Inspection on 08/08/06 for 25 Beacon Close

This inspection was carried out on 8th August 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

25 Beacon Close 05/01/06

25 Beacon Close 12/09/05

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 25 Beacon Close 25 Beacon Close Gillingham Kent ME8 9AP Lead Inspector Robert Pettiford Unannounced Inspection 8th August 2006 9:45 25 Beacon Close DS0000064376.V306281.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 25 Beacon Close DS0000064376.V306281.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. 25 Beacon Close DS0000064376.V306281.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 25 Beacon Close Address 25 Beacon Close Gillingham Kent ME8 9AP 01634 370581 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 Jane Shoults Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 25 Beacon Close DS0000064376.V306281.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th January 2006 Brief Description of the Service: 25 Beacon Close is one of a number of homes now managed by Avenues Trust. The home offers 24-hour care for 3 adults with learning disability. It is located in the end of a cul-de-sac within a residential area. There is a local bus route nearby to Rainham town centre is approximately a 15 minute walk away. The home also has its own transport for the of service users. The home is a detached premises with accommodation on two floors. There are three single bedrooms, none of which have en-suite facilities. The first floor is accessed via a stairway. The home employs one manager and care staff. There is one member of staff at night on sleep-in and the organisation has an emergency on-call system. 25 Beacon Close DS0000064376.V306281.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on 1st August 2006. The Inspector agreed and explained the inspection process with the Registered Manager. Documentation and records were read. Time was spent reading a sample of written policies and procedures, reviewing care plans and records kept within the home. A tour of premises was also undertaken. The focus of the inspection was to assess 25, Beacon Close in accordance to the National Minimum Standards for Younger Adults. In some instances the judgement of compliance was based solely on verbal responses given by those spoken with. Time was spent by the inspector observing service users in their daily activities and discussing the standard of care within the home with the Registered Manager and staff. Information with regard to fees are available and in the range £1,031.84 to £1,104.25 depending on the assessments of the service users needs. What the service does well: What has improved since the last inspection? 25 Beacon Close DS0000064376.V306281.R01.S.doc Version 5.2 Page 6 Improvements were noted and some progress made with regard to meeting the National Minimum Standards with improvements to the environment. Various areas of the home have been re-decorated and new carpets have been laid in the lounge. 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. 25 Beacon Close DS0000064376.V306281.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 25 Beacon Close DS0000064376.V306281.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): 1,2,3,4, Quality in this outcome group is good Prospective service users on the whole have all the information they need to make an informed choice about whether they wish to live at the home. Service users can be confident that their needs will be suitably assessed and that they will have the benefit of a trial period at the home prior to moving in. EVIDENCE: The home has a Statement of Purpose that on the whole meets with the required standards, and includes most of the information as required of Schedule 1 of the Care Home Regulations 2001. The manager has prepared service users’ guides that are in a format that is appropriate for all the service users living within the home and will ensure that the Statement of Purpose contains all the elements of schedule 1 of the Care Home Regulations 2001. The pre assessments seen contained all of the information needed to make an informed decision as whether the home would be able to meet the prospective service users needs. Admissions are not made to the home until a full needs assessment has been undertaken. The assessment is conducted professionally and sensitively and involves the individual, and their family or representative, where appropriate. Where the assessment has been undertaken through care management 25 Beacon Close DS0000064376.V306281.R01.S.doc Version 5.2 Page 9 arrangements the service insists on receiving a summary of the assessment and a copy of the care plan. Admissions to the home only take place if the service is confident staff have the skills, ability and qualifications to meet the assessed needs of the prospective resident. The staff management team may consider the application together with other staff, where all information is shared, views, opinions, and comments are listened to and fully debated, before agreement is give for the admission. The home does encourage prospective service users to come to the home for the day and have a meal, they also invite for an overnight stay. All service users coming into the home do so on a trail basis, during this time the assessment continues and the service user has the opportunity to see if they are happy at the home. If at the end of this period the home feels it can meet the service users needs and the service user is happy then the placement can become permanent. 