Inspection on 21/12/05 for 1 Malling Terrace

This inspection was carried out on 21st December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

1 Malling Terrace 22/08/06

1 Malling Terrace 05/09/05

1 Malling Terrace 25/01/05

1 Malling Terrace 21/09/04

Similar services:

Thorndene

Sutton Lodge Nursing Home

Wingham Court

Bethany Lodge

17 John Street

Red Oaks

Clare House Nursing Home

Broad Oak Manor Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 1 Malling Terrace 1 Malling Terrace Maidstone Kent ME16 0JU Lead Inspector Lynnette Gajjar Unannounced Inspection 21st December 2005 08:40 1 Malling Terrace DS0000024080.V270190.R01.S.doc Version 5.0 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 1 Malling Terrace DS0000024080.V270190.R01.S.doc Version 5.0 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. 1 Malling Terrace DS0000024080.V270190.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 1 Malling Terrace Address 1 Malling Terrace Maidstone Kent ME16 0JU 01622 692152 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) mailing@mcch.org.uk MCCH Society Limited Mr Paul Tompsett Care Home 4 Category(ies) of Physical disability (4) registration, with number of places 1 Malling Terrace DS0000024080.V270190.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th September 2005 Brief Description of the Service: 1 Malling Terrace is one of a group of homes managed by MCCH Society Ltd in the South East of England. The home provides long term care to 4 adults with a Physical Disability. The home provides 4 individual flat-lets in a purpose built bungalow unit. These comprise of an open planned kitchen, dining room, lounge bedroom and separate bathroom. The homes philosophy is to provide the staffing support to encourage and promote residents to be as independent as possible within their own flats but realising that due to the physical disabilities, 24 hour staffing support is required with a sleepover cover (there are no waking night staff) to the four flats in the bungalow unit. The home provides a separate staff flat / office. There is off road parking for approximately 5 cars. The home is situated in a quiet lane of the main Queens Road Maidstone, with easy access to public transport into Maidstone town centre. There is a small local shop and public house with in walking distance. 1 Malling Terrace DS0000024080.V270190.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the unannounced inspection, the second in the year running from April 1st 2005 to March 31st 2006. The visit lasted from 08:40 am until 12:25 pm. The home currently has four residents with no vacancies. The visit was spent talking privately with two residents and collectively with the three care staff and senior support worker. Two residents declined talking with the inspector today. The registered manager was on off duty. Due to the nature of the service, it is difficult to reliably incorporate accurate reflections of the service in the report, as not all residents were spoken with. Some judgements about quality of life and choices were taken from direct conversation with residents, observation followed by discussion with care staff and evidencing records held at the home. Time was spent reviewing care plans and other associated documentation. A tour of the premises was undertaken. Some comments shared included: “I am really happy here” “Staff are good” “Yes I do feel safe, staff are very good and help me” What the service does well: The home offers four individual flats promoting personal independence and space. Residents feel they are involved in making decisions about their lives. They have a real sense of ownership about their flats and trust that staff maintain their confidences. Good relationships and contact is maintained with residents and their family. Personal health care needs are well supported. Residents are encouraged to maintain regular contact with external agencies and professionals to manage their health care and personal preferences. Residents continue to state they felt safe and secure at the home and locally. Resident’s continue to benefit from a stable staff team who know the individuals well and communicate effectively with them. 1 Malling Terrace DS0000024080.V270190.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Two residents will find mealtimes more comfortable in their flats with the delivery of their assessed and designed dining tables suitable for their adapted wheelchairs. All residents would benefit from the reassessment and upgrade of their current kitchen units due to their heavy use, knocks and damage from the wheelchairs. One resident would highly benefit from further assessment from Occupational Therapy and housing association to the suitability of the current WC and bathroom layout with agreed action implemented. Residents expressed their wish to have a communal lounge/diner for socialising with each other. Discussion with staff identified that they could be more mindful of information written in communication books / records to comply with the Freedom of information and Data Protection Acts. Please contact the provider for advice of actions taken in response to this 1 Malling Terrace DS0000024080.V270190.R01.S.doc Version 5.0 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 1 Malling Terrace DS0000024080.V270190.R01.S.doc Version 5.0 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 1 Malling Terrace DS0000024080.V270190.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 Prospective residents and their families are given all the information they need to make an informed choice about whether to move into 1 Malling Terrace. EVIDENCE: The home has developed a detailed, graphic and comprehensive guide to the home and facilities and services provided, known as the Statement of Purpose and Residents guide. This is also available on CD Rom. There have not been any changes since the last visit. Through discussion with resident they were supported to visit the home on numerous occasions prior to deciding to move in. Records evidenced gathering of relevant information from others such as relatives and professionals. Residents are fully supported to achieve their aspirations in a safe and supported way. Specific work has taken place with a resident, occupational therapist, and staff to assess a safe route and use of their mobility scooter on local roads to be able to travel independently to the local public house and shop as one personal aspiration to achieve. 1 Malling Terrace DS0000024080.V270190.