Inspection on 19/01/09 for 26 Beltinge Road

This inspection was carried out on 19th January 2009.

CSCI found this care home to be providing an Good service.

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

26 Beltinge Road 25/03/08

26 Beltinge Road 26/07/06

26 Beltinge Road 16/10/05

26 Beltinge Road 13/05/05

26 Beltinge Road 21/09/04

26 Beltinge Road 29/04/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 26 Beltinge Road 26 Beltinge Road Herne Bay Kent CT6 6DB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Wendy Gabriel     Date: 1 9 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: 26 Beltinge Road 26 Beltinge Road Herne Bay Kent CT6 6DB 01227375210 01227740371 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Care Management Group Ltd (trading as CMG Homes Ltd) care home 11 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 11 The maximum number of service users who can be accommodated is: 11 The registered person may provide the following category of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Learning disability - LD Date of last inspection Brief description of the care home 26 Beltinge Road is a care home providing personal care and support to 11 adults with learning disabilities. Care Management Group owns the home and two smaller homes close by and others throughout the southeast. The property is a large detached building with gardens to the front and rear. There is one parking place on the property but parking is available on the road at the side and front of the property. Accommodation consists of single rooms on various levels accessed by stairs making the home unsuitable for people with limited mobility. The home is situated close to Herne Bay town centre where there are shops, bus stops and a railway station. Other local amenities are easily accessed. Information about the home, including the latest report from the Commission for Social Care Inspection (CSCI) and the homes quality Care Homes for Adults (18-65 years) Page 4 of 26 Brief description of the care home monitoring records will be made available on request. For up to date information about the range of fees, please contact the provider. Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The key unannounced inspection started in the morning and the home was fully staffed with eight members of staff at this time. We were in the home between 10am and 5pm. We spoke to the registered manager, the deputy manager, the team leader and briefly to other staff on duty through out the day. Some residents were out for their activities, others were in the home and another was meeting a parent for an outing. We spoke briefly to some service users during the day according to communication abilities and to a relative in the home. An accompanied tour of the home was undertaken and observations made of staff and service user interactions. This was seen to be friendly and positive. We cross referenced documents and files regarding two service users chosen at Care Homes for Adults (18-65 years) Page 6 of 26 random and viewed other documents and records in the home including a sample of two staff files. The organisation had just provided a computer system for the service to provide access to company policies, procedures and other documents. This is to be made available to staff as well as senior and management team. Staff have enrolled on e learning, which is learning via the computer system. During the year the home has told us about things that have happened in the service, these are called notifications and are a legal requirement. The findings of the inspection visit indicated that the home provided mainly good outcomes for the residents such as with activities and the quality judgement ratings reflects this. There is still an ongoing Safeguarding Vulnerable Adults investigation for this service the outcome of which is not yet known. No requirements were made at this inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective service users know their needs will be assessed and resources will be available to meet their needs and aspirations when they move into the home. Evidence: The service has a robust pre admission procedure supported by the organisations assessment and referral team. A sample of pre admission documents was seen and these were augmented with written assessments from the placing authority and other health care professionals as necessary. The placement can take about two months to allow for visits to be made to and by the prospective service user. This also allows for the service to be sure resources are adequate for meeting the needs of the prospective service user. The organisation has produced a booklet for the service to make specific to the the home. It is in a clear and easy to understand format and staff are getting photographs ready for the current service users to choose to help complete the booklet. This will then give prospective service users an idea of what their lifestyle might be like. A Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: placing authority care manager and an adviser from the organisations assessment and referral team were in the home to meet a prospective service user and family. The prospective service user has already visited and accepted an offer to go for a one to one walk with a member of staff to a cafe and activity area. This gave both people the opportunity to get to know each other and for the prospective service user the chance to see the locality. Service users are consulted about a new admission to the home. The home is also producing a booklet called Someone New is Moving In for the service users already living in the home. The service has undertaken a lot of person centred changes to general documents. The statement of purpose and service users guide is written in this manner and the registered manager said further work is being undertaken to include more photographs and widget pictures. Care