CARE HOME ADULTS 18-65
12 Channel Lea Walmer Deal Kent CT14 7UG Lead Inspector
June Davies Announced Inspection 12th January 2006 09:30 DS0000041065.V267390.R01.S.doc Version 5.0 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 DS0000041065.V267390.R01.S.doc Version 5.0 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. DS0000041065.V267390.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service 12 Channel Lea Address Walmer Deal Kent CT14 7UG 01304 242363 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) Robinia Care South East Ltd Miss Sharon Anne Head Care Home 3 Category(ies) of Learning disability (3) registration, with number of places DS0000041065.V267390.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 31st August 2005 Brief Description of the Service: 12 Channel Lea, is a family home situated in the town of Walmer on the outskirts of Deal. The house is situated in a quiet residential street that is close to the local amenities, shops and bus service. The home is registered for three male adults with learning difficulties, who receive supportive care from staff. 12 Channel Lea has a small front garden and a small back garden, both of which are well maintained by the clients in the home, there is also a garage in a block of garages. There are no car parking facilities at the home, but parking is available in the street. The home is very tastefully decorated and furnished; the clients appreciate this and show a keen interest in keeping the home looking nice. DS0000041065.V267390.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an announced inspection carried out over period of six hours. On the day of inspection one client was attending his work placement, and the remaining two clients were pursuing activities of their choice and were escorted by the staff on duty. The inspector viewed documentation relating to clients, staff, health and safety, and made a tour of the home. In depth discussion took place with the registered manager, and the inspector was able to meet with a member of staff covering the p.m. shift in the home. What the service does well: What has improved since the last inspection?
All documentation relating to Channel Lea was available for this announced inspection, which made is easier for the inspector to gain evidence, especially when clients on not present in the home. DS0000041065.V267390.R01.S.doc Version 5.0 Page 6 What they could do better: 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. DS0000041065.V267390.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000041065.V267390.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 The homes statement of purpose and service user guide are good; and provide clients and prospective clients with the information they need to make a decision about moving into the home. EVIDENCE: Statement of Purpose and Service User Guide have been updated to accommodate staff changes and qualifications. No new clients have been admitted to the home in the last year therefore none of the other standards in this section have been inspected. DS0000041065.V267390.R01.S.doc Version 5.0 Page 9 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, and 9 Clients know that their care needs are well assessed, that their personal goals are reflected in their care plans and that their potential risks are managed. Clients know that their views are listened to and acted upon. EVIDENCE: The inspector was able to view the three individual care plans of the clients who live in Channel Lea. All care plans contained detailed information regarding the clients plan of care, their likes and dislikes, hygiene chart, mood chart, weight chart, medication records, weekly hygiene chart, professional visits, health checks, risk assessments, activities, property list, incentives chart, and who their key worker is. Other information relevant to each individual was also contained within the individual care plans. Each client’s care plan is drawn up with their involvement, and was seen to be reviewed six monthly. Clients are able to make decisions on a daily basis through discussion with staff. Channel Lea is a satellite home of Wellington House, and the manager is registered to manage both homes, when the registered manager is working at Wellington House, the clients in Channel Lea can contact her via the telephone or they are able to visit Wellington House if they wish. The registered manager was able to verify with the inspector that the clients are
DS0000041065.V267390.R01.S.doc Version 5.0 Page 10 very much involved in their own risk assessments; some clients are more able to reduce their own risk than others who live in the home. DS0000041065.V267390.R01.S.doc Version 5.0 Page 11 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 and 15 Links with the local community are good and support and enrich client’s social and educational opportunities. The meals in this home are good offering both choice and variety and catering for special diets as and when required. EVIDENCE: From evidence contained within the care plans, the clients in the home are able to develop their own lifestyles, which are only limited by their risk assessments. Two of the clients in the home pursue educational opportunities, such as woodwork, life skills, adult education (words and numbers), art, craft, and cookery. One client takes part in work experience work, involving horticulture, and working as a shop assistant. All the clients are involved with the local community; they visit the local shops, pubs, cinemas, and theatres. All clients have good relationships with the local neighbours, and one client regularly helps a local neighbours gardening and car cleaning, and another client is involved in dog walking. Clients are able to pursue leisure activities of their own choosing, which include activities like fishing, swimming, golf, bowling, horse riding. One client has an interest in gardening and keeps the gardens of the home neat tidy and well planted. On the day of the inspection one client was attending his work experience, and the remaining two clients were participating in out door activities.
