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Inspection on 31/08/05 for 12 Channel Lea

Also see our care home review for 12 Channel Lea for more information

This inspection was carried out on 31st August 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Pre-admission assessments and care plans are always detailed, with evidence of good input from outside professionals. Staff in the home communicate well with the clients about every issue of their daily lives, and this includes well written risk assessments, giving the clients good information on what restrictions that need to be put in place to reduce risk. All clients in the home have a full and varied social life, which meets their needs and their planned action of care. The clients maintain independence with personal hygiene and healthcare with gentle reminders from staff. Clients` medication is well managed in the home. The home always remains well maintained, all furniture is of good quality and domestic in style. The home is kept in a clean, neat and tidy condition. Staffing levels in the home meet the assessed needs and working and social life of the clients.

What has improved since the last inspection?

Many policies and procedures have been updated, and these include those relating to clients, which have also been illustrated to enable clients to have a greater understanding of the policy and procedure.

What the care home could do better:

The inspector has made three requirements to the home as a result of this inspection. Care plans need to be reviewed at least every six months. Staff working in the home need to be regularly supervised, and supervision should be recorded and carried out at least six times per year. The home needs to ensure that it has in a place an effective quality assurance system.

CARE HOME ADULTS 18-65 12 Channel Lea 12, Channel Lea Walmer, Deal Kent CT14 7UG Lead Inspector June Davies Unannounced 31/08/05 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 12 Channel Lea H56-H05 S41065 12 Channel Lea V235728 310805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 12 Channel Lea Address 12 Channel Lea, Walmer, Deal, Kent, CT14 7UG Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01304 242363 Robinia Care South East Limited Miss Sharon Anne Head Registered Care Home 3 Category(ies) of Learning Disability registration, with number of places 12 Channel Lea H56-H05 S41065 12 Channel Lea V235728 310805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15/03/05 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. 12 Channel Lea H56-H05 S41065 12 Channel Lea V235728 310805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out at the home on the 1/09/05 over a period of four hours. The home is registered for three male clients with learning disabilities. At the time of the visit all the clients were out, and two staff were present in the home. Evidence was gained by discussion with staff, from viewing the relevant paperwork, and observation. What the service does well: What has improved since the last inspection? What they could do better: The inspector has made three requirements to the home as a result of this inspection. Care plans need to be reviewed at least every six months. Staff working in the home need to be regularly supervised, and supervision should be recorded and carried out at least six times per year. The home needs to ensure that it has in a place an effective quality assurance system. 12 Channel Lea H56-H05 S41065 12 Channel Lea V235728 310805 Stage 4.doc Version 1.40 Page 6 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. 12 Channel Lea H56-H05 S41065 12 Channel Lea V235728 310805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection 12 Channel Lea H56-H05 S41065 12 Channel Lea V235728 310805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 5. The homes, statement of purpose and service user guide, are well written and provide clients and prospective clients with the information they need to make a decision about moving into the home. Each client, is aware of their role and responsibilities in the home. Clients move into the home knowing that their needs will be met and that their independence will be maximised and promoted. EVIDENCE: All clients have a copy of the statement of purpose and service user guide on file. The service user guide is illustrated which makes this document more accessible to the clients. The inspector found both the statement of purpose and service user guide provided the information required by the standard. There have been no new clients into the home since it opened two years ago. All the clients have holistic pre-admission assessments, and external professional pre-admission assessments are available for the clients in this home. The clients in this home moved on from the assessment home, which is also owned by Robinia Care, therefore their needs were assessed in regard to more independent living prior to moving into Channel Lea. The inspector witnessed that each client has a signed illustrated copy of terms and conditions, within the care plan. 12 Channel Lea H56-H05 S41065 12 Channel Lea V235728 310805 Stage 4.doc Version 1.40 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 standard(s) 6, 7, 8, 9, 10. Clients know that their personal goals are reflected in their individual care plans and that potential risks are managed. Clients know that their views are listened to and that their records will be kept securely maintaining confidentiality. EVIDENCE: The inspector noted that each client has a care plan, which clearly describes their plan of care, including planned interventions, restrictions, and risk assessments. The inspector did note that review of care plans was out of date, and had made a requirement that reviews take place at least every six months. Staff confirmed that clients in the home are encouraged to discuss and make decisions regarding their lives, and any restrictions relating to their decision would be made through a thorough assessment and a risk assessment process. Evidence was available in the care plans to