Homes for Adults (18-65 years) Page 11 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users know that their changing needs and aspirations will be met and that they will be supported to make decisions and take risks to enable as independent lifestyle as possible. Service users know that they are consulted on aspects of the daily life of the home. Evidence: The files of two service users chosen at random were looked at. These indicated that assessments are in place for individuals and that goals and aspirations are particularly noted. The home promotes service users to attain their desired goals. Each step towards the goal is detailed as it is achieved and is called My Pyramid of Success. Records are also maintained for people about their health and welfare. Key workers write an individual monthly report with the advice of each service user as appropriate. Risk assessments are in place and each person has an individual action plan. A daily diary is maintained for individuals. Service users have recorded information in their plans on How to meet my Cultural Needs. Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: Service users meetings record that finances are spoken about and one person is recorded as saying I go to the bank to get money and I sign for my money. One person showed us his individual safe in his room and indicated that a member of staff helps him do regular checks on it. A check on a random sample of finances and records held by the home on behalf of service users was correct. Each service user has a record kept of Infringements of Rights detailing for example if they hold their own front door key. Service users may sit in on recruitment interviews for new staff. Service users also have a say on who they want to be their key worker. Care Homes for Adults (18-65 years) Page 13 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users know they will be encouraged to take part in appropriate activities and learning opportunities in the community. They benefit from having relationships and rights supported. Service users benefit from a varied and healthy diet and individul choices are recognised. Evidence: Service users are enabled to undertake educational and social activites. The activity matrix was full and includes attendance at college, the skills centre and the day opportunities centre. People are given the choice of attending and if they do not wish to attend the home is flexible. A family member wrote that xxx has a very full and well planned week of activities. A member of staff said that the ethos of the registered manager is that everyone must be treated as human beings with their own thoughts and ideas. Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: A wide variety of activities are on offer both out of and in the home. The local community is accessed and people engage in activities with service users from other company owned homes and at other skills or day opportunity centres. Service users have regular meetings in house and occasional meetings with people from the co owned home across the road.There was written evidence of service users participation in the meetings with comments from some people about issues the staff raised with them about their health and welfare. Family relationships are encouraged and a relative said in a private conversation to us that her relative is so happy there and that the staff had supported her relative to meet the health challenges he had had to face. The staff held a surprise buffet evening for the service users recently. The staff had spent time very carefully considering each individual and their particular achievments throughout the year. During the evening they presented each service user with a certificate of achievement for their own particular success. Photographs of the event showed that the service users were so proud as they received their certificates. Meals are varied and suit individual tastes and dietary needs and choices. The food storage was plentiful and included fresh fruit and vegetables as well as dried and frozen foods. The kitchen was clean and well organised and there are plans to redecorate and refurbish parts of the kitchen in the near future. The dining room is spacious and was being decorated at that time. Care Homes for Adults (18-65 years) Page 15 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are protected by the homes medication policies and procedures. Service users physical and emotional needs will be responded to. Evidence: There was good evidence of information in files of health care being supported by visits to and by gp and other health care professionals. Medication has suitable policies and procedures. Staff undertake training before they are allowed to administer medication to service users. They are then assessed in the home. Medication storage is suitable. Two service users have their own medication cabinets in their own rooms where, although they do not self administer, they may receive their medication in a private environment. Medication administration sheets were in order and up to date. The service keeps records of preferred methods of taking medication as well as a medical profile. Daily hand overs between staff shifts include health issues. Care Homes for Adults (18-65 years) Page 16 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are mainly protected from abuse and their views are listened to and acted on. Evidence: The home maintains a complaints procedure, this is on display and in several documents including the service user guide that is given to all prospective service users and their families. It is written in an illustrated and simple to understand format. Complaints are recorded. Adult protection has been discussed at staff and service user meetings. Keyworkers have followed up their own meetings with one to one time with service users to make sure they understand about abuse and how to report it. Written comments