25 Beacon Close DS0000064376.V306281.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 Quality in this outcome group is excellent Service users benefit from having clear and in-depth care plans that identify their individual needs, aspirations and goals and give clear guidance to staff. Service users are treated with respect and their dignity and independence is promoted. Service users are enabled to take risk within a risk management framework. EVIDENCE: The inspector viewed and discussed with the Registered Manager the care records relating to several service users. In the care plans viewed there were clear guidelines in respect to support needed with regard to strategies to manage and support service users with their needs. Plans sampled demonstrated that the home used positive planned interventions to manage behaviour. 25 Beacon Close DS0000064376.V306281.R01.S.doc Version 5.2 Page 11 The home is to be complimented on such details of support plans which were found to be of a high quality. The home undertakes regular reviews. Formal reviews involving significant professionals and relatives where possible are also undertaken. Evidence was available that service users were involved in drawing up personal care plans in the documentation seen and that they are consulted in reviewing and amending such care plans in accordance with their understanding. The home and its staff are committed to supporting the service users in accordance with their needs at 25, Beacon Close. This was evidenced through the knowledge and experience of the staff seen by the inspector whilst supporting several service users. The Registered Manager and care staff are to be commended in promoting an individually appropriate lifestyle as evidenced within the service user plans. The care plans at 25, Beacon Close have been determined by assessment and drawn up between the home and the service user. It puts the individual at the centre of service delivery by the care home. The Plan reflect the needs, aspirations and goals of the individual, set out the services to be provided by the care home to meet needs and achieve goals, and develop as the service users life and circumstances change. The home’s care plans use a socially lead model. They include in depth information concerning the preferred lifestyle, goals and choices of the service users. The system of care planning draws in all the information into one document to assist the care worker in delivering the care. Such care plan clearly assists care staff with the following; Needs (What are the assessed needs?) Objectives (What do you want to achieve? Action (Agreed action and by whom?) Comments, Review, Date. It is evident through talking to members of staff that the emotional health of the service users is of a high priority to the home and that staff are pro-active in maintaining and supporting Service Users with their emotional needs in order to maintain their quality of life. Risk assessments were discussed and viewed and detailed documentation recorded how to support Service Users to minimise risks for personal safety. 25 Beacon Close DS0000064376.V306281.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected 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 Quality in this outcome group is excellent Service users can be confident that they are offered opportunities for personal development and to learn new skills and feel part of the wider community as they wish. Service users engage in a high level of activities which are appropriate to their needs. Service users are supported to maintain contact with family and friends, which ensures they continue to receive stimulation and emotional support. The service users benefit from the appetising meals and balanced diet offered at the home. EVIDENCE: Service users are enabled to participate and contribute to meeting their own self care needs and day to day chores around the house. Thus providing them 25 Beacon Close DS0000064376.V306281.R01.S.doc Version 5.2 Page 13 with opportunities to maintain and develop, communication and independent living skills. Service users enjoyed an excellent level of stimulation through leisure and recreational activities both inside and outside the home in accordance with their needs and wishes. The home benefits from having its own transport to enable service users to gain full access to the community. It was confirmed that service users are enabled to maintain contact with relatives and friends where they wished to do so. Service users were consulted with regard to whom they saw and when and were under no compulsion to accept visitors should they not wish to do so. The home has sought the views of the residents and considered their varied interests when planning the routines of daily living and arranging activities both in the home and the community. Routines are very flexible and residents can make choices in major areas of their life. The routines, activities and plans are resident focused, regularly reviewed, and can be quickly changed to meet individual service users needs. The home actively encourages and provides imaginative and varied opportunities for service users to develop and