Inspection on 18/10/05 for 239 Boxley Road

This inspection was carried out on 18th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

239 Boxley Road 30/11/07

239 Boxley Road 19/12/06

239 Boxley Road 14/06/05

239 Boxley Road 08/10/04

239 Boxley Road 26/04/04

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

CARE HOME ADULTS 18-65 239 Boxley Road Maidstone Kent ME14 2BG Lead Inspector Lynnette Gajjar & Justine Williams Unannounced Inspection 18th October 2005 12:15p 239 Boxley Road DS0000023869.V256105.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 239 Boxley Road DS0000023869.V256105.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. 239 Boxley Road DS0000023869.V256105.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 239 Boxley Road Address Maidstone Kent ME14 2BG 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) 01622 764979 01622 686457 yes.oshea@invitanet.co.uk Mrs Lorna O`Shea Mr Sean O`Shea Mrs Linda Sharon Cochrane Care Home 10 Category(ies) of Learning disability (10) registration, with number of places 239 Boxley Road DS0000023869.V256105.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th June 2005 Brief Description of the Service: 239 Boxely Road is a detached property in Maidstone. The home is situated on the outskirts of Maidstone town centre with easy access to public transport. The home is registered to provide 24-hour care to adults 18 – 65 years who have a learning disability. Boxely Road statement of purpose promotes their aims to offer support and advice to teach adults with a Learning Disability to achieve personal independence to the best of their abilities. Resident’s private accommodation is mainly on the first and second floors currently consisting of 7 single rooms (two of which have en-suite facilities) and one double room. These floors are accessible by stairs and the home does not have a lift. The ground floor accommodates the kitchen, dining room, laundry area, staff office, main lounge, small private room and one ground floor bedroom. Plans are in hand to make all room single in the near future. The home has a small garden and garage, with car parking for two cars. There is road parking in the streets around the home but this is restricted to two hours. 239 Boxley Road DS0000023869.V256105.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the second in the year running from April 1st 2005 to March 31st 2006. The inspection took place on 18th October 2005 and the visit lasted from 12:15 to 15:15pm. The home currently has eight residents and is running with two vacancies. However all rooms are currently being used as single bedrooms with plans to convert the top floor into two single bedrooms rather than one. Keeping the registration to 10. Plans have not been submitted to the commission for agreement. Time was spent speaking with three residents collectively and privately, staff, the manager and service manager. The home was clean and comfortable. Concerns regarding one bathroom had escalated since the last inspection with more tiles being removed to address the damp problems. However this has not been successful and the ground floor bathroom has a very strong damp odour and not pleasant to be in for short periods of time. Documentation was on the whole in good order and the requirements and recommendations from the previous inspection had been implemented. Residents were relaxed and happy with both staff and the inspectors. What the service does well: What has improved since the last inspection? 239 Boxley Road DS0000023869.V256105.R01.S.doc Version 5.0 Page 6 Risk assessments and care plans continue to develop ensuring residents safety, whilst allowing opportunities to grow and be independent. The recommendations made for developing safer medication practice, has been implemented by the manager and staff. Plans are being discussed to convert the top room into two single rooms with en-suite to enable all bedrooms at the home to be for single occupancy and no longer have a shared bedroom, offering residents more privacy and personal space. Two residents have moved on to live with out 24-hour care, in supported housing in the local community. Residents continue to benefit from having a stable management team who work well together to promote open and resident led service. 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. 239 Boxley Road DS0000023869.V256105.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 239 Boxley Road DS0000023869.V256105.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): 1,4 Residents are given all the information and opportunity to test-drive the home before making a decision to live at 239 Boxely Road. EVIDENCE: Residents openly discussed the new residents induction to the home and current trial living arrangements. Residents were consulted on the new resident moving in and all expressed how they knew them before they moved in and how nice it was having her here. There are ongoing reviews with care management and the resident at present before a final decision is made whether to continue to live at the home. As to whether this meets their aims and aspirations for the future. There have been no changes to the homes statement of purpose and resident guide since the last inspection. Continuing to offer clear information about the services provided. These are in both written word and object reference pictorial formats. 239 Boxley Road DS0000023869.V256105.