show that clients are able to manage their own finances and are supported to do this by the care staff working in the home. Staff told the inspector that clients are able to be involved in the day to day running of the home, and would be encouraged to voice opinions of any planned changes made in the home. All policies and procedures relating to the clients are clearly written and illustrated, to ensure that clients are able to understand their responsibilities. Staff also told the 12 Channel Lea H56-H05 S41065 12 Channel Lea V235728 310805 Stage 4.doc Version 1.40 Page 10 inspector that daily discussions take place with the clients either collectively or on a one to one basis. The inspector was able to view the risk assessments, which showed that risk assessments are carried out on client’s activities, and that appropriate actions are taken to reduce risk to the clients. Each care plan contains information, a good description and photograph of the client, which staff would use to report to appropriate authority an unexplained absence from the home. The home has a good policy and procedure on protection of client, confidentiality. Any confidential information given by a client to a staff member would only be shared with the manager with the client’s knowledge and not with relatives and friends unless specifically stated by the client. 12 Channel Lea H56-H05 S41065 12 Channel Lea V235728 310805 Stage 4.doc Version 1.40 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 standard(s) 11, 12, 13, 14, 15, 16, 17. Links with the community are good and support and enrich the clients’ social and educational opportunities. Staff, understand the need for clients to maintain external family relationships, and support the clients to do this. The meals in this home are good offering both choice and variety. EVIDENCE: The inspector saw evidence within the care plans to show that clients are able to develop social, communication and independent living skills. All the clients attend college courses or are involved in the local day centre where they take part in daily living skills. Staff confirmed that they would give assistance to any of the clients wishing to attend college, to develop skills. Two of the clients take part in gardening work experience, and one of these clients also takes part in work experience at a local fishing tackle shop. The inspector saw evidence to show that the clients make regular trips into the local community, to go shopping, visit the local working mens’ club, and the local public house. Clients are able to choose which leisure activities they wish to take part in, and the inspector saw evidence of a variety of leisure activities, such as fishing, eating out, visiting places of interest, playing snooker and bowling. There was 12 Channel Lea H56-H05 S41065 12 Channel Lea V235728 310805 Stage 4.doc Version 1.40 Page 12 also good evidence of maintaining links with families and friends, by frequent trips home, and telephone calls. The clients are also able to make friends at local clubs, public houses and from other local homes within the Robinia group. All clients have daily housework routines, which involve keeping their own bedrooms and the rest of the house clean and tidy. Staff only, enter clients bedrooms with permission, all clients have a key to their own bedroom. One of the clients is especially keen on keeping both the back and front garden tidy and well tended. Staff reported to the inspector that the clients through discussion are able to make decisions in regard to their weekly menu, and this was evidence through the menu for the week which was displayed in the kitchen. The menu showed that the clients have a good choice of fresh and nutritious food. 12 Channel Lea H56-H05 S41065 12 Channel Lea V235728 310805 Stage 4.doc Version 1.40 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 standard(s) 18, 19, 20, 21 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 such a way as to protect the clients’ privacy and dignity and to promote their independence. The medication at this home is well managed promoting good health. EVIDENCE: All the clients in Channel Lea, are able to look after their own personal hygiene, and only require gentle reminders from the staff to ensure that daily hygiene tasks are carried out. Staff told the inspector that if a client required help with personal hygiene then this would be carried out in private. There are no routine restrictions placed on the clients in the home in regard to going to bed or getting up in the morning. Weekend routines are more flexible because the clients do not have to attend work experience or day centres. Evidence was available through the daily report written individually for each client, that they are able to manage their own health care needs, like visiting their general practitioner, chiropodist, and optician. Clients also have access to a variety of external health care professionals as and when the need arises. None of the clients in the home manage their medication, this is administered by trained staff. Channel Lea uses the Nomad system of medication, and the inspector carried out an audit of medication, this showed that medication is ordered appropriately, secured in a locked medication cupboard within the staff 12 Channel Lea H56-H05 S41065 12 Channel Lea V235728 310805 Stage 4.doc Version 1.40 Page 14 office, MAR sheets were correctly completed and any homely remedies used, are properly accounted for. None of the clients take controlled drugs. All medication was in date, and any unused medication is returned to pharmacy. Staff have obtained information in regard to the clients wishes should they die, and this has been recorded and placed in each individuals care plan. 12 Channel Lea H56-H05 S41065 12 Channel Lea V235728 310805 Stage 4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22, 23. The home has a satisfactory complaints system, which assures the clients that their views will be listened to and acted upon. Staff, have a good knowledge and understanding of adult protection issues which protects the clients from abuse. EVIDENCE: Each client has a copy of the updated complaints policy and procedure in their individual care plan. This complaints policy and procedure is illustrated to assist the clients in their understanding of how to make a complaint. There have been no complaints made since the last inspection. The inspector was able to discuss with the staff on duty how the clients are able to discuss any areas of concern on a daily basis as and when they occur. Staff, have received a variety of training to ensure that the clients are not abused, and the policies and procedures handbook contains updated policies and procedures in relation to the protection of vulnerable adults together with a whistle blowing policy and procedure. 