Inspection on 27/06/08 for 1 St Alphege Road

This inspection was carried out on 27th June 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

1 St Alphege Road 23/10/08

1 St Alphege Road 17/07/07

1 St Alphege Road 04/08/06

1 St Alphege Road 20/12/05

1 St Alphege Road 05/09/05

1 St Alphege Road 13/12/04

1 St Alphege Road 01/09/04

1 St Alphege Road 20/01/04

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

Crossways Community

Belle Vue Country House

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

CARE HOME ADULTS 18-65 1 St Alphege Road Dover Kent CT16 2PU Lead Inspector Mark Hemmings Unannounced Inspection 27th June 2008 09:00 1 St Alphege Road DS0000023757.V365148.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 St Alphege Road DS0000023757.V365148.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 St Alphege Road DS0000023757.V365148.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 1 St Alphege Road Address Dover Kent CT16 2PU 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) 01304 225252 None United Response Manager post vacant Care Home 7 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (7) of places 1 St Alphege Road DS0000023757.V365148.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th July 2007 Brief Description of the Service: 1 St Alphege Road (the Service) is registered to provide accommodation and personal care for seven people who have problems with parts of their mental health. The premises are a detached property. Each of the people who live in the Service has their own bedroom. All of the bedrooms have a private wash hand basin. One of them also has a private toilet and bath. There are two lounges and a dining area. There is quite a large kitchen. At the back of the property there is a conservatory that leads out into a small enclosed garden. The Service is located in a residential area. It is within easy walking distance of Dover town centre. To one side of the property there is a busy road and there is quite a lot of traffic noise in the garden and in the conservatory. People who might want to move in can get information in several ways. There is a Service Users’ Guide. This is a brochure that outlines the main things available in the Service. There is also a document called a Statement of Purpose. This gives a more detailed account than is in the Guide. The Registered Provider ensures that a copy of our most recent Inspection Report is available in the Service. The fee charged currently for each person’s residence in the Service is £815.20 per week. The fee includes all accommodation, meals, personal care, laundry and use of the Service’s vehicle. It does not cover things such as personal toiletries and hairdressing. 1 St Alphege Road DS0000023757.V365148.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this Service is 2 Star. This means that the people who use this Service experience good quality outcomes. The commission since 1 April 2006, has developed the way it undertakes its inspection of care services. This inspection of the Service was an unannounced “Key Inspection”. The Inspector arrived at the Service at 09.00 and was in the Service for about seven and a half hours. It was a thorough look at how well the Service is doing. It took into account detailed information provided by the Registered Provider in its self-assessment. This is called the Annual Quality Assurance Assessment (AQAA). Further, it considered any information that the commission has received about the Service since the last inspection. During the inspection visit, we looked at a selection of the records and documents kept in the Service. We spoke with the Manager, the deputy manager and with three support workers. Also, we spoke with three of the people who live in the Service and spent time in the company of others. We examined parts of the accommodation and grounds. There are five Requirements at the end of this Report. What the service does well: There is a relaxed and homely atmosphere. The people who live in the Service say that members of staff respect their individuality and provide them with the support they need. People are encouraged to take responsibility for themselves. People are supported to take care of their health. 1 St Alphege Road DS0000023757.V365148.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: There is a mistake in the complaints procedure. This might make people confused if they want to contact us. There is no fire safety risk assessment. This means that the fire safety system in the Service has not been checked to make sure that it is still working in the correct manner. There are shortfalls in the training arrangements. This means that some support workers have not received organised training in relevant subjects. This might result in them not having all of the skills and knowledge they need. The Manager has not been registered by the Commission. This is a legal requirement. The quality assurance system does not collect enough information. It does not tell all the necessary people what is going to be done to respond to suggested improvements. There is a shortfall in the fire safety training system. This might reduce the level of fire safety protection in the Service. The electrical wiring installation has not been inspected recently. This means that we cannot be sure that it is safe-worthy. 1 St Alphege Road DS0000023757.V365148.R01.S.doc Version 5.2 Page 7 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. 1 St Alphege Road DS0000023757.V365148.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 St Alphege Road DS0000023757.V365148.