Inspection on 16/01/07 for 165 Jemmett Road

This inspection was carried out on 16th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

165 Jemmett Road 24/02/06

165 Jemmett Road 23/08/05

165 Jemmett Road 15/02/05

165 Jemmett Road 01/02/05

165 Jemmett Road 16/02/04

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

CARE HOME ADULTS 18-65 165 Jemmett Road 165 Jemmett Road Ashford Kent TN23 4RH Lead Inspector Mrs Sue Gaskell Key Unannounced Inspection 16th January 2007 12:30 165 Jemmett Road DS0000023321.V321703.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 165 Jemmett Road DS0000023321.V321703.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. 165 Jemmett Road DS0000023321.V321703.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 165 Jemmett Road Address 165 Jemmett Road Ashford Kent TN23 4RH 01233 664753 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 Kent Autistic Trust Mrs Susan Trevett Care Home 6 Category(ies) of Learning disability (6) registration, with number of places 165 Jemmett Road DS0000023321.V321703.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th February 2006 Brief Description of the Service: 165 Jemmett Road is a purpose built detached property owned by a housing association and managed by the Kent Autistic Trust. The fees are in the range of £1,273 - £2,187. The home is in a residential area of Ashford, within 15 minutes walking distance of the town centre, with easy access to public transport, health and adult education centres, shops, churches, a swimming pool and other amenities. The house provides accommodation on 2 floors. There are 6 single bedrooms for residents, lounge, dining room, kitchen and bathrooms. In addition there is a staff sleeping in room, office/sleep in room, laundry, storage areas and a large enclosed garden. Staffing comprises a registered manager, team leaders, support staff and day care staff. 165 Jemmett Road DS0000023321.V321703.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 16th January 2007, between 12.30pm and 5 00pm. There were six people living at the home, and there are no vacancies. The inspector met two residents, the trust’s family liaison offer and two members of staff. Some residents have limited communication and therefore the inspector spent some time with these residents in order to see whether they appeared relaxed and comfortable. The Inspector toured the building and looked at all communal areas. 1 resident showed the Inspector her bedroom. The inspection process also consisted of information collected before and during the visit to the home, and feedback from two families and three Care Managers after the site visit finished. Other information seen included general assessments, risk assessments and care plans, medication records, the duty rota and staff recruitment and supervision records. There were no outstanding requirements from the previous inspection and no requirements made following this inspection. What the service does well: What has improved since the last inspection? What they could do better: Update the lounge décor and furnishings. 165 Jemmett Road DS0000023321.V321703.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. 165 Jemmett Road DS0000023321.V321703.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 165 Jemmett Road DS0000023321.V321703.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The statement of purpose, service user guide and individual statement of terms and conditions, clearly says what service will be offered. Prospective residents can be confident that their needs will be assessed and can be met. EVIDENCE: There have been no new admissions since the last inspection visit. However the home has an admissions policy which involves a detailed and comprehensive pre-admission assessment. Previous admissions have included input from the prospective residents, Care Managers, families and other health care professionals. The home does not take emergency admissions. All residents have been issued with a service user guide and part of this is in a pictorial format. Residents also are issued with individual agreements stating their terms and conditions of residence. 165 Jemmett Road DS0000023321.V321703.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7, 9 & 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The care plans are easy to use and descriptive. Residents’ choices are respected and their decision-making is well supported. Residents are supported in taking risks in the daily and social activities that form part of an independent lifestyle. EVIDENCE: Four care plan files were examined in detail. The files include personal profiles and assessments, likes and dislikes, and guidelines on how the home will assist residents in achieving their short and longer term goals. Residents have key workers who monitor their individual needs and activities. The files included comments by residents which indicated that the key-workers have helped 165 Jemmett Road DS0000023321.V321703.R01.S.doc Version 5.2 Page 10 them to contribute as much as possible to the contents of their care plans. Residents and/or their relatives are invited to the annual or six monthly reviews and are asked what they think about their care. The records showed that the care plans are updated following the reviews or as and when their care needs change. The manager referred to recent improvements in setting and monitoring what residents are achieving and linking this into their overall care plans. Risk assessments have been prepared for each resident’s needs or activities, and include specific guidelines on how to minimise any risk. The manager said that the home is constantly looking at whether the risk assessments are clear and ways to include more detail about how much risk is justified. Staff confirmed that they sign care plans and risk assessments to acknowledge having read any important information or guidelines. Staffing at the time of the inspection consisted of the registered manager and three support staff. Staff said that extra staffing has always provided if there is a necessity. Staff confirmed that issues relating to confidentiality are addressed during their induction period. All records are stored in a cupboard in a lockable office and there was no public display of confidential or personal information. 