12 Channel Lea H56-H05 S41065 12 Channel Lea V235728 310805 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28, 29, 30. The standard of the environment within the home is good providing the clients with an attractive and homely place to live. EVIDENCE: Channel Lea is a suitable domestic style home for the three clients who live there. The inspector found the home to be in good decorative order with modern domestic style furniture, which is of a good quality. Robinia Care who own the home ensure that there is a planned maintenance and renewal programme for the home and this is reflected in the homes appearance both externally and internally. Each client has their own bedroom, and the bedroom on the ground floor has en suite facilities, with the two first floor bedrooms sharing a domestic style toilet and bathroom. Each bedroom is well decorated and furnished with good quality modern domestic furniture and fittings. The inspector evidenced that the clients are also able to reflect their own personalities in their bedrooms with personal items, which are of interest to them. The communal lounge and kitchen are domestic in style with good quality domestic style furniture and fittings. On the day of the visit the home was very clean and free from offensive odours. The domestic style washing machine is situated in the kitchen area of the home, but this would not be used 12 Channel Lea H56-H05 S41065 12 Channel Lea V235728 310805 Stage 4.doc Version 1.40 Page 17 while food is being prepared in the kitchen. On the ground floor of the home there is a cloakroom with hand washing facilities and liquid soap available. 12 Channel Lea H56-H05 S41065 12 Channel Lea V235728 310805 Stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 36 EVIDENCE: The inspector evidenced that 45 of staff working in the home have NVQ qualifications, and that other staff or working towards their NVQ. Staff on duty said that there were excellent client/staff relationships in the home. On the day of the visit staff were on an outing with two of the clients to the Dymchurch light railway. Another client was on work experience. The inspector was able to evidence via the individual daily report sheets, that there is good communication between the clients and the staff. The duty rotas reflected that there is always sufficient staff, on duty to meet the needs, and activities of the clients. Through discussion with staff present in the home on the day of the visit, the inspector found that staff are not at the present time regularly supervised, while this in part was due to staff sickness and annual leave, no evidence was available to identify when supervision had taken place, therefore the inspector has made a requirement that staff supervision takes places at least six times per year. 12 Channel Lea H56-H05 S41065 12 Channel Lea V235728 310805 Stage 4.doc Version 1.40 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39, 42. The home does not regularly review aspects of its performance through a good programme of self-review and consultation, which should include the views of the clients, staff and relatives. The home ensures that all aspects of Health and Safety are adhered to, which ensures that both clients and staff are safe. EVIDENCE: Robinia Care does have a quality assurance system in place for the whole company in general, but it was noted by the inspector that Channel Lea does not have its own quality assurance system in place, and therefore a requirement has been made for a quality assurance system to be compiled for Channel Lea. The inspector was able to evidence that Health and Safety procedures in the home are adhered to, and evidence was available to show that staff had received all relevant training. This training is organised by Robinia Care’s head office, and staff receive reminders when their training needs to be updated. All maintenance certificates for appliances used in the home were up to date. There was an environmental risk assessment and this is checked on a quarterly basis. Fire appliances and the fire system is 12 Channel Lea H56-H05 S41065 12 Channel Lea V235728 310805 Stage 4.doc Version 1.40 Page 20 checked regularly. room. Health and Safety posters were displayed in the staff 12 Channel Lea H56-H05 S41065 12 Channel Lea V235728 310805 Stage 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 x x 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 12 Channel Lea Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x H56-H05 S41065 12 Channel Lea V235728 310805 Stage 4.doc Version 1.40 Page 22 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. 1. Standard 6 Regulation 15 Requirement The care plan is reviewed with the client, at the request of the client or at least every six months and updated to reflect changing needs. Timescale for action 1/10/05 2. 3. 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 Good Practice Recommendations 12 Channel Lea H56-H05 S41065 12 Channel Lea V235728 310805 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection 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 © 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 12 Channel Lea H56-H05 S41065 12 Channel Lea V235728 310805 Stage 4.doc Version 1.40 Page 24 - 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. 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