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

This inspection was carried out on 8th October 2007.

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

The inspector 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 7 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 15/08/06

102 Long Catlis Road 18/10/05

102 Long Catlis Road 11/08/05

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Thorndene

Insight - Eastchurch

Southfields

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33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 102 Long Catlis Road 102 Long Catlis Road Gillingham Kent ME5 8LF Lead Inspector Debbie Sullivan Key Unannounced Inspection 8th October 2007 09:00 102 Long Catlis Road DS0000064411.V348190.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 102 Long Catlis Road DS0000064411.V348190.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 Older People and 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. 102 Long Catlis Road DS0000064411.V348190.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 102 Long Catlis Road Address 102 Long Catlis Road Gillingham Kent ME5 8LF 01634 370568 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) MCCH Society Ltd Care Home 4 Category(ies) of Learning disability (2), Learning disability over registration, with number 65 years of age (2) of places 102 Long Catlis Road DS0000064411.V348190.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th February 2007 Brief Description of the Service: 102 Long Catlis Road is a small residential home, which provides care and accommodation for three people with a physical and learning disability. It is one of a number of homes managed by MCCH Ltd. Twenty-four 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 parking is available. The garage of the premises has been converted to provide a range of living and storage space. Service users have opportunities to access a range of activities at home and in the community, the home shares transport that can accommodate wheelchairs with other Medway MCCH services. The fees for this service are arranged on an individual basis with MCCH. 102 Long Catlis Road DS0000064411.V348190.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place over just under seven hours. During the visit time was spent with service users, the manager and support staff. The house was toured and records in relation to care and support of service users, the running of the service and staffing were read. Survey forms completed by staff and the Annual Quality Assurance Assessment form completed by the manager provided further information. Throughout the visit staff were very helpful in providing information and although service users were unable to offer direct comments on the home, staff assisted them to have opportunities to be involved with the inspection. The last Key inspection took place in August 2007 followed by a Random inspection in February 2007.The Random inspection found that work had taken place to meet the majority of the requirements made at the key inspection although some remained outstanding, mainly in relation to the environment and staffing. Further positive progress has now been made but some environmental requirements still remain only partially met. What the service does well: Where care plans and risk assessments have been reviewed information is clearer and up to date and person centred planning is being introduced. Health needs are well met and any concerns attended to promptly, staff awareness of the management of needs is being improved and this is having a positive effect on the rest of the service. Efforts are being made by staff to make the house more homely and mealtimes are enjoyable with well-balanced meals being provided. Staff say they enjoy working at the home more, they are well supported and there are good training opportunities. Staff demonstrate that they are genuinely interested in the welfare of the service users and want to provide a good service. The manager is putting into place improved working practices in liaison with staff and senior managers. 102 Long Catlis Road DS0000064411.V348190.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: The reviewing of care plans needs to be continued so that all the information is as up to date as possible. There is an identified need to explore more activities for service users that are appropriate to their ages, interests and abilities. There must be better access to transport for wheelchair users and sufficient staff on duty at weekends so that all service users can go out if they choose. The outstanding requirements regarding the lounge flooring and wheelchair access to the garden must be met and all bedrooms must be made more suitable for the needs of service users. 102 Long Catlis Road DS0000064411.V348190.R01.S.doc Version 5.2 Page 7 The use of a shared wardrobe and an airing cupboard in one bedroom (currently vacant) must be discontinued. The permeable area of the laundry floor must be repaired. 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. 102 Long Catlis Road DS0000064411.V348190.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Outcomes Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) 102 Long Catlis Road DS0000064411.V348190.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users and their representatives have access to information about the service. The needs of service users are assessed and kept under review. EVIDENCE: Since the last key inspection a new statement of purpose and service users guide has been completed, it includes pictorial information and is currently 102 Long Catlis Road DS0000064411.V348190.R01.S.doc Version 5.2 Page 10 under review so that new photographs can be added showing changes to the décor in the home and staffing. There is one vacancy as a service user moved out this year due to a change in needs; the other two service users have lived at the home for some time and the manager said that the introduction of a new third service user would be very carefully planned, compatability considered and introductions would take place. The needs of current service users have been assessed and are kept under review within the service and with outside professionals. Service users have been provided with tenancy and occupancy agreements. 