Inspection on 05/09/05 for 1 Malling Terrace

This inspection was carried out on 5th September 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 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 22/08/06

1 Malling Terrace 21/12/05

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 Announced 05 September 2005 09:45 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 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 Stationary 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 H56-H06 S24080 1 Malling Terrace V239135 050905 Stage 4.doc Version 1.40 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 Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) malling@mcch.org.uk MCCH Society Limited Mr Paul Tompsett CRH Care Home 4 Category(ies) of Physical disability (4) registration, with number of places 1 Malling Terrace H56-H06 S24080 1 Malling Terrace V239135 050905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25 January 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 H56-H06 S24080 1 Malling Terrace V239135 050905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the announced inspection, the first in the year running from April 1st 2005 to March 31st 2006. The visit lasted from 9:45 am until 13:45 pm. The home currently has four residents. Two were attending work placements and did not wish to talk with the inspector but had completed comment cards. The visit was spent talking privately with two residents and collectively with the four care staff and senior support worker. The registered manager was on annual leave. 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. Additional evidence was gained from the returned pre inspection questionnaire and comment cards received from relatives and visiting professionals. What the service does well: What has improved since the last inspection? 1 Malling Terrace H56-H06 S24080 1 Malling Terrace V239135 050905 Stage 4.doc Version 1.40 Page 6 Residents have benefited from a more stable staff team. Staff know the individuals well and communicate effectively with them. Residents have benefited from the fundraising and acquisition of the additional adapted vehicle to assist to transport them to activities. Residents are happy with the redecoration of two flats and purchase of new fridges/freezers and microwaves for all their kitchens. 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. 1 Malling Terrace H56-H06 S24080 1 Malling Terrace V239135 050905 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection 1 Malling Terrace H56-H06 S24080 1 Malling Terrace V239135 050905 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4,5, 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 Service Users guide. This is also available on CD Rom. Residents discussed visiting the home on a number of occasions and short stays prior to making the final decision to move into the home. Records evidenced gathering of relevant information from others such as relatives and professionals. Resident’s personal aspirations and needs are assessed through internal reviews with care staff, as well annual reviews with the placing authority. All residents have a tenancy agreement with the housing association with an appendix detailing the support provided by MCCH care staff. 1 Malling Terrace H56-H06 S24080 1 Malling Terrace V239135 050905 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for 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. Residents told the inspector that they know the contents of care plans and have agreed the targets with support of the care staff. All of the residents 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 enable residents to make their own views known and all such meetings are recorded in writing. Residents’ individual activities and wishes determine mealtimes, menus, holiday venues, décor and activities. Staff 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 H56-H06 S24080 1 Malling Terrace V239135 050905 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15,16,17 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. Important relationships are respected; encouraged and residents feel valued. Staff encourage individuals to take responsibility for their own actions. 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 ”. Residents enjoy additional one to one time provided by staff, to events such as music gigs, visiting the coast, meals out. One resident would prefer to have more activities that are music influenced. Staff evidenced continued support to find these. Due to physical disabilities 1 Malling Terrace H56-H06 S24080 1 Malling Terrace V239135 050905 Stage 4.doc Version 1.40 Page 11 transport to such activities can be restricted due to the availability of the homes two adapted vehicles and others residents activities. Residents continue to enjoy work placements/ experience with local Social Services and Growing Concern. Residents are supported to shop and purchase their own food shopping. They are helped to prepare, cook and eat their meal in their individual flats. One resident said that they would like to have a communal lounge/diner to sit with their peers, relax and eat with others. Staff encourage residents to invite each other for meals where appropriate. Resident’s benefit from a knowledgeable staff, who have a good understanding of personal preferences and encouraging a good well balanced diet. 1 Malling Terrace H56-H06 S24080 1 Malling Terrace V239135 050905 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20 Intimate and personal care needs are attended to in a dignified manner and the physical and emotional health of individuals is promoted. EVIDENCE: Staff are clearly 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. There is ongoing support from occupational therapists, physiotherapists, hydrotherapy, wheelchair dept and local GP. It was suggested by a visiting professional “staff may sometimes need to encourage service users to trial equipment before making decisions”. 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 residents 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 noted. Further development of PRN guidelines would ensure consistent safe administration within clear set triggers and action to be taken. 