Inspection on 11/08/05 for 102 Long Catlis Road

This inspection was carried out on 11th August 2005.

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 no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

102 Long Catlis Road 07/10/08

102 Long Catlis Road 08/10/07

102 Long Catlis Road 15/08/06

102 Long Catlis Road 18/10/05

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

CARE HOME ADULTS 18-65 102 Long Catlis Road Gillingham Kent ME5 8LF Lead Inspector Sue McGrath Unannounced 11 August 2005 9.30am 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. 102 Long Catlis Road H56-H06 S64411 102 Long Catlis Road V243538 110805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Long Catlis Road Address Gillingham Kent ME5 8LF 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) Category(ies) of registration, with number of places 01622 769100 MCCH Society Limited Care Home 102 Long Catlis Road H56-H06 S64411 102 Long Catlis Road V243538 110805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: 102 Long Catlis Rd, Gillingham, is a small residential home, which provides care and accommodation for 3 people with physical and learning disabilities. It is one of a number of residential homes managed by MCCH Ltd who are currently in the process of registering the home with the Commission. Twentyfour hour care is provided and members of staff have support and training as part of a larger organisation.The premises are in a residential suburb of Gillingham and local facilities are within walking distance, as is access to a bus route. On-street car parking is available. The garage of the premises has been converted to provide a range of living and storage space. 102 Long Catlis Road H56-H06 S64411 102 Long Catlis Road V243538 110805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and took place over 4 hours on the 11th August 2005. The inspector spoke with some of Residents and members of staff plus the manager. Many judgements about the quality of life for residents were taken from observations, speaking with staff, reviewing records and from direct discussion with residents. A tour of the premises was undertaken which included all of the resident’s rooms. Some records were viewed including care plans. What the service does well: What has improved since the last inspection? What they could do better: The general environment is poor and most of the rooms are in need of redecoration. New carpets or suitable floor coverings are needed throughout. Access to the lounge and rear garden is not easily accessible for residents who require the use of a wheelchair, due to a narrow doorway and a lip on the patio door. All of the toilets need attention. The home is understaffed and this causes activities to be cancelled and affects the well being of the residents. Limited access to transport also makes this situation difficult. The home has high usage of agency and bank staff. 102 Long Catlis Road H56-H06 S64411 102 Long Catlis Road V243538 110805 Stage 4.doc Version 1.40 Page 6 The majority of the bedrooms are below the minimum space required and the lounge is only barely large enough for three residents. The home currently has four residents and this overcrowding is making life at Long Catlis Road difficult for some of the residents. This issue over the extra resident will need to be resolved in the very near future. Although residents have care plans in place, which are regularly reviewed, service users needs and wishes in terms of community access are not properly assessed and the outcomes and goals are not incorporated into the care plans. As two of the three residents are over 65, the manager should ensure staff have an awareness of the needs of older people. 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. 102 Long Catlis Road H56-H06 S64411 102 Long Catlis Road V243538 110805 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 102 Long Catlis Road H56-H06 S64411 102 Long Catlis Road V243538 110805 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) 1,3,5, The home’s Statement of Purpose and Service User Guide do not reflect the current physical environment of the home and do not provide prospective residents and their relatives with the information they need regarding levels of care and the philosophy of the home. EVIDENCE: The manager had been provided with a new Statement of Purpose from MCCH Ltd dated July 2005. This document does not give a true reflection of life at Long Catlis Road. One of the statements is that the home offers services and care tailored to meet the individual’s needs and aspirations, including education and day activities. It also states that Residents have house meetings once a month where they can express a desire to undertake activities if they wish. Staff stated they do not hold such meetings. Several other areas in the Statement of Purpose do not reflect actual practise in the home. It will be a requirement that the Statement of Purpose is either adhered to or changed to reflect actual practise. Apart from the inaccuracies contained the Statement of Purpose was well presented and was in an appropriate format. The organisation is currently developing contracts for all of the residents. These will be assessed at the next inspection. 