Inspection on 30/07/07 for 2 Emily Jackson

This inspection was carried out on 30th July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

2 Emily Jackson 06/12/05

2 Emily Jackson 24/08/05

2 Emily Jackson 21/10/04

2 Emily Jackson 07/05/04

Similar services:

Thorndene

Sutton Lodge Nursing Home

Wingham Court

Bethany Lodge

17 John Street

Red Oaks

Clare House Nursing Home

Broad Oak Manor Nursing Home

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

CARE HOME ADULTS 18-65 2 Emily Jackson Eardley Road Sevenoaks Kent TN13 1XT Lead Inspector Geoff Senior Key Unannounced Inspection 30th July 2007 10:00 2 Emily Jackson DS0000023882.V345929.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 2 Emily Jackson DS0000023882.V345929.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. 2 Emily Jackson DS0000023882.V345929.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 2 Emily Jackson Address Eardley Road Sevenoaks Kent TN13 1XT 01732 457284 01732 457284 Emily.Jack2on@theavenuestrust.co.uk glebe.house@theavenuestrust.co.uk The Avenues Trust Limited 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) Mrs Michelle Kim Louise Butler Care Home 6 Category(ies) of Physical disability (6) registration, with number of places 2 Emily Jackson DS0000023882.V345929.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 6 People with a physical disability may also have a learning disability Care of one Service User over 65 years of age is restricted to one Service User whose date of birth is 31/03/1938. The Manager must be allocated a minimum of 20 hours per week to undertake management duties Date of last inspection Brief Description of the Service: 2 Emily Jackson Close was purpose built in 1995 to provide accommodation for six service users with learning disabilities and physical disability. It is currently managed by The Avenues Trust Ltd who manage a number of care homes and social care services in the South East of England. Accommodation is single storey and consists of six single bedrooms with ensuite shower and toilet facilities. All bedrooms have a TV point. Day space consists of a lounge and separate dining room and there is a sensory room. There is an accessible rear garden laid to lawn and a patio area. The home is situated in a quiet residential area within walking distance of Sevenoaks town centre and main transport systems. There is limited on site parking. The home’s current fee scale ranges from £1093.39 to £1773.48 per week. Additional charges include: Hairdressing £10-£25, Professional Massage £25 per hour, Toiletries Varies, Magazines-Varies, Holidays - individual, Transport 15p per mile. 2 Emily Jackson DS0000023882.V345929.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit undertaken on 30th July 2007 between 10 am and 4pm. Discussions were held with management and support workers and, to a more limited degree, with the service users. Judgements were based in conversations, direct observations and reference to documentation. Additional information was gained from telephone discussion with service user parents after the visit and from the Quality Assurance Assessment completed by the manager. Not all the NMS were inspected at this visit. Key standards were looked at and two recommendations are made. These relate to the environment and staffing. The findings are contained in the text of the report. What the service does well: What has improved since the last inspection? The manager and staff team look to innovate and further develop the service. Active Support has increased involvement and levels of engagement. 2 Emily Jackson DS0000023882.V345929.R01.S.doc Version 5.2 Page 6 The home has responded positively to the findings of the last report, Issues identified have been fully addressed or are in the development planning. 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. 2 Emily Jackson DS0000023882.V345929.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 2 Emily Jackson DS0000023882.V345929.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): 2 Quality in this outcome area is good. The home endeavours to ensure that individual needs and aspirations are assessed, monitored and addressed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The current resident group have lived at the home for over six years. The needs of the service users are monitored on an ongoing basis. There are indications that the changing needs of individuals are catered for, including the acquisition of equipment and modifications to improve safety and access in and around the house. There is a good staff programme to encourage development of the skills required to deliver appropriate support. The management and staff team have developed awareness and introduced aids to promote communication for those who have difficulty expressing their needs and wishes. The service reported good links with the community healthcare professionals. 2 Emily Jackson DS0000023882.V345929.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. Quality in this outcome area is good, Service user plans identify the support needs of the service users and the home ensures that healthcare needs are addressed. Service users are enabled to make decisions affecting their daily lives. Risks are assessed positively. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has reasonably well-structured and informative service user files. The needs of the individual are identified as well as the action required by staff to support residents. Care plans are reviewed on a regular basis and information from key workers and from team meetings is used to further develop support plans. The home has a system of risk management and assessment in place to address issues and promote independence of the 2 Emily Jackson DS0000023882.V345929.R01.S.doc Version 5.2 Page 10 service users. Guidance is developed to ensure staff minimise any potential risks and assessments are regularly reviewed. There is evidence in documentation and observation that service users are facilitated to make decisions affecting their daily lives with regard to routine, activities and food choices amongst other things. A positive ethos of sharing and involvement has been developed within the house. 