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9,10 Care plans and risk assessments have been developed to keep residents safe, whilst allowing opportunities to grow and be independent. Residents feel they are involved in making decisions about their lives. EVIDENCE: Two individual care plans and records were tracked. Goals and care needs have been expanded to be clear and easy to follow. Those seen are regularly monitored with formal reviews planned including a new auditing and monitoring sheet at the front of each section for ease of access. Residents continue to know the contents of care plans and have agreed the targets The residents continue lead busy lives, which present challenges, risks and the opportunity to make mistakes. Increasing independence is a key aspect of the home’s aims for its residents. Regular house meetings continue to enable residents to make their own views known and all such meetings are recorded in writing. 1 Malling Terrace DS0000024080.V270190.R01.S.doc Version 5.0 Page 11 Residents’ individual activities and wishes determine mealtimes, menus, holiday venues, décor and activities. Staff continues to have a good understanding of handling of confidential information. They know when and how such information should be ‘passed on’. The inspector observed close, positive interaction between staff and residents, enabling residents to feel genuinely liked and respected. 1 Malling Terrace DS0000024080.V270190.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16 Resident’s access a wide and varied range of leisure, work and education opportunities within the local community offering personal development and promoting self esteem. Staff encourage individuals to take responsibility for their own actions. Important relationships are respected; encouraged and residents feel valued. EVIDENCE: Specific hobbies and interests of individuals are identified and they are supported to follow these at a pace suitable to them. A small shop and pub is within walking distance, good working relationships are fostered between the home, residents and local pub landlord. The town of Maidstone is easily accessible by public transport and car; therefore leisure centres, cinemas and restaurants are easily visited. Residents talked to the inspector about aspects of their lives that were important to them including, “going to work, college and adult education classes”, “ visiting and contact with family and friends” and “going on holiday ”. 1 Malling Terrace DS0000024080.V270190.R01.S.doc Version 5.0 Page 13 Residents continue to enjoy additional one to one time provided by staff, to events such as music gigs, darts matches, visiting the coast, meals out. Much was being planned for the Christmas period including visiting of family and friends. New friendships have opened more social contact and plans for holidays. Due to physical disabilities transport to such activities can be restricted due to the availability of the homes two adapted vehicles and others residents activities. Two residents said that they would like to have a communal lounge/diner to sit with their peers, relax and eat with others. With staff reiterating this in conversation also. Staff encourage residents to invite each other for meals where appropriate. Ongoing work is evident to try and obtain suitable dining tables to meet physical needs of individuals. 1 Malling Terrace DS0000024080.V270190.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,20 Intimate and personal care needs are attended to in a dignified manner and the physical and emotional health of individuals is promoted. EVIDENCE: Staff continue to be aware of the type and nature of the support required for individual’s personal and intimate care needs. Every effort is made to maintain privacy and dignity when people are being supported with bathing, washing and dressing. Due to layout of one resident’s bathroom this can be compromised and should be reviewed trough the OT and housing department. There is ongoing support from occupational therapists, physiotherapists, hydrotherapy, wheelchair dept and local GP. Records seen evidenced work by visiting professionals to access a standing frame with suppliers for a trial period in the home. Individual medication storage in each flat to complies with regulations. Due to one resident’s choice, their cabinet remains located in the bathroom. Full consultation and advice has been given to the resident and medication checked to ensure medication is not affected by this location. All staff have received training and were confident of the system in place with regards the storage and administration of medicines. Records were inspected, with no errors 1 Malling Terrace DS0000024080.V270190.R01.S.doc Version 5.0 Page 15 noted. Development of PRN guidelines has ensured consistent safe administration within clear set triggers and action to be taken. 1 Malling Terrace DS0000024080.V270190.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 Residents have ample opportunities to express their views. They feel they are listened to, valued and concerns acted upon. EVIDENCE: Joint residents and staff meetings are held and are recorded in writing. All of those spoken with stated that these meetings, and individual key worker sessions, are meaningful and worthwhile. The two residents spoken with expressed feeling good and listened to when making suggestions and comments. In fact, the inspector observed how confident people were in expressing views, through the culture that exists within the home. Residents know how to complain and whom they would talk to if they had any concerns. Predominantly their key worker or family. 