Inspection on 23/06/05 for 146 Lower Robin Hood Lane

This inspection was carried out on 23rd June 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.

Other inspections for this house

146 Lower Robin Hood Lane 29/04/09

146 Lower Robin Hood Lane 20/12/06

146 Lower Robin Hood Lane 03/02/06

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 146 Lower Robin Hood Lane 146 Lower Robin Hood Lane Walderslade Chatham ME5 9LB Lead Inspector Sue McGrath Announced 23 June 2005 10:00 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. 146 Lower Robin Hood Lane H56-H06 S64409 146 Robin Hood Lane V225736 230605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 146 Lower Robin Hood Lane Address 146 Lower Robin Hood Lane Walderslade Chatham Kent ME5 9LB 01634 685656 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) MCCH Society Limited Wendy Smith Care Home 5 Category(ies) of Learning Disability (1) registration, with number Learning Disability - over 65 (4) of places 146 Lower Robin Hood Lane H56-H06 S64409 146 Robin Hood Lane V225736 230605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: 146 Robin Hood Lane is a large detached bungalow situatedin a quiet cul-desac in Chatham. Shops and other amenities are situated close by. The establishment cares for residents who have a learning disablity with the majority being over 65 years of age.The home is staffed and managed by MCCH Society Ltd. 146 Lower Robin Hood Lane H56-H06 S64409 146 Robin Hood Lane V225736 230605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place on the 23rd June 2005. One inspector was in the home and the main focus of the inspection was on the general environment and the well being of the residents. During the inspection documentation and records were read, including care plans. A tour of the building was undertaken and most of the residents were spoken to. Time was also spent talking to staff and members of the management team. What the service does well: What has improved since the last inspection? The new proposed bathroom should improve the quality of life for the Residents and make bathing easier for staff. Service users do enjoy activities in the local community. 146 Lower Robin Hood Lane H56-H06 S64409 146 Robin Hood Lane V225736 230605 Stage 4.doc Version 1.30 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. 146 Lower Robin Hood Lane H56-H06 S64409 146 Robin Hood Lane V225736 230605 Stage 4.doc Version 1.30 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 146 Lower Robin Hood Lane H56-H06 S64409 146 Robin Hood Lane V225736 230605 Stage 4.doc Version 1.30 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) 1,2,3,4,5 Prospective service users are currently not provided with the information they need to make an informed choice about moving into the home. Service users benefit from a comprehensive assessment of their needs prior to moving into the home to ensure their assessed needs can be met. Service users and families also benefit from the opportunity to visit the home prior to admission to assess the quality, facilities and suitability of the service. Contracts stating terms and condition are not currently supplied. EVIDENCE: The home does not have a current Statement of Purpose or a Service User Guide that reflects the recent change in registered provider. The new provider (MCCH Society Ltd) took over the management role on the 1st April 2005. The manager stated that this work is currently being undertaken and that it would be ready for the next inspection. Discussion took place over the contents and format of the proposed documents. The home had not admitted any new service users recently but did have a copy of MCCH policies and procedures on the admission of service users. The manager was able to discuss in detail what information she would require before she could make a judgement on whether the home would be able to meet the needs of any new service user. It was evident that any prospective service user would be invited to visit the home and also offered the 146 Lower Robin Hood Lane H56-H06 S64409 146 Robin Hood Lane V225736 230605 Stage 4.doc Version 1.30 Page 9 opportunity to stay overnight to ensure they mixed well with the existing service users and were compatible with them. Staff were seen to communicate effectively and appropriately with the residents and were aware, when spoken to, about the individual’s preferred mode of communication. Training records of the staff on duty at the time of the inspection and observation of their practise, demonstrated that they had the skills and experience to care for the residents at that home. Contracts / statements of terms and conditions were currently being written by the new provider. The residents had previously held contracts with MCLS. 146 Lower Robin Hood Lane H56-H06 S64409 146 Robin Hood Lane V225736 230605 Stage 4.doc Version 1.30 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 standard(s) 6,7,8,9,10 Service users benefit from knowing their assessed and changing needs are reflected in their individual plan and that they are involved with making decisions about their lives where possible. Service user ’s benefit from a robust confidentiality policy. EVIDENCE: Several care plans were viewed and were found to be detailed and comprehensive and gave clear guidelines in respect of routines, particular lifestyle agreements and details of individual programmes. Information seen on care plans confirmed that current residents aspirations and needs had been assessed and were well documented. Care plans were regularly reviewed at monthly staff meetings, however little evidence was seen that the service users themselves were involved in these reviews. It was also advised that all information relating to each service user was complied in one folder. Regular service user meetings were held every 4-6 weeks and action had been taken as a result. One service user had expressed as wish to go to the cinema more often and this had been arranged. Service users were fully enabled to 146 Lower Robin Hood Lane H56-H06 S64409 146 Robin Hood Lane V225736 230605 Stage 4.doc Version 1.30 Page 11 make choices over their daily living plans and activities. It was clear it was very important to the manager and staff that all service users should be treated as individuals. Rising and retiring times were completely flexible as was what clothing was chosen on a daily basis. Detailed risk assessments were seen which identified specific risks to individual residents and gave clear direction to staff to enable them to minimise the risk. Staff spoken to were aware of the policies about confidentiality and the manager confirmed that this was an important part of new staffs induction. 