Inspection on 27/09/05 for 2a Higham Road

This inspection was carried out on 27th September 2005.

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

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

2a Higham Road 04/08/06

2a Higham Road 01/02/06

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 2A Higham Road 2A Higham Road Wainscott Rochester Kent ME3 8BB Lead Inspector Andrea Leverett Announced Inspection 27th September 2005 9:30 2A Higham Road DS0000064373.V254384.R01.S.doc Version 5.0 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.V254384.R01.S.doc Version 5.0 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.V254384.R01.S.doc Version 5.0 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.V254384.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: The Home is now 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.V254384.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place between 9.30am and 12.30am on the 27th of September. 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? The quality of life and opportunities for service users has been improved by the Home providing annual holidays. 2A Higham Road DS0000064373.V254384.R01.S.doc Version 5.0 Page 6 Service users needs are better reflected and represented in the staff recruitment process since the manager has been allowed to be on the interview panel. A new vehicle has now been ordered, which will improve service users access to the community. 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.V254384.R01.S.doc Version 5.0 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.V254384.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,5 Service users are given the information they need to be able to make an informed decision to live at 2a Higham Rd but are put at a disadvantage by not currently being provided with an individual contract or statement of terms and conditions for the home. EVIDENCE: Service users have access to a reviewed statement of purpose and service users’ guide which give good representation of the service provided in the home. Avenues Trust has recently taken over the management of this service and are currently in the process of drawing up individual service user contracts. 2A Higham Road DS0000064373.V254384.R01.S.doc Version 5.0 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): None of these standards were inspected on this occasion but outcomes as regards these standards were considered good for service users at the last inspection. EVIDENCE: 2A Higham Road DS0000064373.V254384.R01.S.doc Version 5.0 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): 13,14,15,16,17 Service users benefit from having the opportunity for personal development with their daily living skills and enjoy leisure activities in their local community and holidays. Service users are supported to maintain contact with family and friends, which ensures they continue to receive stimulation and emotional support. Service users’ choices regarding food are respected and they benefit from a balanced diet, using a range of vegetables and freshly prepared meals. EVIDENCE: It was evident throughout the inspection that service users were supported to maintain their individual living skills, and their social and emotional skills. Records and discussion with staff and the manager and observation on the day of the inspection evidenced that service users were encouraged to take part in tasks such as cooking. Activity records evidenced that outings in the local community were undertaken regularly. Service users have had their first holiday for a number of years, which went very well and the manager informed the inspector that these would now be offered regularly. 2A Higham Road DS0000064373.V254384.R01.S.doc Version 5.0 Page 11 An inspection of the home’s kitchen, food storage areas and the home’s menus was undertaken and it was evident that a balanced diet was provided. 2A Higham Road DS0000064373.V254384.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 The Home ensures that service users receive personal support in a way that they prefer and require and their physical and emotional health needs are met. On the whole the Home ensures that service users benefit from a safe medication administration system but minor shortfalls were identified. EVIDENCE: Discussion with the manager and records viewed revealed that information was available to ensure that staff were able to meet service users personal needs and that this was being acted upon. Information was also available regarding service users preferred routines and observation on the day indicated that these were adhered to. Evidence seen on the day suggests that the Home continues to be proactive in accessing specialist health services on behalf of service users. An inspection of the home’s administration and medication procedures was undertaken. Records inspected indicated that appropriate record keeping was being maintained and that medication was being stored appropriately. However it was noted that some staff have not received certificated medication training and a requirement has been made regarding this. 2A Higham Road DS0000064373.V254384.R01.S.doc Version 5.0 Page 13 2A Higham Road DS0000064373.V254384.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not inspected on this occasion, but previous inspections evidenced that the Home has robust systems and staff training to protect service users from abuse and promote their right to complain. EVIDENCE: 2A Higham Road DS0000064373.V254384.