Inspection on 07/10/08 for 102 Long Catlis Road

This inspection was carried out on 7th 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

102 Long Catlis Road 08/10/07

102 Long Catlis Road 15/08/06

102 Long Catlis Road 18/10/05

102 Long Catlis Road 11/08/05

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Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 102 Long Catlis Road 102 Long Catlis Road Gillingham Kent ME5 8LF 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 7 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. They reflect the things that people have said are important to them: 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. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 29 Care Homes for Adults (18-65 years) Audience Further copies from Copyright 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 29 Information about the care home Name of care home: Address: 102 Long Catlis Road 102 Long Catlis Road Gillingham Kent ME5 8LF 01634370568 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : s.hoptrough@mcch.org.uk MCCH Society Ltd care home 4 Number of places (if applicable): Under 65 Over 65 4 0 learning disability Additional conditions: 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). The maximum number of service users to be accommodated is 4. Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 29 A bit about the care home 102 Long Catlis Road is provides support for people with a physical and learning disability. It is one of a number of homes managed by MCCH Ltd. 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 parking is available. Residents have opportunities to access a range of activities at home and in the community. The fees for this service are arranged on an individual basis with MCCH. Care Homes for Adults (18-65 years) Page 5 of 29 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 Care Homes for Adults (18-65 years) Page 6 of 29 How we did our inspection: This is what the inspector did when they were at the care home The inspection took place on 7th October 2008. It consisted of meeting with the manager, Mrs Susan Hoptrough, two support workers on duty and three residents. Care practices were discussed and all parts of the premises were visited. Some records were seen during the visit principally those addressing the personal and healthcare support of residents. The Commission received an annual quality assurance assessment (AQAA) from the manager. The Commission also received completed surveys from four members of staff and one resident. The previous report contained seven requirements. These releted to the need for the premises to be improved and for residents to be better supported. The required improvements to the premises have bben addressed and the manager is now able to recruit the optimum numbers of staff to enable suitable support for residents. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well What has got better from the last inspection The previous inspection report required a number of improvements to the premises. Current and former providers had difficulty in implementing the improvements regarded as necessary for the comfort and safety of residents. Over the past 15 months the requirements have been addressed and many additional developments have taken place. New carpets have been fitted throughout, advanced infection control procedures are followed, internal and external parts of the premises have been renovated, new aids and adaptations have been apopted, staffing levels have improved and risk assessments and medication procedures have been reviewed and improved. Care Homes for Adults (18-65 years) Page 8 of 29 What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Eamonn Kelly 33 Greycoat Street London SW1P 2QF 02079792000 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. Care Homes for Adults (18-65 years) Page 9 of 29 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 10 of 29 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 11 of 29 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 . The support needs of residents are assessed and kept under constant review. Evidence: Prospective residents and their advocates receive information about the homes 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 companys website. 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 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 Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: organisation. There is an individual contract available for each resident. Care Homes for Adults (18-65 years) Page 13 of 29 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 excellent 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 express themselves as part of developing their quality of life. Each resident is helped in specific ways based on detailed knowledge of their routines and support needs by members of staff. Evidence: The manager has introduced detailed risk assessments for each resident that complement those that relate to routines within the premises. The examples seen had detailed information covering all relevant aspects of residents needs and activities. Information relating to the residents basic support and developmental needs and how these are being addressed for the residents benefit were outlined in the examples of care plan records seen. Support workers have access to information maintained in support plans and they 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 residents progress. Copies of formal reviews seen for two residents were up to date. Each resident has notes kept on their pattern of activity, their preferred options and how they are progressing. Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: Communication profiles are in place to help residents residents who have communication difficulties. Residents are very active within and outside the premises. Care Homes for Adults (18-65 years) Page 15 of 29 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 excellent 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 with a necessarily high level of supervision and assistance by staff. Evidence: Residents are helped to take part in activities they enjoy and to be a part of community life. Profiles of each resident indicated that the manager and support workers have developed broad routines for residents that meet their capabilities and temperaments. 