are cared for by a cheerful and well qualified staff team. EVIDENCE: As there are only three residents, all whom have developed their independence over the years, there is usually one member of the care staff and the manager on duty during the day and one sleeping staff member at nights. From discussion with the manager, it was ascertained that the staffing levels are sufficient to meet the needs of the residents. There are enough staff to support the residents in all their activities. More staff are placed on shift should the need arise. For example, should one of the residents need more attention due to illness or emotional distress. In addition, there is an on call system to cover unforeseen circumstances. 31 Hadlow Road DS0000023883.V361125.R01.S.doc Version 5.2 Page 19 The Avenues Trust makes a wide range of training available to all staff. This includes both statutory training, such as fire safety and food hygiene, and specialist training, such as epilepsy and challenging behaviour. It was not possible to examine staff files as these are held at the Trust’s head office. However, staff said that they receive plenty of training. They were able to name recent courses they had undertaken. Staff spoken to say that there is good team working in the home. Observation showed that staff respect the residents and are able to prompt them discretely and in a positive way to promote their independence. As previously mentioned, staff files are kept at the Trust’s head office but there are tracking forms that are kept in the home. These forms record that Criminal records Bureau (CRB) checks and two written references have been taken up for all staff members. The Trust has very sound recruitment policies and procedures and offered to make all files available for inspection if required. As the Trust is known to follow proper procedures and because there are no new members of staff working at the home the staff files were not requested from head office on this occasion. There are regular staff meetings. Staff receive one-to-one supervision at which training needs and other work related issues are identified and discussed. 31 Hadlow Road DS0000023883.V361125.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 & 42 The outcomes in this area for the people who use this service are good. This judgement has been made using available evidence including a visit to this service. The home is well managed. This means that it listens to the views of the residents and their supporters and is run in their best interests. EVIDENCE: The manager has been in post for approximately four months is currently preparing his application for registration with the Commission. He has good previous experience in working and managing in care settings and was the registered manager at another learning disability home before joining the Avenues Trust. He is working towards achieving the National Vocational Qualification at level four (NVQIV) in Management and Care. 31 Hadlow Road DS0000023883.V361125.R01.S.doc Version 5.2 Page 21 Staff spoke very positively about the manager. They said that he is approachable and listens to concerns and acts upon them. One described the home as, “The best house I’ve ever worked in”. Discussion with the manager showed that he is knowledgeable about best practice in care. Observation showed that he relates and communicates very well with the residents and staff. The Trust has good organisational structures and provides support and supervision for the manager on a regular basis. It has sound quality assurance systems in place. A service manager visits monthly to carry out checks in accordance with Regulation 26 of the Care Standards Act. This means that the service manager is required to make monthly checks on the environment and the work of the manager. During these visits, the residents and staff are also spoken to make sure they are happy and that things are going well in the home. Health and safety documentation is up-to-date and in order. No health and safety hazards were noted during the course of this visit 31 Hadlow Road DS0000023883.V361125.R01.S.doc Version 5.2 Page 22 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 1 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 3 3 LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 3 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X X 3 X 31 Hadlow Road DS0000023883.V361125.R01.S.doc Version 5.2 Page 23 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA19 Good Practice Recommendations The Trust should review the templates it uses to record the residents’ weight. They should consider including goals, body mass indices and actions taken should there be significant weight loss or weight gain. 31 Hadlow Road DS0000023883.V361125.R01.S.doc Version 5.2 Page 24 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. Extracts may not be used or reproduced without the express permission of CSCI 31 Hadlow Road DS0000023883.V361125.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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