Inspection on 06/12/06 for 12 Channel Lea

This inspection was carried out on 6th December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

12 Channel Lea 25/02/08

12 Channel Lea 12/01/06

12 Channel Lea 31/08/05

12 Channel Lea 15/03/05

12 Channel Lea 15/03/05

12 Channel Lea 15/03/05

12 Channel Lea 15/03/05

12 Channel Lea 09/12/04

12 Channel Lea 09/12/04

12 Channel Lea 09/12/04

12 Channel Lea 09/12/04

12 Channel Lea 28/02/04

12 Channel Lea 28/02/04

12 Channel Lea 28/02/04

12 Channel Lea 28/02/04

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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 12 Channel Lea Walmer Deal Kent CT14 7UG Lead Inspector Kim Rogers Unannounced Inspection 6th December 2006 09:55 12 Channel Lea DS0000041065.V312055.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 12 Channel Lea DS0000041065.V312055.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. 12 Channel Lea DS0000041065.V312055.R01.S.doc Version 5.2 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) The Robinia Care Group Ltd Miss Sharon Anne Head Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 12 Channel Lea DS0000041065.V312055.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th January 2006 Brief Description of the Service: 12 Channel Lea is 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 adults with learning difficulties, who may need personal care and support from staff. The home is run by Robinia care Ltd. 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. The fee for this home is about £1,700 per week. For more details of the fee and what it includes please contact the Provider. Past reports are available from the Provider. 12 Channel Lea DS0000041065.V312055.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key site visit was unannounced and carried out by two inspectors over about 4 hours. The manager, Ms. Sharon Head, service users and staff assisted in the process. Three people currently live at the home, and all gave some feedback. People were coming and going in and out of the house and were doing activities with the staff and independently during the visit. The inspectors had a tour of the home, and with permission, some bedrooms were seen. The inspectors spent time with service users, spoke to and observed staff and interviewed and observed the manager. Service users said they feel safe and they have enough to do. All service users have a key to their room and take part in the daily chores of the home. Some work was done before the visit including talking to and surveying care managers and service users. The manager supplied a pre inspection questionnaire, with details of domestic checks and various other data about the home. A selection of records about service users, and some other documents such as staff recruitment files was seen. What the service does well: What has improved since the last inspection? 12 Channel Lea DS0000041065.V312055.R01.S.doc Version 5.2 Page 6 A competency assessment has been developed and implemented to test staff competency in medication administration. One service user is happy with his new bedroom carpet. There is a new tumble dryer. The home has developed systems to better predict when an incident of behaviour may occur. 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. 12 Channel Lea DS0000041065.V312055.R01.S.doc Version 5.2 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 12 Channel Lea DS0000041065.V312055.R01.S.doc Version 5.2 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): 2 Quality in this outcome area for service users is adequate. This judgement has been made using available evidence including a visit to the service. Service users cannot be sure their needs and aspirations will be assessed. EVIDENCE: The home has a statement of purpose, which is currently being reviewed. This should outline what services the home intends to provide and should outline the home’s aims. The service users guide has been reviewed and is in line with the minimum standard. There were no pre admission assessment documents at the home for the inspectors to view (although most service users have been at the home for some time) Therefore some important information about service users was missing from their service user plans. 12 Channel Lea DS0000041065.V312055.R01.S.doc Version 5.2 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): 6,7,9 Quality in this outcome area for service users is good. This judgement has been made using available evidence including a visit to the service. Service users cannot be sure all their personal goals will be supported. Risk taking is generally supported but there could be more emphasis on enabling people. Service users are supported to make decisions about their lives. EVIDENCE: Each service user has a service user plan, which is quite clinical with a focus on deficits. After reading these you do not get a feel for who the person is, where they are from and what life they want. Service users spoke about their hopes and dreams for the future but these have not all been recorded or planned for. Service users would benefit from having support plans with a focus on selfdevelopment. The manager said that all plans are being reviewed to be more person centred. Basic risk assessments are in place and show review. However, some risks have not taken place for a long time so it is not clear if the assessment is still relevant or may need expanding. Some areas of independence have been 12 Channel Lea DS0000041065.V312055.R01.S.doc Version 5.2 Page 10 increased. Some