DS0000041065.V267390.R01.S.doc Version 5.0 Page 12 All three clients in the home choose their menus on a weekly basis, and with the assistance of staff, visit the local supermarket to purchase the food for these weekly menus. While clients are able to choose the food of their choice, they will also accept guidance from staff, to ensure that they have a nutritious, varied and balanced diet, assistance will also be given, to ensure that clients who medically need to be careful of weight gain, eat sensibly. All clients choose one meal a week to cook under the guidance of the staff on duty at the time. DS0000041065.V267390.R01.S.doc Version 5.0 Page 13 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 and 20 The health needs of the clients are well met with evidence of good multi disciplinary working taking place on a regular basis. Personal care is offered in a way to protect the client’s privacy and dignity and to promote their independence. The medication at this home is well managed promoting good health, but further attention needs to be paid to homely remedies. EVIDENCE: Clients receive assistance with personal care as and when required, or when specified in their care plan. Staff ensure that this help is given to maintain the privacy and dignity of the client. Clients are able to choose when they go to bed at night, and are encouraged to rise in accordance with their daily programme, of going to college or on work experience. Weekends are spent at a more leisurely pace, and the clients are able to get up when they wish to. The clients are able to shop for their own clothes, toiletries, and visit the hairdresser of their choice. Specialist support is available via psychiatrists, community nurses, the company’s psychologist as and when required, and any visits would be recorded on the care plan of the client. Care plans clearly state individual client’s likes and dislikes. The registered manager would know how to access an advocate if this was the client’s wish. The inspector carried out an audit of the medication in the home. None of the clients are self-medicating because they choose not to manage their own medication. The inspector found that MAR sheet had been completed
DS0000041065.V267390.R01.S.doc Version 5.0 Page 14 correctly, and all medications received, had been appropriately recorded with the amount of medication, the signature of the person receiving the medication into the home and the date on which it was received. The inspector did note that homely remedies need to be accurately recorded on the MAR sheet, and liquid medication should be dated on the bottle on the day of opening, to ensure that it can be accurately audited, and the inspector has made a recommendation that this practice takes place in the future. DS0000041065.V267390.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The home has a good complaints system, and clients know that any complaints made will be listened to and acted upon immediately. Staff have a good knowledge and understanding of Adult protection issues, which protects the clients from abuse. EVIDENCE: The inspector viewed the complaints policy and procedure, which is both written and in picture format, so the clients in the home can easily understand it. No complaints have been made. The inspector discussed with the registered manager how clients can discuss any issues that may occur on a daily basis with the staff on duty, or can easily access the registered manager, during her visits to the home, by telephone, or by visiting the other home that the registered manager has responsibility for. The home has policies and procedures for the protection of vulnerable adults and a whistle blowing policy and procedure, which have been reviewed in the last year. Staff are made aware of these policies and procedures during the course of their induction. The registered manager confirmed that in any case of suspected abuse between a member of care staff and a client, that the member of care staff would be suspended immediately pending an enquiry. DS0000041065.V267390.R01.S.doc Version 5.0 Page 16 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28 and 30 The standard of the environment throughout the home is good providing the clients with an attractive and homely place to live. EVIDENCE: Channel Lea provides a comfortable family type home to three clients with learning disabilities. The premises are well maintained, decorated and furnished in a homely style. The registered manager confirmed that the clients take a pride in the home, and this was evident on the day of the inspection. Clients inform the registered manager immediately of any repairs or replacements that are required. On the day of this visit the home was light and airy and free from offensive odours. Channel Lea is situated close to the main shops in the village of Walmer, and also has close proximity to public transport into the town of Deal or Dover. Letters were seen by the inspector to show that the home meets with the requirements of the local fire service and the environmental health officer. The inspector was able to view all the clients’ bedrooms, which were of a good size furnished to the clients choosing, had been individualised according to the interests of the clients. The clients are able to lock their bedroom doors if they wish to, but staff in the case of emergency can access the bedroom. All three clients in the home have their own personal mobile phones, and do not require a landline in their bedrooms. The ground floor bedroom has it’s own en suite and the two bedrooms on the