146 Lower Robin Hood Lane H56-H06 S64409 146 Robin Hood Lane V225736 230605 Stage 4.doc Version 1.30 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 standard(s) 11,12,13,14,15,16,17 Service user’s benefit from having the opportunity for personal development with their daily living skills and have appropriate level of leisure activities. Service users also benefit from being part of the local community. Service users are supported to maintain contact with family and friends, which ensures they continue to receive stimulation and emotional support. The service user’s benefit from the appetising meals and balanced diet offered by the home. EVIDENCE: Each service user had an activity plan which was individual to them and their needs. It was clear that all of the service users were treated as individuals who all had different aspirations and activities were arranged accordingly. Only one service user was under 65 and the manager was trying to arrange suitable work experience with a MCCH organisation working in horticulture. This service user clearly enjoyed working in the garden and also helped maintain the garden at the home. Discussion with this service user confirmed that he 146 Lower Robin Hood Lane H56-H06 S64409 146 Robin Hood Lane V225736 230605 Stage 4.doc Version 1.30 Page 13 enjoyed this activity very much. He also spoke about his pleasure in attending football matches. Although none of the service users regularly attend any church services this is entirely their choice. Several have recently started attending a local Baptist club and are involved with activities and singing sessions. Activities are organise at a time that is appropriate to that activity with Residents going out regularly during the evenings and at the week-ends. One service user regularly attends Age Concern and therefore mixes well with people without a disability. One other service user regularly attend football matches. The manager stated that the home enjoys good relationships with the neighbours. Typical leisure activities include going to shows at several local theatres where musicals are particularly enjoyed, eating out and going to local pubs. A recent VE day celebration was particularly enjoyed. Individual holidays are currently being discussed with the service users as these had not happened before. Where possible family visits are encouraged and relatives are invited to attend IIP meetings. Families and friends can visit at any time. Some of the service users visit other homes within the MCCH group for joint parties and get togethers. The daily routines are based on individual needs and the home had a very family orientated feel to it. Staff were seen to communicate appropriately and affectively with the service user and interacted well with them. Comments from staff confirmed that they felt they were invited to work in the service user home first and foremost. The guidance on smoking and drinking had recently been reduced resulting in full choice being given if medical advice allowed. Currently no service users smoke, but some do enjoy a small drink at the local pub on outings. The home does not currently have any pets but this is the choice of the residents. Meals feature highly with the service users and they are involved with the drawing up of menus and the house shopping where possible. Foods taken is recorded to ensure a healthy, balanced diet is taken. There was little evidence of nutritional assessments being undertaken and advise was given about such assessments. Three meals a day were offered with snacks being available as require. Drinks were available as wanted. The arrangements over food were very flexible. 146 Lower Robin Hood Lane H56-H06 S64409 146 Robin Hood Lane V225736 230605 Stage 4.doc Version 1.30 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 standard(s) 18,19,20,21 Service users have clear and in-depth care plans that identify their individual needs and give clear guidance to staff. Care plans are regularly updated to ensure changes are recorded and acted upon. Health needs are met and service users have full access to all professional health care services as required. Service users are protected by the home’s policies and procedures for dealing with medicines. EVIDENCE: Care plans and observations on the day demonstrated that service users preferences about how they wished to be cared for were observed with all personal care being provided in the privacy of either bathrooms or bedrooms. Service users were offered full choice over what clothing to wear and their hairstyles and appearance reflected their personality. The home operated a key worker system, which ensures consistent levels of care were achieved. Service users health was monitored and potential complications were dealt with at an early stage. All service users were registered with a local GP and had full access to all NHS healthcare facilities and professionals. The manager confirmed that all had annual health checks. 146 Lower Robin Hood Lane H56-H06 S64409 146 Robin Hood Lane V225736 230605 Stage 4.doc Version 1.30 Page 15 The homes administration of medication was assessed and was found to be following the guidelines from the Royal Pharmaceutical Society of Great Britain. One minor discrepancy was discussed with the manager around the ordering of prescription from the GP. It was agreed that this procedure would be modified to ensure full compliance. Although the Registered Manager is a qualified nurse it was advised that if possible she should attend an accredited course on the administration of medication to ensure she is following up to date guidelines. All of the service users needed assistance to administer their medication. Due to the ages of the current service users discussion took place over the homes policy on ageing and death. MCCH was currently in discussion with families over this, however the manager confirmed that the home would endeavour to keep a service user with a terminal illness for as long as it was medically possible. It was evident that she felt strongly it was their home for as long as possible. 