Inspection on 26/04/07 for 17 John Street

This inspection was carried out on 26th April 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

17 John Street 17/01/06

17 John Street 07/07/05

17 John Street 17/03/05

17 John Street 21/07/04

17 John Street 25/03/04

Similar services:

Thorndene

Sutton Lodge Nursing Home

Wingham Court

Bethany Lodge

Red Oaks

Clare House Nursing Home

Broad Oak Manor Nursing Home

Ernest Kleinwort Court

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

CARE HOME ADULTS 18-65 17 John Street 17 John Street Maidstone Kent ME14 2SQ Lead Inspector Eamonn Kelly Key Unannounced Inspection 26th April 2007 10:00 17 John Street DS0000024078.V334499.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 17 John Street DS0000024078.V334499.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. 17 John Street DS0000024078.V334499.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 17 John Street Address 17 John Street Maidstone Kent ME14 2SQ 01622 664021 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) john.street@unitedresponse.org.uk None United Response Ms Karen Suzanne Herwin Care Home 5 Category(ies) of Physical disability (5) registration, with number of places 17 John Street DS0000024078.V334499.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th January 2006 Brief Description of the Service: The home cares for people with learning and physical disabilities. The premises are owned by Moat housing association and United Response Ltd operates the service. According to its website www.unitedresponse.org.uk the company “supports people with learning and physical disabilities and mental health needs to have the things they want and need in their lives”. The organisation “takes account of peoples history and background and works with each person and their circle of support, including families, carers and advocates”. The premises are close to the centre of Maidstone. The weekly fees are £2000. Additional charges are made for chiropody, hairdressing, specific costs of some activities (eg. aromatherapy),personal spending and the cost of holidays. Fees and other costs are shown in the Resident’s Guide and are agreed with care managers at pre-admission stage. 17 John Street DS0000024078.V334499.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on 26th April 2007. It consisted of meeting with residents, the manager of the home and members of staff. United Response’s service manager was at the home carrying out a quality audit. Care practices were observed and discussed with members of staff. A variety of records were seen during the visit principally those that supported the care of residents. The manager made a copy of the home’s draft AQAA (annual quality assurance assessment) available. Four parents responded to the CSCI survey prior to the inspection visit. The replies were very positive. The improvements requested in the previous inspection report have been implemented or are in the course of completion. What the service does well: What has improved since the last inspection? Important renovations are taking place including provision of a bathroom designed for supporting people with physical disabilities and provision of a rise and fall bath. New curtains and furniture have been purchased. Better storage facilities have been obtained. The manager has access to staffing information that is needed including a list of CRB checks undertaken and the outcomes. 17 John Street DS0000024078.V334499.R01.S.doc Version 5.2 Page 6 Medication training has been provided for staff. A revised procedure for maintaining care plans and daily records has been put in place. 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. The summary of this inspection report can be made available in other formats on request. 17 John Street DS0000024078.V334499.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 17 John Street DS0000024078.V334499.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, 4, 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users and their advocates receive the information they need to make an informed choice as to whether to use the service. EVIDENCE: Prospective resident’s advocates are provided with a recently re-designed Resident’s Guide that gives them clear information about services and facilities. The service considers carefully the needs assessment for each prospective resident before agreeing admission to the home. The procedure being followed is intended to do all that is necessary to enable a proper decision to be made by the resident/family and advocates. Significant time and effort is spent making admissions to the home. All new residents receive a full comprehensive needs assessment before admission. In the case of a potential admission currently under consideration, detailed assessments are being carried out involving the prospective resident, family and advocates. 17 John Street DS0000024078.V334499.R01.S.doc Version 5.2 Page 9 The manager says that when this procedure is complete a comprehensive personal contract will be provided that will show the rights and responsibilities of both parties to the agreement. 17 John Street DS0000024078.V334499.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are assisted to make decisions about how to lead their lives and they each have relatively independent lifestyles. They benefit from involvement in care plans and risk assessments that are regularly reviewed. EVIDENCE: The quality of care plans seen and risk assessments conducted indicate that residents remain safe whilst they benefit from many opportunities and leisure pursuits. The home strongly promotes resident’s independence. Resident’s have complex communication difficulties and physical disabilities. Each is known as an individual with specific needs and capabilities. The home has a strong ethos of involving residents in all aspects of their life. Over the past year, a new approach to maintaining care plans and risk assessments has been developed. The person-centred planning approach espoused by the 17 John Street DS0000024078.V334499.R01.S.doc Version 5.2 Page 11 organisation involves the use of “shift planners” for each day that highlights progress towards simple goals. In an example seen, the scoring system related to progress in drinking from a cup, passive physical exercise and walking. The care plan is used as a working tool to help staff identify support needs and provide the types of assistance needed. Capabilities and preferences are noted as part of the home’s procedures for supporting residents. Members of staff spoke about the objective of helping residents to make improvements, however small, and for these to be identified. Members of staff keep up to date with training, professional research and literature in both the social care and clinical fields. This helps to ensure that care plans are informed by the relevant social and clinical guidance. Some referred to the United Response video and part of it was viewed on the day. 17 John Street DS0000024078.V334499.