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. Staff are able to use an MCCH vehicle based some distance away at another MCCH residential home and the services of a local taxi that provides suitable arrangements for wheelchair transport is, staff said, of great benefit to residents. Two members of staff are able to drive the MCCH wheelchair adapted Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: vehicle. Residents are encouraged to maintain contact with relatives where they wish to and can do so. Residents are helped to retain their links with the wider community in a variety of ways and the managers agreement with MCCH to provide suitable levels of staffing at particular times during the week and on weekends is, in the view of the manager, leading to development of bespoke activities suitable for each resident. The AQAA refers to continuing efforts to provide individual opportunities for activities to enable residents to enhance current skills and perhaps develop new ones. Meal times are flexible to suit residents activities and schedules. Residents weights are recorded when thought necessary for the purpose of monitoring health. The manager said that staff always eat with residents. Residents fluid and food intake is monitored continually and staff showed how this essential support is provided. The AQAA refers to the level of importance of providing good meals for residents. Care Homes for Adults (18-65 years) Page 17 of 29 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 good 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 residents 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 residents 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. Residents who could keep their own medicines could do so subject to recorded risk Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: assessment and regular review. No residents currently maintain their own medicines. Medicines and MAR (records of administation) sheets are securely stored. From the managers description of current administration arrangements, all necessary procedures are followed to protect residents. Examples of risk assessments showed where medicines have to be provided in food and the circumstances and subsequest procedures followed. The AQAA (annual quality assurance assessment) refers in detail to how healthcare support is considered a priority. An example is the care taken in administering as and when required medicines and how this is monitored. Care Homes for Adults (18-65 years) Page 19 of 29 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: Care plan records are used to identify patterns for development of residents lifestyles and health. Recorded information contributes to the way staff use their skills to defuse threatening situations and address such situations. The improvement in staffing levels contributes, according to the manager, in addressing the close supervision needs of residents. A recruitment process that includes CRB and POVA checks is in place. The manager explained how 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 manager said there are no on-going adult protection issues currently underway by a local authority and the AQAA states that no complaints have been received. Care Homes for Adults (18-65 years) Page 20 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The premises, refurbished fully over the last 15 months, are suitable for the support of vulnerable people. Evidence: The premises have been greatly 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. Excellent new artwork, prepared by a support worker and resident, are displayed. The evidence is that a very high standard of hygiene is practiced, particularly important where all residents need continence support. Specialist aids, adaptations and bedroom furnishings have been obtained. These have been sourced from professionals and each piece of equipment has been purchased for a particular resident for specific reasons. The AQAA outlines how these developments will be supplemented by further improvements, for example, provision of a gardening plot for residents, further Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: improvement of utility room, refurbishment of former bedroom as an activities centre, replacement of some kitchen furniture and maintaining rotas for keeping good standards of housekeeping. Care Homes for Adults (18-65 years) Page 22 of 29 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 closely involved in recruitment procedures and are responsible ensuring that staff are in place, are trained and 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. A support worker outlined how all staff receive training and continuing support to enable them to assist residents and achieve the objectives outlined in care plans. The staffing arrangements for these premises are of great importance because of the very high care needs of residents. During this inspection, it became evident that Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: residents need close supervision at all times. An example was the need to ensure that good hygiene procedures are followed without which there would inevitably be a return to the events where infections occurred. The manager has achieved agreement on additional staffing levels that, in her opinion, is enabling the needs of residents to be addressed in a consistant way. There was evidence that all staff are encouraged to undertake an NVQ qualification. Mandatory training comprises moving & handling, COSHH, care planning and person centred approach, adult protection, safe handling of medicines, food safety and infection control. Care Homes for Adults (18-65 years) Page 24 of 29 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 and conducted. Evidence: Teh AQAA states that all aspects of practice are being reviewed, that a person centred approach is being encouraged and that the aims outlined in the homes business plan are being carried out. It outlines how policies and procedures are followed to enable support workers work progressively more effectively with people who have high support needs. It also outlines how the manager keeps up to date with new strategies in residential care and changing legislation affecting the care sector. The AQAA refers in detail to the changes that have taken place. 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. It gave the Commission a range of information including a declaration that all 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. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: There was evidence that the manager has the qualifications and experience to enable the business plan of the service to be delivered. There has been a big improvement over the last 18 months in how the service is conducted. There is evidence that the improvements in the service is contributing greatly to the well being and health of residents. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes  No  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 27 of 29 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 Description 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 Description 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 28 of 29 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 29 of 29 - 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. 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