146 Lower Robin Hood Lane H56-H06 S64409 146 Robin Hood Lane V225736 230605 Stage 4.doc Version 1.30 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 standard(s) 22,23 The home has a robust complaints system and the home’s Adult Protection Policy and procedures protect service users from abuse. EVIDENCE: The home has a new complaints procedure with the new provider and staff are currently digesting all the new procedures. The procedure was seen to be robust and include a whistle blowing policy. The manager was aware of the Protection of Vulnerable Adults register (POVA). There had been no complaints in the past 12 months. The complaints procedure was also seen in a format suitable for the Residents. The home has adopted Kent and Medway’s procedure on Adult Abuse and all staff were trained in this subject. Discussion with staff confirmed they had a good knowledge of Adult Abuse. 146 Lower Robin Hood Lane H56-H06 S64409 146 Robin Hood Lane V225736 230605 Stage 4.doc Version 1.30 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 standard(s) 24,25,26,27,29 Service users benefit from living in a clean, safe, well-maintained environment and have safe access to comfortable indoor and outdoor communal areas. Service users were encouraged to maximise their independence by having access to a range of specialist equipment supplied by the home. EVIDENCE: All of the service users rooms were viewed and were found to be comfortable and very homely. The rooms were personalised with one having french doors leading to a small garden. All had lockable safes for personal belongings and hand washbasins. One room had en-suite facilities. All of the rooms had televisions and or musical centres or CD players. It was evident that these rooms met the needs and lifestyles of the service users. The premises generally were safe, comfortable and clean and free from offensive odours. A large conservatory to the rear of the building could be used as a quiet room or visitors room. Some areas in the lounge were starting to show signs of wear and it is advised that a planned maintenance and renewal programme for the fabrics and decoration be produced and adhered to. 146 Lower Robin Hood Lane H56-H06 S64409 146 Robin Hood Lane V225736 230605 Stage 4.doc Version 1.30 Page 18 The manager discussed the proposed new bathroom that was soon to be installed. The budget figure had been approved and the work was due to start in the very near future. The premises were in keeping with the local community and were generally well maintained. The manager confirmed that the home met with the requirement of the local fire service and environmental health departments. Residents had access to specialist environmental aids and disability equipment necessary to meet their assessed needs. 146 Lower Robin Hood Lane H56-H06 S64409 146 Robin Hood Lane V225736 230605 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,34, The service users benefit from being cared for by staff who have a good understanding of their needs, who are trained and competent to do their jobs and who enjoy good morale. EVIDENCE: All of the staff had relevant job descriptions and knew the main values and aims of the home. Staff had clearly developed good working relationships with the service users and were able to meet individual needs and personal interests. Staff were very clear that they were invited into the homes of the service users to work and that it was first and foremost their home. Staff were also seen to interact very well with all of the service users. The home used one volunteer driver, who has the necessary CRB check completed. It was evident that staff respected the service users and were approachable and comfortable with them. There appeared to be a high level of commitment and motivation within the staff group. Evidence was seen that the staff team was effective and supported the residents assessed needs at all times. Regular staff meetings took, place with minutes being recorded. 146 Lower Robin Hood Lane H56-H06 S64409 146 Robin Hood Lane V225736 230605 Stage 4.doc Version 1.30 Page 20 The manager has recently undertaken training in staff recruitment and is looking forward to being more involved with the recruitment of any new staff. MCCH recruitment procedure was seen and was found to be robust and comprehensive. 146 Lower Robin Hood Lane H56-H06 S64409 146 Robin Hood Lane V225736 230605 Stage 4.doc Version 1.30 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 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) 37,38 The service user’s benefit from having a manager who provides clear leadership throughout the home and is supported by staff who demonstrate an awareness of their roles and responsibilities. EVIDENCE: The registered manager is a qualified nurse and has almost completed her Registered Managers Award. She had also undertaken periodic training and development to maintain her knowledge and skills whilst managing the home. These included recruitment and selection, supervision skills, D32/D33, first aid, disciplinary and grievance procedures, communication skills, epilepsy care, Adult Abuse. The manager was also a qualified manual handling trainer. Staff confirmed that the manager was approachable and communicated a clear sense of direction and leadership. The manager had recently been selected to complete a secondment as a Service Co-Coordinator for Mapping and Person Centred Planning. Whilst this is 146 Lower Robin Hood Lane H56-H06 S64409 146 Robin Hood Lane V225736 230605 Stage 4.doc Version 1.30 Page 22 to be congratulated she was reminded that it is the expectation of the Commission that registered manager works within the home for a minimum of twenty hours a week. She must ensure that commitment is carried out. 146 Lower Robin Hood Lane H56-H06 S64409 146 Robin Hood Lane V225736 230605 Stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 1 3 3 3 1 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 x 3 x 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 3 2 x 3 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 146 Lower Robin Hood Lane Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 x x x x x H56-H06 S64409 146 Robin Hood Lane V225736 230605 Stage 4.doc Version 1.30 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. 1. 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. Refer to Standard YA24 YA37 Good Practice Recommendations it is recommended that the home has a planned maintenance and renewal programme for the fabric and decoraton of the premises. It is recommended that the Registered Manager works in the home for a minimum of 20 hours per week.i 146 Lower Robin Hood Lane H56-H06 S64409 146 Robin Hood Lane V225736 230605 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane Maidstone Kent. 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 146 Lower Robin Hood Lane H56-H06 S64409 146 Robin Hood Lane V225736 230605 Stage 4.doc Version 1.30 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!