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. People are asked about what support they need before they move in. Additional information is collected to fill out the picture. EVIDENCE: The Manager completes an assessment of each prospective person’s needs for support. This is done before a decision is made about whether or not the Service is a suitable place for the person to live. The assessment is completed in consultation with the person concerned. As appropriate, other people are involved. For example, family members, care managers (social workers) and community psychiatric nurses. The sort of information considered includes important things such as the person’s mental health needs, the presence of anything that might put people at risk and what the person likes to do each day. We spoke to one of the people who live in the Service about what it was like to move in. They say that the Manager spoke with them to find out what support they wanted to have. Also, they say that support workers knew about all of this from the point they moved in so they felt that they did not have to 1 St Alphege Road DS0000023757.V365148.R01.S.doc Version 5.2 Page 10 go through it all again. They visited the Service before they moved in and so had a good idea of what to expect. The Annual Quality Assurance Assessment says that more work needs to be done to strengthen the pre-admission assessments. This will involve double checking the accuracy of the information that is received from other services to make sure that it is correct. 1 St Alphege Road DS0000023757.V365148.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. People get the support they need and want. They are helped to manage their money. Sensible steps are taken to help people avoid unnecessary risks. EVIDENCE: People say that the support workers offer them all the assistance they need. There is a written individual plan of care for each person. These are important documents. This is because they form one of the means by which people can be informed about and can agree to the support they will receive. Also, the plans are a source of information for support workers. This then helps them to provide support in a consistent manner. The Annual Quality Assurance Assessment recognises the importance of both of these aspects of the planning process. We looked at three sets of these plans. They contain a lot of useful information. For example, one person needs support to not interrupt people all 1 St Alphege Road DS0000023757.V365148.R01.S.doc Version 5.2 Page 12 the time. Another person needs support to do everyday things such as attending to personal hygiene, changing clothes and preparing their meals. The plans of support are kept under review to make sure that they are up to date. The people concerned say that they are actively involved in this process. We asked four of the support workers their understanding of the needs of some of the people’s needs. They have a thorough and consistent knowledge of the support each person has asked to receive. People are helped to manage their financial affairs. Most of the people have their own bank accounts. They are helped to run these and they also are helped to manage their personal spending monies. For example, one person is being supported so that they do not spend too much money at once and then find themselves short. Another person is being helped to save up to go on a holiday to Scotland. We looked at some of the records of the various transactions made. We found things to be in order. People are helped to not take unreasonable risks that might put themselves and other people in difficult situations. For example, one person has been assisted to smoke in a room where there is less of a fire risk and where other people do not have to breathe in smoke. Another person has been helped to work out a way of sitting in the Service’s car without getting in the way of the driver. 1 St Alphege Road DS0000023757.V365148.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14, 15, 16 and 17. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. People can do the things that interest them. They are helped to keep in touch with family and friends. People are helped to do their own catering. EVIDENCE: People are free to do things that interest them. For example, one person goes to a pottery course. Another person does some office work. Someone else has been set up on the internet in their bedroom. This person says that they have been able to do e-research on all sorts of subjects that interest them. People are encouraged and helped to develop occupational interests without being pushed and put under pressure. The balance between being encouraged to do things and being left alone is very important. We think that it is about right in the Service. 1 St Alphege Road DS0000023757.V365148.R01.S.doc Version 5.2 Page 14 People say that the pace of their daily life is relaxed and unhurried. While they have considerable choice about how to spend their day, there are broad expectations about some of the things they will do. For example, they are expected to care for their home. Also, they are expected to treat other people with the respect that would want for themselves. The Annual Quality Assurance Assessment emphasises the importance of recognising that some people can do more than others. This is reflected by support workers who respond to each person in an individual way. People are assisted to keep in touch with members of their families, if this is necessary and if it is their wish. Family members and friends are welcome to call to the Service. The staff in consultation with the person concerned, keep in touch with family members so that they know how things are going. People are expected to prepare their own meals. Support workers help them to plan what they want to have and to shop accordingly. They also give varying degrees of support in the kitchen. For example, when we were there we were speaking with one of the support workers in the conservatory. She broke off now and then to remind one of the people to keep an eye on their meal that was in the oven. Without this help, the meal might have got burnt. We asked two people how the catering arrangements work out in practice. They say that take it for granted that they will do their own meals. They say that there is always enough food in the Service for them to prepare the meals they want to have. 1 St Alphege Road DS0000023757.V365148.