102 Long Catlis Road DS0000064411.V348190.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14 and 33 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9,and 10 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have care plans that now reflect their needs more accurately and give staff clearer direction. Service users are supported to take acceptable risks and are encouraged to be involved in the running of the home. EVIDENCE: 102 Long Catlis Road DS0000064411.V348190.R01.S.doc Version 5.2 Page 12 New care plans are in place and work on updating them is continuing. Person centred planning has been introduced and records are being amended to reflect this. Each service user has a main care plan and a health and risk assessment file. The manager is in the process of bringing risk assessments up to date and those completed give clearer direction for staff. A lot of work has taken place on improving the content of the plans so that it is current and accurate and in the right folder, there is still some work to be done on this. Health care plans include details of appointments and advice from a wide range of health professionals. Reviews are recorded and the manager said that she plans to commence work with service users on bringing their strengths and goals information up to date and discuss thoughts on goals they may be hoping to achieve. Service users are encouraged and supported to make choices and decisions about their daily lives, during the visit choices offered were when get up, what to wear that day, what to have for lunch and what activities at home to be involved in. One service user has no verbal communication; most of the staff are established at the home, are aware of their methods of communication and can interpret wishes and moods. Recorded individual service users meetings have been introduced and as far as possible views are gained. Service users are encouraged to help with housework if possible, a staff member said that they had been pleased to see one service user recently dusting their room, this is part of the very positive progress that had been made recently with this service user in terms of hygiene and behaviour. One service user is able to help in the kitchen and the manager discussed plans to expand these opportunities for both service users. Staff offer support with personal finances, one service user can sign for their own money, whilst both have an appointee within the local authority. Financial procedures are robust and the new manager has tightened them up. Risks are supported with the use of risk assessments some of which have been revised and are now more thorough, if a new risk or activity is identified a risk assessment is prepared. All records relating to service users are kept confidentially in the home and staff sign a confidentiality policy. 102 Long Catlis Road DS0000064411.V348190.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. Service Users find the lifestyle experienced in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. Service users find the lifestyle experienced in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 102 Long Catlis Road DS0000064411.V348190.R01.S.doc Version 5.2 Page 14 12,13,14,15,16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have opportunities to take part in a number of activities and more opportunities are being explored and made available. Contact with friends and relatives is supported. Meals are healthy and nutritious and mealtimes are a pleasant experience. EVIDENCE: Service users take part in activities that are appropriate to their ages and abilities. The provision of activities has improved and the manager is hoping to introduce more options and make some activities more geared to the individual. Some activities that service users access are a weekly music session, swimming, shopping, going out for meals or coffee, and a specialist activity co-ordinator visits the home once a week. At home, staff encourage service users to be involved in activities. Pictures drawn by one service user had been laminated to make placemats and one was framed on the wall. Staff are able take one service user in their own cars, the other who is a wheelchair user can only go out in specialist transport and accesses taxis or a vehicle shared between a number of MCCH services. Four staff are booked onto training in November so that they can drive the MCCH vehicle although its availability is very limited due to the shared use. There is also a need to increase weekend staffing levels so that both service users have equal opportunities to go out then, recruitment is taking place and the manager said they would review rotas to enable this. The manager had facilitated a day out to a wildlife park for both service users and was considering other outings such as to a sea life centre and the possibility of short holidays for next year. During the inspection an off duty member of staff visited with their young child by arrangement with the manager, service users enjoyed the visit and after lunch one had a game of ball in the garden and was drawing with the young visitor for most of the afternoon as it was a warm day. Staff commented that the service user was having a really good day behaviourally and this was encouraging. Contact with friends and relatives is supported, one service user is supported to maintain contact with a family member who is unable to travel to the home 102 Long Catlis