Inspection on 04/03/08 for Swerford House

This is the latest available inspection report for this service, carried out on 4th March 2008.

CSCI found this care home to be providing an Good service.

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

Swerford House 24/02/06

Swerford House 23/08/05

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Swerford House The Avenue Temple Ewell Kent CT16 3AW Lead Inspector Christine Lawrence Key Unannounced Inspection 4 March 2008 13:00 Swerford House DS0000062504.V359474.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 Swerford House DS0000062504.V359474.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. Swerford House DS0000062504.V359474.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Swerford House Address The Avenue Temple Ewell Kent CT16 3AW 01304 821432 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) infor@hqls.org.uk www.hqls.org.uk High Quality Lifestyles Ltd Post Vacant - Application in progress Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Swerford House DS0000062504.V359474.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 22 March 2007 Brief Description of the Service: Swerford House is a home for people with learning disabilities and communication difficulties who present challenging behaviour at times. The home is owned by High Quality Lifestyles. The companys philosophy is to support people who have displayed behaviour that has caused them and others difficulty and has limited ordinary/usual kinds of life opportunities by positive guidance and a specialised environment. Swerford is registered to provide accommodation for up to 5 people. The home is a detached property set in spacious grounds on a hill in Temple Ewell near Dover. It is a semi rural area and the home provides transport to ensure that residents are able to access facilities in Dover or Folkestone and pursue a variety of activities. The local bus route is on the main road just down the road from the home. The current fees for the service at the time of the visit range from £1885.00 to £3110.00. Information on the home’s services and the CSCI reports for prospective service users will be detailed in the Statement of Purpose and Service User Guide. Swerford House DS0000062504.V359474.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was unannounced and started at 13.00 and finished at 17.50. We (the Commission for Social Care Inspection, CSCI) looked at various records in the home and also used information sent to us by the deputy manager before the visit. This was the Annual Quality Assurance Assessment (AQAA). Information from the previous inspection was also referred to. We observed the residents who live at the home, noting how they reacted to staff and how relaxed and comfortable they were within the home. A tour of the building was undertaken and some of the residents showed their rooms. We made observations of staff interacting with and supporting residents. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. 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. Swerford House DS0000062504.V359474.R01.S.doc Version 5.2 Page 6 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 Swerford House DS0000062504.V359474.R01.S.doc Version 5.2 Page 7 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): 2 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Prospective residents’ individual aspirations and needs will be assessed. EVIDENCE: No new resident has been admitted since the last inspection but the care plans and assessments seen for this inspection were person-centred and reflected residents’ wishes as well as their needs. Both the team leader spoken to and the manager confirmed that any new admission would be very carefully planned and assessments would be undertaken by experienced staff. Swerford House DS0000062504.V359474.R01.S.doc Version 5.2 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents can be confident that their changing needs will be noted in their individual plans and that they will be supported to make decisions and take risks to enable as independent lifestyle as possible. EVIDENCE: The records of two residents were looked at for this inspection. The residents have plans which are focussed on their individual needs and wishes and examples were seen of residents being supported to have goals that they wish to work towards such as travelling on a train for a family visit and planning a day trip to France. Daily activities are planned and carefully managed by staff to ensure that residents achieve what has been identified for and with them. On the day of this inspection some residents had gone out for lunch; there was a plan to have a cake making session with one person; an outing to a pub was planned for some residents that evening and all of these things were about individuals making choices. Risks and any necessary restrictions are identified throughout individual’s records but they are about managing risks so people Swerford House DS0000062504.V359474.R01.S.doc Version 5.2 Page 9 can be as independent as possible within their own personal limits, rather than stopping them doing things. The team leader and the manager explained that the emphasis on person-centred planning and having a structure had reduced some of the difficult behaviours. Residents were observed to be making some decisions such as having a drink, watching television, listening to music and staff were observed to be supportive and knowledgeable about individual’s communication needs. Swerford House DS0000062504.V359474.R01.S.doc Version 5.2 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Activities and involvement in the local community, as well as support for personal relationships will be provided for residents. They will benefit from having a healthy diet. EVIDENCE: Lots of activities take place in the local community. This includes the following:- swimming, bowling, cinema trips, going to local parks, going to the pub, riding a bike, going out for lunch and shopping. Staff spoken to said that it was important for activities to be meaningful. The home has transport so residents can be helped to access things in the area. As noted previously residents are also supported to try new things which have been identified and recorded within their plans. Some activities take place within the home and this includes gardening, trampolining and art and craft sessions. One person is hoping to attend a local further education college session and staff said they are looking into the possibilities. Examples were noted of residents being Swerford House DS0000062504.V359474.R01.S.doc Version 5.2 Page 11 supported to maintain contact with family and this was reflected in residents’ care plans. Residents’ rooms are respected as private and staff were seen to knock for permission to enter. Staff interact with residents and include them in conversations and discussions, regardless of their abilities to respond. Residents are encouraged to take responsibility for some of the daily routines within the home but this is dependant on their