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. People are helped to support themselves. This includes using health care services and taking medication. EVIDENCE: People are assisted in ways that are right for them. Support workers are courteous in their manner and informal in their approach. People say that the support workers are approachable and that they can rely upon them to be there when they are needed. People are assisted to maintain their health. Support workers are alert to the need to identify occasions when someone is becoming unwell. This is so that medical assistance can be sought promptly. Since the last inspection, support workers have helped one person see their doctor who has advised that a particular diet needs to be followed. They have then supported this person to 1 St Alphege Road DS0000023757.V365148.R01.S.doc Version 5.2 Page 16 stick to the diet plan. Another person became quite ill. Support workers contacted various medical people to get the person admitted to hospital as soon as possible. Another person needs to have some dental work done but is not too keen on seeing the dentist. Support workers are trying to sort this out. This is so that the person can be reassured enough to enable the dental work to be completed. People are supported to manage their own medicines. At the moment one person is doing most of this for themselves. Support workers hold and dispense the other people’s medicines. We looked at how this is done. Medicines are checked when they are received into the Service to make sure that they are the right ones. They are stored securely and in an organised manner. There is a procedure that support workers follow to make sure that each person receives the right medicine at the right time. The Registered Provider expects all of the support workers to receive organised training to make sure that they are using all parts of the procedure in the right way. We looked at the records of this training. They show that Support Workers G and I have not yet done this training. The Manager says that this shortfall is in the process of being sorted out. There is a record kept of each time a medicine is given. We looked at three sets of these records and we found them to have been completed correctly. We then checked three medicines in detail to see if the amount recorded as having been given matched the remaining stock. The amounts left were correct. 1 St Alphege Road DS0000023757.V365148.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. There is a mistake in the information contained in the complaints procedure. The wellbeing of the people who live in the Service is safeguarded. EVIDENCE: There is a written complaints procedure. This explains how the people who live in the Service and other interested parties can go about raising a concern. As a first step, it is often best for people to try to sort out concerns informally with the Registered Provider. However, as an alternative they can contact us direct. The procedure does not give our correct contact details. The Manager is going put this right by 1 September 2008. Since our last inspection, the Registered Provider has looked into four complaints. These have been about quite minor matters and they have been sorted out. One of them involved an argument between two of the people who live in the Service. We looked at what had been done to get it sorted. The Manager first of all found out what had actually happened. Then he discussed the matter with the people concerned. Then he helped them to change part of their routines to reduce the chance of the problem happening again. This is a sensible way to deal with complaints. 1 St Alphege Road DS0000023757.V365148.R01.S.doc Version 5.2 Page 18 The Registered Provider says that it is committed to making sure that people who live in the Service are safeguarded from being abused or from being taken advantage of. There is a written policy and procedure that says what support workers should do if they become concerned about someone’s wellbeing. Support workers know about this and who to contact if the need arises. None of the support workers we spoke with have any concerns at the moment about how things are going. We asked three of the people who live in the Service about their sense of wellbeing. They say that they feel completely safe living in 1 St Alphege Road. 1 St Alphege Road DS0000023757.V365148.R01.S.doc Version 5.2 Page 19 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): Standards 24 and 30. People who use the Service experience adequate outcomes. This judgement has been made using available evidence including a visit to the Service. People live in a comfortable setting that has a lived-in feeling to it. The bathrooms and the toilets are rather bare. The fire safety procedure has not been reviewed recently. The kitchen is clean. The laundry is well equipped. EVIDENCE: Most areas of the accommodation are decorated and furnished to a homely standard. However, the bathrooms and toilets are rather bare with little having been done to make them into comfortable spaces. On the outside some of the woodwork on the conservatory is rotten. Some of the shrubs are quite overgrown both outwards onto the pavement and inwards into the garden. It is not clear at the moment whether it is the Registered Provider or the landlord 1 St Alphege Road DS0000023757.V365148.R01.S.doc Version 5.2 Page 20 that is responsible for cutting these back. The Manager says that this matter will now be sorted out before the problem gets even worse. The premises are fitted with an automated fire detection system. This provides a high level of fire safety protection. The Registered Provider should have prepared a fire risk assessment. This is necessary so that it can be sure that the system is working in the way intended. The assessment has not been done. This will now need to be put right. The kitchen is clean and well organised. The local Department of Environmental Health has not identified the need for any improvements to be made to the food handling arrangements used in the Service. The Annual Quality Assurance Assessment says that support workers help people do sensible things such as washing their hands before handling food. The laundry is equipped with a washing machine and dryer. People are encouraged to do their own laundry. Most do bits of it themselves and support workers help out with the rest. In general, the arrangements used work well. Each person has a normal supply of presentable clothes. There are new regulations that have been introduced to ensure that used water does not leak back into the main pipe-work. The Registered Provider is going to check with the local water supply company to make sure that it complies with these provisions. This will be done by 1 August 2008. 