Inspection on 06/09/06 for 111 Hempstead Road

This inspection was carried out on 6th September 2006.

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 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

111 Hempstead Road 07/09/07

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

CARE HOME ADULTS 18-65 111 Hempstead Road 111 Hempstead Road Hempstead Gillingham Kent ME7 3RH Lead Inspector Graham Cummings Key Unannounced Inspection 6 September 2006 10:00 th 111 Hempstead Road DS0000067422.V305091.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 111 Hempstead Road DS0000067422.V305091.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 111 Hempstead Road DS0000067422.V305091.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 111 Hempstead Road Address 111 Hempstead Road Hempstead Gillingham Kent ME7 3RH 01634 363750 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 Limited Care Home 2 Category(ies) of Learning disability (2) registration, with number of places 111 Hempstead Road DS0000067422.V305091.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One Service user over the age of 65 - Learning Disability. Date of last inspection Brief Description of the Service: 111 Hempstead Road is a 3 bedroom semi-detached bungalow that has a small front and large rear garden with a lawned area, trees and patio. The home is set in a residential area near to Hempstead Valley shopping centre with supermarket, cafes, shops and restaurants. The home has easy and close access to a convenience store, Chemist, Library and Public House. The home is fully wheelchair accessible. Nearest public transport runs from the shopping centre. The quality of the Service Provided is Good The fees range from £1300 to £1500 per week. 111 Hempstead Road DS0000067422.V305091.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first inspection of 111 Hempstead Road since it has been purchased by MCCH Society Limited. On the day of the Inspection both Service Users living at the home were going out with the 2 staff on duty shopping. The home was clean and free from any offensive odours. The new company had supplied the home with what appeared to be generic documents related to Supported Living, these did not reflect how the home was functioning. The Acting Manager has written a Statement of Purpose and a pictorial Service User Guide was almost complete that reflects the running of the home. The new company MCCH are looking to deregister the home and make it Supported Living, however, the Inspector was not sure that either Service User would be able to meet the criteria for this. The Acting Manger was also responsible for another home close by but is not included on the work rota and is supernumerary. New care plans are in place with risk assessments and these were drawn up with the Service Users participating and making choices through the use of flash cards regarding likes and dislikes, food and activities. The care plans are reviewed monthly by the Key-worker, the Inspector saw evidence of this. The two Service Users do not interact very much and individual activities are usually carried out, however, as on the day of inspection joint activities and outings do take place and this is being encouraged. All outings and activities are on a 1-1 basis. Staff were aware of the needs of the Service Users and were able to distinguish vocal tones that indicated a Service User was becoming unsteady on their feet. The accommodation is rented from another organisation that are responsible for the maintenance and upkeep of the property and that the service users are tenants under this agreement – the organisation needs to ensure that service users are also protected under this agreement. The Inspector left the home with no concerns for the Service Users present care and positive lifestyle outcomes. However should an application for deregistration be approved and changed to Supported Living, the Inspector would have concerns for the welfare of the Service Users. 111 Hempstead Road DS0000067422.V305091.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Some of the furniture in the lounge looked old and in poor repair, the wall unit had varnish worn off through wear and tear and could do with being refurbished or replaced. The microwave in the kitchen was securely fitted at eye level, approximately 5 foot off the ground, and could be dangerous to staff and/or Service Users when removing hot food and drinks from it. It would be safer sited on the kitchen work surface. The bedroom by the front door could do with being redecorated as the wallpaper was ripped in several places. The Inspector was informed that the Service User had wanted to change their room around but was not able to do this as there were no plug sockets close enough for him to put his t.v. and stereo. When the room is redecorated it would be a good opportunity to fit another plug socket in the required area. 111 Hempstead Road DS0000067422.V305091.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 111 Hempstead Road DS0000067422.V305091.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 111 Hempstead Road DS0000067422.V305091.