Inspection on 22/08/06 for 1 Malling Terrace

This inspection was carried out on 22nd August 2006.

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 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

1 Malling Terrace 21/12/05

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 Debbie Sullivan Key Unannounced Inspection 22nd August 2006 09:15 1 Malling Terrace DS0000024080.V301441.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 1 Malling Terrace DS0000024080.V301441.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. 1 Malling Terrace DS0000024080.V301441.R01.S.doc Version 5.2 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.V301441.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st December 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 offers long-term care and support to 4 adults with a Physical Disability. The home provides 4 individual flatlets in a purpose built bungalow unit. The flats comprise of an open planned kitchen, dining room, lounge, bedroom and separate bathroom and WC. The home’s philosophy is to provide the staffing to encourage and promote the service users to be as independent as possible within their own flats, whilst realising that due to their physical disabilities 24 hour staffing support is needed with sleep in cover 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 off the main Queens Road in Maidstone, with easy access to public transport into Maidstone town centre. There is a small local shop and public house within walking distance. The fees ranged from £871.64 to £1146.14 per week. 1 Malling Terrace DS0000024080.V301441.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced Key inspection site visit took place over five and three quarter hours. Time was spent with the home’s manager, service users and support staff. Two service users were out during much of the site visit, the two who remained at the house were spoken with in private. The property was toured and records and other documentation read. Information was also gained from the pre inspection questionnaire completed by the manager. Due to the nature of the service it is difficult to reliably incorporate accurate reflections of the service users views in this report, and not all the service users were spoken with individually, therefore some judgements about quality of life and choices have been made from discussion with staff, observation and documentation. The home had no service user vacancies at the time of the inspection. Comment cards were received from service users, relatives and visitors, care managers and a health professional. Comments made by service users on the comment cards and during the inspection included, “ There is always a member of staff I can approach on different matters” “I’m quite happy” “I would pull them (staff) up if they went wrong” “I swapped key worker as I fancied a change” Comments from relatives and visitors included, “ Staff that can drive are not always available to enable clients to get out when they want” A comment from a care manager was, “A very well run unit, that is forward thinking with it’s care planning -----families are very much involved in forward planning, goals etc “ What the service does well: 1 Malling Terrace DS0000024080.V301441.R01.S.doc Version 5.2 Page 6 The home provides an environment in which service users can live as independently as possible whilst staff are available twenty four hours a day. Service users are supported and encouraged to make choices and decisions about their lives. Health needs are well supported and promoted and good links are maintained with health and other professionals involved. Individual flats are very personalised and homely. Staff are genuinely interested in the lives and well being of service users, are very aware of their preferences and needs and good relationships have built up. Service users benefit from a stable staff group. What has improved since the last inspection? What they could do better: Some improvements to the environment are required; these are in respect of, The provision of new kitchen units in each flatlet; the need for these had been identified and outstanding for some time. A cupboard in which to safely and accessibly store cleaning materials is needed in one flat, this will increase the independence of the service user. 1 Malling Terrace DS0000024080.V301441.R01.S.doc Version 5.2 Page 7 A new carpet is needed in the entrance and whilst wheelchair damage cannot be avoided, some areas of the home need repainting or making good where damage is most obvious. The garden and patio area is untidy and could be made a more attractive space. 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. 1 Malling Terrace DS0000024080.V301441.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 1 Malling Terrace DS0000024080.V301441.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 and 5 The quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. Prospective service users are able to access information about the home before making a decision to move in. Needs are fully assessed prior to admission. EVIDENCE: The home has a Statement of Purpose and Service User’s Guide; both are available in written form and on CD Rom.The information is clear and comprehensive and is in written and pictorial format. Care plans included contracts. There have been no new admissions for approximately two years, the manager explained that when admissions take place prospective service users visit the home, spend time there before making a decision on moving in and their needs are fully assessed. Care plans included very thorough information on the service users, some of which had been supplied by other agencies and there was evidence of regular reviews of needs and goals taking place. The home works hard to support and assist service users to achieve their goals and aims and offers opportunities to build on these. 