service users want more independence in some areas and this should be assessed and supported. Choice and decision making is well supported in some areas like daily programmes, food and cooking, holidays and socialisation. People really do have good support to find and keep jobs they enjoy. There is a real possibility people could earn wages from their work. Improvements could be made in assessing service users for their own front door key, risks and the potential for service users opening the front door to staff rather than staff letting themselves in. 12 Channel Lea DS0000041065.V312055.R01.S.doc Version 5.2 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): 12,13,15,16,17 Quality in this outcome area for service users is good. This judgement has been made using available evidence including a visit to the service. Service users have opportunities to access community facilities and appropriate activities. Relationships are well supported. Service users rights and responsibilities could be better respected regarding who has a front door key. Service users take part in planning and preparing meals and are offered a healthy diet. EVIDENCE: Service users have opportunities to take part in a range of activities at home and in the community. Service users told the inspectors about a variety of community-based facilities accessed like the theatre, cinema, pubs, clubs and cafes. One service user has a job and another said he would like a job. There is no person centred plan currently in place to support this. Service users can use the home’s transport if the member of staff on duty who drives. If not service 12 Channel Lea DS0000041065.V312055.R01.S.doc Version 5.2 Page 12 users said they use pubic transport. One service user said they would like to be more independent in using public transport. Service users hobbies and interests are supported by the home, as are relationships. Service users take part in planning and preparing meals. A menu is displayed in the kitchen. Service users said they make their own breakfast and lunch ad have staff support to cook the evening meal. Not all service users have a front door key. There were no assessments to establish why some service users have no front door key. During the inspection a staff member let himself in with a key without knocking. This happened again when a support worker let himself in with a key without knocking. This practice must be reviewed to ensure service users rights are respected and maybe increase independence and ownership. 12 Channel Lea DS0000041065.V312055.R01.S.doc Version 5.2 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): 18,19,20 Quality in this outcome area for service users is good. This judgement has been made using available evidence including a visit to the service. Service users personal and health care needs are met. Medication practice is safe but service users could have more control over their medication. EVIDENCE: Service users require minimal support with personal care. The recording of needs and strategies to develop more independence in personal care could be improved. Health needs are recorded and well monitored although there are no individual assessments or health action plans. Service users said they have the support they need when they are unwell. Some service users administer their own medication when they are away from the home but not when they are at the home. The manager said service users have been asked but declined. The manager agreed to discuss this with individuals again as presently staff are in control of medication. Records relating to medication were in good order. The manager has introduced a competency assessment to check staff who administer medication. 12 Channel Lea DS0000041065.V312055.R01.S.doc Version 5.2 Page 14 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 Quality in this outcome area for service users is good. This judgement has been made using available evidence including a visit to the service. Service users are confident their complaints will be listened to and acted on. Service users feel protected and feel safe. EVIDENCE: The home has an adult protection and whistle blowing policy. Staff attend training in safeguarding vulnerable adults. Service users said they feel safe. The home has a complaints policy and records any complaints. Service users said they would talk to staff if they were not happy about something and are confident that staff would act on their views. There have been no complaints since the last inspection. There has been an incident when a restrictive physical intervention was used. It was clear that this was used in the service users best interests and was the least restrictive way of ensuring the service users safety. Since this incident the home has developed systems to give a better understanding of triggers that may predict certain behaviours. 