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,4,5 Prospective Service Users have the information required to make an informed choice about where to live. Service Users needs are assessed. Service users can visit the home prior to any placement. Each Service User has a written contract. EVIDENCE: The new company had supplied the home with what appears to be generic documents related to Supported Living. These did not reflect how the home was functioning. The Acting Manager has written a Statement of Purpose and a pictorial Service User Guide was almost complete that reflects the running of the home. The present Service Users have been living at the home for a long time and there are no known plans for either of them to leave in the near future. The Acting Manager was able to go through the admission policy she would follow if a vacancy arose and this followed the guidelines set out in the policies and procedures and good practice. Both of the Service Users had contracts on their file. 111 Hempstead Road DS0000067422.V305091.R01.S.doc Version 5.2 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 the following standard(s): 6,7,8,9,10 The quality of the service provided is good. Service Users changing needs are assessed and they can make decisions about their lives with assistance. Service users participate in all aspects of life in the home. Service Users are supported to take risks and know that the information about them is handled appropriately. EVIDENCE: The care plans were informative and written in plain English. There was evidence that they are evaluated monthly by the key-workers. The care plans were made up from information and assessments from speech and language, physiotherapist, epilepsy service families and Service Users. Risk assessments were seen and included actions to be taken to reduce the risk. 111 Hempstead Road DS0000067422.V305091.R01.S.doc Version 5.2 Page 11 One of the Service Users has a copy of his care plan that is completed pictorially this was completed with his participation. The Inspector saw evidence that there were 6 monthly care reviews carried out with care managers and significant others. The care plan file was quite large and contained documentation that was out of date, it would be beneficial to all concerned if only relevant information was contained in the file and the rest archived into a main file. 111 Hempstead Road DS0000067422.V305091.R01.S.doc Version 5.2 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 the following standard(s): 11,12,13,14,15,16,17 The quality of the service provided is good. Service Users have the opportunity for personal development and take part in appropriate activities. Service Users are part of the local community and have good contact with family members. Service Users are respected and are offered a nutritious and healthy diet. EVIDENCE: One of the Service Users had regular meetings with their key-worker to look at the following weeks menu and activities. The 2nd Service User on the advise of Speech and Language therapist was not involved in this as they became anxious and agitated when having to make decisions. The staff were aware of their likes and dislikes in food and his menu was completed with him daily with flash cards. 111 Hempstead Road DS0000067422.V305091.R01.S.doc Version 5.2 Page 13 Service Users participated in activities mainly on an individual basis due to their differing likes and dislikes. These activities included Hydro Therapy, Mencap Club, Adult Education course in Arts and Crafts, library, hiring DVD’s, pub lunches and cafes. Both Service Users have contact with their families on regular basis, including telephone calls, visits to the home and home visits. 111 Hempstead Road DS0000067422.V305091.R01.S.doc Version 5.2 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 the following standard(s): 18,19,20,21 The quality of the service provided is good. Service Users receive personal support in the way they prefer and their health needs are met. Service Users do not self medicate and their wishes regarding illness and death are recorded. EVIDENCE: The Inspector when looking at the care plans noted that individuals preferred routines in personal support were stated. Both of the Service users are registered with a local G.P., Dentist and Optician. The home also has regular visits from Physiotherapist, Aromatherapist, Epilepsy Service and Speech and Language worker. Neither Service User self medicates. All staff are trained in Medication Administration. Two staff check incoming medication and both sign records to confirm it is correct. 111 Hempstead Road DS0000067422.V305091.R01.S.doc Version 5.2 Page 15 The Inspector noted that one Service User had details of their wishes regarding illness and death, the Acting Manager informed the inspector that the family members of the other Service User had not been forthcoming with the information as yet but the key-worker was still working with the family. 111 Hempstead Road DS0000067422.V305091.R01.S.doc Version 5.2 Page 16 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 the following standard(s): 22,23 The quality of the service provided is Adequate. Service Users views are listened to and they are protected from abuse, neglect and self harm. EVIDENCE: There have been no complaints since the new company have taken over. Sometime ago a neighbour did complain about a tree in the front garden that was overgrown and blocking light this was dealt by the previous owners. The Acting Manager was aware that the tree had re-grown and was almost of a similar size to when the complaint was made, they have informed the new company of this. The rear garden is untidy and overgrown with bushes shrubs and trees, the grass is also in need of cutting. At present it would be difficult for either Service User to walk around the garden safely. All of the staff have been booked to attend Adult Protection awareness training in October. 