Inspection on 20/09/06 for 248 Brompton Farm Road

This inspection was carried out on 20th September 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

248 Brompton Farm Road 17/03/06

248 Brompton Farm Road 04/10/05

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

CARE HOME ADULTS 18-65 248 Brompton Farm Road 248 Brompton Farm Road Rochester Kent ME2 3NP Lead Inspector Andrea Leverett Unannounced Inspection 20th September 2006 12:00 248 Brompton Farm Road DS0000064374.V314054.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 248 Brompton Farm Road DS0000064374.V314054.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. 248 Brompton Farm Road DS0000064374.V314054.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 248 Brompton Farm Road Address 248 Brompton Farm Road Rochester Kent ME2 3NP 01634 290327 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) The Avenues Trust Limited Jennifer Ann Smith Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 248 Brompton Farm Road DS0000064374.V314054.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th March 2006 Brief Description of the Service: 248 Brompton Farm Road is a care home for adults with learning disabilities. The home is managed and run by Avenues Trust, while the Health Authority owns the property. The home is situated in a residential area of Strood, Rochester and is on a bus route. Strood town centre is approximately two miles away. Local shops are approximately ½ mile away in Wainscott. The Home currently provides care and accommodation for three service users. Leisure facilities are accessed via community resources and adult education. The home has off road parking facilities and a rear garden. 248 Brompton Farm Road DS0000064374.V314054.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place on the 20th September 2006 All three-service users were observed during the visit and 2 staff and the manager were spoken with. Some judgements about quality of life and choices were taken from direct observation of service users followed by discussion with support staff and the manager and viewing evidencing records held at the home. The inspector concluded that the Home has not continued to improve access to the community since the last inspection and this has affected the quality of life and opportunities for service users at Brompton Farm. Improvements to the environment are on going, with service users no longer having to share bedrooms and there are plans to redesign the bathroom and downstairs communal rooms to create more living space for service users. Service users are supported in a respectful and dignified manner and detailed and comprehensive person centred plans are greatly enhancing service users ability to make choices and gain control over their lives. What the service does well: What has improved since the last inspection? The quality of the bedroom environment for one service user has been improved now that the room has been redecorated and partially refurbished. All three-service users now have their own room. 248 Brompton Farm Road DS0000064374.V314054.R01.S.doc Version 5.2 Page 6 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. 248 Brompton Farm Road DS0000064374.V314054.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 248 Brompton Farm Road DS0000064374.V314054.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The quality of service in this outcome group has been judged as good. Service users can be confident that their individual aspirations and needs are assessed and addressed. EVIDENCE: Although no new service users have moved into Brompton Farm Rd for a number of years, all current service users have had their needs comprehensively re-assessed by the new provider, Avenues Trust. These assessments have been followed up by appropriate action such as changes to service users living arrangements, a reduction in the home’s registration from 4 to 3 service users and the planned work to redesign the downstairs living spaces to create more room. The organisation’s admissions policy states that all service users needs would be assessed before a place is offered. 248 Brompton Farm Road DS0000064374.V314054.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8 The quality of service in this outcome area is judged as good. Service users benefit from having Holistic Person Centred Plans, which have been put together with their involvement and take into account their assessed needs, wishes and aspirations. EVIDENCE: A sample of service user Person Centred Plans viewed included holistic profiles, daily routines, a weekly plan, risk assessments, communication systems and health records. Information about service users was presented in a very positive and sensitive style and was easy to understand, comprehensive and detailed. The plans were cross-referenced with the home’s daily records and discussion with staff and the manager evidenced that these were generally followed, although service user plans in terms of community activities were not followed consistently. 248 Brompton Farm Road DS0000064374.V314054.R01.S.doc Version 5.2 Page 10 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): 12,13,15,16,17 The quality of service in this outcome area is judged as adequate. Service users benefit from a staff team that work hard to develop meaning full communication systems, which enables them to seek their views and take their right to make choices seriously. Service users do not always benefit from having access to a range of appropriate leisure activities in keeping with their wishes. Service users benefit from being offered a healthy diet, which respects their needs and wishes. EVIDENCE: Observation during the site visit and assessment and care records seen showed that staff in the home have continued to develop appropriate communication systems with service users. Several pictorial communication boards were seen in use. Discussion with staff and the manager and evidence from daily records showed that community based activities did not always take place as stated in the 248 Brompton Farm Road DS0000064374.V314054.R01.S.doc Version 5.2 Page 11 service users person centred plan. The manager explained that the home had had staffing problems for several months and acknowledged that a significant amount of activities were cancelled. A requirement has been made regarding the need for the home to develop the range and consistency of community activities. The home has it’s own transport for the benefit of service users, which is domestic in character and unmarked. All service users have now had their second annual holiday since the new providers have taken over the management of the Home. An inspection of the home’s kitchen, food storage areas, menu’s and service users assessments in relation to diet were inspected. The inspector was impressed the range of healthy fresh foods provided. Records showed that service users were encouraged to go shopping and help plan and prepare food if this was their wish. Daily records showed that their individual preferences were respected when eating food, for example service users morning routines detailed their preferences in regards to what and how they liked to eat breakfast and records showed that this was happening. 