102 Long Catlis Road H56-H06 S64411 102 Long Catlis Road V243538 110805 Stage 4.doc Version 1.40 Page 9 MCCH Ltd have applied for the registration of four beds. The original registration was for three beds, however four residents are living at Long Catlis Road. Whilst the Commission is aware that this situation was inherited by MCCH, the home will only be registered for three as the room being currently used is below the minimum space required. It will be a requirement that this resident be found alternative accommodation and a reasonable timescale will be required for this to happen. The Commission will not be expecting immediate action and would advise that a full assessment of need is carried out to ensure a more suitable placement is found in the near future. 102 Long Catlis Road H56-H06 S64411 102 Long Catlis Road V243538 110805 Stage 4.doc Version 1.40 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8 Residents do not benefit from having care plans that reflect their current personal needs; these plans do not address personal goals and achievements. Residents are not very involved with all aspects of life in the home. The extra resident in the home adversely affects residents’ quality of life. EVIDENCE: Several care plans were viewed and discussed with the manager. It was difficult to see if service users needs and wishes in terms of community access were properly assessed as any outcomes and goals had not been incorporated into the care plans. Some Service users had received speech therapy assessments, but records were not consistent in terms of implementing programmes and the actual assessments could not be found. Staff stated that it was difficult for the Residents to make clear decisions as their level of disability prevented this. They stated that choices were made by physical reactions to choices offered. The manager also stated that staff knew the Residents very well and were aware of the likes and dislikes. The home does not offer residents meetings but does have a key worker system in operation. Two of the residents are over 65 with one having a diagnosis of 102 Long Catlis Road H56-H06 S64411 102 Long Catlis Road V243538 110805 Stage 4.doc Version 1.40 Page 11 dementia. The home must ensure they are providing suitable care and stimulation for this client group. 102 Long Catlis Road H56-H06 S64411 102 Long Catlis Road V243538 110805 Stage 4.doc Version 1.40 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,14,15,17 Resident’s do not benefit from having the opportunity for personal development with their daily living skills or have appropriate level of leisure activities. The residents do benefit from the appetising meals and balanced diet offered by the home. EVIDENCE: Current issues with a specific Resident is impinging on the lives of the other Residents, in that they are not comfortable in his presence. One of the Residents in particular is restricted to what he can do because he is afraid, and his quality of life is being affected. Staff did not demonstrate that they had the skills to deal with the challenging behaviour displayed on the day. The manager is strongly advised to review the placement concerned and seek an appropriate placement with the Care Manager, to ensure the safety and well being of the other Residents. Opportunities to develop social, emotional, communication and independent living skills in this home were limited. It is accepted that none of the service users would be able to access employment and due to the age group further education is not applicable. However, more could be done to stimulate the residents and make activities 102 Long Catlis Road H56-H06 S64411 102 Long Catlis Road V243538 110805 Stage 4.doc Version 1.40 Page 13 more freely available. Problems with transport and staffing levels also impinge on the amount of leisure activities offered. Residents do not currently have a holiday; the manager stated that this was mainly due to staff shortages. The home had an open policy on visiting with visitors welcomed t any time. Staff do assist one resident to visit his family. Meals were offered at regular intervals and the manager stated that all of the residents enjoyed their food and had good appetites. Menus were not viewed. Nutritional assessments are not routinely carried out and advice was given over the format of such assessments. The dining area was cramped and did not appear to have sufficient space for four residents to eat at the table. The table was fairly small but did have sufficient chairs, not all of these appeared to be used. 102 Long Catlis Road H56-H06 S64411 102 Long Catlis Road V243538 