Inspection on 17/05/07 for 288 Shipbourne Road

This inspection was carried out on 17th May 2007.

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

288 Shipbourne Road 13/01/06

288 Shipbourne Road 08/09/05

288 Shipbourne Road 21/09/04

288 Shipbourne Road 13/04/04

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Insight - Eastchurch

Southfields

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33 St John`s Church Road

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

CARE HOME ADULTS 18-65 288 Shipbourne Road 288 Shipbourne Road Tonbridge Kent TN10 3EX Lead Inspector Christine Lawrence Key Unannounced Inspection 17th May 2007 10:00 288 Shipbourne Road DS0000043938.V334449.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 288 Shipbourne Road DS0000043938.V334449.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. 288 Shipbourne Road DS0000043938.V334449.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 288 Shipbourne Road Address 288 Shipbourne Road Tonbridge Kent TN10 3EX 01732 773460 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 Mr Eric Chong Care Home 6 Category(ies) of Learning disability (4), Learning disability over registration, with number 65 years of age (2) of places 288 Shipbourne Road DS0000043938.V334449.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. No one under the age of 45 years old may be admitted to this home. Service Users may also have a physical disability. Date of last inspection 13 January 2006 Brief Description of the Service: 288 Shipbourne Road provides residential care and support to 6 adults with a learning disability and other associated needs. The home is within walking distance of local shops and library. The home has a vehicle equipped with a tail lift for wheelchair users and it is only a short journey to Tonbridge town centre with all of its amenities. All of the rooms are single and have en suite toilet facilities. Two rooms also have en suite showers. There is a large lounge/dining room and a lift to the first floor. The home has a room for private visits. There are car parking spaces at the front of the building. Information included in the pre-inspection questionnaire provided by the manager prior to the visit to the home, confirmed the fees as £1385.18 per week. Information about the home, including the previous inspection report from the Commission for Social Care Inspection, would be made available on request. 288 Shipbourne Road DS0000043938.V334449.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was unannounced and started at 10.00 and finished at 15.00. I looked at various records in the home and also used information sent to the commission by the registered manager, Eric Chong before the visit. Information from the previous inspection was also referred to. I spoke with several of the residents and was invited to see some bedrooms. I also joined some of the residents for lunch. A tour of the parts of the rest of the building was undertaken. I made observations of staff interacting with and supporting residents. Comment cards were completed by various health and social care professionals as well as relatives, and the information they provided is also used for this report. Staff chatted informally with me and I had discussions with the manager. What the service does well: 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. 288 Shipbourne Road DS0000043938.V334449.R01.S.doc Version 5.2 Page 6 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 288 Shipbourne Road DS0000043938.V334449.R01.S.doc Version 5.2 Page 7 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): 2 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 will be assessed. EVIDENCE: Four individual records were looked at for this inspection. It is clear that new residents will only be admitted after a detailed assessment process which includes getting information from the placing authority’s representative. The assessment information is used to compile a care plan. The format being used in the home is based on person centred planning and focuses on an individual’s wishes as well as their needs. 288 Shipbourne Road DS0000043938.V334449.R01.S.doc Version 5.2 Page 8 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): 6, 7 and 9 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 lifestyle as possible. EVIDENCE: Four individual records were looked at for this inspection. There is a lot of information on each person and therefore it is separated out by an index. A broad range of subjects is assessed including communication and choice, education (includes weekly plans), behaviour, finance and cultural needs. Information is used to identify any personal goal that the staff are trying to support the resident to achieve (Goal/Action Plan). Specialist advice is sought for particular needs and the home also operates a key worker system. Communication requirements are noted eg current Makaton signs used by an individual and new ones being worked on. The plans are regularly reviewed and this includes the residents and their representatives where appropriate. 288 Shipbourne Road DS0000043938.V334449.R01.S.doc Version 5.2 Page 9 An example was noted of a resident being supported by an advocate and the manager said that this would be looked at for anyone who needed that support. Each resident had a financial section in their individual record and examples were noted of people being enabled to be as independent as possible. Each person has a risk action plan which is individual and focuses on benefits to the individual with steps to reduce any risk rather than simply avoiding an activity that has a degree of risk. The Action Plan has clear guidelines for staff to enable an activity to take place. 288 Shipbourne Road DS0000043938.V334449.R01.S.doc Version 5.2 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Activities and involvement in the local community, as well as support for personal relationships will be provided for residents. They will benefit from being offered a healthy diet and a sociable setting for mealtimes EVIDENCE: The records seen for this visit, as well as information provided by staff, the manager and residents all reflect that residents are enabled and encouraged to take part in appropriate activities both within and outside the home. This includes household activities and responsibilities (which varies according to residents’ individual abilities), musical sessions (including outside performers), aromatherapy, gardening, using local day opportunities provision, Age Concern day centre, classes at local college and all sorts of local amenities such as shops, library, pubs and churches. 