12 Channel Lea DS0000041065.V312055.R01.S.doc Version 5.2 Page 15 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): 24,25,30 Quality in this outcome area for service users is good. This judgement has been made using available evidence including a visit to the service. Service users live in a clean, well-maintained home. Service users are happy with their bedrooms. EVIDENCE: A service user showed the inspector around the home, which is well maintained and homelike. He said he is happy with his room especially the new carpet that he chose. Furniture is comfortable and of good quality. Service users said bathroom and toilet facilities are sufficient and the home is always clean. Service users take responsibility for cleaning their own rooms and have the support they need to do their laundry. A new tumble dryer was delivered during the visit. Service users have a key to their room but not all have a key to the front door. A service user said he would like his own key to the front door rather than borrow a staff member’s key. The manager said she would look into this. 12 Channel Lea DS0000041065.V312055.R01.S.doc Version 5.2 Page 16 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): 32,34,35 Quality in this outcome area for service users is good. This judgement has been made using available evidence including a visit to the service. Staff have mandatory training but would benefit from training in person centred planning. Service users are not fully involved in the recruitment of staff. EVIDENCE: The organisation has a training manager. Courses can be accessed through the training manager. Courses have an emphasis on health and safety rather than values and learning disability issues. Most staff are not trained in person centred planning or person centred active support. The manager said the organisation has recognised this and is seeking to address it. Staff induction is on line with the standard. A staff file was sampled. References were included and other recruitment checks. The manager said service users meet staff when they attend a trial day after passing the interview process but are not fully involved in the selection of staff. Service users confirmed this. This could be improved. Staff were observed supporting people positively giving encouragement and praise when necessary. Staff spoke with knowledge and understanding of service users needs. 12 Channel Lea DS0000041065.V312055.R01.S.doc Version 5.2 Page 17 There was discussion about one staff’s practice regarding service user choice, which the manager said she was aware of and would address. 12 Channel Lea DS0000041065.V312055.R01.S.doc Version 5.2 Page 18 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): 37,39,42 Quality in this outcome area for service users is good. This judgement has been made using available evidence including a visit to the service. The home is well run but lacks effective monitoring and audit. A quality assurance system needs to be developed to ensure service users views underpin the review and improvement of the home. Service users health and safety is protected. EVIDENCE: The manager has worked for Robinia since 1989 and has been a home manager for several years. Although this experience is important the manager has no recent qualification and none relating specifically to service users needs. The organisation has plans to address this. Care managers said that the manager is a ‘good manager’. The inspectors observed the manager to be approachable and positive in interactions with 12 Channel Lea DS0000041065.V312055.R01.S.doc Version 5.2 Page 19 staff and service users. The manager is also the registered manager of another home nearby. A lack of supervision for the manager was evident. The lack of effective monitoring and audit systems means that the home is not demonstrating improvement and development, as it should be. The quality assurance system, based on service users and stakeholder’s views, needs to be improved and implemented. The pre inspection questionnaire supplied by the manager shows that health and safety checks are carried out, as they should be. The home’s fire risk assessment needs reviewing following recent changes to legislation. It was evident that staff may not be following the homes policy in relation to using supermarket reward cards. The manager said she would investigate this. 12 Channel Lea DS0000041065.V312055.R01.S.doc Version 5.2 Page 20 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 2 2 1 3 X 4 X 5 X 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 3 25 3 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 2 X X 3 X 12 Channel Lea DS0000041065.V312055.R01.S.doc Version 5.2 Page 21 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 YA2 Regulation 14 Requirement Assessments must be carried out and include a person’s aspirations. These assessments must be kept at the home. Standards 6, 7, 9, 18. Consult with service users (through person centred plans) and improve service users opportunity for independence and fulfilment. Improve quality assurance processes seeking and taking note of the service users opinions. The homes’ fire risk assessment must be reviewed. Timescale for action 31/01/07 2. YA6 12,16 30/04/07 3. YA39 24 28/02/07 4. YA42 12,13 31/12/06 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. Refer to Standard YA37 YA37 Good Practice Recommendations The manager and staff should have up to date training to support service users specific needs. Ensure that staff know about and follow the home’s DS0000041065.V312055.R01.S.doc Version 5.2 Page 22 12 Channel Lea 3. 4. 5. YA20 YA34 YA16 policies. Ensure that, following assessments and consultation, service users have the support they need to control their own medication. Ensure that service users have the support they need to be fully involved in recruitment. Ensure that, following assessments and consultation, service users have the support they need to have their own front door key. 12 Channel Lea DS0000041065.V312055.R01.S.doc Version 5.2 Page 23 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 12 Channel Lea DS0000041065.V312055.R01.S.doc Version 5.2 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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