of statements made by some service users at their meetings indicated that they were aware of what to do and who to go to if they wanted to tell someone about abuse. Staff receive training about safeguarding and adult protection. policies and procedures are in place. Currently there is an ongoing adult protection investigation and the manager of the home sought the advice of relevant agencies at the time of the incident. Care Homes for Adults (18-65 years) Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean and comfortable and safe for the service users. Evidence: The home is comfortable, clean and hygienic. Service users were seen freely accessing the communal areas. Some bedrooms were in the process of being redecorated and one service user and parent said they were due to choose the colours for the individuals bedroom that day. A comment recorded in a residents meeting states I do like my bedroom, its nice and big. It is warm. One service user showed us his room. When asked about his room he made it clear that he liked it and felt comfortable there and was enabled to include in it all the things that represented some of his favourite activities. The garden is large and despite it being Winter, presented as tidy and well maintained. There were no outstanding issues from the fire officer or the local environmental officer. Maintenance certificates are in date. The windows are in need of replacing but due to the home being in a conservation area, permission has to be given from the local council. The registered manager stated that despite the company identifying a specialist company for this the council has yet to give permission. In the meantime the company is increasing their risk assessments Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: to detail the deterioration of the windows. Windows have restrictors on. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from a well trained and supportive team. Service users are protected by the homes recruitment policies and procedures. Evidence: Staff were observed speaking to the service users in a friendly, respectful and supportive manner. There was a sense of humour in interactions that was appropriate and seen to be enjoyed or led by the service users. Recording of daily events takes place in diverse files and daily diaries. Staff undertake shift handovers and these are signed by the team leaders on the shifts. Two staff files chosen at random to represent a new and a more established member of staff were viewed. Both contained evidence of robust recruitment practice including CRB checks. The organisation has policies and procedures in place regarding recruitment. The registered manager said that the home was fully staffed but that in the future they were planning on recruiting dedicated cooks for the service. Prospective staff visit the home to meet the service users who may also sit in on interviews. Induction is in line with Skills for Care. Supervision is undertaken regularly. Staff meetings include references to ongoing training and advice. Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: Training includes NVQ 2 and 3 and a high percentage of staff have obtained this. The matrix for training in the home evidences a variety of courses, both mandatory and service specific. Some written comments seen in letters and feedback to the service includes thank you for all the care and kindness that you give to xxx, xxx is obviously well and happy. An external trainer has written A well run professional team. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from a well run home and their health and safety is mainly promoted and protected. Evidence: The registered manager is experienced and qualified. A member of staff said of the registered manager that supportive is an understatement and that she is straight and honest. Another member of staff said the registered managers ethos of the home is that everyone must be treated as human beings with their own thoughts and ideas. The home provides Regulation 26 reports and evidence of these was seen. Maintenence certificates were up to date. The registered manager and the company are trying to get permission from the local council to replace the windows. In the meantime the home is increasing risk assessments to detail the deterioration of the windows. Windows have restrictors on. The company has a quality support officer who makes assessments of the service. Feedback sheets are given quarterly to people and families. Quality assurance procedures also includes service users meetings and the annual company forum where representatives from each home may attend. Keyworker Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: and staff meetings are held and an annual plan for the home is in place. The home has provided the AQAA when asked and the new AQAA was due following the inspection so could not be utilised for this report. The registered manager has introduced person centred formats for everyday documents in the home such as care plans, pre admission forms and the service users guide and is gradually ensuring they include photographs and widget pictures. The registered manager was observed talking to a member of staff about this and encouraging their input into obtaining suitable photographs that the member of staff then told us, would be finally chosen by the service users. The registered manager said that she is promoting recording infringements of rights and has produced a form documenting if for example, a service user holds his or her own bedroom door key and reasons why or not. Evidence was seen of these in each service users file viewed. A parent who spoke to us said that her family is always made welcome whenever they visit and that the home always keeps them informed of things. A member of staff said that it is a pleasure working here. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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