Inspection on 05/12/08 for 15-17 Kew Gardens

This inspection was carried out on 5th December 2008.

CSCI found this care home to be providing an Good service.

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

15-17 Kew Gardens 08/06/06

15-17 Kew Gardens 14/11/05

15-17 Kew Gardens 19/07/05

15-17 Kew Gardens 11/11/04

15-17 Kew Gardens 25/06/04

15-17 Kew Gardens 09/02/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/06/2011.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 15-17 Kew Gardens West Mead Drive Bognor Regis West Sussex PO21 5RD The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sheila Gawley Date: 0 5 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 26 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: 15-17 Kew Gardens West Mead Drive Bognor Regis West Sussex PO21 5RD 01243830214/830242 01243829017 h4047mencap@mencap.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Royal Mencap Society care home 8 Number of places (if applicable): Under 65 Over 65 8 0 learning disability Additional conditions: The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). The maximum number of service users to be accommodated is 8. Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 26 A bit about the care home Kew Gardens is registered to provide accommodation for up to eight residents within the category of adults with a learning disability. The home is situated in a quiet residential area in Bognor Regis. The property is divided into two self-contained houses, which are linked on the first floor. Four residents live in each of the houses. Each house provides four bedrooms, a lounge and dining room, kitchen and bathroom facilities. There is a garden at the rear of the property. Mencap are responsible for the service. The Downland Housing Association owns the property. The Responsible Individual acting on behalf of the organisation is Ms Jan Tregelles. The registered manager is Ms Michelle Allen. Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 26 How we did our inspection: This is what the inspector did when they were at the care home Prior to the visit all files held by the commission, complaints and safeguarding issues were reviewed. The home had sent us their Annual Quality Assurance Assessment for the inspection, which gave us the information we needed on the home. We were in receipt of four surveys from people who use the service and one from a staff member and people who use the service, relatives and staff were spoken to on the day. One person who uses the service stated, All the staff are good here. One staff member has been a key worker to one person who uses the service for 19 years Staff spoken to on the day stated that they were happy working in the home and confirmed that they receive induction. Two people who use the service were case tracked during the inspection and all records relating to them were inspected. The premises were toured. The registered manager facilitated the inspection and any documents required on the day were made available. The atmosphere within the home was peaceful and relaxed and the staff carried out their duties in a respectful manner taking into account the Care Homes for Adults (18-65 years) Page 7 of 26 dignity and privacy of residents What the care home does well What has got better from the last inspection A continuous improvement plan is in place. Some rooms have been decorated. Placements for three staff to complete National vocational Qualification Level 5 have been secured. A dental and vision service now visit the home. Care Homes for Adults (18-65 years) Page 8 of 26 What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Sheila Gawley 33 Greycoat Street London SW1P 2QF 02079792000 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Adults (18-65 years) Page 9 of 26 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 10 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 11 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People using this service experience good outcomes in this area because needs are fully assessed prior to admission. Evidence: There is a comprehensive pre admission process in place. Prospective people wishing to use the service are visited to be assessed in their own environment. An assessment was seen for a prospective admission. It is planned that when he is admitted that his carers from his previous placement will attend to offer support over the transition period. There were details of any conditions such as epilepsy or autism and communication/sensory needs. There is an up to date statement of purpose in easy read format which is supplied to all people who use the service. Care Homes for Adults (18-65 years) Page 12 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People using this service experience good outcomes in this area because they are supported as they wish in their personal care. Evidence: Two people who use the service were case tracked, their care plans and medicine administration charts were examined. The way they wish staff to assist them in meeting their need was recorded. Aids to communication such as picture boards are in place. Care needs such as hoisting needs, personal care, likes and dislikes, communication ability were recorded. Health professionals are consulted as required such the occupational therapist. learning disabilities team, speech and language therapist, psychologist, district nurse and general practitioner. There was evidence of review. There is a key worker system in place. Risk assessment is in place and people who use the service are allowed to take risks. Care Homes for Adults (18-65 years) Page 13 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People using this service experience good outcomes in this area because they can participate and contribute to life in the home the local community. Evidence: There is a range of activities in the home. Activities coordinators are not employed as all staff interact with the people who use the service and help with outings and activities. People who use the service are facilitated in maintaining contact with family and friends, one persons family recently treated all people who use the service to a Chinese meal. People are supported to go on walks, to the shops, visits to families, People have, when able, attended colleges. One person who uses the service went on a 2 day trip to see steam trains in Kent. Independence is encouraged but the abilities of the people who use the service are limited. Staff were seen talking and interacting with the people who use the service and they knock before entering rooms. One has learned to swim in the past year. There are theatre trips and a trip to a pantomime is booked. Some people have been to Dorset on holiday. Goals and activities participated Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: in were recorded in care plans. Independence is encouraged but the ability of people to be involved in household tasks is limited, one person does like to hang out laundry.. Staff were seen talking and interacting with the people who use the service and they knock before entering rooms. The expert by experience did note that one person sat alone in the siting room for most of the visit and that she appeared bored. Four surveys received responded that they always can make decisions on what to do each day. Care Homes for Adults (18-65 years) Page 15 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People using this service experience good outcomes in this area because