maintain social, emotional, communication and independent living skills. The service has a strong ethos and focuses on involving service users in all areas of their life, and actively promotes the rights of individuals to make informed choices, providing links to specialist support when needed. Service users from records viewed it was evident that service users were offered a choice of menus that meet their dietary needs and individual preferences. Meal times are flexible to suit the service users’ activities and schedules. Service users are able to choose where to eat, and also have facility to make drinks, meals and snacks for themselves and others. Service users on evidence seen have had been involved in planning and choosing menus. Staff talk to and interact with service users, not exclusively with each other. Service users choose when to be alone or in company, and when not to join an activity. Service users have unrestricted access to the home and grounds. 25 Beacon Close DS0000064376.V306281.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 Quality in this outcome group is good Service users feel supported by the level of help given and that their healthcare needs are addressed EVIDENCE: Times of getting up / going to bed, having baths, eating meals and other activities are flexible to allow for different service users daily routines. The inspector observed excellent interaction between staff and service users. The documentation seen confirmed that all service users have a GP and visits from other health professionals are arranged and enabled. The health care issues of the residents were seen recorded in the daily record. 25 Beacon Close DS0000064376.V306281.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome group is good. Service users rights are protected with regard to making complaints. Service users are protected from the risks of abuse. EVIDENCE: The complaints procedure seen within the home at time of inspection met with the National Minimum Standards. The complaints procedure contained all of the information as required of the standards with regard to timescales for responding to a complaint and was found in a format that was appropriate for all service users living within the home. The home’s Policy for the Protection of Service Users and staff “Whistle blowing” procedure at 25, Beacon Close was discussed. These include procedures for the reporting of suspicion or evidence of abuse with a format for the recording of any allegations and action to be taken. The manager stated that staff had received the training required to protect service users from abuse. 25 Beacon Close DS0000064376.V306281.R01.S.doc Version 5.2 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): 24,25,26,27,28,30 Quality in this outcome group is adequate. Service users benefit from living in on the whole a home that is clean, and safe, but the quality of the decoration and furnishings could be improved. The quality of service users environment could be improved by providing an additional communal space. EVIDENCE: The Inspector undertook a tour of the home including one of the service users rooms, bathroom/toilet facilities and communal areas. All areas viewed appeared clean and tidy and in keeping with a homely environment. Fixtures and fittings and general decoration were seen to be of a reasonable standard with the exception of the kitchen. The house was homely and central to amenities. The living areas and kitchen were found to be clean and tidy. However the kitchen floor was seen to be in need of some degree of re-furbishment or replacement. The flooring was in a poor state of repair and could in the view of the inspector be considered a hygiene risk due to the cracks in the flooring. 25 Beacon Close DS0000064376.V306281.R01.S.doc Version 5.2 Page 17 The bath chair that forms part of the hoist in the bathroom was found to be not suitable for the identified service user. Health and safety risks had previously been identified that had not been addressed. The replacement of the seat was seen as a priority by the inspector. Bedrooms were seen to be personal in nature with each service users expressing their own identity. The number of toilet and bathroom facilities provided by the Home meets current required standards. Toilets and bathrooms were lockable offering service users’ privacy, although staff are able to access toilets/bathrooms in an emergency if required. Service users are unable to regulate the temperature of the radiators within their own private bedrooms. This was seen as a shortfall at the last inspection and has still not been addressed. The lack of communal space was also seen as a shortfall at this and previous inspections. Although requirements from the last inspection regarding the environment have not yet been met the inspector saw evidence that a renovation and building project is planned and new carpets have been fitted and some areas of the home re-decorated. The manager was requested to review the inspectors comments and take appropriate actions and include such actions in the homes action plan. 25 Beacon Close DS0000064376.V306281.R01.S.doc Version 5.2 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): 35,36 Quality in this outcome group is good. Service users care, social and emotional needs are promoted by the employment of suitably trained and experienced