1 Malling Terrace DS0000024080.V270190.R01.S.doc Version 5.0 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,27,29,30 Residents live in a clean and homely environment. Flats are very much ‘owned’ by the occupant and are furnished in a way that best meets their physical needs and promotes independence. One resident would benefit from a review of current bathroom layout to meet their personal needs. Residents continue to express the wish for a communal lounge. EVIDENCE: 1 Malling Terrace DS0000024080.V270190.R01.S.doc Version 5.0 Page 18 The home is located off a main Queens Road; there is a local shop and post office nearby. There are four individual flats, each having an open plan bedroom, lounge/dining area, adapted bathroom and WC and kitchen/utility area. The flats are furnished and equipped to personal needs and taste, with individual aids to daily living incorporated. Each flat has a tracked ceiling hoist fitted and an adapted bathroom. Two flats were visited on this occasion by the inspector; one resident stated that they were very happy with the accommodation; especially now it had been redecorated. Sanctuary Housing have undertaken a review of the property and assessment, possibly looking to replace current kitchen units which have been heavily damaged through knocks and wheelchair access. This has been an ongoing area for refurbishment for the past three inspection reports. Following on going problems in one bathroom and breaking of toilet eat, it is strongly recommended that the Occupational therapist was request to reassess suitability of equipment and current layout and make recommendations for action to make this more suitable and dignified for the tenant living here. A combined office /flat is used by the staff in the home. Two residents expressed their wish for a communal lounge to use, which resident’s often try to use as social communal area but were seen to respect staff space and knock before entering. 1 Malling Terrace DS0000024080.V270190.R01.S.doc Version 5.0 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35 The home has sufficient numbers of confident and knowledgeable staff working as a team to support residents in their daily lives. EVIDENCE: The home has in the past year experienced a turnover of staff, this has stabilised offering a stable support team. The home has a whole time equivalent staffing level of 6 carers, 1 senior carer and the manager. Staff on duty during the inspection presented as confident and approachable in their roles. Their commitment to the ensuring the safety and independence of residents was very evident in the manner of working and support seen during the visit. Good team working, communication and direct respect for each other were observed during the inspection. Of the 7 care staff in post; two have achieved NVQ 2 or 3 in Care. Two staff members are undertaking NVQ 2 and two staff are undertaking NVQ 3. One staff member has started their second year of psychology degree. 1 Malling Terrace DS0000024080.V270190.R01.S.doc Version 5.0 Page 20 Staff and records confirmed that they are in the process of updating and renewing mandatory training and applications have been submitted to the training department for processing. Acknowledgement letters were evident on the staff files for core mandatory training. Staff confirmed that they had recently undertaken moving and handling training but there were no records to verify this. 1 Malling Terrace DS0000024080.V270190.R01.S.doc Version 5.0 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38,39,41,42 Resident’s personal preferences support and care needs are encouraged through the registered manager’s open leadership and the promotion of a safe home and working environment. EVIDENCE: 1 Malling Terrace DS0000024080.V270190.R01.S.doc Version 5.0 Page 22 Formal surveys are undertaken with residents. The commission receives regular regulation 26 visit reports (monitoring visits made by a representative of the organisation) from MCCH. Formal environmental and fire risk assessments are in place. Weekly walking routes records are undertaken to monitor and report maintenance and health and safety issues for action. Regular servicing of equipment in the home is undertaken as required. Incidents, which affect the well being of residents, are recorded detailing action taken. All recent incidents have been reported to Commission for Social Care Inspection (Kent and Medway) as required by regulation 37. Residents discussed feeling comfortable to talk to staff about their home and lifestyle. Staff evidenced a good understanding and detailed consultation with residents when such conflicts occur to resolve them as amicably as possible, whilst ensuring personal safety as well as personal choice is promoted. Risk assessments and agreements are clearly detailed in individual care plans in such circumstances. Discussion took place with staff regarding appropriateness of some information shared and style of written records seen today. Staff continue to speak of feeling well supported by the registered manager and MCCH organisation as a whole. 1 Malling Terrace DS0000024080.V270190.R01.S.doc Version 5.0 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 X X X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 X 2 X 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 X 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 1 Malling Terrace Score 3 X 3 X Standard No 37 38 39 40 41 42 43 Score X 3 3 X 2 3 X DS0000024080.V270190.R01.S.doc Version 5.0 Page 24 YES 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 YA20 Good Practice Recommendations It is recommended that all PRN medication have protocols and guidelines in place. A system is introduced to remind staff of all sections of the case file that need to be updated when there are medication changes. Minor gaps were identified today. It is recommended that consideration be given to a communal social room for residents. It is strongly recommended that the home continues to work with Sanctuary Housing and MCCH budget planning to upgrade and replace damaged kitchen units, carpeting and specialist equipment. It is strongly recommended that occupational therapy assessment and advise be sought regarding the current layout of one residents bathroom is undertaken to ensure meets their needs, reduce the breakage of WC seat and make this a more dignified area for use for the tenant. It is recommended that the home continue to work closely DS0000024080.V270190.R01.S.doc Version 5.0 Page 25 2 3 YA24 YA24 4 YA27 5 YA29 1 Malling Terrace 6 7 YA32 YA41 with occupational therapists to establish the best specialist equipment to aid mobility and independence, including dining furniture, wheelchairs and standing aids. It is recommended that when refresher training has been given a record is held of attendance and competency is held in the training files. It is strongly recommended that careful consideration of information recorded in the communication book and daily records is appropriate and mindful of Freedom of Information Act and Data Protection Act. 1 Malling Terrace DS0000024080.V270190.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 0845 015 0120 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 1 Malling Terrace DS0000024080.V270190.R01.S.doc Version 5.0 Page 27 - 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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