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): 6,7,8,9 Resident’s have a real sense of ownership about their home and trust that staff maintains their confidences. Residents feel they are involved in making decisions about their lives. Care plans and risk assessments continue to develop to keep residents safe, whilst allowing opportunities to grow and be independent. EVIDENCE: Two individual care plans were inspected. Goals and care needs have been expanded to be clear and in appropriate language. Those seen are monitored and regularly reviewed. Further work is evolving to try to make a simple care plan that can be followed by the residents. All of the residents continue to lead busy lives, which present challenges, risks and the opportunity to make mistakes. Increasing independence is a key aspect of the home’s aims for its residents. Two residents have recently moved on to live locally through the supported living scheme, offering more independence and personal achievement. 239 Boxley Road DS0000023869.V256105.R01.S.doc Version 5.0 Page 10 Residents feel they are involved in decision about their home ands lifestyle. This is very evident through individual preference, activities and wishes determining mealtimes, menus, holiday venues, décor and activities. Residents discussed recent holidays to Butlins at Bognor Regis with staff and friend as well as another going to Spain with their family. The inspector observed close, positive interaction between staff and residents, enabling residents to feel genuinely liked and respected. Close working is identified and encouraged through the adult advocacy support. 239 Boxley Road DS0000023869.V256105.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): 11,12,13,14,15,16,17 Resident’s access a wide and varied range of leisure, work and education opportunities within the local community offering personal development and high self esteem EVIDENCE: Specific hobbies and interests of individuals are identified and they are supported to follow these at a pace suitable to them. The home has plenty of leisure equipment and resources within the lounge and quiet room. There are three communal rooms enabling people to choose whether to be alone or join in with the others. Shops and pubs are within walking distance and the town of Maidstone is easily accessible by public transport and car, therefore leisure centres, cinemas and restaurants are easily visited. Residents talked to the inspector about aspects of their lives that were important to them including, “going to work, college and adult education classes”, “seeing my boyfriend/girlfriend” “ going to visit my family” and “going on holiday ”. Residents enjoy additional outings provided by the outreach support staff. 239 Boxley Road DS0000023869.V256105.R01.S.doc Version 5.0 Page 12 239 Boxley Road DS0000023869.V256105.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): 19,20 Residents are supported with appropriate health care. Residents are safe through good medication practice and development of written protocols EVIDENCE: Some residents require more personal care than others. For those that do, care plans clearly detail how and under what circumstances this support should be delivered. Staff spoken to demonstrated a sound understanding as to how they would ensure privacy and dignity at such times although through discussion with residents they did not always feel this happened in practice. Referrals to behavioural therapist have been successful for one resident with support booked to assess and work together in meeting their personal need. At present, no residents control and administer their own medication. All recommendations made at the last inspection relating to medication practice have been reviewed to put new systems in place to improve administration. Development of the homes procedures: for visits/holidays, dispensing method on blister pack files has not been resolved with Boot Chemist but is ongoing to achieve. 239 Boxley Road DS0000023869.V256105.R01.S.doc Version 5.0 Page 14 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 Residents have ample opportunities to express their views. They feel they are listened to, valued and concerns acted upon. Clear procedures are in place to ensure residents are protected from abuse, neglect and self – harm. EVIDENCE: Residents are confident in expressing their own views, suggestions, and concerns, through the culture that exists within the home, particularly towards the proprietor. Residents know how to complain if they are unhappy about anything. Residents were seen directly to raise concerns to the manager and being supported to achieve a satisfactory resolve. The home implements clear and specific guidance for staff and external training courses are accessed. These measures and the use of clear risk assessments, protect residents, staff and visitors from abuse and accusations. Residents stated they felt safe and secure at the home and locally from both staff and peers support. 239 Boxley Road DS0000023869.V256105.R01.S.doc Version 5.0 Page 15 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): 24,25,27,30 Residents live in a clean and homely environment. There is ample private bedrooms and communal space, accessed and enjoyed by all. Work must take priority to address the damp and infection control issues in the ground floor bathroom and toilet, to offer a safe, clean and pleasant bathing facility. EVIDENCE: The home is spacious and regularly maintained. All bedrooms are used as single and are personalised in accordance with the occupant’s wishes. All residents can lock their bedroom doors, with a number bringing in their own furniture and possessions when they first moved in. Residents have moved bedrooms at their choice since vacancies have occurred to meet their individual needs. Rooms are redecorated and new furnishings are purchased as they are required. Communal areas include a large kitchen – completely refurbished, dining room, lounge, quiet room and a small rear garden. All of these areas are accessible to everyone. 