Road DS0000064411.V348190.R01.S.doc Version 5.2 Page 15 and with another relative who is in a residential service. Visits to other services take place and to social events. Lunch and dinner are taken at the dining room table, staff eat with service users and at lunchtime during the visit there was a pleasant atmosphere with lots of discussion and fun. All were involved and ideas for activities were raised. One service user chooses to have breakfast in their room. The menu has recently been revised; it is fairly flexible with guidelines for staff on weekly main meals and foods that must be included. Service users have a well-balanced and healthy diet, are consulted about the menu and meals taken are fully recorded. The manager has started to compile more information on nutrition for staff. Service users are encouraged to be as independent as possible and individual choices are respected. Staff observed during the visit spoke respectfully with service users and only entered bedooms with permission. 102 Long Catlis Road DS0000064411.V348190.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) 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. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 and 21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The personal and healthcare needs of service are well documented and information is being updated. Health needs are well met and contact with a range of health professionals is supported. EVIDENCE: 102 Long Catlis Road DS0000064411.V348190.R01.S.doc Version 5.2 Page 17 The health and personal care needs of service users are recorded in their care plans, as with the overall review and revision of all care plan information health care plans are currently under review and work is progressing. Staff awareness of how to manage some needs better and there are clearer guidelines for them. The service users have a variety of healthcare needs and contact with a range of health professionals is recorded and supported, these include occupational therapists, physiotherapists, speech and language therapy and an epilepsy nurse. Each appointment and the outcome are recorded. Very positive progress had been made recently with one service user where continence issues had impacted on the whole standard of the service. The house had become unhygienic and unpleasant for both service users and staff, there was a lack of dignity for the service user, options for community involvement were reduced and there were additional health risks such as of skin breakdown. Now following the input of a continence advisor, improved cleaning, better staff awareness of needs, and the purchase of specialist mats for the service users’ bedroom, some refurbishment is able to take place, the service user has readily accepted continence aids, they have new clothes and more opportunities for activities and staff say they find the home a much nicer place to work in. Methods for managing incidents of challenging behaviour have been made clearer for staff and have resulted in the service users benefiting from clearer boundaries. New equipment has been provided such as a reclining chair and a banana board and a specialist bed is on order. Medication is securely stored and the manager expressed a wish to relocate the cabinet to improve security. Since the last key inspection medications have been reviewed and the GP has confirmed the prescribed dosages with the home and pharmacy. Some MAR sheets were seen and were correctly completed, staff receive medication training. PRN guidelines are in place, one read required review following a visit to a health specialist the previous week. The AQAA states that as far as possible service users and their relatives are consulted about their wishes in the event of death, one service user is over eighty and staff respect that they have age related needs. 102 Long Catlis Road DS0000064411.V348190.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16-18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are safeguarded. (OP NMS 35) The Commission considers Standards 22-23 (Adults 18-65) and Standards 16-18 and 35 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and others have access to a complaints procedure and service users are supported to make their views known. Adult protection procedures are in place and staff receive adult protection training. EVIDENCE: The home has a complaints procedure that is now included in the service users guide in a pictorial format. There had been one complaint made since the last inspection that had been addressed by the organisation. Service users are encouraged to voice their views, each has a keyworker and service user meetings are held. One service user makes their wishes and views known via gestures, mood and non-verbal communication. The manager and staff spoken with said that they know when the service user is not happy and make every effort to find out why. 102 Long Catlis Road DS0000064411.V348190.R01.S.doc Version 5.2 Page 19 There is an organisational adult protection procedure and staff receive adult protection training with updates provided. Financial procedures in respect of service users’ personal monies have been made much more thorough. 102 Long Catlis Road DS0000064411.V348190.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29 and 30. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The home is clean and made as comfortable as possible for service users. Improvements to the environment have been made but all bedrooms do not yet satisfactorily meet the needs of service users and communal areas must be made more homely. Infection control is much improved but the laundry floor must be repaired. 