Inspection on 05/01/06 for 2 Beacon Road

This inspection was carried out on 5th January 2006.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

2 Beacon Road 25/10/07

2 Beacon Road 27/07/06

2 Beacon Road 22/07/05

2 Beacon Road 23/11/04

2 Beacon Road 11/06/04

2 Beacon Road 29/02/04

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 2 Beacon Road 2 Beacon Road Herne Bay Kent CT6 6DH Lead Inspector Kim Rogers Unannounced Inspection 5th January2006 11:10 2 Beacon Road DS0000023137.V258816.R01.S.doc Version 5.0 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 2 Beacon Road DS0000023137.V258816.R01.S.doc Version 5.0 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. 2 Beacon Road DS0000023137.V258816.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 2 Beacon Road Address 2 Beacon Road Herne Bay Kent CT6 6DH 01227 360334 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) Care Management Group Limited Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 2 Beacon Road DS0000023137.V258816.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd July 2005 Brief Description of the Service: 2 Beacon Road is a detached bungalow set in a residential road of Herne Bay. The Home provides 24-hour residential care and support to three adults with learning disabilities. Part of the Home is separately registered as an annexe for one person. The Home is owned and run by the Care Management Group. Accommodation is over two floors. Stairs access the first floor. All bedrooms are single with wash hand basins. The Home has a lounge, dining room, kitchen and three bedrooms. There is a duty office which doubles as staffs sleep in room. The Home has parking and garden to the front and a garden to the rear. Local shops and the sea front of Herne Bay are nearby, as are bus stops and Herne Bay railway station. 2 Beacon Road DS0000023137.V258816.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and carried out during the day on a Thursday by one Inspector. One service user was at the home during the visit. The Inspector spoke to the service user, staff on duty and the manager. The Inspector had a look around the home and looked at some records. The home was clean and orderly on the day of the visit. There was one staff on duty with one service user and one other service user from the attached home. The manager Audrey Emmett is the manager of the home, the attached home for one service user and a neighbouring home. Mrs. Emmett has applied to the Commission to become the Registered Manager. Most of the requirements from the last inspection have been met. Improvements needed to the bathroom remain outstanding. Staff said they have applied for corporate funding for the alterations. Service users appeared relaxed and happy and said they continue to like living at 2 Beacon road. The staff provide the care and support service users need in a pleasant environment. Staff said ‘This is an enjoyable place to work’ ‘The service users are fully involved’ What the service does well: The home supports service users relationships with families and friends. Staff benefit from good leadership and clear direction. Staff support each other in their roles at this home. The service user appeared happy and relaxed and continues to be happy living at the Annexe. Service users have opportunities for personal development including further education, social and leisure activities. Staff have awareness of the importance to maximise and promote independence as well as support decision making. The induction of new staff is comprehensive detailing how competency is assessed and is accredited to the Learning Disability Awards Framework. 2 Beacon Road DS0000023137.V258816.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? 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. 2 Beacon Road DS0000023137.V258816.R01.S.doc Version 5.0 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 2 Beacon Road DS0000023137.V258816.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3,5 Service users know their needs will be assessed. Service users know this home will meet their needs and aspirations. Service users are aware of the terms and conditions of their stay. EVIDENCE: No service user has moved into this home since the last inspection. The Inspector sampled a service user plan (care plan), which included a detailed assessment of the persons needs. There was also an assessment of potential risks. The standards emphasise the importance of this assessment as it forms the basis of the service user plan. Each service user is issued with a contract detailing the terms and conditions of their stay. The fee is included which is broken down. The service user and a representative from the home signed contracts seen. Contracts are presented with some symbols included making them more accessible to some service users. Staff go through an ‘induction checklist’ with service users when they move in. This ensures service users are given the information they need about the service and facilities on offer. The staff spoke with knowledge about the importance of promoting choice and empowering and supporting service users to make decisions. 2 Beacon Road DS0000023137.V258816.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9,10 Service users know their personal goals will be identified, recorded and supported. Service users are supported to make decisions about their lives. Service users know that potential risks will be managed and supported. Service users know that information about them will be kept confidential. EVIDENCE: Each service user has a service user plan. The Inspector sampled a service user plan, which is developed from the initial assessment of needs. Potential risks were assessed and recorded with interventions by staff to reduce these risks. Service users sign up to these risk assessments. Service users are supported to take risks as part of an independent life. Specialist support needs are recorded with actions by staff to support these needs. Any restrictions on choice and freedom made in the service users best interest are detailed. Specialist support guidelines are in place and approved where necessary. Service users had signed the plans sampled. All service users have a named 2 Beacon Road DS0000023137.V258816.R01.S.doc Version 5.0 Page 10 key worker. Key workers record monthly updates and reviews. The Inspector saw evidence of formal reviews being held six monthly. Service users are supported to involved in the preparation for reviews. Care manager, friends and family members are invited to reviews. The Inspector spoke to the staff member involved who spoke with awareness of promoting and maximising independence. The Inspector heard examples of service users being supported to make decisions about their lives. All information about service users is held securely. The staff office is kept locked when unattended. This home complies with the 8 principles of the Data protection Act 1998. 