239 Boxley Road DS0000023869.V256105.R01.S.doc Version 5.0 Page 16 Bathrooms are in need of an upgrade and attention due to heavy staining of toilets and damp issues. Particular attention must be given priority to the ground floor bathroom that has strong offensive damp odour (that has increased since the last inspection) but also broken, lost tiles/splash back, exposed piping and broken vanity unit glass surface. This is of concern due to the communal sharing of the bathroom and effective infection control management. Residents spoken with all preferred to use this bathroom due to the shower facility and were very unhappy with the smell “ it stinks, I try not to stay to long in there”. The home has proposals to adapt the second floor flat to, two single rooms with en-suite facilities to enable the current double bedroom to become a single but the home continuing to offer care for 10 residents. This is planned for later this year. All residents are currently living in single bedrooms. The conservatory has been upgraded and new sink installed due to the washing machine being located here. All parts of the home are open and accessible to all the residents, except their private rooms and the office. 239 Boxley Road DS0000023869.V256105.R01.S.doc Version 5.0 Page 17 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): 32,33,34 Clear lines of accountability and responsibility are followed and residents know exactly who to talk to. Staff would benefit from their induction being developed to that recommended by the skills sector for all staff working in adult social care. EVIDENCE: New staff files were seen. This held all information required to promote safe recruitment practice. Including the beginning of the organisations induction forms. Discussion took place regarding the latest guidelines from the skills sector regarding 12-week recorded induction for all staff working in adult social care. The managers felt this would be a good package to explore with the proprietors. New training programmes are currently being devised using external training bodies. Staff on duty today had a good understanding of individuals care needs and interacted in a professional but familiar manner. 239 Boxley Road DS0000023869.V256105.R01.S.doc Version 5.0 Page 18 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): 37,38,42 Resident’s personal preferences, support and care needs are encouraged through the registered manager and service managers open leadership and the promotion of a safe home and working environment. EVIDENCE: The registered manager has worked with this resident group for many years and is nearing completion of the Registered Managers Award NVQ 4. Residents and staff expressed a satisfaction towards the management approach to the home. Residents felt the registered manager was approachable and staff feel well supported. The registered manager and service manager demonstrated through discussion, clear understanding of the needs of current residents and current issues. Monitoring health and safety in the home is to a good standard, with regular health and safety walking routes taking place, and equipment serviced as required to maintain a safe home and facilities. Risk assessments continue to develop for individuals and staff activities in the home and care duties. 239 Boxley Road DS0000023869.V256105.R01.S.doc Version 5.0 Page 19 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 3 X X 3 X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 X 1 X X 2 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 3 3 X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 239 Boxley Road Score X 3 2 X Standard No 37 38 39 40 41 42 43 Score 2 3 X X X 2 X DS0000023869.V256105.R01.S.doc Version 5.0 Page 20 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. 1 Standard YA30YA27 Regulation 13(3) Timescale for action The registered person shall make 31/12/05 suitable arrangements to prevent infection, toxic conditions and the spread of infections at the care home. In that: The ground floor bathroom is repaired / upgraded to eradicate the damp smell and issues causing tiles to fall of walls. Toilet basins are replaced due to heavy scaling and staining. Requirement 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 YA6 Good Practice Recommendations It is recommended that care plans are translated in formats that are easiy to understand and follow for DS0000023869.V256105.R01.S.doc Version 5.0 Page 21 239 Boxley Road 2 YA20YA6 3 YA20 individual residents personal needs. There is evidence of this progressing since the last inspection. It is recommended that care plans are developed further to detail residents using inhalers with clear guidance to triggers to look for to indicate hoew much PRN Medication is required : 2-4 puffs. It is recommended for good practice in administration and recording of medicines that:· The medication policy should be reviewed to ensure that it include protocols for medication storage, recording and administration for home visits / holidays, but also to include details of the G.P and Pharmacies.· Reviewing current practice for visit/ holidays must be undertaken to ensure medication is dispensed from original containers and not decanted into alternative pots / bottles.· There is evidence of the home working to address this with the local pharmacist, but this has not yet been fully achieved. One MAR sheet must be reviewed with the G.P to be amended to reflect current practice. 4 5 YA30 YA35 6 YA42 It is recommended that the home seeks support and advice from Kent and Medway Protection of Health Unit, regarding infection control management. It is recommended that 50 of care staff be NVQ2 /3 trained by 2005There was evidence of the organisation continuing to work towards this target. The remains a recommendation from today’s inspection It is recommended that fresh vegetables are not stored in the same area as cleaning materials (the cellar) 239 Boxley Road DS0000023869.V256105.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 239 Boxley Road DS0000023869.V256105.R01.S.doc Version 5.0 Page 23 - 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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