needs are met in a person centered way. Evidence: Personal support required is noted in the care plans. Professional visits, therapies and treatments are recorded. Risk assessments are in place. Staff spoken to stated that the home is run in the interests of the residents and they feel that they meet the needs of people who use the service in a caring manner and in privacy. They understand the key worker system. People who use the service have an up to date communication passport which has a summary of all need to help any staff on duty to meet these needs, including agency staff. People who use the service are facilitated to access health care in the community such as general practitioner, district nurse. A chiropdist and dentist visit the home as does an optician, hearing tests are also carried out in the home. Medicines are received, administered, recorded and returned correctly. Medicine administration charts inspected were up to date. Service users that had previously been prescribed with rectal Diazapam have now been changed over to Buccal Midazolam, which is a more dignified treatment for epileptic seizures. The home does not currently have a controlled drug cupboard or a drugs fridge The provision of these items will be a requirement of this inspection.. Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: Care Homes for Adults (18-65 years) Page 17 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People using this service experience good outcomes in this area because they are protected from harm Evidence: There is a pictorial complaints procedure in place and it is included in the Statement of Purpose. There have not been any complaints since the last inspection. People who use the service spoken to by the expert by experience stated that they would be able to tell their keyworker if they had a problem. Staff have received safeguarding adults training. Staff spoken to demonstrated an awareness of procedures. The home reports to the commission any incident that may pose a risk to the health and safety of residents. Four surveys received from people who use the service all responded that they know hoe to make a complaint. Monies for people who use the service are held seperately, securely and are receited and recorded. Care Homes for Adults (18-65 years) Page 18 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People using this service experience good outcomes in this area because they live in a safe and well maintained environment. Evidence: The home is comfortable and decorated in a domestic manner. It is a bus ride from local amenities and transport and is in keeping with the local community. Furniture is of good quality and there has been some new flooring laid. Bedrooms are well decorated and are personalised, all have a sink but no en suite facilities. The home meets the requirements of the local Fire and Environmental Health Authority. There is not a lift in the home and those people accommodated on the first floor are risk assessed regarding use of the stairs. Each person who uses the service has an individual risk assessment for evacuation in the event of fire. There are assisted baths and shower rooms. Laundry facilities are sited away from areas of food preparation and storage. Clothes are colour coded to prevent loss in the laundry system Hand washing facilities are available. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People using this service experience good outcomes in this area because needs are met by a well-trained staff. Evidence: Staff rota show sufficient staff on duty to meet the needs of people who use the service although the expert by experience was unsure if the ratio of four staff to eight was sufficient to meet needs, there are usually five carers on duty` All people were up on arrival at the home indicating there were enough staff to achieve this. The home does use agency staff, most are supplied by Mencaps own agency and are familiar with the home. A staff member spoken to was supplied by another agency but she does frequent shifts in the home. Staff files inspected had all required documentation, two references, criminal records bureau clearance and POVA check. All staff have contracts and terms and conditions. Staff spoken to stated that the home is a supportive place to work and that the management is approachable. There is a staff training and development programme in place which clearly shows what training has been done and when something is next due. There is a training matrix in place detailing all training and completion dates. It covers safeguarding, fire, first aid, food hygiene, health and safety, infection control moving and handling and Control of Substances Hazardous to health. There is further training in medicines, maketon, food and nutrition and and communication. Training and induction records were seen. Two staff are currently completing induction. More than 50 of staff have National Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: Vocational Qualifications above Level 2. One staff survey received expressed satisfaction with all areas of the home. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People using this service experience good outcomes in this area because the home is well run and the opinions of people who use the service are sought.. Evidence: The registered manager has met the criteria for registration with the Commission. She had worked in management in the care sector for five years prior to becoming the registered manager in January of 2007. She has The NVQ level 4 in care and has undertaken the registered Managers Award. She is a strong advocate for people who use the service, she accesses training and services that are of little or no cost to the organisation such a dental care and Seeability for vision testing. There is a continuous improvement plan in place identifying areas of improvement in the home. Staff training is up to date. The use of agency staff is well managed in that they use regular carers who know the service and the people who use the service. Staff training nd induction is in place and is up to date. The home complies with the requirements of the local fire and Environmental Health Authorities. There was evidence of fire testing and utilities maintenance. Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: There are quality assurance systems in place. The Responsible Individual undertakes regulation 26 reports, has completed and submitted an AQAA. Information is sought from social workers and families on how the service meet needs. There are staff meetings and people who use the service have meetings. They meet weekly to choose the menu from a folder of pictorial menus. Relatives are not regularly surveyed but they are spoken to frequently. Each person who uses the service has an individual risk assessment for evacuation in the event of fire. Staff training is up to date. The use of agency staff is well managed in that they use regular carer who know the service and the people who use the service. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action 1 20 2 The registered person must 19/03/2009 make suitable arrangements for the storage of medicines. This includes the provision of a controlled drug cupboard and a drug fridge. To ensure the safe storage of medicines. Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web:www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 26 of 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. 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