165 Jemmett Road DS0000023321.V321703.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. 12,13,15,16 & 17 Daily life meets the residents’ lifestyle preferences and expectations. Residents have regular contact with their families and friends. Residents receive a nourishing and balanced diet. EVIDENCE: The residents are supported by the staff and manager to help them participate in a range of activities for educational, recreational and therapeutic purposes. There is a weekly programme of activities but the home has to be flexible if residents’ needs change or if they would rather do something else. An example of this is that one resident enjoys a particular activity at certain times but not other times, and this is respected. On the day of the inspection another resident had not wished to go out and remained in the house. A member of 165 Jemmett Road DS0000023321.V321703.R01.S.doc Version 5.2 Page 12 staff said that residents’ activities include bowling, swimming, trampoline activities and going to clubs and discos. The care plans contain a list of residents’ needs, likes and dislikes and preferences, and some of this is in pictorial form. Residents may come and go as they please in the house subject to risk assessments, eg it might not be appropriate for all residents to have unsupervised access to the kitchen. The manager said that this is risk assessed on a continuous basis as residents’ needs change. There was evidence in the residents’ daily records to show that families, and other visitors are encouraged and welcomed. One resident was away at the time of the inspection visiting his family. The manager said that there are no residents at present with different cultural needs, as the residents have said that they do not wish to be treated differently, but staff are aware of the importance of checking this regularly with the residents. One resident regularly attends a local church and staff are looking at whether another resident might also like to go. None of the residents have relationship issues but staff are aware of the importance of respecting one resident’s personal needs. All of the residents have their own bank accounts. Records and receipts and kept for the monies held in personal wallets and individual tins. Staff signatures are required for monies taken out when residents spend money on social activities such as going to the pub. There were entries and check sheets to show that the records are audited as part of Regulation 26 visits. Meals are provided mainly based on residents’ choices, but also taking into account the need for a reasonably balanced diet. One resident has a particular need which requires consideration and the records showed that he has been referred to a consultant. The store cupboard contained a wide range of good quality food including fresh fruit and vegetables. 165 Jemmett Road DS0000023321.V321703.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. 18,19 & 20 Residents’ choices over their care are respected. Residents’ care plans are reviewed and their health care needs are met. Residents are protected by the home’s policies and procedures for dealing with their medication. EVIDENCE: 1 resident showed the inspector her room and the inspector met 2 others briefly whilst they were with other staff. All of the residents were seen to be relaxed and comfortable being with staff. Residents care plans and daily records referred to clear guidelines on providing support and monitoring health care and social care needs. There was evidence to show that residents had been referred for specialist help whenever necessary. The manager and all members of staff showed a high level of awareness of residents’ needs and referred to a variety of issues, such as the importance of ensuring that 165 Jemmett Road DS0000023321.V321703.R01.S.doc Version 5.2 Page 14 residents’ needs are treated with sensitivity or that they have a suitable room and the right equipment. There is regular input from speech and language therapists, eg for swallowing or communication, physiotherapists, psychiatrists and counsellors. Residents are also referred for specialist help if they have other health care needs such as epilepsy or other conditions. The home has sound medication procedures. Staff confirmed that all staff must be trained and have to read the procedures stored in the medication file. Medication was stored securely and appropriately and the medication records were clear and current. 165 Jemmett Road DS0000023321.V321703.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 22 & 23 Residents can be confident their complaints will be listened to and dealt with appropriately and that they will be protected from abuse. EVIDENCE: Although it was difficult to obtain information from some of the residents due to their communication needs, there were entries in the records to indicate that residents tell staff about anything they are not happy with. Support staff said that every effort is made to ensure that residents can communicate their feelings if they are not happy with something. The home uses complaints forms that have been produced in a pictorial format. There was a letter in one resident’s file which indicated that he had been happy with how the home had dealt with his complaint. The home has adult abuse procedures in place and staff confirmed that they have received training on adult protection and when and how to intervene in order to safeguard and assist residents. The staff induction process includes information for staff on policies and procedures concerning appropriate behaviour when assisting with personal care, the use of appropriate intervention techniques, and “whistle blowing. 