CARE HOME ADULTS 18-65
2A Higham Road 2A Higham Road Wainscott Rochester Kent ME3 8BB Lead Inspector
Andrea Leverett Unannounced Inspection 1st February 2006 10:00 2A Higham Road DS0000064373.V285540.R01.S.doc Version 5.1 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 2A Higham Road DS0000064373.V285540.R01.S.doc Version 5.1 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. 2A Higham Road DS0000064373.V285540.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service 2A Higham Road Address 2A Higham Road Wainscott Rochester Kent ME3 8BB 0208 3082900 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 Mrs Hannah Townshend Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 2A Higham Road DS0000064373.V285540.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 27th September 2005 Brief Description of the Service: The Home is managed by Avenues Trust and provides service for up to 3 people with a Learning Disability. The home itself is situated in Wainscott and has some beautiful views of the countryside. Service users have access to a large garden. The home has a Lounge/Dining room, a Kitchen and a Utility Room. The service users bedrooms are large and well furnished. The home is on two floors and there is a stair lift to access the upper level. Service users can access Rochester via the local bus route. There are local shops and amenities, which the service users can access. 2A Higham Road DS0000064373.V285540.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place between 9.30am and 12.30am on the 1st February 2006. Two service users were spoken with as well as a staff member and the manager. Due to the nature of the service, it is difficult to reliably incorporate accurate reflections of the service users in the report. Some judgements about quality of life and choices were taken from direct observation on the day followed by discussion with support staff and evidencing records held at the home. The inspector concluded that the service users continue to be given a good service at Higham Rd, although there are concerns about lack of separate communal space. What the service does well: What has improved since the last inspection?
2A Higham Road DS0000064373.V285540.R01.S.doc Version 5.1 Page 6 Some improvements have been made to the quality of the service users environment by redesigning the communal spaces. Safety of service users has improved by ensuring that all staff that administers medication has certificated medication administration training. The needs of one service user have been better understood and met by ensuring all staff have received refresher training in ‘dementia with people with learning difficulties.’ The quality of the bedroom environment has been improved for one service user by replacing his existing bed with one that can be easily cleaned and replacing the carpet. 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. 2A Higham Road DS0000064373.V285540.R01.S.doc Version 5.1 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 2A Higham Road DS0000064373.V285540.R01.S.doc Version 5.1 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): 5 Service users benefit from having individual written contracts, which include the terms and conditions of the Home. EVIDENCE: Avenues have now completed the process of renewing all service users contracts to reflect the recent change in care contracts from the old providers to Avenues Trust. 2A Higham Road DS0000064373.V285540.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, Service users know their assessed and changing needs and personal goals are reflected in their individual plan. EVIDENCE: A sample of person centred plans was inspected. The inspector was impressed with the holistic profiles of service users and comprehensive person centred plans. These were thoughtfully prepared and demonstrated a good understanding of service users needs, their wishes and aspirations. 2A Higham Road DS0000064373.V285540.R01.S.doc Version 5.1 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the above was inspected on this occasion EVIDENCE: 2A Higham Road DS0000064373.V285540.R01.S.doc Version 5.1 Page 11 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): 20 Service users benefit from a staff team that are trained to administer a safe system of medication administration. EVIDENCE: Records seen and discussion with staff confirmed that the Home has a programme of staff training for medication administration in place. 2A Higham Road DS0000064373.V285540.R01.S.doc Version 5.1 Page 12 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 Service users are protected from abuse and systems are in place to ensure their concerns are listened to. EVIDENCE: The Home has a complaints procedure, which is accessible to service users. The homes compliments and complaints record was viewed and showed that the Home has had no complaints in the last 12 months and has received several compliments. Staff undergo refresher Adult Protection training yearly and staff spoken to demonstrated a good understanding of the Local Authority Adult Protection Procedures and Policies. 2A Higham Road DS0000064373.V285540.R01.S.doc Version 5.1 Page 13 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): 24,28,30 Service users benefit from living in a homely environment that is safe and free from offensive odours. More could be done to provide service users with space and privacy in the homes communal areas. EVIDENCE: Records seen and a partial tour of the premises showed that maintenance checks are carried out regularly and the Home is maintained to a good standard in terms of hygiene, décor and furnishings. Although it is acknowledged that separating out the lounge/diner has brought some benefits for service users in terms of privacy and choice, these spaces are still small and in the inspectors view not adequate in the longer term. 2A Higham Road DS0000064373.V285540.R01.S.doc Version 5.1 Page 14 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 Service users benefit from staff that are trained to meet their individual and joint needs. EVIDENCE: This standard was nearly met at the last inspection. Training records seen at the time showed that a comprehensive range of mandatory and service specific training was offered. However in order to better meet the individual needs of one service user it was recommended that staff undergo refresher dementia awareness training. The manager informed the inspector that this has now been undertaken and staff from the Home are working closely with the community health team and psychologist to improve their knowledge in this area. 2A Higham Road DS0000064373.V285540.R01.S.doc Version 5.1 Page 15 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): None of the above was inspected on this occasion. EVIDENCE: 2A Higham Road DS0000064373.V285540.R01.S.doc Version 5.1 Page 16 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 X 3 X 4 X 5 3 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 2 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 X X X X X X X X 2A Higham Road DS0000064373.V285540.R01.S.doc Version 5.1 Page 17 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 Refer to Standard YA28 Good Practice Recommendations It is recommended that additional communal space be provided. 2A Higham Road DS0000064373.V285540.R01.S.doc Version 5.1 Page 18 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
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