1 Malling Terrace DS0000024080.V301441.R01.S.doc Version 5.2 Page 10 1 Malling Terrace DS0000024080.V301441.R01.S.doc Version 5.2 Page 11 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 and 10 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users are encouraged and supported in making choices about their daily lives. Care plans include comprehensive information and needs are regularly reviewed. EVIDENCE: The care plans of three service users were read, care plans are kept in two folders one with relevant information that is needed on a daily or weekly basis and the other includes in depth information, assessments and reports and more comprehensive medical information. Care plans also included risk assessments, weekly planners and personal financial information. There was evidence that service users are supported to take risks and make decisions about their daily lives. One service user preferred their bath water to be hotter than the recommended temperature, this had been risk assessed, is 1 Malling Terrace DS0000024080.V301441.R01.S.doc Version 5.2 Page 12 monitored and the service user had signed agreement to the procedure in place. Service users who are able to go out independently, one has a scooter and a safe route to local facilities has been established. Service users choose their daily activities; some are pre planned such as work experience or attendance at a day opportunities service. During the site visit two service users chose to go to Maidstone market, whilst the others preferred to stay at home and the manager took a call from a relative arranging a day out for a service user later in the week. Service users are consulted about the running of the home and are able to attend regular house meetings, offer views on a daily basis, and receive a quality assurance questionnaire at reviews. The whole ethos of the service is one of promoting choice and independence. Records are kept safely and securely. 1 Malling Terrace DS0000024080.V301441.R01.S.doc Version 5.2 Page 13 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 and 17 The quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. Service users take part in a wide range of social, educational and recreational activities and independence is promoted. Contact with relatives and friends is supported. Service users are given advice and support with meals and healthy eating. EVIDENCE: Service users have opportunities to participate in a wide range of activities of their choice. Interests are recorded on care plans and weekly planners were full. One service user works part time in a supported employment setting, another attends a horticultural day opportunities service, and college has been an option although the manager said the course attended was no longer running so an alternative was being sought. Social activities include attending the cinema and theatre, going to the pub, various groups and clubs, trips to the coast and trampolining. Links are made 1 Malling Terrace DS0000024080.V301441.R01.S.doc Version 5.2 Page 14 with other MCCH houses and the manager spoke of a recent social event that had been arranged in liaison with a home in another area. The home has two vehicles and service users can go out together or individually as long as staff on duty are drivers. Service users spoken with felt that they had plenty of opportunities to go out and were able to do so independently if they were able. One service user who could be at risk when out due to their own actions has comprehensive risk assessments in place, and whilst it is acknowledged that there are concerns, the service user is encouraged to take responsibility for themselves. Contact with friends and relatives is encouraged and service users spoke of visits from relatives that take place regularly, flats are equipped with bed settees so that visitors can stay if necessary, one service user regularly accommodates a relative overnight. Care plans and daily records included plenty of entries about visits and outings and one care plan had a section for the service users’ cat. Service users are supported to budget and shop for their own food; meals are prepared in their personal kitchens with the necessary support from staff and staff support service users with their shopping. Service users vary in their choice of diet, information on healthy eating is given and daily meal choices recorded. Staff support service users to make sure that food in their flats is not out of date. One to one time is provided regularly. Two service users have now been provided with new dining room tables so that wheelchairs can more easily be accommodated and another is awaiting a new table. 1 Malling Terrace DS0000024080.V301441.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 and 21 The quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service The health needs of service users are well met and there is good liaison with health professionals. Service users are offered the choice to self medicate. EVIDENCE: The personal support needs of service users are on care plans. Each service user has their own bathroom containing equipment to support independence with personal care; one bathroom is to be equipped with a rail to improve the safety and independence of a service user. Service users said that personal care is given as flexibly as possible; staff giving personal care during the site visit did so discreetly. All the service users were male; there is a mix of male and female staff. One service user said they did not mind who supported them with personal care but if they would be happier with male only carers they thought this would be respected. Care plans contained information regarding contact with other professionals such as occupational therapists, G.P’s and dentists, and health needs were well recorded, the manager said that the home has a good relationship with the local GP practice. 1 Malling Terrace DS0000024080.V301441.R01.S.doc Version 5.2 Page 16 Not all of the service users are on regular medication, each service user has a suitable space in which to store medication and one has chosen to store it in their bathroom. One service user partially self medicates. The MAR sheets of those on medication are on individual care plans and were correctly completed. The manager spoke of a service user who had been supported at the end of their life at the home and had chosen to remain there with additional support from specialist nurses. 1 Malling Terrace DS0000024080.V301441.R01.S.doc Version 5.2 Page 17 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 and 23 The quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. Service users can feel confident that any concerns will be listened to and taken seriously. Service users are protected from harm by the home’s policies and procedures. EVIDENCE: The home has a complaints procedure that is available in a written and pictorial format and was displayed in the home. There had been no complaints recorded since the last inspection and no adult protection issues. Service users spoken with said that they would be happy to go to the manager with any complaints and one had had cause to in the past. Service users were very confident that they would be listened to and that concerns would be addressed. Staff receive adult protection training and adult protection policies and procedures are in place. The safety of service users had been improved by additional measures to make the property secure, as it is near a public footpath. 