Inspection on 25/03/08 for 26 Beltinge Road

This inspection was carried out on 25th March 2008.

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

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

Other inspections for this house

26 Beltinge Road 19/01/09

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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Southfields

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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 26 Beltinge Road Herne Bay Kent CT6 6DB Lead Inspector Sandra Crosby Unannounced Inspection 25th March 2008 13:00 26 Beltinge Road DS0000023302.V359103.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 26 Beltinge Road DS0000023302.V359103.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. 26 Beltinge Road DS0000023302.V359103.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 26 Beltinge Road Address Herne Bay Kent CT6 6DB 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) 01227 375210 01227 740371 www.caremanagementgroup.com Care Management Group Ltd (trading as CMG Homes Ltd) Mrs Audrey Emmett Care Home 11 Category(ies) of Learning disability (11) registration, with number of places 26 Beltinge Road DS0000023302.V359103.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th July 2006 Brief Description of the Service: 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 monitoring records will be made available on request. The manager confirmed that the current range of fees are from £636.00 to £1350.00 per week. 26 Beltinge Road DS0000023302.V359103.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means that people who use this service experience adequate, quality outcomes. This report contains the findings of the home’s key inspection and takes account of information obtained from various sources since the last inspection of 26 July 2006, including a visit to the home. An unannounced visit took place on the 25 March 2008 between 13.00 hours and 17.30 hours. The visit included talking with the registered manager, staff on duty and residents, plus observing social interactions. All persons at the home or visiting the home were made welcome, and spoken to positively by staff. An accompanied tour of the home was made, and various records were seen. The inspector made observations of staff interacting with residents and was also able to sit in on a shift handover. Information contained in the completed Annual Quality Assurance Assessment (AQAA) a copy of which was provided at the inspection visit, as this was due to be returned to the Commission by the 03 April 2008. During the first two weeks in April 2008, ten completed service user surveys were returned to the Commission office all of which contained positive comments about life at the home. The findings of this inspection visit indicated that the home provided mainly good outcomes for the residents, and the quality judgement ratings reflect this. However due to an ongoing Adult Protection investigation the outcome of which is not as yet known, the service has been judged as Adequate. What the service does well: The manager and staff team have created an atmosphere within the home that focuses on the individuals living there. The knowledge and professionalism of staff has been increased. Records are well maintained and staff are confident about the role they have. Seven residents took part after much planning in a holiday to visit Mickey Mouse in America. 26 Beltinge Road DS0000023302.V359103.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 26 Beltinge Road DS0000023302.V359103.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 26 Beltinge Road DS0000023302.V359103.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2 was inspected at this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents’ individual aspirations and needs are being assessed. EVIDENCE: The completed AQAA documentation states that the Service User Guide and Statement of Purpose are made available for the person as a guide to the home aspirations. The Deputy said that these documents were currently being updated. The records for two residents were viewed at this time. The home had sought information from the placing authority and the manager confirmed that this was a part of the pre-admission procedure. The AQAA documentation states that the assessment team and the home manager do pre-assessments in advance. This includes assessing the suitability of the home and environment. The initial assessments seen showed that a range of subjects is looked at, and formats for ‘person centred planning’ were used when new residents arrived at the home. 26 Beltinge Road DS0000023302.V359103.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6,7 and 9 were inspected at this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that their changing needs will be noted in their individual plans and that they will be supported to make decisions and take risks to enable as independent a lifestyle as possible. EVIDENCE: The individual records of the two service user plans looked at show that the residents’ needs are assessed clearly and that more emphasis is placed on the individual’s own perceptions and wishes. The ‘person centred planning’ formats are designed and recorded from the point of view of the resident. Photographs and illustrations are used according to individuals’ own needs or wishes. 