248 Brompton Farm Road DS0000064374.V314054.R01.S.doc Version 5.2 Page 12 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): 18,19,20 The quality of service in this outcome area is judged as good. Service users know they will receive health and personal care and will be supported in a way they prefer and require. Service users benefit from a safe system of medication administration and storage. EVIDENCE: Service users plans included holistic personal and health care assessments and a record of preferred daily routines. The inspector was impressed with the detail of this information and observation on the day indicated that these were being followed. Health records showed that access to routine and specialist health services was being provided. An inspection of the home’s medication storage, administration and record system was undertaken. Medication records were maintained appropriately and medication was stored correctly. Records included staff signatures and detailed Guidelines for administering individual medications. Training records showed that staff are trained to administer medication, although the inspector was unable to establish if the course included all aspects of medication administration and record keeping, was undertaken by a person qualified to do so and whether the training included a competency test. A requirement has 248 Brompton Farm Road DS0000064374.V314054.R01.S.doc Version 5.2 Page 13 been made for the Home to evidence that medication administration training provided by the service meets these requirements. 248 Brompton Farm Road DS0000064374.V314054.R01.S.doc Version 5.2 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 The quality of service in this outcome area is judged as good. Service users know that their views and concerns will be sort and acted upon and they will be protected from abuse and neglect. EVIDENCE: The home has a pictorial complaints system on the notice board in the hallway, which was easy to understand and records of service user meetings showed that their views were sought and acted upon. The home has an Adult Protection policy and procedure and a copy of the local authority procedures and protocols for Adult Protection. Training records showed that staff have undertaken Adult Protection training. 248 Brompton Farm Road DS0000064374.V314054.R01.S.doc Version 5.2 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): 24,30 The quality of service in this outcome area is judged as adequate. Service users live in a nicely decorated and well maintained home and continue to benefit from ongoing improvements to the home’s bedrooms and communal spaces. EVIDENCE: A tour of the home was undertaken and it was found to be clean and free from offensive odours throughout. Improvements to the environment are on-going; all three service users now have their own rooms, although one room is small, the space has been well utilised to accommodate appropriate furniture and fittings and it was clear that the service user was happy in it. The assessment of the home’s bathroom has been undertaken and the home is in the process of working with the Occupational Therapist to agree a plan to it redesign to meet service users’ needs. The home has also drawn up plans to have the down stairs communal spaces redesigned to create more room for service users. This work has not yet started. A recommendation has also been made that the brick walls and concrete floor in the down stairs toilet be upgraded to create a warmer and more homely feel. 248 Brompton Farm Road DS0000064374.V314054.R01.S.doc Version 5.2 Page 16 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): 32,33,34,35 The quality of service in this outcome area is judged as adequate. More needs to be done to ensure that the home has enough staff to support service users’ community activities. Service users benefit from a staff team that is supervised and supported. Service users’ individual and joint needs are met by appropriately trained staff. EVIDENCE: As stated previously records showed that community activity levels were not consistent and the manager explained that the home had experienced staffing difficulties over the past few months. A requirement has been made regarding the need to ensure that the home has enough staff to meet service users’ needs. An inspection of staff training records and discussion with staff evidenced that a range of mandatory and service specific training was undertaken. An inspection of staff files was undertaken including the records of the most recently employed staff. Records demonstrated that the home ensured that robust recruitment practices were in place. 248 Brompton Farm Road DS0000064374.V314054.R01.S.doc Version 5.2 Page 17 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): 37,39,42 The quality of service in this outcome area is judged as good. The care of service users is enhanced by a staff team that is led by a competent and experienced manager, who ensures that the home is run well. Service users can be confident that their views underpin self-monitoring, review and development of the service. EVIDENCE: The manager has several years experience of working with this client group as a support worker and later in a management capacity. Observation on the day, records viewed and discussion with staff evidenced that on the whole the manager delivered an effective service user led service. Observation on the day of the site visit showed that she was approachable and inclusive in her management style. It was clear from records and observation on the day that service users were consulted regarding meals and activities and regular individual reviews were undertaken. 248 Brompton Farm Road DS0000064374.V314054.R01.S.doc Version 5.2 Page 18 Information taken from the home’s pre-inspection questionnaire, records seen at the Home and a tour of the premises showed that the home was maintained appropriately. 248 Brompton Farm Road DS0000064374.V314054.R01.S.doc Version 5.2 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 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 X X LIFESTYLES Standard No Score 11 X 12 2 13 2 14 X 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X 248 Brompton Farm Road DS0000064374.V314054.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 Home’s Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA24 Regulation 16.2(c) Requirement The registered person must ensure that the stained carpet in the lounge/diner is replaced or made good. Improvement plan by: The registered person must provide an action plan detailing how it will meet the assessed needs of service users in terms of bathing facilities and adaptations. Not inspected. The registered person must ensure that the home provides the commission with an action plan with time scales that details how the Home will provide communal space, which is suitable for the provision of social activities appropriate to the circumstances of the service users. Improvement plan by: The registered person must ensure that staffing levels are sufficient to support service users activities in the DS0000064374.V314054.R01.S.doc Timescale for action 28/01/07 2. YA27 23.2(j)(n) 28/01/07 3. YA28 23.2(e), (h)(I) 28/01/07 4 YA33 18(1)(b) 28/01/07 248 Brompton Farm Road Version 5.2 Page 21 community. 5 YA20 18(1)(c ) (i) The registered person must evidence that staff have received appropriate medication administration training. Action plan by. 28/01/07 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 YA27 Good Practice Recommendations It is recommended that the registered person upgrade the bare brick walls and concrete floor in the down stairs toilet. 248 Brompton Farm Road DS0000064374.V314054.R01.S.doc Version 5.2 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 248 Brompton Farm Road DS0000064374.V314054.R01.S.doc Version 5.2 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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