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Resident’s derive benefit from opportunities for leisure and personal development. They are helped to develop through regular contact with the local community. EVIDENCE: The home has a new minibus that can transport up to 4 residents whilst in wheelchairs. On the day 2 residents, supported by two members of staff, used the minibus to visit a local physiotherapist. Residents are helped with access to a very wide range of leisure facilities in the local community and to specialist services. 17 John Street DS0000024078.V334499.R01.S.doc Version 5.2 Page 13 Family members are welcome to visit at any time and are made welcome. Important relationships are noted on care plans, respected and encouraged. Staff individually value residents by, amongst a variety of ways, actively encouraging self-determination. Examples were seen (via photographs, items displayed in bedrooms and communal areas and discussion with staff) where excellent opportunities are provided for each resident. These include hydrotherapy, speech therapy, specialist massage, music therapy, and sound beam experiences. An example of shared sitting body massage was observed. Many more opportunities and facilities are also available for residents. Residents are encouraged to participate in daily living activities. They have access to a garden that has a raised flowerbed, crunchy gravel path, waterfall features for visual and sound effect, scented plants, paddling pool, hammock, pergola, and wind chimes. The new garden shed is used, in addition to storage, by a resident for painting and artwork. Within the premises residents have the benefit of large padded sofas, additional lighting for residents with sight impairment, sprung floor (to assist deaf and blind people detect vibrations), door bell light instead of sound to reduce anxieties, padded chairs, treadmill, strong colour contrasts and carpet textures to assist residents who have visual impairments. The sensory room has a variety of mechanisms (eg. sound beam machine, lights activated by people with disablements) to help residents. Residents are able to enjoy a full and stimulating life style with a variety of options to choose from. Routines are very flexible and residents can make choices in major areas of their life. Policies, procedures and practice guidance focus on residents maintaining as much control of their life as possible. The system in place and the practice and attitude of the staff team give residents the opportunity and support to remain independent. Food is considered to be highly important and meal times considered a social occasion. Food is served to meet the need of residents including those who have swallowing or chewing difficulty. 17 John Street DS0000024078.V334499.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20, 21. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents receive good healthcare and personal support. Personal care is delivered sensitively and care plans clearly detail how physical and emotional health needs are to be supported. EVIDENCE: Care plans include the type and nature of support that individuals need to maintain their physical and emotional health. A section of each individual care plan defines service users specific health care needs. Resident’s have complex communication difficulties and physical disabilities. Each is known as an individual with specific needs and capabilities. The home has a strong ethos of involving residents in all aspects of their life. Over the past year, a new approach to maintaining care plans and risk assessments has been developed. The person-centred planning approach espoused by the organisation involves the use of “shift planners” for each day that highlights progress towards simple goals. In an example seen, the scoring system related to progress in drinking 17 John Street DS0000024078.V334499.R01.S.doc Version 5.2 Page 15 from a cup, passive physical exercise and walking. The care plan is used as a working tool to help staff. Written records showed the home continues to liaise with specialist and local healthcare specialists in supporting residents with their health support needs. A member of staff demonstrated how training in medication administration has served to give staff a better appreciation of the need for careful administration and recording. Members of staff routinely observe a proper attitude and approach to privacy and respect. The organisation’s policies, procedures and guidance support and inform practice. The home has detailed practice guidance to help staff when working with residents who are seriously ill and dying. The manager described how staff receive practical advice in caring for residents in these circumstances and have opportunities to discuss any areas of anxiety and concern. 17 John Street DS0000024078.V334499.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Procedures at the home serve to protect residents and promote their safety. EVIDENCE: A complaints procedure, incorporating symbols and pictures, has been provided to residents, families and advocates. No new complaints or expressions of concern were received by the home since the last inspection. If necessary the manager seeks to resolve any concerns at an early stage through informal discussions with all parties. The home had up to date policies and procedures regarding the protection of vulnerable adults. Staff say they are aware of POVA procedures. Members of resident’s families who responded to the CSCI survey state that they are very satisfied with the service provision and feel well supported by staff at the home. 17 John Street DS0000024078.V334499.