111 Hempstead Road DS0000067422.V305091.R01.S.doc Version 5.2 Page 17 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 the following standard(s): 24,25,26,27,28,29,30 The quality of the service provided is Adequate. Service Users live in a clean, homely, comfortable but not completely safe environment. Service Users bedrooms suit their needs and promote independence. Service Users toilets and bathrooms provide sufficient privacy to meet their needs. Shared space supplements Service Users individual rooms. Service Users do not require specialist equipment. EVIDENCE: The home was clean and tidy and free from any offensive odours. Service User bedrooms were well furnished and had personal belongings on display, one Service User did not want too much on display whilst the other had photographs and drawings completed by themselves and some sensory 111 Hempstead Road DS0000067422.V305091.R01.S.doc Version 5.2 Page 18 lights. However, the bedroom nearest the entrance is in need of re-decoration the wallpaper had been ripped in several places. The room that is now used as a staff room, the bathroom and lounge all have a track and hoist system that is rented to the home but not required by either Service User. At one time the home was registered for 3 Service Users and the 3rd Service User required the equipment but passed away approximately 1 year ago. The wall units could do with being replaced in the lounge, they looked old and worn with broken bits and the varnish had worn off parts. 111 Hempstead Road DS0000067422.V305091.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36 The quality of the service provided is good. Service Users benefit from having an effective, competent and qualified staff team who understand their roles and responsibilities. Service Users are protected by the homes recruitment practices and benefit from staff that are trained, well supported and supervised. EVIDENCE: The Inspector looked at staff files and found that they contained all the relevant paperwork required under Schedule 5. Staff had copies of their job descriptions and completed their induction through TOPPS. The home has an in house induction that is signed by both staff and inductor. The Team Leader is currently completing their NVQ4 and has completed their RMA. The home employs 6 staff and of these 1 has an NVQ level 3 and 4 have NVQ level 2. The Team Leader carries out individual staff supervision every 4 to 6 weeks. The home has access to appropriate induction and training. Service Users have a Key-worker who is responsible for ensuring appointments are made and kept with health services and significant others including care 111 Hempstead Road DS0000067422.V305091.R01.S.doc Version 5.2 Page 20 managers for reviews, monthly evaluation of the care plan and purchasing of clothes. The Team Leader went through the process of recruiting staff and was aware of the requirements and good practice. 111 Hempstead Road DS0000067422.V305091.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,40,41,42,43 The quality of the service provided is adequate. EVIDENCE: The home is run by a competent and confident Team Leader who involves the Service Users wherever possible in the making of decision in the day to day running of the home. The staff structure for the home is Team Leader, Senior Support Worker and Support staff. The Senior Support worker was working their last shift on the day of the inspection, this meant that the Team Leader would have no management support within the home as the Company were not looking to replace the post until the outcome of the homes application to be deregistered and become Supported Living. 111 Hempstead Road DS0000067422.V305091.R01.S.doc Version 5.2 Page 22 The Team Leader receives supervision from the MCCH Area Manager approximately 4 weekly, since the takeover they have been supervised by 3 different Area Managers. The homes recording and record keeping was good and Policies and Procedures were in place. The Team Leader is responsible for the Health and Safety in the home and carries out daily, weekly and monthly checks that are recorded. 111 Hempstead Road DS0000067422.V305091.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 3 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 2 25 2 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 3 3 3 3 111 Hempstead Road DS0000067422.V305091.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action 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. Refer to Standard YA6 YA24 YA25 Good Practice Recommendations That the information contained in the care plan is relevant and current and all other information be archived. That consideration be given to replacing or refurbishing the wall unit in the lounge. That the bedroom nearest the front door be redecorated. 111 Hempstead Road DS0000067422.V305091.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone 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 111 Hempstead Road DS0000067422.V305091.R01.S.doc Version 5.2 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. 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