1 Malling Terrace H56-H06 S24080 1 Malling Terrace V239135 050905 Stage 4.doc Version 1.40 Page 13 1 Malling Terrace H56-H06 S24080 1 Malling Terrace V239135 050905 Stage 4.doc Version 1.40 Page 14 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 standard(s) 22,23 Residents have ample opportunities to express their views. They feel they are listened to, valued and concerns acted upon. Not all relatives are aware of the complaint procedure. Clear procedures are in place to ensure residents are protected from abuse, neglect and self – harm. 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. None of the residents are afraid to make 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. From the feedback comment cards not all relatives were aware of the formal complaints procedure. Residents were seen to raise informal concerns directly with staff and being supported to achieve a satisfactory resolve. The home implements clear and specific guidance for staff and external training courses are accessed. These measures and the use of clear risk assessments protect residents, staff and visitors from abuse and accusations. Residents stated they felt safe and secure at the home and locally from both staff and peer support. 1 Malling Terrace H56-H06 S24080 1 Malling Terrace V239135 050905 Stage 4.doc Version 1.40 Page 15 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 standard(s) 24,25,26,27,28,29, 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. Residents expressed the wish for a communal lounge. EVIDENCE: 1 Malling Terrace H56-H06 S24080 1 Malling Terrace V239135 050905 Stage 4.doc Version 1.40 Page 16 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. Each flat was visited on this occasion by an inspector; one resident stated that they were very happy with the accommodation; especially now it had been redecorated. Electrical kitchen appliances have been replaced. 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. Carpeting in two flats is heavily stained and needs costing for replacement. Staff indicated this was in hand. A combined office /flat is used by the staff in the home. Two residents expressed their wish for a communal lounge to use. 1 Malling Terrace H56-H06 S24080 1 Malling Terrace V239135 050905 Stage 4.doc Version 1.40 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,36 The home has sufficient numbers of confident and knowledgeable staff working as a team to support service users in their daily lives. EVIDENCE: The home has in the past year experienced a turnover of staff, this has stabilised since the last inspection. The home has a whole time equivalent staffing level of 6 carers, 1 senior carer and the manager. New staff complete a full induction and probation period. 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 about to start NVQ 3. One staff member has started their second year of psychology degree. Staff 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 files evidenced good recruitment processes with checks being undertaken to ensure residents safety. Regular one to one supervision with the acting manager takes place. Written records indicate that all staff will receive supervision at least 6 times within 12 months. 1 Malling Terrace H56-H06 S24080 1 Malling Terrace V239135 050905 Stage 4.doc Version 1.40 Page 18 1 Malling Terrace H56-H06 S24080 1 Malling Terrace V239135 050905 Stage 4.doc Version 1.40 Page 19 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38,39,42 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 H56-H06 S24080 1 Malling Terrace V239135 050905 Stage 4.doc Version 1.40 Page 20 The home has an allocated team away day to explore the homes yearly goals and action plan. This represents their annual development plan. Formal surveys are undertaken with service users. 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 service users 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. One resident commented, “ I feel sometimes I am restricted in what I want to do due to regulations and red tape”. 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. Staff spoke of feeling well supported by the registered manager and MCCH organisation as a whole. 1 Malling Terrace H56-H06 S24080 1 Malling Terrace V239135 050905 Stage 4.doc Version 1.40 Page 21 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 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 1 Malling Terrace Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x 3 3 x x 3 x H56-H06 S24080 1 Malling Terrace V239135 050905 Stage 4.doc Version 1.40 Page 22 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. 1. 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. 2. Refer to Standard YA6 YA 20 Good Practice Recommendations It is strongly recommended that all care plan risk assessments and guidelines are formally reviewed at least 6 monthly and recorded as such. It is strongly recommended that PRN protocols and guidelines be clearly detailed in one residents care plan regarding allergies to bee stings, together with reaction symptoms and action to be taken by staff. It is strongly recommended that PRN medication guidelines should be detailed with signs and symptoms (triggers) and action to be taken to ensure consistent safe administration. These guidelines should be stored with the current MAR charts. It is recommended that times of administration of medication on MAR sheets are clear and specific to ensure consistent administration times and adequate spacing between doses. It is strongly recommended that the homes complaint procedure is explained to all relevant relatives and representatives as part of the individual review process. It is recommended that the home continues to work with H56-H06 S24080 1 Malling Terrace V239135 050905 Stage 4.doc Version 1.40 Page 23 3. YA20 4. YA20 5. 6. YA22 YA24 1 Malling Terrace 7. YA29 Sanctuary Housing and MCCH budget planning to upgrade and replace damaged kitchen units, carpeting and specialist equipment. It is recommended that the home continues to work closely with occupational therapists to establish the best specialist equipment to aid mobility and independence, including dining furniture, wheelchairs and standing aids. 1 Malling Terrace H56-H06 S24080 1 Malling Terrace V239135 050905 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection The Oast, Hermitage Court Hermitage Lane Maidstone Kent 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 H56-H06 S24080 1 Malling Terrace V239135 050905 Stage 4.doc Version 1.40 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!