102 Long Catlis Road DS0000064411.V348190.R01.S.doc Version 5.2 Page 21 EVIDENCE: Since the last key inspection some improvements have been made to the environment, the hallway has been redecorated; new flooring has been fitted in the downstairs toilet /shower room and upstairs bathroom, and recently a stair and landing carpet has been fitted. There is no longer any storage of food in the laundry area. A new and more thorough cleaning schedule has improved overall hygiene and measures are in place to alleviate any odours in the bedroom of a service user with the use of new specialist rugs on the floor. The home is clean and well maintained, the living /dining room is made as homely and comfortable as possible and a new rug, cushions and ornaments had been introduced to add interest and brighten it up, but there is still hard flooring that has been needed due to continence issues. Now that suitable carpeting is being introduced into other areas plans are underway to fit skirting again in the lounge and hallway and then fit carpeting in these areas. Although evidence was seen of the proposal there was no definite agreement available to a costing or to ordering the work, this must be progressed. There is a small well-kept garden but it is not easily accessible for wheelchair users as there is a step from the patio windows. The manager had sourced materials to fit to provide access, but said MCCH were possibly planning to fit a new window and was waiting for confirmation of plans. New furniture is on order for one bedroom and the organisation is looking into providing specialist furniture for another so that the service user can have their clothes and other personal items kept in their room, this is not possible at present due to their behaviour and for safety reasons. This bedroom needs complete redecorating as it rather gloomy and worn looking. The vacant bedroom contains the airing cupboard and a large wardrobe that is used by all service users. This does not allow for privacy and all service users must have sufficient suitable personal storage and alternative airing space must be made available. The kitchen is well equipped and clean. The laundry is well equipped and a staff member on duty over the weekend had voluntarily fitted new storage shelving to allow for more floor space, an area of flooring in the laundry was permeable possibly caused by damp. 102 Long Catlis Road DS0000064411.V348190.R01.S.doc Version 5.2 Page 22 There is a washing machine with a sluicing facility. 102 Long Catlis Road DS0000064411.V348190.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 32, 34 and 35 (Adults 18-65) and Standards 27, 28, 29 and 30 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,3,35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A well-supported and well-trained staff team supports service users. Weekend staffing levels need to be increased so that the needs of service users can be fully met. EVIDENCE: 102 Long Catlis Road DS0000064411.V348190.R01.S.doc Version 5.2 Page 24 Standard 34 was not inspected as CSCI’s Provider Relationship Manager for MCCH inspects recruitment records centrally at least once a year; the last inspection in early 2007 identified no major shortfalls in the process. Some training and supervision records were seen; staff are receiving regular recorded supervision, those spoken with found this helpful and said team meetings are held. Most staff had worked at the home for some time and two new support workers who had previous experience of working there and a new senior support worker had been employed. The training schedule had been brought up to date, mandatory training is renewed and when a need is identified for specialist training staff can apply for it, the manager said that it is made available. Over 50 of the staff team had NVQ 2 or 3 in care and new staff were enrolled on NVQ 2 following a satisfactory probationary period. Staff felt that training opportunities were good. Staff observed working with service users had a good rapport with them and service users were comfortable in their presence. Staff spoken with commented that “It is 100 better than it was six months ago, it is now a pleasant place to work” and “The team is a lot better”. Staff appreciated positive improvements and identified those needed such as more wheelchair friendly transport. Bank and agency staff are used to fill gaps in the rota and permanent staff sometimes cover gaps. Recruitment is taking place for another member of the support staff. There are sufficient staff on duty during the week to allow for both service users to go out when they wish, although it is an outstanding requirement that weekend staffing be increased to allow for this. 102 Long Catlis Road DS0000064411.V348190.R01.S.doc Version 5.2 Page 25 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. Service users live in a home which is run and managed by a person who is fit to be in charge of good character and able to discharge his or her responsibilities fully. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) 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 homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 37, 39 and 42 (Adults 18-65) and Standards 31, 33, 35 and 38 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 102 Long Catlis Road DS0000064411.V348190.R01.S.doc Version 5.2 Page 26 37,38,39,40,41,42 and 43 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There have been improvements in the quality of the service, however, the organisation must continue to invest in improved staffing, transport, and the environment and the improvement be seen to be sustained. The views of service users are now sought and their health and safety better protected. EVIDENCE: The home is well run and has become a nicer place to live and work, it is more hygienic and staff now have more direction and clarity about tasks and roles. The home has experienced both management and staffing changes over the past year and been thorough a period when it lacked consistent leadership. A new manager is in post