DS0000041065.V267390.R01.S.doc Version 5.0 Page 17 first floor share a bathroom and toilet, all bedrooms have their own wash basins. The communal lounge is domestically modern, and well furnished; the kitchen/diner is also well furnished and domestically equipped. The gardens in the home are neat and tidy, and well tended. Garden work is carried out by one of the clients in the home, as part of his hobby and interest. This client has also made himself responsible for ensuring that a garage set and the bottom of the back garden is kept neat and tidy. The office is also used as a staff sleep-in room by night staff. On the day of the inspection the home was very clean and tidy and free from offensive odours. Because Channel Lea is a small family type home the washing machine is situated in the kitchen as in any family home. Clients are aware that they should not bring dirty laundry into the kitchen while food is being prepared or while other clients are eating in the dining area. There is no clinical waste produced by the home at the present time. DS0000041065.V267390.R01.S.doc Version 5.0 Page 18 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 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 and 36 The morale of staff in the home is high resulting in an enthusiastic workforce that works positively with clients to improve their whole quality of life. Staff are multi skilled ensuring the clients receive good quality care and support. Recruitment practices are good therefore reducing the risk to the clients in the home. All staff receive a detailed induction, and therefore have a clear understanding of their roles. EVIDENCE: When new staff are recruited they are provided with clear job descriptions, which clearly define their role within the home. Prospective new care staff are required to spend one or two trial shifts within the home prior to taking up employment to ensure that they will understand that their priority will be to helping clients to achieve their individual goals. All new staff are issued with the GSCC code of conduct booklet. The care staff in Channel Lea are very motivated, this is achieved by ensuring that staff receive the appropriate job related training, and training organised for these staff is relevant to the assessed needs of the clients. 80 of the care staff are trained to NVQ level 2 and above, and other staff are due to start NVQ training as soon as a space is available on this course. The duty rota reflects that there is sufficient staff on duty throughout the day, and this was true on the day of inspection when care staff were out and about with clients. The duty rota also reflected that staff gender meets the gender of the clients in the home. The inspector was also able to view the personnel files of four of the care staff in the home, these showed that POVA first checks and at least two references are pursued prior to
DS0000041065.V267390.R01.S.doc Version 5.0 Page 19 a prospective member of staff taking up employment. The company also requires prospective staff to take part in trial shifts in the home and it is after these shifts that the views of the clients are sort. All staff are issued with a statement of terms and conditions of employment and a contract. All files contained evidence of CRB checks, two forms of identification. With exception of the newest recruit all staff have undertaken mandatory training, and certificates were available on personnel files. There was also good evidence of induction training. All staff working at Channel Lea receive at least six formal supervisions per year plus annual appraisal, and evidence of this is kept with the staff personnel file. DS0000041065.V267390.R01.S.doc Version 5.0 Page 20 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 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, 40 and 42 EVIDENCE: The registered manager has been in a management position for Robinia care for many years. She has recently completed her NVQ level 4 and RMA, and also updates client related training on a regular basis. It is Robinia Care policy that all staff updates their training on a regular basis and this includes the registered managers. An open door policy is operation at Channel Lea, and both clients and care staff can have immediate access to the registered manager, either by telephone or visiting the assessment home that the registered manager has management responsibility for. The inspector viewed the policies and procedures file and this showed that all policies and procedures are reviewed on a regular basis by Robinia Care head office. Maintenance records associated with appliances used in the home, showed up to date certificates were in place, for fire equipment, gas boiler, central heating system, electrical circuit, PAT’s testing, emergency lighting. The inspector noted that fire alarm tests are carried out weekly, hot water delivery from taps
DS0000041065.V267390.R01.S.doc Version 5.0 Page 21 is carried out on a monthly basis and that the last COSHH assessment had been carried out in October 2005. All staff with exception of the newest recruit has received training in relation to moving and handling, fire safety, first aid, food hygiene and infection control. The registered manager ensures that an environmental risk assessment is carried out regularly. Any accident to clients or staff is appropriately recorded on a HSE accident form, and any notifiable incidents are correctly reported via a regulation 37 form and where appropriate to RIDDOR. All new members of staff receive induction training in health and safety procedures within the first six weeks of their employment, and evidence of this is contained within the staff personnel files. DS0000041065.V267390.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 X X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 3 3 3 X 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X 3 X DS0000041065.V267390.R01.S.doc Version 5.0 Page 23 NO 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 Refer to Standard YA20 Good Practice Recommendations Liquid medication is dated on the bottle on day of opening to enable auditing checks to take place. DS0000041065.V267390.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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