26 Beltinge Road DS0000023302.V359103.R01.S.doc Version 5.2 Page 10 The completed AQAA documentation states that the residents have a designated key worker who will have regular monthly meetings to discuss future plans, aspirations and achievable goals. It was reported in the last inspection report that these regular meetings between residents and key workers allows for residents to make decisions or requests for support for instance going to the cinema to see a particular film, purchasing a present for a parent. Key workers compile a monthly review and these were seen. These reviews helps to set goals with and for the individual. It was also seen that a record of daily activities, appointments and behaviours are recorded in the individual daily diaries for residents as stated in the AQAA documentation. Comprehensive risk assessments are in place for residents and there were examples of individuals being encouraged to try things to improve their levels of independence. Previously, the home has demonstrated its awareness of the principles regarding ‘best interest’ when helping residents to make decisions. Information was provided to the Commission about the five residents for whom the Head of Finance at Care Management Group is appointee. Residents are encouraged to be as responsible and involved in their own personal finances as possible, whether this is just encouraging someone to keep their own cash in their purse/wallet or being involved in drawing money out of accounts. 26 Beltinge Road DS0000023302.V359103.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,15,16 and 17 were inspected at this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents take part in appropriate activities and see themselves as part of the local community. They are supported in their relationships and their rights are respected. They benefit from being offered a healthy diet and a sociable setting for mealtimes. EVIDENCE: Observations made during this inspection showed that residents have choices and freedom of movement. There are routines within the home but they are flexible and are there to support people. Care plans contain information about individuals’ preferences regarding daily routines. Some people have their own keys to their rooms and others do not. The inspector was informed that this is based on preference. Residents can choose to spend time on their own and privacy is respected. The name a person prefers to be called is noted in the 26 Beltinge Road DS0000023302.V359103.R01.S.doc Version 5.2 Page 12 care plan. Staff and residents confirmed that personal and housekeeping tasks are carried out with the support of staff in general and key workers in particular. The records seen showed many examples of residents using local facilities such as cinemas, restaurants, bowling alleys, swimming pools, local shops and libraries. Weekly activity programmes were seen and included for example activities undertaken at the Skills Centre, and attendance at various college courses. Seven residents have recently returned from a planned holiday to visit Mickey Mouse in America. To undertake a visit of this kind involved a large amount of pre planning, however it was indicated that the efforts put in before the trip were very worthwhile when listening to interactions between residents and staff talking about their holiday. The home has a vehicle but everyone is also encouraged/enabled to use public transport. Residents are enabled to vote and are listed on the electoral roll. The completed AQAA documentation states that annually there is a residents forum whereupon residents are able to speak and tell of what they enjoy/dislike doing within the service or places they have visited. The menu information provided for this inspection shows that the food provided is suitable. There is variation and balance and the dining area and kitchen have both been improved since the manager was appointed and the atmosphere for food preparation and for enjoying mealtimes has been greatly enhanced. Residents spoken to said or indicated that they liked the food. 26 Beltinge Road DS0000023302.V359103.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18,19 and 20 were inspected at this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by the home’s policies and procedures regarding medication and their physical and emotional needs will be responded to. EVIDENCE: The completed AQAA documentation states that the home offers the resident their own Health Action Plan and that this is taken to medical appointments, and any changes that occur and any results will be recorded. These records were seen as an addition to the ‘person centred planning’ service user plans. Residents attend at their GP’s surgery for Well Man or Well Woman appointments. The records seen at this time gave lots of examples of the involvement of health care professionals from consultants to dentists, from opticians to learning disability community nurses. The medication records were seen and indicated that they were appropriately signed and up to date. A medication profile is included in each individual’s 26 Beltinge Road DS0000023302.V359103.R01.S.doc Version 5.2 Page 14 care plan as are preferences for taking medication. The storage of medication was not seen at this visit. 26 Beltinge Road DS0000023302.V359103.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23 were inspected at this visit. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are mainly protected from abuse and their views are listened to and acted on. EVIDENCE: There is a complaints procedure in place at the home and this includes versions that are illustrated to enable residents to understand the process. Staff said that meetings (both key worker and house) allow for issues to be aired. It was seen that there have been no complaints recorded since the last inspection. Staff receive training and instruction regarding safeguarding the people living in the home and those spoken to were aware of their responsibilities. There are appropriate policies and procedures in place. Currently there is an ongoing adult protection investigation and the manager of the home sought the involvement of relevant agencies at the time of the incident. Subsequently, staff involved were and remain suspended until the outcome of the investigation is known. Due to this investigation being unresolved this Outcome area has been judged Adequate. 