care staff whose training exceeds the required standard. Service users can feel confident that they are supported by staff how have the benefit of regular staff supervision EVIDENCE: The inspector viewed the home’s training matrix which indicated planned and undertaken training. A wide range of training has been identified for all staff over and above core skills courses. Many staff had been trained to NVQ Level II therefore meeting the required standard. Current staff have received training in many areas which include. Fire safety awareness, Adult protection, First Aid, Basic food Hygiene, Manual Handling, health and safety, Administration of Medication, COSH (Containment of substances hazardous to health), and others. The home was able to evidence that all new staff receive structured induction training (within six weeks of appointment) and foundation training (within six months of appointment) to Sector Skills Council specification (including 25 Beacon Close DS0000064376.V306281.R01.S.doc Version 5.2 Page 19 training on the principles of care, safe working practices, the organisation and worker role, the experiences and particular needs of the service user group, and the influences and particular requirements of the service setting). 25 Beacon Close DS0000064376.V306281.R01.S.doc Version 5.2 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): 37,39,42 Quality in this outcome group is good Service users benefit from a competent and experienced manager, who ensures that the home is managed in their best interests. Service users benefit from living in a home where the quality of the service is regularly monitored Service users health and safety is protected by the homes policies ,procedures and checks and servicing of fire and other related equipment. EVIDENCE: The Registered Manager is currently working towards obtaining fully the qualifications she needs to meet with the National Minimum Standards. She has demonstrated that she has the experience and is competent to run the home to meet the needs of the service users. She works to continuously improve services and provides with the support of the care staff an increased quality of life for service users. There is a strong ethos of being open and 25 Beacon Close DS0000064376.V306281.R01.S.doc Version 5.2 Page 21 transparent in all areas of running of the home. The manager is person centred in her approach, and leads and supports a strong staff team who have been recruited and trained to a good standard. The home operates a keyworker system to identify an individual staff member to directly to work with a service user on a one to one basis and has various quality assurance systems in place. The provider Avenues Trust undertakes regular regulation 26 visits to monitor the quality of care within the home. The home undertakes survey’s, is inspected by Social Service’s and The Commission of Social Care Inspection. Other quality assurance methods include regular staff meetings and staff supervised. The inspector viewed records relating to Health and Safety Procedures, maintenance and servicing, and risk assessments. The inspector viewed the Fire Log book, which was up-to-date. The inspector was able to evidence that checks and servicing of fire safety equipment / emergency lighting and other checks had been undertaken at the required frequency. COSH (containment of substances hazardous to health) assessments and data sheets were available along with risk assessments. Procedures are available for the reporting of accidents and incidents (Regulation 37) occurring within the home. Staff training was evidenced with regard to First Aid, Food Hygiene and other mandatory courses. 25 Beacon Close DS0000064376.V306281.R01.S.doc Version 5.2 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 Standard No Score 1 3 2 3 3 3 4 3 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 3 26 2 27 3 28 2 29 3 30 3 STAFFING Standard No Score 31 x 32 x 33 x 34 x 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 3 x LIFESTYLES Standard No Score 11 3 12 4 13 4 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 x x 2 x 3 x x 3 x 25 Beacon Close DS0000064376.V306281.R01.S.doc Version 5.2 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. Standard YA24 Regulation 23.2(d)& 16.2 (c) Requirement The registered person must ensure that all areas of the home are reasonably decorated and furnished. Timescale for action 08/11/06 2 YA24 23.2(n) Suitable adaptations are made, 08/10/06 and such support, equipment and facilities, as may be required are provided, for service users who are old, infirm or physically disabled; The registered person must ensure that the temperature of the radiators can be controlled individually. The registered person is required to assess service users needs in terms of additional communal space. The Registered Manager is required to have the qualifications for managing the care home 08/11/06 3. YA26 23.2(p) 4 YA28 23.2(i) 08/01/07 5 YA37 9.2(b)(i) 08/11/06 25 Beacon Close DS0000064376.V306281.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 25 Beacon Close DS0000064376.V306281.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: 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 25 Beacon Close DS0000064376.V306281.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. 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