2 Emily Jackson DS0000023882.V345929.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): 12,13,15,16,17. Quality in this outcome area is good. The home provides a range of therapeutic and leisure activities based on personal needs, wishes and interests. Family and friends are welcome to visit the home and contact with the local community is well maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff in the home have worked positively with the service users to establish interests, likes and dislikes. They are supported by the organisation to provide a wide range of formal and informal activities and events for recreational and therapeutic purposes. These include a number of day centre venues, hydrotherapy pools, various trips out and the opportunity for fully supported holidays. Photos of service users participating in activities are on display and serve as reminders and as an aid to communication. It was reported that 2 Emily Jackson DS0000023882.V345929.R01.S.doc Version 5.2 Page 12 additional staff have been recruited who can drive the minibus and staff rotas have been adjusted to accommodate attendance at late finish evening clubs. The Manager and staff have fostered a positive and active culture in the home. Family and friends are welcome to visit and staff maintain contact with significant others to update them on progress and changes. The menu offers a varied and wholesome variety of meals, with ample fresh fruit and vegetables. These are tailored to the specific that those living here like and dislike. Specialist diets are catered for, with specially adapted crockery and cutlery to assist those as required and PEG feeding. Due to nil by mouth alternative activities are planned at mealtimes for those who receive their nutrition through the PEG feed in a dignified and appropriate manner. Clear support and guidelines for assisting individuals are in place, that are personal, respectful of preferences and special support needs to make mealtimes an enjoyable time. Service users are supported to be involved in write shopping lists, purchase foods locally and be involved in the preparation and cooking of foods to the best of their ability. 2 Emily Jackson DS0000023882.V345929.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): 18,19,20. Quality in this outcome area is good. The health, social and personal care needs of those living here are well supported with regular contact with specialists and external professionals. The Service users are treated with genuine respect and dignity by care staff and are protected by robust medication procedures This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users are treated with dignity and respect and levels of privacy are maintained. All of the service users require assistance with aspects of personal hygiene and care. The organisation ensures that staff are instructed and supervised to provide this thoughtfully and sensitively. Each service user has a health action plan for recording, monitoring and communicating matters relating to the individual. It was reported that the home has developed positive relationships with the local healthcare professionals who provide a good level of support. Additional equipment and 2 Emily Jackson DS0000023882.V345929.R01.S.doc Version 5.2 Page 14 facilities are assessed and provided where service users have had changing levels of need. Each has an en-suite shower or choice of bath or spa bath. All staff involved in the handling and administration of medication are trained and are subject to an annual assessment and top up training. The home uses a Monitored Dose System of medication. Storage is adequate for the needs of the home and records were clear and up to date. 2 Emily Jackson DS0000023882.V345929.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): 22,23. Quality in this outcome area is good. Systems are in place to enable those living and those visiting the home to raise concerns or complaints with staff and people they trust. Protection from abuse is promoted through staff training and understanding of the support and actions they may need to take This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a clear complaints procedure both in written and audio formats. Due to the nature of the service and those living here, using this system is limited. It is evident that the majority would be heavily reliant on a relative/ advocate/staff to identify concerns and raise them on their behalf. Feedback from relatives indicated an awareness of the procedure and an assurance that they would be comfortable raising concerns with the management if need be. The home’s records indicate they have not had any formal complaints. The home does hold a compliment book with a number of positive entries. Staff spoken with indicated a good understanding of how to protect the vulnerable and prevent abuse, including reporting under local procedures. 2 Emily Jackson DS0000023882.V345929.R01.S.doc Version 5.2 Page 16 There are no current Adult Protection alerts regarding this home. Due to disabilities experienced by the service users, adaptations, bedsides and brackets are used to support service users in bed. Full assessment of such restraint is undertaken within multi disciplinary process to ensure restraint is use in the best interest of the service user and their well-being. 2 Emily Jackson DS0000023882.V345929.