Inspection on 03/10/08 for 10 Leyton Avenue

This inspection was carried out on 3rd October 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

10 Leyton Avenue 09/11/06

10 Leyton Avenue 22/12/05

10 Leyton Avenue 09/06/05

Extracts from inspection reports are licensed from CQC, this page was updated on 16/12/2008.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 10 Leyton Avenue 10 Leyton Avenue Gillingham Kent ME7 3DB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Eamonn Kelly     Date: 0 3 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: 10 Leyton Avenue 10 Leyton Avenue Gillingham Kent ME7 3DB 01634280235 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Karen McCaw Type of registration: Number of places registered: MCCH Society Ltd care home 2 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 2. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home 10 Leyton Avenue is one of a number of residential homes by MCCH Society Ltd. The home offers 24-hour care for 2 people with a learning disability. There is a local bus route nearby giving access to Gillingham town centre. The service provides two single bedrooms on the first floor. One member of staff is on duty at night and the company has an on-call system for emergency cover. Catering, domestic work, gardening and administration is dealt with by the manager and support workers. Residents are encouraged to take part in daily activities to the best of their abilities and they are helped to have ready access the local community and amenities. Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 2 Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The inspection took place on 3rd October 2008. It consisted of meeting with a support worker on duty, one resident and a phone discussion with the manager. Care practices relating to current and previous residents were discussed with the support worker. Some records were seen during the visit principally those addressing the personal and healthcare support of residents. We received an annual quality assurance assessment (AQAA) from the manager of the service. Use was also made of the annual service review of this service which was carried out in January 2008. This report, a copy of which was sent to the manager, contained reference to all information about the service known to the Commission at that time. The previous report contained requirements for the premises to be improved and for Care Homes for Adults (18-65 years) Page 6 of 27 more specific information about residents health to be contained in care plan records. The required improvements to the premises have bben addressed and care plans contain relevant information to enable staff to support residents effectively. This report contains no requirements or recommendations. Information about fees and other charges made to residents are available from the manager. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have their individual aspirations and needs assessed before they enter residential care. Evidence: Prospective residents and their advocates receive information about the home’s services and facilities. This is through information from the manager and members of staff, through the written guide, and via the information for parents and others on the company’s website. This includes recommendations to help manage a successful transition. Detailed assessments are made of each prospective resident. Information gathered at this early stage forms part of care plan records and a risk assessment is constructed by the manager as a working tool for support workers. Depending on the support needs of residents, different methods of assessment and initial introduction to the premises are practiced. Prospective residents generally visit Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: for shorter periods and may have an overnight stay. During the initial settling-in period, the assessment process continues. The company has a business contract for each resident with the sponsoring organisation. There is an individual contract available for each resident. Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are helped to make decisions and to express themselves as part of developing their confidence and quality of life. Evidence: Successive managers have introduced detailed risk assessments for each resident. These contain concise blocks of information relating to the resident’s developmental needs and how these can be addressed for the residents benefit and continuing comfort/safety of other residents and staff. Support workers also have recourse to information maintained in support plans. Support workers are involved in updating risk assessments and identifying risks. These are part of the overall care plan process which includes records of identified support needs, how these are being met and reviews of resident’s progress. Copies of formal reviews seen for one resident were up to date and an appointment for such a review for a resident who took up residentce about six months ago was scheduled. Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: Each resident has notes kept on their pattern of activity, their preferred options and how they are progressing. Communication profiles are in place to help residents residents who have communication difficulties. Residents are very active within and outside the premises. They are encouraged to have independent lifestyles and care plan procedures are used as working tools to meet this objective. Care Homes for Adults (18-65 years) Page 13 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Routines and activities developed with each resident give them opportunities to exercise preferences on a day-to-day basis. Evidence: Residents are helped to take part in activities they enjoy and to be a part of community life. During the inspection visit, a resident was preparing to travel with a support worker to a local amenity for which she had an annual entry pass. The other resident was spending a long weekend at her family home. The support worker explained how essential medicines are checked and prepared for residents who are going out for the day or are going away for longer periods of time. Staff vehicles are available for the purpose of independent travel to a variety of locations. Residents have access to leisure pursuits and customised activities. Care plan folders contain information of the types of activities they enjoy and derive benefit from. Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: They are encouraged to maintain contact with relatives and friends where they wish to and can do so. They are helped to maintain private relationships and their continuing safety is monitored. Information on improvement or deterioration is maintained in support plan records. Care Homes for Adults (18-65 years) Page 15 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive good physical, emotional and personal support. They are protected by procedures for administering medication. Evidence: Times of getting up and going to bed, having baths, eating meals and other activities are flexible to allow for resident’s respective daily routines. They are able to make their own choice with assistance and advice from staff about what they wish to wear and general hairstyles. There is a high and discreet staff input into the support they need and receive. Each resident’s care plan record documents personal, physical and emotional healthcare needs. Records of health care provided by G.P, chiropodist, dentist, and opticians are part of each folder. The intention is that procedures are in place to enable them to receive the personal and healthcare support needed and that potential complications and problems are recognised and dealt with at an early stage. Regular appointments are seen as important and there are systems in place to make sure residents are reminded and appointments are not missed. Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: Residents who could keep their own medicines could do so subject to recorded risk assessment and regular review. No residents currently maintain their own medicines. Medicines and MAR (records of administation) sheets are securely stored. From the support workers description of current administration arrangements, all necessary procedures are followed to protect residents. The AQAA (annual quality assurance assessment) refers in detail to how healthcare support is considered a priority. Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are protected from abuse and are able (directly or via staff skills in anticipating their actions/concerns) to make their views known to members of staff and others. Evidence: Essential life plans are used to identify patterns for development of resident’s lifestyles and health. Recorded information contributes to the way staff use their skills to defuse threatening situations and address such situations. Staffing levels, according to the support worker and reiterated in the AQAA, is also a positive factor in maintaining good relationships within reason. A recruitment process that includes CRB and POVA checks is in place. Members of staff receive training in Safeguarding Adults procedures operated by local authorities. The AQAA (annual quality assurance assessment) identifies factors regarded as important for protecting residents, for example, accurate incident records are maintained to monitor trends and assess responses, records are maintained of all financial transactions affecting clients and the needs of vulnerable people are kept under constant review. The support worker was not aware of any on-going adult protection issues currently underway by a local authority and the AQAA states that, apart from an incident since Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: the previous inspection that has received proper consideration, no complaints have been received. Care Homes for Adults (18-65 years) Page 19 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The premises are suitable for the support needs of residents. Evidence: The premises have been improved since the previous inspection. The garden is suitable for use by residents. Bedrooms are suitable for the accommodation and care of residents as are communal areas on the ground floor. There are good security devices in use for the safety of residnts and staff. At the time of the inspection visit, the premises were in very good condition and all areas were clean and tidy. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are in the care of members of staff that are well supported by the company. Evidence: According to the Commissions agreement with MCCH, there is a central recruitment procedure that covers all residential homes in the group. The Commission has received an assurance that all new staff are required to complete application forms, written references are taken up, CRB and POVA checks are undertaken and a Skills for Care (the relevant training organisation for the care sector) recommended induction procedure is followed. Managers of individual services are involved in recruitment procedures and are responsible for ensuring that staff are in place, are trained, are formally supervised and have access to all necessary HR support. Over the past 18 months, the training received by staff has been improved in all essential areas. The personal development needs of staff is formally discussed and recorded and the agreed action is taken. All support workers are encouraged to obtain NVQ Levels 2 or 3 in Care. The support worker outlined how all staff receive training and continuing support via a range of mandatory training courses to enable them to assist residents and achieve the objectives outlined in care plans. Care Homes for Adults (18-65 years) Page 21 of 27 Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in an environment that is well managed. Residents and members of staff are benefiting from improvements in the way the service is conducted. Evidence: The service is managed by senior MCCH staff who have experience in providing residential support for vulnerable adults. The AQAA states that the manager is currently undertaking a management development course and keeps up to date with current events affecting strategies in residential care and changing legislation affecting the care sector. The AQAA refers to the changes that have taken place in 2008. These include premises refurbishment, improvements in bedroom and communal areas, more realistic staffing levels, introduction of better risk assessments, improved staff support, better information system and better knowledge of how to work with vulnerable people. The AQAA gave the Commission a range of information including a declaration that all Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: necessary safety checks on premises and equipment is carried out. It also referred to the relatively recent initiative by MCCH in introducing new Quality Assurance approaches to assess the effectiveness of the support in place for residents. According to the AQAA, close attention is given to recording incidents and their outcomes. The purpose is to monitor how they are dealt with and to improve general procedures for the benefit of rersidents and staff. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 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. 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!