2 Beacon Road DS0000023137.V258816.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,14,15 Service users know they will have opportunities for personal development. Service users take part in various activities. Service users relationships are supported. EVIDENCE: Service users are offered the opportunity to access a wide range of further education courses. The staff have developed links with various local colleges and adult education centres. Two service users were out on the day of the visit. Information about leisure activities is recorded in service user plans. Some service users are supported to attend a local church and some go with friends. A weekly in house session is held aimed at developing life skills. Service users have the opportunity to participate in and enjoy various leisure activities. Service users have been abroad since the last inspection for their annual holiday. 2 Beacon Road DS0000023137.V258816.R01.S.doc Version 5.0 Page 12 Staff have access to vehicles which are used to access community facilities. One staff member is allocated to support service users with travelling to and from college and gives any necessary support at college. Service users hobbies are encouraged. Service users friends and family are recorded in service user plans. Relationships are supported by the home. Some service users stayed with family and friends over Christmas. Visits to family and friends at weekends are supported. Friends and family members are invited to attend review meetings of the service user chooses to invite them. 2 Beacon Road DS0000023137.V258816.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 Service users know their personal care needs will be met. Service users health needs are met. EVIDENCE: Since the last inspection the Inspector made an announced visit with a Pharmacy Inspector to look at Standard 20 relating to medication practices. Some requirements and recommendations were made which the Deputy manager said have now been addressed and changes implemented. Details of the outcome of this visit made on 16/11/05 can be viewed on request at the Ashford office of CSCI. Service users personal care needs are recorded in service user plans. This includes details of how a person prefers to be supported. Most service users need minimal support with personal care. Staff spoke with awareness about promoting and maximising independence with personal care. 3 service users share on first floor bathroom. The bathroom requires improving which is detailed under standard 27 of this report. There is a standard bath installed with two grab handles as part of the bath. Staff said that some of the current service users have difficulty getting in and out of the bath so staff have submitted a request to their head office for funding for an adapted bathroom 2 Beacon Road DS0000023137.V258816.R01.S.doc Version 5.0 Page 14 more suitable to the service users needs. In the meantime the bathroom is in need of cosmetic improvement. All service users have a named key worker who carries out monthly reviews of service user plans. All service users are registered with a GP. There were records of regular checks with dentist’s, opticians and chiropodists. Health is monitored in service user plans. The Inspector was satisfied that service users have access to a full range of medical and healthcare support and advice. Staff act as ‘health facilitators’ as required by the government white paper ‘Valuing People’ The Inspector noted that ‘Health Action Plan’ booklets produced by the Department of Health were included in 2 service users files seen but were not completed. The Government target as stated in Valuing People is that all service users have a health action plan by the end of June 2005. The Inspector recommends that the manager give thought to this. 2 Beacon Road DS0000023137.V258816.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Service users know their complaints will be listened to. Service users are protected from abuse. EVIDENCE: The home has a complaints procedure. This is included in the homes Statement of Purpose and service user guide. This is service user friendly with the addition of pictures and photographs of people service users can complain to. The home not the Commission has received no complaints since the last inspection. When asked the service user said he would report any complaint to Audrey. (The Manager) The home has an adult protection policy and whistle blowing policy. Staff initially learn about how to protect vulnerable adults during their induction. Courses are then offered on a rolling programme. The home has a copy of the Kent and Medway joint policy on adult abuse. Any necessary guidelines about supporting service users who may be aggressive are included in service user plans. These are based on positive approaches and good practice and showed regular review. Staff are aware of who they would report any suspicions or concerns to. 2 Beacon Road DS0000023137.V258816.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,27,28,29,30 The home is comfortable. Improvements to the bathroom will enhance service users lives. Shared space meets service users needs. The home is clean. Thought should be given to planning for any necessary adaptations for service users. EVIDENCE: The home has a lounge/diner and a kitchen. There is one bedroom on the ground floor with two bedrooms, a bathroom, WC and staff sleep in room on the first floor. All three bedrooms are for single occupancy and have wash hand basins. There is new lino in the WC. As noted at the last inspection the bathroom is in need of improving. One tap was leaking as noted at the last inspection. The maintenance man was at the 2 Beacon Road DS0000023137.V258816.R01.S.doc Version 5.0 Page 17 home during the visit and tightened up this tap. He said he has tightened the tap on a previous occasion. There is peeling paint on the wall around the window and the paint on the walls is tatty. For example a towel rail has been removed but the wall not made good. There are no grab rails on the walls. The bath is a standard bath with two handles. The bathroom appears cold and unwelcoming. There is no individual control on the bathroom radiator and no lampshade. Thought must be given to adapting the bathroom due to the needs and age of the current service users. Staff said that some service users have difficulty getting in and out of the bath. Staff said they have applied to their head office for funds to improve the bathroom so the facilities are more suited to service users needs. A requirement was made to improve and up date the bathroom at the last inspection. However, no redecoration has been carried out to the bathroom. The Inspector understands that adapting the bathroom to meet the increasing needs of the service users will be part of a longer-term development plan for the home. In the short term, the bathroom should be cosmetically improved as far as possible to enhance service users lives. The Inspector will monitor progress towards meeting this requirement. Both the WC and bathroom have had new locks fitted since the last inspection. The home was clean and tidy and felt comfortable. New sofas and dining room table and chairs have been provided since the last inspection. The guttering and fascia boards have been replaced enabling service users to access the garden safely. The home is in keeping with the properties on the area and has off street parking and gardens to front and rear. 2 Beacon Road DS0000023137.V258816.