288 Shipbourne Road DS0000043938.V334449.R01.S.doc Version 5.2 Page 11 Relationships are supported and examples were noted of staff facilitating contact through the use of letters and card writing on behalf of residents, supporting people to use the phone, making residents’ visitors welcome and using the internet to send and receive emails. There are daily plans for each person which contain clear guidance for staff about routines, preferences for personal care and any particular support needs for eating. I joined the residents that were at home for lunch. This was a sociable time with the staff joining in as well. The three residents who were at home (one was at work and the other attending a lunch club) all chose something different to eat. I was informed that residents’ preferences are known and any planned meal reflects residents’ choices and this is recorded on the menu sheet. 288 Shipbourne Road DS0000043938.V334449.R01.S.doc Version 5.2 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 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: As noted under the previous standard there is guidance for staff about how an individual prefers and requires personal care to be provided. Same gender care is provided whenever possible. The daily records show that people get up and go to bed when they wish although mostly people have a routine that they like. There were examples of residents choosing whether or not to go to a day activity and other examples of having control over their lives. Independence is considered an important part of the support provided at the home and there were lots of examples of specialist equipment in place to help with this. Professional advice has been sought on behalf of residents such as particular guidance about how to help someone with no sight to move around with more confidence. Healthcare needs are clearly assessed and recorded within the individual care plans and other health care professionals are accessed regularly or as required. 288 Shipbourne Road DS0000043938.V334449.R01.S.doc Version 5.2 Page 13 Each person has healthcare profile which brings this information together and includes an individual’s preference about how they take their medication. Medication is appropriately stored and administered. Most of the staff who are responsible for medication are either qualified nurses, have received some training in medication or have completed National Vocational Qualification (NVQ) Level 2 or 3. The manager needs to review training to ensure that competency is regularly assessed if an individual has not yet received training in medication. 288 Shipbourne Road DS0000043938.V334449.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected from abuse and their views are listened to and acted on. EVIDENCE: The procedures for making complaints are appropriate and one example was noted of the organization taking residents’ concerns seriously. Most things are dealt with at a ‘problem solving‘ stage before they become a complaint. The recordings reflect a professional attitude. Staff have received training regarding safeguarding adults and the organization has a range of relevant policies and procedures. Staff spoken to were clear about their responsibilities towards the residents and confirmed that they were aware of the procedures for whistle blowing. 288 Shipbourne Road DS0000043938.V334449.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 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: The building is purpose built and suitable for its stated purpose. The house is bright and cheerful and satisfactorily maintained. The manager and staff confirmed that redecoration and replacement of fittings is on going. The garden at the front needs some attention and the manager explained that the poor weather recently has prevented them cutting the grass. There is easy access to some local amenities which are within walking distance and the home has a suitable vehicle to take people further afield if needed. The home was clean and fresh on the day of this visit. The laundry facilities are satisfactory and staff have received training in various aspects of health and safety relating to infection control. 288 Shipbourne Road DS0000043938.V334449.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sound recruitment procedures and training provided to staff will have a beneficial impact on residents. EVIDENCE: The staff on duty at the time of the inspection were knowledgeable about the residents and their individual needs such as communication. A Cultural Needs Assessment has been completed for each person which helps staff to understand any particular need relating to the individual such as their religion. One or two of these assessments were less well completed and this was brought to the attention of the manager. I observed members of staff to be interested in the people they were supporting and good communicators. The manager and deputy manager both have NVQs Level 4, one member of staff has Level 3 and 3 others have Level 2. The home is currently having to use agency staff as there are people on long term sick leave but the manager said that they try to be consistent in who works at the home to try and reduce the risk of lack of consistency. 288 Shipbourne Road DS0000043938.V334449.R01.S.doc Version 5.2 Page 17 The manager and staff confirmed that the process of recruiting new staff includes a criminal records bureau check, two written references, application forms and interviews. Staff have written terms and conditions of employment and are all given a copy of the General Social Care Council’s code of practice. There is a programme of training, including induction training which covers a range of subjects relating to the care of people with learning disabilities, physical disabilities and age related needs. Makaton training is provided as is training regarding valuing diversity. 288 Shipbourne Road DS0000043938.V334449.R01.S.doc Version 5.2 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well run home and their health and safety is promoted and protected. EVIDENCE: The manager is qualified and experienced and keeps up to date with periodic training. The organization seeks the opinions of residents and their representatives about the home. They carry out visits under Regulation 26 ie they visit the home regularly to undertake their own checks on quality. Policies and procedures are regularly reviewed. The training programme covers a range of aspects of health and safety such as first aid, food hygiene, manual handling and fire safety. The fire safety checks are appropriately carried out. The organization has relevant and appropriate policies and procedures and a spot check on maintenance and service contracts showed that these were satisfactory and up to date. 288 Shipbourne Road DS0000043938.V334449.R01.S.doc Version 5.2 Page 19 288 Shipbourne Road DS0000043938.V334449.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 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 X 3 X X 3 X 288 Shipbourne Road DS0000043938.V334449.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No 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. Refer to Standard Good Practice Recommendations 288 Shipbourne Road DS0000043938.V334449.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 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 288 Shipbourne Road DS0000043938.V334449.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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