110805 Stage 4.doc Version 1.40 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20 The service users can be confident that their health needs are met and that they have full access to all professional health care services as required. Whilst residents are mainly protected by the home’s policies and procedures for dealing with medicines some shortfalls in practice were noted. EVIDENCE: The home does operate a key worker system to support residents and personal care is delivered in private. One hoist was seen on the premises but staff stated that it was not used often due to difficulty in moving it into the lounge areas. It was stored in a room that had a step down into it and staff had difficulty in lifting the hoist out of the room. It will be recommended that if the use of a hoist has been identified in a moving and handling assessment it must be stored in a more accessible place. All residents are registered with a local GP and had full access to healthcare facilities in the local area. Some minor errors were found with the administration of medication and these were discussed with the manager. Medication will be assessed in full at the next inspection. 102 Long Catlis Road H56-H06 S64411 102 Long Catlis Road V243538 110805 Stage 4.doc Version 1.40 Page 15 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) Not assessed at this inspection EVIDENCE: 102 Long Catlis Road H56-H06 S64411 102 Long Catlis Road V243538 110805 Stage 4.doc Version 1.40 Page 16 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, The residents do not benefit from living in a pleasant, comfortable or homely environment since the home is in need of refurbishment. The level of cleanliness and infection control procedures, particularly in the toilets, needs to be improved to ensure residents live in a safe, hygienic environment. EVIDENCE: The internal décor is poor and needs to be re-decorated. The flooring in the hall and lounge/diner is also in a poor state and needs replacing. The thresholds between these areas are dangerous and urgently need attention. They constitute a trip hazard. Some light bulbs and some light shades were missing. The lounge does not have sufficient comfortable armchairs for all of the four residents. The door into the lounge was too narrow for wheelchair access and this needs to be widened as soon as possible. Access to the rear garden was also difficult for wheelchair access. The ramp to the garden had no handrail and this should also be provided. The rear garden was pleasant. 102 Long Catlis Road H56-H06 S64411 102 Long Catlis Road V243538 110805 Stage 4.doc Version 1.40 Page 17 The laundry room at the rear of what was the garage was damp and needed new impervious flooring. The washing machine was very old and in a poor state externally. The manager was unsure if it had a sluice facility. The use of powdered gloves was seen. It is strongly recommended that nonpowdered latex gloves were provided. Non powdered/latex free gloves should be available for those staff members with confirmed allergies. The manager is advised to obtain a copy of Kent and Medway Community Infection Control Guidelines. All service users have their own room and although 3 rooms are below the minimum space requirement additional compensatory space is available in a small separate activities room. The Home is currently applying for registration for 4 Residents. One resident is occupying an unregistered room, which is below minimum space requirements. As the lounge area is also fairly small the home can only be registered for three. This had been discussed earlier in the report. All of the toilets had very strong odours of urine with floors being badly stained. These needed to be thoroughly cleaned or replaced. The manager was concerned that the odour was from the floorboards. If this is the case these may need to be replaced also. The home generally would benefit from a thorough spring clean. 102 Long Catlis Road H56-H06 S64411 102 Long Catlis Road V243538 110805 Stage 4.doc Version 1.40 Page 18 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) 33,36 The quality of care and the safety of service users is compromised because of the home’s inadequate staffing levels. EVIDENCE: Staffing levels were low and a high number of agency/bank staff were regularly used. Particular concern was raised over night staff. The home only had one permanent night staff who works three nights one week and four the next. Bank staff are used to cover the other nights. As the home only had one waking night this means that staff that may be unfamiliar with the home and the residents are working alone and unsupervised. Although the manager tries to use the same bank staff this is not always possible. It will be a requirement that sufficient night staffs are employed to cover all nights. Shortages in day staff are also affecting the quality of life for the residents with some activities not being carried out. Currently all cooking and cleaning in the Home is undertaken by care staff and in order to assess staffing levels against the recommended guidance from the residential staffing formula, a requirement has now been made that the home identify what proportion of staff hours, including the managers, are spent on direct care of service users. The manager confirmed that regular supervision was taking place for all staff. This would be assessed in full at the next inspection. 