26 Beltinge Road DS0000023302.V359103.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30 were inspected at this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean, comfortable and safe for the residents. EVIDENCE: Re-decoration at the home is ongoing. Previously both the laundry and the kitchen have been improved, including new impervious flooring. The dining area and lounges have been redecorated since the manager was appointed and the whole of the communal area has a pleasant comfortable feel to it. There are still plans for further improvements. The house was clean and free from any unwelcome smells at the time of the inspection. There are no outstanding issues from the fire safety officer or the local environmental health officer. Work is planned for the replacement of windows and although this has been identified for some time, the hold up to 26 Beltinge Road DS0000023302.V359103.R01.S.doc Version 5.2 Page 17 the work being completed is in relation to the property being within a conservation area. The home therefore needs to obtain the necessary permission from the Council for replacement windows of a suitable design to be fitted. The manager said it is hopefully that permission will be given in the not to distant future. The gardens are well maintained providing an attractive and welcoming area to sit out in good weather. 26 Beltinge Road DS0000023302.V359103.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32,34 and 35 were inspected at this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from on the whole a well-trained, enthusiastic and supportive staff team and residents are supported and protected by the home’s recruitment policy and practices. EVIDENCE: Staff spoken to and observed during this inspection were very focussed on the needs of the residents. Shift handovers are established and the inspector was able to observe this practice as part of the inspection process. Observations were that staff were professional and respectful. Three staff files were seen and the records seen reflect a robust recruitment procedure which includes application forms, references, terms and conditions of employment and criminal record bureau checks. The policies and procedures that the organisation has in place cover relevant aspects of recruitment, including a questionnaire relating to equal opportunities. Part of the recruitment of new staff involves candidates visiting the home and meeting residents. This took place during the of the inspection visit. 26 Beltinge Road DS0000023302.V359103.R01.S.doc Version 5.2 Page 19 The completed AQAA documentation states that the home has good staff retention, and indicates that a high percentage of staff hold an NVQ Level 2 or above qualification. A staff training matrix is maintained and shows that staff receive regular training and staff spoken with confirmed this. 26 Beltinge Road DS0000023302.V359103.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37,38,39 and 42 were inspected at this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from a well run home and their health and safety is mainly promoted and protected. EVIDENCE: The manager has considerable experience and is qualified. She is very clear about the aims of the home and the regulations relating to providing care. She was observed to provided a clear sense of leadership and more than one member of staff made a point of emphasising the support and direction she provides. Staff confirmed that she is approachable and listens to what they 26 Beltinge Road DS0000023302.V359103.R01.S.doc Version 5.2 Page 21 say. Her attitude to people with learning disability reflects professionalism and knowledge. In relation to the Adult Protection investigation, the manager followed the due processes except in the written notification under RIDDOR. This has since been completed. The organisation has good quality assurance procedures and the home has a continuous Improvement Plan in place. This is underpinned by key worker meetings, questionnaires to staff, residents and their representatives and there is a Residents’ Forum each year which all people living within a Care Management Group home are invited to. These occasions are also videoed and each home has a copy. The completed AQAA documentation indicates that maintenance of equipment is appropriate and up to date. 26 Beltinge Road DS0000023302.V359103.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 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 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X X 3 X 26 Beltinge Road DS0000023302.V359103.R01.S.doc Version 5.2 Page 23 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA23 YA24 Good Practice Recommendations Ensure that RIDDOR are informed of any incidents as appropriate within the required timescale The planned replacement of windows should be completed 26 Beltinge Road DS0000023302.V359103.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Oxford Office 4630 Kingsgate Oxford Business Park South Cowley Oxford OX4 2SU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 26 Beltinge Road DS0000023302.V359103.R01.S.doc Version 5.2 Page 25 - 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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