165 Jemmett Road DS0000023321.V321703.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. 24 & 30 Residents live in a homely,comfortable and safe environment. The home is hygienic and clean. EVIDENCE: All bedrooms and living areas are furnished and decorated to a good standard, and contained the type of furniture and equipment necessary to provide a homely environment. Residents have their own single rooms and 2 of the residents have access to kitchen facilities in individual flatlets. Residents may bring as many of their possessions as is practical and the rooms were seen to be arranged to their liking. 1 resident said that she likes her bedroom and that she had been asked how she would like the furniture arranged. 165 Jemmett Road DS0000023321.V321703.R01.S.doc Version 5.2 Page 17 Although the lounge is comfortable and adequately furnished and decorated, it will need updating in the near future. The garden is attractive and well-maintained and there are various items of garden furniture which are used by the residents. Staff showed a good awareness of health and safety issues and referred to training in health and safety, COSHH, fire safety etc. All staff are trained in infection control and all areas were seen to be clean and hygienic. There is a separate laundry with commercial type washers and driers. Toilets and bathrooms are also provided with paper towels and soap dispensers to reduce the risks of cross infection. The home is well maintained. Maintenance certificates are current, appropriate checks are carried out regularly and there are no outstanding health and safety requirements. 165 Jemmett Road DS0000023321.V321703.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. 32,34,35 & 36 Staffing, in terms of both numbers and competency, is appropriate to the current needs of the residents. Residents are protected by the Home’s sound recruitment procedures. Staff are well trained and supported and morale is high. EVIDENCE: There have been no new staff since the last inspection and one senior member of staff said that the low staff turnover helps the residents feel more secure. One member of staff said that the training provided is excellent and that staff will be funded and supported with any training which is associated to residents’ needs or interests. Four staff have completed their NVQs since the last inspection. Recent training includes supervision skills, sexual awareness, and 165 Jemmett Road DS0000023321.V321703.R01.S.doc Version 5.2 Page 19 PSV driver training. New staff received a range of induction training over a 4 week period. Four staff files were examined and showed that there are sound recruitment systems in place and that all staff have references and CRB checks taken up prior to employment. Staff said that the morale in the home is very high, due to the ethos of “give and take” and the registered manager and staff referred to the high level of supervision and support provided by the Trust. 165 Jemmett Road DS0000023321.V321703.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. 37,39 & 42 The home is well run in a manner that encourages the development of clients. There are regular quality assurance and safety checks to ensure that the home is run in the best interests of the clients and their safety and welfare is protected and promoted. All areas are clean, hygienic and well maintained. EVIDENCE: The registered manager has many years experience in working with adults with learning disabilities, and appeared knowledgeable and competent. The general 165 Jemmett Road DS0000023321.V321703.R01.S.doc Version 5.2 Page 21 management of the home and completion of records are of generally of a good standard. Quality assurance is carried out through the Regulation 26 visits and there were check sheets to show that the manager also uses the trust’s own internal audit system. Staff said that residents’ views and feelings are regularly questioned and monitored, either through talking to them or through observing them to see whether or not they appear happy. Staff said that quality assurance is given a high priority and any feedback from residents and/or their families or advocates is acted upon. Two residents’ Care Managers confirmed this. There were no obvious safety hazards around the home and there was evidence to show that health and safety issues are taken seriously eg. The laundry door was locked and cleaning chemicals had been locked away. Environmental risk assessments have been carried out including the use of the kitchen. There are CCTV cameras but this is only to provide security around the exterior of the building. Regular weekly tests on fire alarms and equipment are carried out and recorded. All staff have had recent fire safety training and the regular fire drills also include residents. The maintenance file also contained current certificates to show that regular checks eg gas, electricity, are carried out. 165 Jemmett Road DS0000023321.V321703.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 4 2 4 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 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 4 33 X 34 4 35 4 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 4 LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 x 4 X 4 X X 4 X 165 Jemmett Road DS0000023321.V321703.R01.S.doc Version 5.2 Page 23 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 165 Jemmett Road DS0000023321.V321703.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 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 © 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 165 Jemmett Road DS0000023321.V321703.R01.S.doc Version 5.2 Page 25 - 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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