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,26,28,30 Whilst service users benefit from living in a comfortable environment and have access to indoor and outdoor communal areas, some improvements are needed to ensure a safe environment is maintained. Service users live in a clean home but improvements are needed to control the offensive odour in one service user’s room. Service users would benefit from having access to additional separate communal space. EVIDENCE: A tour of the home was undertaken and maintenance records were viewed. Although all areas of the home were clean one service users room had an offensive odour. Advice was given regarding the need to consider purchasing a new bed, which is designed to be cleaned more easily and replacing the carpet. Procedures and equipment for ensuring appropriate infection control was evident throughout the home. The home’s lounge/diner was decorated in a homely style and was nicely furnished. The lounge /diner is small and open 2A Higham Road DS0000064373.V254384.R01.S.doc Version 5.0 Page 16 plan and it was evident that there was friction between two service users who do not appear to enjoy each other’s company. The home does not have a separate communal space where additional activities or privacy could be provided for service users and in this respect their rights and choices are being undermined. A requirement has been made to assess the particular service users needs in this regard and the inspector recommends that additional communal space be provided. Maintenance records showed that gas and electricity supplies were not being serviced and maintained properly and a requirement has been made regarding this. 2A Higham Road DS0000064373.V254384.R01.S.doc Version 5.0 Page 17 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): 33,35 Although service users benefit from being supported by a sufficient number of staff at all times improvements are needed to ensure service users benefit from a more stable staff team. On the whole service users benefit from a staff team that are trained to meet their needs although some minor improvements are needed. EVIDENCE: Discussion with the manager and staff and evidenced seen on the day of the inspection showed that at least 2 staff are on duty at all times during waking hours rising to 3 for particular activities. Activity and daily records viewed and discussion with staff evidenced that sufficient staff are provided to consistently support service users with a wide range of activities including in the evenings and at weekends. Staff also confirmed that they had sufficient staff to meet service users personal care needs at all times. It was noted that less than 50 of staff posts are filled with permanent staff and the rest is made up of a mixture of agency and bank staff. The manager informed the inspector that Avenues is working to address these staffing shortfalls. 2A Higham Road DS0000064373.V254384.R01.S.doc Version 5.0 Page 18 2A Higham Road DS0000064373.V254384.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,42 Service users benefit from a competent and experienced manager, who ensures a well run and accountable management of the service. On the whole service users health and welfare are protected but more could be done to ensure the safety of service users and staff in the Home. EVIDENCE: The manager has an NVQ 3 and the Assessors Award and records demonstrated that she attends periodic training to maintain and update her knowledge. The manager has several years experience of working with this client group in a management capacity. Observation on the day, records viewed and discussion with staff evidenced that the manager delivered an effective service and had an in-depth understanding of service users needs. Staff spoke highly of her and felt that she was approachable and inclusive in her management style. 2A Higham Road DS0000064373.V254384.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 X X X 2 Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X 2 X 2 X 3 LIFESTYLES Standard No Score 11 X 12 X 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X X 2 X 2 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 2A Higham Road Score 3 3 2 X Standard No 37 38 39 40 41 42 43 Score 3 X X X X 2 X DS0000064373.V254384.R01.S.doc Version 5.0 Page 21 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. 1 Standard YA28 Regulation 23.2(a) Requirement The registered person must ensure that service users needs in terms of communal space are assessed and provide an action plan detailing how these needs are to be met. The registered person must ensure that all staff under goes certificated Medication Administration training. The registered person must ensure that the homes gas and electrical appliances are appropriately maintained and provide evidence to the commission that this has been done. The registered person must ensure that the service users room identified is kept free from offensive odours. The registered person shall produce a written guide to the care, which shall include (c) a standard form of contract for the provision of services and facilities by the registered provider. Timescale for action 30/11/05 2 YA20 13.2 30/11/05 3 YA24 23.2(c) 30/11/05 4 YA24 16.2(k) 30/11/05 5 YA5 5c 30/11/05 2A Higham Road DS0000064373.V254384.R01.S.doc Version 5.0 Page 22 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 3 Refer to Standard YA35 YA28 YA24 Good Practice Recommendations It is recommended that all staff undergo refresher Dementia Care Training regarding People with a Learning Disability. It is recommended that additional communal space be provided so that service users identified do not have to share the same space if they do not wish. It is recommended that the bed in the service users room identified is replaced with one that can be cleaned easily and the carpet is replaced. 2A Higham Road DS0000064373.V254384.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 2A Higham Road DS0000064373.V254384.R01.S.doc Version 5.0 Page 24 - 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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