1 St Alphege Road DS0000023757.V365148.R01.S.doc Version 5.2 Page 21 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): Standards 32, 33, 34 and 35. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. There are enough staff around. There is a reliable recruitment system. Support workers know a lot about the special needs of people who have problems with their mental health. However, there are shortfalls in the training arrangements. EVIDENCE: There are three support workers on duty during the day. During the evening there are two support workers on duty until the nighttime cover starts. There are no housekeeping staff. There is an on-call system. This means that someone senior can be contacted for advice out of office hours. The Registered Provider completes a number of security checks in relation to new support workers. This is done to ensure that they are trustworthy people who are suitable to have unsupervised access to people who may be vulnerable. We looked at the records relating to a newly appointed support 1 St Alphege Road DS0000023757.V365148.R01.S.doc Version 5.2 Page 22 worker. We saw that there is adequate identification and that references have been obtained. There is also a suitable police check. New support workers receive introductory training before they work without direct supervision. We looked at the records of the introductory training provided recently for a new support worker. They received training in a number of relevant subjects such as fire safety and the Service’s communication systems. They also received information about the needs and wishes of the each of the people who live in the Service. After that, support workers are provided with ongoing training. This is designed to develop further their ability to provide a high quality residential care experience. The Registered Provider has identified a number of key courses that it thinks support workers need to attend. We looked at the records of who has done what training. There are some shortfalls. For example, the Registered Provider has arranged three courses and then a refresher course on how best to support people who are expressing themselves through difficult behaviour. Four support workers have not attended any of these. Five of them have not attended the courses on mental health awareness and on how to safeguard people’s wellbeing. Six support workers have not received training on how to respond to a particular medical condition that one of the people has. The Registered Provider will need to get these shortfalls sorted out. In addition to the ongoing training, support workers are encouraged to study for a relevant National Vocational Qualification (NVQ). Of the ten support workers employed in the Service, seven have obtained the qualification and two more are working towards it. This qualification is important because it is designed to develop their ability to support people in the right way and to a high standard. We looked at the adequacy of some of the skills and knowledge of four of the support workers. They have a good knowledge of how to respond helpfully to people who have problems with their mental health. For example, they know how important it is to have realistic expectations about the things that people might be interested in doing. Also, they understand that some people need to have more space than do others. They organise the support that they deliver accordingly. 1 St Alphege Road DS0000023757.V365148.R01.S.doc Version 5.2 Page 23 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): Standards 37, 39 and 42. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. The Manager has not been registered in his post. The quality assurance system does not collect enough information. There are gaps in some of the health and safety arrangements. EVIDENCE: The Manager has been in post for more than two years. In three consecutive inspection reports we have reminded the Registered Provider about the need to have someone registered as being the manager. This is a legal requirement. It is important because when someone applies for registration the Commission 1 St Alphege Road DS0000023757.V365148.R01.S.doc Version 5.2 Page 24 has the chance to have a detailed look at the person’s knowledge and skills. Also, we can check out how they plan to run a particular service. The Manager says that he has completed our application form. He cannot send this to us until he can show us a suitable police check. We know that this can take some time to come through. With this in mind, we have set a particular timescale for our receipt of the application. We will write to the Registered Provider to explain that we will take enforcement action if we do not receive the application by then. The Manager does not hold either of the formal qualifications that are recommended for someone in his position. The qualifications are designed to guide managers in setting up the necessary systems to provide high quality residential care. He says that he hopes to begin studying for one of these by the end of the year. Again, this is overdue and now needs to be sorted out. There are various systems used to promote good teamwork. These include handover meetings at the beginning and end of each shift. The Annual Quality Assurance Assessment says that considerable importance is attached to these meetings. We sat in on one of these. It is informal but follows a clear pattern. The support workers discuss how each person is doing and they work