102 Long Catlis Road H56-H06 S64411 102 Long Catlis Road V243538 110805 Stage 4.doc Version 1.40 Page 19 102 Long Catlis Road H56-H06 S64411 102 Long Catlis Road V243538 110805 Stage 4.doc Version 1.40 Page 20 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) 37,42 Current arrangements are not sufficient to fully protect the health, safety and welfare of residents and staff. EVIDENCE: The manager is currently applying to the Commission to become the Registered Manager. Some areas of maintenance of equipment highlighted shortfalls and immediate requirement were made regarding the servicing of the bath hoist and the confirmation that the hard wiring was safe. 102 Long Catlis Road H56-H06 S64411 102 Long Catlis Road V243538 110805 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 2 x 2 x 2 Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 1 x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 2 x 1 x 2 2 Standard No 11 12 13 14 15 16 17 2 2 x 2 3 x 3 Standard No 31 32 33 34 35 36 Score x x 1 x x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 102 Long Catlis Road Score 3 2 2 x Standard No 37 38 39 40 41 42 43 Score 2 x x x x 2 x H56-H06 S64411 102 Long Catlis Road V243538 110805 Stage 4.doc Version 1.40 Page 22 NA 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 YA33 Regulation 18 Requirement The registered person shall,having regard to the size of the care home ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of the residents. In that sufficient night staff are permanently employed . The registered person shall,having regard to the size of the care home ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of the residents. In that the home identify what proportion of staff hours, including the managers, are spent on direct care of service users. Sufficent care hours must be provided to meet the assessed needs of the residents.. The registered person shall provide for consultation with and their representativers over daily living activities. H56-H06 S64411 102 Long Catlis Road V243538 110805 Stage 4.doc Timescale for action Action Plan by 23rd September 2005 2. YA33 18 Action Plan by 23rd September 2005 3. YA8 24 Action Plan by 23rd September 2005 Page 23 102 Long Catlis Road Version 1.40 4. YA24 23(2)(a) 5. YA24 23(2)(d) 6. YA27 23( 7. YA24 23(2)(a) 8. YA2 14.1(a) The registered person shall ensure that the premises used as the care home meet the needs of the residents in that the lounge doorway is widened so that access is improved for the service user identified. The registered person shall ensure that all parts of the home are kept clean and reasonably decorated. This include decoration and flooring The registered operson shall ensure there are sufficient numbers of clean and hygenic toilets The registered person shall ensure that the premises used meet the needs of the residents in that access to the rear garden is provided for wheelchair users. The registered person must ensure that a comprehensive care manager assessment is carried out for the service user who was admitted outside of the homes registration and a more suitable placement found. Action Plan by 23rd September 2005 Action Plan by 23rd September 2005 Action Plan by 23rd September 2005 Action Plan by 23rd September 2005 Action Plan by 23rd September 2005 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. 3. 4. Refer to Standard YA30 YA20 YA37 YA6 Good Practice Recommendations It is recommneded that non-powdered latex gloves be provided. Non powdered/latex free gloves should be available for those staff members with confirmed allergies. It is recommended that the Royal Pharmacuetical Guidelines are followed with regard to the administration and receipt of medication It is recommended that the manager spends a minimum of twenty hours per week in a management role The manager must ensure that service users assessed needs are met, in that recommendations made in speech H56-H06 S64411 102 Long Catlis Road V243538 110805 Stage 4.doc Version 1.40 Page 24 102 Long Catlis Road 5. YA19 therapy assessments are acted upon. It is recommended that, if needed, easier access to the hoist is made avaliable. 102 Long Catlis Road H56-H06 S64411 102 Long Catlis Road V243538 110805 Stage 4.doc Version 1.40 Page 25 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 102 Long Catlis Road H56-H06 S64411 102 Long Catlis Road V243538 110805 Stage 4.doc Version 1.40 Page 26 - 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!