1 Malling Terrace DS0000024080.V301441.R01.S.doc Version 5.2 Page 18 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): 24,25,26,27,28,29 and 30 The quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. Service users live in pleasant and homely environment. Individual space meets needs and equipment to maximise independence is available. Replacement kitchen cupboards are required to improve the quality of the environment and health and safety for service users. EVIDENCE: All areas of the home were cleaned to a good standard, service users are supported with the cleaning of their flats and staff are responsible for cleaning staff and communal spaces. Flats are well furnished, service users had chosen different colour schemes and made their flats very homely, one service user said they had some new furniture. The flats are open plan and have a living, dining, cooking and sleeping space. Individual bathrooms/WC’s are next to main living areas. Flats included items relating to personal interest such as music and football. 1 Malling Terrace DS0000024080.V301441.R01.S.doc Version 5.2 Page 19 The kitchen units in flats have needed replacing for some considerable time and this is outstanding as a recommendation of previous inspections. Each flat leads via a ramp onto the outside of the building, there is a small garden and patio area that is in need of some tidying up. One service user had made the area outside their flat attractive with a small flowerbed and planters. Each service user had the equipment necessary to help to maximise independence or equipment was on order, one service user had recently received a new walking aid. There is no communal space for service users to meet; one service user said they do meet in each other’s rooms sometimes. Service users needing to speak with staff often access the staff office/sleeping area, they are advised when the staff area needs to be kept private. 1 Malling Terrace DS0000024080.V301441.R01.S.doc Version 5.2 Page 20 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 and 36. The quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. A confident, competent and well-trained staff team supports service users. EVIDENCE: An agreement is in place that CSCI’s Performance Relationship Manager audits staff records centrally at least once a year, therefore standard 34 was not fully inspected on this occasion. The first annual audit found that recruitment and vetting documentation for potential new staff was in place and improvements could be made to application forms and the interview process. Two carers and the manager were on duty during most of the site visit, staff were competent and confident in their roles and clearly had a good relationship with the service users. The staff group is now stable having gone through a period of turnover approximately two years ago and few shifts need to be covered by bank or agency staff, this was evidenced on the staff rotas. One member of MCCH’s bank staff came on duty during the visit; gaps at the time were due to annual or study leave. The main staffing files are held centrally, although staff files containing basic information and training and supervision records are kept securely at the home. A sample of these was read; they included supervision records, training 1 Malling Terrace DS0000024080.V301441.R01.S.doc Version 5.2 Page 21 certificates and some recruitment information. A separate training file is kept to track where update training is due or has been attended. Fifty per cent of the care staff now has obtained an NVQ qualification in care. The pre inspection questionnaire states that training planned includes Manual handling, Risk assessment and Challenging behaviour A key worker system is in place, a recent change round of key workers had taken place, service users spoken with were quite happy with the new arrangements. 1 Malling Terrace DS0000024080.V301441.R01.S.doc Version 5.2 Page 22 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): 37,38,39,40,41,42 and 43 The quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. The home is well run in consultation with service users. The health, safety and welfare of service users is promoted by the home’s policies and procedures. EVIDENCE: The home is well run and the manager has extensive experience of the service. The atmosphere is friendly and welcoming and the ethos is one of the service users making as many decisions as possible and leading the provision of their support. Their views are sought very regularly and they are confident in putting these forward. Policies and procedures of an organisational nature and particular to the home are in place and regular safety and maintenance checks take place. The 1 Malling Terrace DS0000024080.V301441.R01.S.doc Version 5.2 Page 23 temperatures of each service users’ fridge and freezer are checked daily and fire equipment is regularly checked and serviced. A valid insurance certificate is displayed. There had been a gap in the receipt by the commission of Regulation 26 reports since February 2006, although a report had recently been received. Staff are well supported and receive regular supervision, monthly house/staff meetings take place. Improvements to the fabric and décor have taken place since the last inspection and more have been requested. 1 Malling Terrace DS0000024080.V301441.R01.S.doc Version 5.2 Page 24 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 3 2 3 3 3 4 3 5 3 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 2 25 3 26 3 27 3 28 2 29 3 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 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 4 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 3 3 3 3 1 Malling Terrace DS0000024080.V301441.R01.S.doc Version 5.2 Page 25 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 YA24 Good Practice Recommendations It is strongly recommended that the home provides service users with new kitchen units without undue further delay; this recommendation is repeated from previous inspections and existing units are very damaged in places. It is recommended that a new entrance hall carpet be fitted and whilst damage is inevitable the areas most damaged by wheelchairs be repaired. It is recommended that the garden and patio area be made a more attractive area for service users. 2. YA24 3. YA28 1 Malling Terrace DS0000024080.V301441.R01.S.doc Version 5.2 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.V301441.R01.S.doc Version 5.2 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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