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): 24,30. Quality in this outcome area is good. Service users live in a clean, comfortable and homely environment, to suit their needs and lifestyles This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is a purpose built bungalow, well presented, and bright, with adequate internal space and equipment for those requiring full physical care. There are good standards of hygiene and cleanliness. The dining room and communal areas are light and airy. The dining area has a high table to allow for wheelchair users. 2 Emily Jackson DS0000023882.V345929.R01.S.doc Version 5.2 Page 18 Individual bedrooms have been decorated to the needs and tastes of the occupant and contain their personal possessions. All bedrooms have en suite shower facilities. It was noted at the last inspection visit that: ‘En-suites are in need of redecoration and action taken to ensure seals around the flooring and ceiling are effective. Wallpaper currently here has become stained yellow with the chemicals used when cleaning and in a number of cases slitting and peeling away from the wall. One en-suite wall was badly damaged due to the shower trolley in use and requires some creative tiling to minimise further damage.’ This has, in the main been addressed although one en-suite remains in need of upgrading/repair (worn flooring, stained sealant on WC and rusty feet on WC frame. There is also one communal bathroom with a bath, bath hoist with weighing scales, storage and call bell. Service users have the use of a lounge that is comfortably furnished and has a TV, video, DVD, and music centre. There is also a small sensory area. The kitchen has been refurbished as part of the ongoing maintenance schedule for the home. New tiling and appropriate height worktops fitted to enable client participation. 2 Emily Jackson DS0000023882.V345929.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 adequate The home maintains an adequate level of staff to safely support the service users. There is a good staff induction and development programme for new and established permanent staff. Service users would benefit from a stable staff team established through continued positive recruitment to the vacant positions and NVQ training This judgement has been made using available evidence including a visit to this service. EVIDENCE: It was confirmed that written references are sought and all staff are CRB and POVA checked prior to commencement of duties. Further to observations noted at the last inspection the management has endeavoured to recruit staff to permanent positions and address the issue of drivers for the minibus. This has had some success but a number of vacancies remain. Bank and agency staff 2 Emily Jackson DS0000023882.V345929.R01.S.doc Version 5.2 Page 20 cover the shortfalls. They are inducted and supported and offered supervision in the same way as permanent staff as well as attending house meetings. The manager needs to ensure that, due to complex needs of the service users and H&S requirements when moving and lifting, the staffing levels at all times are such that the opportunities for choice are not compromised. (eg Day activities and choice of bed time). Avenues offer staff a good development programme. There is a comprehensive induction process that all staff are supported to work through. Staff receive regular role specific and statutory training updates throughout their employment. The manager reported that currently three the staff supporting service users have attained NVQ level 3; two are working towards level 2. This ratio does not meet the expectations of the NMS but the Manager is aware and encourages new staff to apply as soon as they have completed their probation period. 2 Emily Jackson DS0000023882.V345929.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): 37,39,42. Quality in this outcome area is good. The manager has fostered an open and positive environment in which the health, safety and welfare of all is promoted and protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Registered Manager presents as an experienced and well informed individual. She has attained NVQ level 4 Care and Management and is currently working towards the RMA. An open and positive ethos has been fostered in the home enabling staff, relatives and service users to feedback about the service. Relatives spoken with after the visit confirmed that the 2 Emily Jackson DS0000023882.V345929.R01.S.doc Version 5.2 Page 22 management and staff ensure that they are kept up to date with progress and developments. Monthly monitoring visits are carried out by senior managers to the home. These ensure that the standard of care and relevant documentation is maintained and that the premises are in good order. The health, safety and welfare of the service users, staff and visitors to the home are well maintained in all areas. Staff receive necessary induction and training into the service supported by a range of policies and procedures which are reviewed and updated as required 2 Emily Jackson DS0000023882.V345929.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 x 2 3 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 3 25 x 26 x 27 x 28 x 29 x 30 2 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 2 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x 2 Emily Jackson DS0000023882.V345929.R01.S.doc Version 5.2 Page 24 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. 1 Refer to Standard YA35 Good Practice Recommendations It is strongly recommended the organisation continue to work hard in recruiting to the current vacant posts, and ensure the ratio of NVQ trained staff meets the expectations of the NMS en-suite bathrooms - agreed works to address seals to wall and toilet surrounds, replace worn flooring and rusty feet on WC frame. To completed to a satisfactory standard to promote good infection control and cleaning. 2 YA30 2 Emily Jackson DS0000023882.V345929.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 2 Emily Jackson DS0000023882.V345929.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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