out who needs to do what during the forthcoming shift. Also, there are staff meetings. These are held every couple of months or so. We asked four support workers about the management of the Service in general and about communication in the staff team in particular. They say that they are well supported in their work. They like the fact that it is only a small staff team. They think that this helps them to coordinate their work so that people receive a reliable and consistent response to their individual needs. Several things are done to consult with the people in residence about how well the Service is running. These include informal discussions that happen as part of day-to-day life. There are also house meetings held every couple of months. We looked at the records of the last meeting. Most of the people who live in the Service were there. The subjects covered include useful things such as helping people to shop more regularly so that there are always fresh vegetables available. Another thing is a new system to support people cook new dishes so that they have a wider choice of things to eat. We asked two people about the meetings. They say that they feel completely free both in the meetings and outside of them to have their say about their home. Neither can think of anything that they have asked for that has not been provided. The consultation system does not really include support workers. Also, there is no organised system to tell contributors what is going to be done to respond to any suggested improvements. The Registered Provider is going to address these shortfalls. This will be done in time for the results to be notified to us in 2009, when the Registered Provider submits its next Annual Quality Assurance Assessment. 1 St Alphege Road DS0000023757.V365148.R01.S.doc Version 5.2 Page 25 The Area Manager calls to the Service regularly to see how things are going. In addition to this, she completes a more detailed quarterly review. The last one was completed on 10 January 2008 and so the system is a bit overdue. We looked at the most recent report. This shows that a number of relevant things were looked at and were found to in order. For example, handling medication and helping people manage their money. The current Annual Quality Assurance Assessment gives lots of useful information about the Service. It is realistic and it gives a fair account. It says what could be better as well as what is done well. This shows that the Manager and the support workers are thinking actively about and are questioning what they do. Regular checks are completed to ensure that the Service’s fire safety equipment remains in good working order. This includes a weekly test of the fire alarm bells and periodic more detailed checks completed by a contractor. There are unannounced fire drills. There is an annual fire safety lecture. However, the records show that the Manager and Support Workers A, B, D, F, G and H are overdue to do the training. Also, Support Workers C, E and I have not done the training at all. The Manager says that a new system will be introduced to double check that all support workers know how to use the Service’s fire safety procedure. This is important because the level of fire safety protection in the Service largely depends on the actions taken by staff. The Manager says that this will be done by 1 August 2008. We asked two support workers about things to do with fire safety. Both know how to correctly call the Kent Fire and Rescue Service and both know what steps can be taken to reduce the chance of there being a fire safety emergency in the first place. There is no certificate in place to show that the electrical wiring system is in a safe-worthy condition. This shortfall will need to be sorted out. There is a certificate to show that the gas appliances used in the Service are in good working order. There have not been any significant accidents in the Service since our last inspection. The Manager is aware of the need to review any that do occur. This is so that he can take steps to stop things happening again. The Manager checks the building to make sure that there are no hazards that might cause someone to have an accident. He says that no problems have been found. We did not identify any particular hazards. 1 St Alphege Road DS0000023757.V365148.R01.S.doc Version 5.2 Page 26 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 3 3 X 3 4 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 3 3 2 X 3 3 3 2 X 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X X 2 X 3 X 2 X X 2 X 1 St Alphege Road DS0000023757.V365148.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? Yes 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 YA24 Regulation 23 (4) Requirement The Registered Provider must complete a risk assessment of the Service’s fire safety procedure. The assessment must be submitted to the Kent Fire and Rescue Service. Timescale for action 01/09/08 2. YA35 18 (1) (c) 3. YA37 8 (1) The Registered Provider must 01/01/09 ensure that there is an organised system in place to ensure that all support workers have the skills and knowledge they need. The Registered Provider must 01/09/08 submit to us an application to register someone in the post of manager. This Requirement is outstanding from the last inspection report. It should have been completed by 30/09/07. 4. YA42 23 (4) (e) The Registered Provider must ensure that at least every six months each member of staff knows how to use the fire safety procedure. The Registered Provider must DS0000023757.V365148.R01.S.doc 01/09/08 5. YA42 23 (2) (c) 01/09/08 Page 28 1 St Alphege Road Version 5.2 ensure that the electrical installation is certified as being safe-worthy in accordance with the relevant British Standard. 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 1 St Alphege Road DS0000023757.V365148.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 1 St Alphege Road DS0000023757.V365148.R01.S.doc Version 5.2 Page 30 - 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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