who is bringing about positive changes and these must continue to be backed up by further improvements in staffing and the environment in addition to those already made. Sustained improvement needs to be made over coming months. There is a friendly and inclusive atmosphere with lots of interaction between staff and service users. Staff spoken with said that the service had improved under the new manager and that it was moving forward. The manager intends to apply for registration and is on NVQ 4 training. There is now a quality assurance policy and a user friendly survey form is available, it is circulated annually. Service users views are regularly also sought and recorded at service user meetings. There are a range of organisational policies and procedures; the manager said that the organisation has acknowledged a need to make them specific for some services. All service user and other records are stored confidentially and daily recording was completed appropriately. 102 Long Catlis Road DS0000064411.V348190.R01.S.doc Version 5.2 Page 27 The measures to protect the health safety and welfare of service users and staff are better with much improvement to cleaning schedules, infection control, the provision of specialist equipment and a new smoking policy. It is important that this improvement continues and outstanding environmental requirements are met. Regular safety checks such as monitoring fridge and freezer temperatures and fire equipment take place. The home is properly insured and the provider undertakes Regulation 26 visits monthly. 102 Long Catlis Road DS0000064411.V348190.R01.S.doc Version 5.2 Page 28 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 2 3 3 3 4 X 5 3 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 1 25 3 26 2 27 2 28 1 29 2 30 1 STAFFING Standard No Score 31 3 32 3 33 2 34 X 35 3 36 3 CONDUCT AND MANAGEMENT Standard No Score 37 2 38 3 39 3 40 3 41 3 42 3 43 2 2 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 2 13 2 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 102 Long Catlis Road Score 3 3 3 3 DS0000064411.V348190.R01.S.doc Version 5.2 Page 29 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. YA14 16(2)(m) Standard Regulation Requirement “The registered person shall consult service users about their interests and make arrangements to enable them to engage on local, social and community activities” In that there must be sufficient transport available at all times to enable all service users to go out when they wish. There must be no restrictions due to limited wheelchair accessible transport. 2. YA16 12(4)(a) “The registered person shall make suitable arrangements to ensure that the care home is conducted in a manner that respects the privacy and dignity of service users.” In that the airing cupboard must be relocated and the use of a shared wardrobe located in one bedroom must be discontinued. 3. YA24 16(2) “The registered person shall having regard to the size of the DS0000064411.V348190.R01.S.doc Timescale for action 30/12/07 31/12/07 30/11/07 Page 30 102 Long Catlis Road Version 5.2 care home and number and needs of service users provide in rooms occupied by service users adequate furniture and other furnishings including curtains and floor coverings” In that the refitting of skirting to the lounge and hall and the stated plan to fit carpeting to these areas must take place and evidence that materials/work have been ordered be provided by the given timescale. The requirement that alternative lounge flooring be explored is repeated from the last two inspections. 4. YA24 23(2)(a) “The registered person shall 30/11/07 having regard to the number and needs of service users ensure that the physical design and layout of the premises meets the needs of service users” In that access to the rear garden must be provided for wheelchair users. This requirement has been repeated from the last 4 inspections. The organisation must submit evidence that work is to take place to enable access by the specified timescale. 5. YA33 18(1)(a) “The registered person shall ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such DS0000064411.V348190.R01.S.doc 30/11/07 102 Long Catlis Road Version 5.2 Page 31 numbers as are appropriate for the health and welfare of service users” In that sufficient staff must be on duty to ensure service users can go out. Where service users are assessed as needing 2:1 support this must be provided. There has been improvement in staffing but there must be sufficient staff on duty at weekends to ensure that service users can go out then if they wish. This requirement is in part repeated from the last two inspections. 6. YA30 13 (3) “The registered person shall make suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home” In that the area of permeable flooring in the laundry must be repaired. “The registered person shall ensure that all parts of the care home to which service users have access are free from hazards to their safety” In that damaged radiator covers must be replaced. 30/11/07 7. YA42 13(4)(c) 30/11/07 102 Long Catlis Road DS0000064411.V348190.R01.S.doc Version 5.2 Page 32 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. Refer to Standard YA6 YA20 Good Practice Recommendations It is recommended that work progress on developing care plans and the use of person centred planning involving service users in their personal information. It is recommended that the medication cupboard be relocated. It is recommended that when there is a change of PRN medication or guidelines by a health professional these are recorded as soon as possible on the health care plan. 2. 3. YA20 YA20 102 Long Catlis Road DS0000064411.V348190.R01.S.doc Version 5.2 Page 33 Commission for Social Care Inspection Maidstone Local Office 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. 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