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29, 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents have the benefit of living in premises which promote their independence and that are suitable for their support needs. EVIDENCE: Each bedroom is equipped and decorated in a way that suits the disabilities and preferences of residents. Residents have rise/fall/tilt beds. Some bedrooms have ceiling hoists. All have appropriate communication devices. Doorways are wheelchair accessible. Residents have a variety of adaptations to suit their physical conditions. The excellent facilities within and outside the premises have been described earlier in this report. 17 John Street DS0000024078.V334499.R01.S.doc Version 5.2 Page 18 A new bathroom was under construction at the time of the inspection visit. This will have a rise and fall bath, overhead hoist and turning space for wheelchairs. Additional storage space has been achieved by the purchase of a garden shed which is also used for artwork by a resident. The manager has obtained appropriate funding to have repairs and maintenance carried out. New curtains and furniture has been purchased. A sleeping member of staff has the use of a staff bedroom at night. The other sleeping member of staff uses a foldaway bed in the lounge. An epilepsy alerter and monitor alarms are used to draw staff attention to problems at night. A marine theme (pictures, shells) is maintained in a corridor area. “Objects of reference” (door beads for sound and feel effect, raised wallpaper, colour contrasts) are located throughout to residents see and feel objects and locations. Bathrooms are also equipped with “objects of reference” to help encourage residents. The premises were clean and hygienic on the day of the inspection visit. Some feel that, although the premises were purpose-built within the last 15 years, it is not entirely suitable in terms of some lack of very modern equipment and layout. Nevertheless, in-house staff and company managers have succeeded in adapting and equipping the premises so that residents are comfortable and safe. 17 John Street DS0000024078.V334499.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have the benefit of being in the care of members of staff who have a good understanding of their needs and how they must be supported. EVIDENCE: Staffing levels have increased in 2006 to meet the significant support needs of residents. The manager felt that, with the assistance of agency staff to cover absences and holiday, staffing levels are currently adequate. Staff files suggest good recruitment procedures. It is understood that the commission’s provider relationship managers have approved the procedure of keeping most staffing information at its head office with relevant information required by the manager retained at individual registered premises. All staff undergo a CRB check and a list of staff with the outcome of such checks is available at the home. 17 John Street DS0000024078.V334499.R01.S.doc Version 5.2 Page 20 The manager outlined how staff receive formal supervision. All new staff receive induction which appears to meet the standard recommended by Skills for Care. A training matrix indicated that staff receive opportunities to undertake a range of training pertinent to their job. The manager says that, during supervision and at other times, they are encouraged to avail of the opportunities offered. Members of staff say that they have benefited from the personal development opportunities taken. The pre-inspection questionnaire contained a list of training that had been undertaken by staff. 17 John Street DS0000024078.V334499.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 42. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents and members of staff have the benefit of living in a residential home that is well conducted. Sound working practices safeguard the health, safety and well being of staff and residents. EVIDENCE: Health and safety policies and associated guidance documents are clear and available to staff who are conversant with emergency procedures. An ‘on call’ arrangement means the home has 24-hour access to a senior member of staff. 17 John Street DS0000024078.V334499.R01.S.doc Version 5.2 Page 22 Staff work within the organisations guidelines ensuring the health safety and general well being of service users. Members of staff receive encouragement to undertake training to equip them in meeting the needs of residents. All records regarding health and safety checks, routine maintenance and equipment checks are maintained and up-to-date. These are listed in the preinspection questionnaire and were made available during the inspection visit. Staff met said they feel supported, motivated, encouraged and receive appropriate training. There is strong evidence that the ethos of the home is open and transparent with the views of both staff and residents listened to, and valued. The registered manager has the required qualification (including a Certificate in Community Care Practice) and experience to run the home and meet its stated aims and objectives. Quality monitoring systems provide management evidence that practice reflects the homes policies and procedures. The company’s area manager carried out a quality monitoring visit on the day of the CSCI inspection. The company’s service evaluation report, “The Way We Work “ (October 2006), which the University of Kent’s Tizard Centre helped to prepare includes information about the ways people in its residential and supported living schemes are assisted within the aims of the organisation. 17 John Street DS0000024078.V334499.R01.S.doc Version 5.2 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 Standard No Score 1 3 2 4 3 x 4 3 5 3 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 4 26 4 27 4 28 4 29 4 30 4 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 x 4 x LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 4 4 4 4 4 x 4 x 17 John Street DS0000024078.V334499.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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 17 John Street DS0000024078.V334499.R01.S.doc Version 5.2 Page 25 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 17 John Street DS0000024078.V334499.R01.S.doc Version 5.2 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. 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