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,35 Service users are supported by competent staff who are aware of their roles and responsibilities. Staff are well trained and most are qualified. Detailed induction of new staff ensures that competent staff support service users. EVIDENCE: The Inspector spoke to the member of staff on duty who was aware of their role and responsibilities. Line management at this home is clear for staff. Staff are given a copy of the General Social Care Councils guidelines for care staff. The Inspector observed staff supporting service users in a respectful manner. Interactions were positive and appropriate. Staff and the Manager spoke with knowledge and understanding of service users needs. Staff are deployed to meet the needs of the service users. There is generally one staff on duty. The Deputy Manager oversees the staffing with extra staff available when necessary. The staff team are both male and female and there are no current staff vacancies. The Inspector looked at the induction record for a new member of staff. The staff had attended a one-day induction course held at a local college as well as completing the homes induction with a senior staff as a mentor. The homes induction is accredited to the Learning Disability Awards Framework. The member of staff had given written answers to set questions 2 Beacon Road DS0000023137.V258816.R01.S.doc Version 5.0 Page 19 which are signed off by a senior staff. The Inspector questioned some of the answers given with the manager. The manager assured the Inspector that these answers were discussed with the member of staff and more training given where necessary. The Inspector saw the training matrix. Training is planned around the needs of service users. The Manager has identified shortfalls in training and planned relevant courses. Some staff are working towards a National Vocational Qualification. 2 out of 5 staff have completed this award. The training and induction provided ensures that competent staff support service users. 2 Beacon Road DS0000023137.V258816.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,41,42 This home is well run. Service users benefit from a clear, supportive management structure. Records are up to date and in order. Service users know their health and safety is protected. EVIDENCE: Mrs. Audrey Emmett is the Manager of the home and plans to apply to the Commission to be the Registered Manager. Mrs. Emmett was previously a Registered Manager at another Care Management Group home in Kent. Mrs. Emmett transferred to 2 Beacon Road, the Annexe and a neighbouring home at the beginning of July 2004. Mrs. Emmett has several years experience and has completed the City and Guilds Advanced Management in Care Award. 2 Beacon Road DS0000023137.V258816.R01.S.doc Version 5.0 Page 21 Mrs. Emmett plans to consolidate her experience and qualifications with the completion of the required National Vocational Qualification in care at Level 4. Mrs. Emmett is currently working towards this award. A Deputy manager and team leaders support the manager. The Deputy manager is also working towards the required manager’s qualification. The manager said that the company- the Care Management Group is supportive and that she has regular meetings with an area manager. There is a new area manager in post since the last inspection. Staff have regular one to one meetings with the manager or deputy and regular staff meetings and daily handovers are held. Records required were available to the Inspector. Records were up to date and in order and held in line with the Data Protection Act 1998. The Inspector checked some records relating to health and safety issues including the fire log book. Records showed that regular fire checks and drills are held. Regular health and safety audits are also carried out. Staff attend health and safety training during their induction then on a rolling programme. The Inspector looked at the records of incidents in the home and discussed some of the recorded incidents with the manager. The manager said that as far as she was informed two incidents did not happen as they were recorded. The manager said she was unaware of one the incidents recorded in August 2005. One incident report was not dated or signed. No incident had been reported to the Commission. A requirement was made that all incidents are recorded and reported appropriately. The Inspector recommended that ‘action taken to prevent further occurrence’ be added to the pro forma used. There is a business and financial plan for the home. There is planning in place for human resources and training. The home has the required public liability and other insurance. A senior manager conducts monthly visits to the home, speaks to service users and staff and produces a report. The Commission have been supplied with copies of these required reports. There are clear lines of accountability. 2 Beacon Road DS0000023137.V258816.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 3 X 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X 2 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 X 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score 3 2 X X 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 2 Beacon Road Score 3 3 X X Standard No 37 38 39 40 41 42 43 Score 2 3 X X 3 2 3 DS0000023137.V258816.R01.S.doc Version 5.0 Page 23 Yes 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 2 Standard YA42 YA27 Regulation 37 12 Requirement All incidents must be recorded and reported appropriately. The bathroom must be updated and improved to meet service users needs. NOT MET. Timescale for action 28/02/06 30/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard YA19 YA37 YA32 Good Practice Recommendations The manager should give thought to implementing health action plans for all service users. The manager should complete NVQ level 4 in care At least 50 of care staff should be qualified to level 2 NVQ 2 Beacon Road DS0000023137.V258816.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 2 Beacon Road DS0000023137.V258816.R01.S.doc Version 5.0 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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