abilities. The staff team are planning to involve residents more in meal preparation and some are already involved in choosing meal options and food shopping. The menu seen was varied and staff know residents’ preferences. Swerford House DS0000062504.V359474.R01.S.doc Version 5.2 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are protected by the home’s policies and procedures regarding medication and their physical and emotional needs will be responded to. Their preferences and requirements for support are respected. EVIDENCE: The daily records and individual plans showed that residents’ needs and wishes regarding how they want to be supported by staff, are noted. A health update book is used to note individual health care needs and these showed that residents have health care such as dentist, GP appointments and specialist input when required. The company which operates the home arranges for a consultant psychiatrist to monitor medication and provide advice when required. The detailed daily records also reflect residents’ well being and mood, especially in relation to any activity undertaken. The manager said they are planning to introduce health action plans for each person in the coming months. Medication is appropriately stored and administered. Only team leaders, who have received the relevant training, give out medications. Swerford House DS0000062504.V359474.R01.S.doc Version 5.2 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are protected from abuse and their views are listened to and acted on. EVIDENCE: There is a complaints policy and procedure in place. There are no specific individual procedures for residents but staff said that the key worker system is used to help identify if residents have any concerns. One member of staff said that this was very much about getting to know individuals and especially their methods of communication. The daily records were also important in identifying if someone was not happy about something. Two members of staff, as well as the manager, said that everyone has training regarding protecting residents from abuse, and they also have training about how to manage aggressive behaviour. There are various policies in place but some of them appear not to have been reviewed for some time. The manager discussed the procedures for residents’ finances and these are consistent with protecting individuals from abuse. Swerford House DS0000062504.V359474.R01.S.doc Version 5.2 Page 14 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 and 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is clean, comfortable and safe for the residents. benefit from improved infection control procedures. EVIDENCE: The home is suitable for its purpose and during a tour of the building it was seen to be safe, comfortable, bright, spacious and clean. The home offers access to local amenities and to local transport if required. Furniture and fittings are satisfactory and maintenance is carried out as required. At the moment it is not possible to access the laundry without going into the kitchen and there are no suitable hand washing facilities in the laundry. Although staff have received training regarding the control of infection and there are procedures in place for managing laundry tasks, there is still a possibility of cross infection especially as staff wish to encourage residents to be involved in doing their own laundry. The manager agreed to ensure a hand basin is fitted in the laundry and that clear guidelines are in place. Swerford House DS0000062504.V359474.R01.S.doc Version 5.2 Page 15 Residents would Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Sound recruitment procedures and training provided to staff will have a beneficial impact on residents. EVIDENCE: Staff were observed to be very positive in their interactions with the residents. There were good examples of staff knowing the communication needs of individuals as well as an understanding of anticipating behaviour and responding appropriately. Staff clearly worked consistently with individuals according to the planned structure for the shift. Nine members of staff have their national vocational qualification at level 2 or above and three are currently working towards this. The records seen for this inspection showed that the organization has good recruitment procedures. This includes seeking references, an application form which allows for gaps in employment to be identified, undertaking criminal record bureau checks, written statement of terms and conditions of employment and the use of a ‘probationary’ period to ensure that someone is suitable. During this inspection a prospective member of staff was ‘shadowing’ Swerford House DS0000062504.V359474.R01.S.doc Version 5.2 Page 16 a staff member, meeting and interacting with residents, as part of the overall interview process. The training records for the home show that there is an ongoing programme of mandatory and more specialized training taking place. Two staff members spoken to said that they had opportunities for training which ranged from inhouse training to university courses. Structured induction training is provided to all new staff and one newer member of staff confirmed that this was very beneficial. Swerford House DS0000062504.V359474.R01.S.doc Version 5.2 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well run home and their health and safety is promoted and protected. EVIDENCE: The manager is experienced and was previously the registered manager at another home owned by the organization. She has a national vocational qualification in care at level four as well as the registered manager’s award and she has also gained a diploma in positive behaviour support as specialist training relating to the purpose of the home. The home is now using a quality assurance system from the Institute of Applied Behaviour Analysis. The manager demonstrated how this works in setting service standards to achieve and then measuring performance against Swerford House DS0000062504.V359474.R01.S.doc Version 5.2 Page 18 them. Along side these service standards there is a new appraisal system in place which allows for targets and action plans to be written, to which members of staff can work. She also explained that she makes regular observations and provides feedback to the team. A spot check on service and maintenance contracts showed them to be appropriate and other health and safety records are also in place and properly recorded such as fire safety checks, accident records and risk assessments. Staff have received the appropriate health and safety training. Swerford House DS0000062504.V359474.R01.S.doc Version 5.2 Page 19 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 3 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Swerford House DS0000062504.V359474.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? NO 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 Swerford House DS0000062504.V359474.R01.S.doc Version 5.2 Page 21 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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