Inspection on 04/08/06 for 2a Higham Road

This inspection was carried out on 4th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

2a Higham Road 01/02/06

2a Higham Road 27/09/05

Similar services:

Thorndene

Insight - Eastchurch

Southfields

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Seabourne House

33 St John`s Church Road

Dovedale Court

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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 2A Higham Road 2A Higham Road Wainscott Rochester Kent ME3 8BB Lead Inspector Andrea Leverett Key Unannounced Inspection 4th August 2006 10:00 2A Higham Road DS0000064373.V307589.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 2A Higham Road DS0000064373.V307589.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. 2A Higham Road DS0000064373.V307589.R01.S.doc Version 5.2 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.V307589.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st February 2006 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.V307589.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place between 9.30am and 12.30am on the 4th of August 2006. One service user was spoken with as well as two staff members 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 very good service at Higham Rd, although there are concerns about lack of separate communal space and the effect this is having on service users right to choose who they spend time with. The current charges are £1341.00 What the service does well: What has improved since the last inspection? The Home has continued to up grade its furniture and fittings for the benefit of service users. Since getting its own transport the Home has continued to expand the range and volume of community based activities that service users have access to. 2A Higham Road DS0000064373.V307589.R01.S.doc Version 5.2 Page 6 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.V307589.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 2A Higham Road DS0000064373.V307589.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The quality of service in this outcome area is judged as excellent. Prospective service users can be confident that their individual aspirations and needs will be assessed. EVIDENCE: Since Avenues trust became the new care provider they have undertaken very detailed and comprehensive assessments of all service users’ aspirations and needs and have used a person centred planning approach to ensure that assessments are based on individuals. So although no new service users have moved into this Home for many years, given the new assessment work that has been undertaken for existing service users and the services policies and procedures for admitting new service users, the inspector is confident that all prospective service users will have their individual needs assessed. 2A Higham Road DS0000064373.V307589.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 The quality of service in this outcome area is judged as excellent. Service users benefit from having their assessed and changing needs and personal gaols reflected in their Person centred Plan and are supported to make decisions and take risks as part of an independent life style. EVIDENCE: The inspector tracked the assessment and person centred planning systems for two service users and was impressed with the comprehensive and detailed information. Information included activities time table, participation record, holistic profiles, What an average day and a best day would look like, Likes and dislikes, risk assessments, weight charts, health visits, assessment of cultural needs and faiths, therapeutic certificates, record of reviews, speech and language records and medication reviews. Discussion with staff and observation on the day of the site visit showed that this information was being used to aid choice making and guide daily living. 2A Higham Road DS0000064373.V307589.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 The quality of service in this outcome area is judged as excellent. Service users have opportunities for personal development through the provision of a range of age, peer and culturally appropriate therapeutic and leisure activities. Service users benefit from having good family contact and living in a Home that encourages their involvement. Service users have a healthy diet and are supported to make choices regarding food and drink. EVIDENCE: All service users have access to a range of activities to meet their needs. Records viewed showed that these were being undertaken regularly. On the day of the inspection one service user was having a therapeutic music session, the facilitator was a skilled musician and used a variety of instruments including an electronic keyboard. Another service user explained how she was going to the cinema to see a film of her choice in the afternoon. Records also 2A Higham Road DS0000064373.V307589.R01.S.doc Version 5.2 Page 11 showed that service users attended hydrotherapy, foot spar, reflexology, massage and sensory activities, visits to cafes and evening clubs, meals out, bowling and holidays that service users have helped plan and choose. Overall the inspector continues to be impressed with the range and frequency of activities offered. Discussion with staff and feedback from family members shows that family contact and their involvement in the Home is promoted and valued by the staff. An inspection of the Homes kitchen, food storage and menus was undertaken. A broad range of healthy food was seen in stock including a variety of fresh fruits and vegetables. Menus were varied and balanced and discussion with service users showed that they were encouraged to shop and prepare their own food if that was their wish and their choices around food were respected and promoted. 2A Higham Road DS0000064373.V307589.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 The quality of service in this outcome area is judged as excellent. Service users receive support in the way they prefer and require and their physical and emotional health needs are met. Service users are protected by the Home’s policies and procedures for dealing with medicines. EVIDENCE: Records of assessments and care plans seen and observation and discussion with staff showed that service users receive personal care and support in the way they prefer and require. Records included guidelines for undertaking aspects of personal care and daily records evidenced that preferred choices in daily living were respected. Records seen and discussion with staff showed that access to routine and specialist health services was provided. An inspection of the Home’s medication storage and administration systems showed that medication was being stored administered and recorded appropriately. Records included staff signatures and detailed guidelines for administering individual medications. Training records showed that staff are 2A Higham Road DS0000064373.V307589.R01.S.doc Version 5.2 Page 13 trained to administer medication, although the inspector was unable to establish if the in house course included all aspects of medication administration and record keeping, and was undertaken by a person qualified to do so and whether the training included a competency test. A requirement has been made for the Home to evidence that medication administration training provided by the service meets these requirements. 2A Higham Road DS0000064373.V307589.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 The quality of service in this outcome area is judged as good. Service users and their families know that their concerns will be listened to and acted upon. Service users are protected from abuse, neglect and self-harm. EVIDENCE: The Home has a complaints procedure, which meets all the requirements of this standard. Discussion with staff and the manager demonstrated that concerns and complaints would be taken seriously, although no complaints have been made in the last 12 months. Records showed that staff work hard to establish service users wishes and needs. The Home has appropriate Adult Protection procedures and policies, 1 staff spoken to demonstrate a good understanding of Adult Protection issues and how they relate to local authority protocols. The staff informed the inspector that Adult Protection refresher training is undertaken annually and a sample of staff training records seen confirmed this. 2A Higham Road DS0000064373.V307589.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,28,30 The quality of service in this outcome area is judged as good. 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 continues to be maintained to a good standard in terms of hygiene, décor and furnishings. Although it was noted at the last inspection that separating out the lounge/diner had brought some benefits for service users in terms of privacy and choice, feedback from this inspection showed that these spaces are still small and are not providing the choice and privacy that has been assessed as being needed by the service users. For example tensions between two service users continue to be apparent and lack of choice of communal spaces is thought to be the main course of this tension. A requirement to address this has now been made. 2A Higham Road DS0000064373.V307589.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 The quality of service in this outcome area is judged as excellent. Service users individual and joint needs are met by an effective and appropriately trained and supervised staff team. Service users are supported and protected by the Homes recruitment policy and practice. EVIDENCE: An inspection of the Home’s rotas, daily records and discussion with staff evidenced that service users benefit from having sufficient staff to meet their needs at all times. Records viewed and discussion with staff showed that staff were trained and supervised to a good standard and staff felt supported by the organisation. The inspector interviewed and tracked the records of the most recently employed staff member. The inspector was particularly impressed with the detailed induction training, which had been undertaken within six. The staff member explained how she had to think about each section of the induction and undertake her own research. She thought the induction was very good and likes working at the Home. She confirmed that she had regular supervision and felt supported by the management team. 2A Higham Road DS0000064373.V307589.R01.S.doc Version 5.2 Page 17 An inspection of staff records showed that all appropriate checks and procedures are being undertaken before staff are offered a job. 2A Higham Road DS0000064373.V307589.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 The quality of service in this outcome area is judged as excellent. The care of service users is enhanced by a staff team that is led by a competent and experienced manager, who ensures that the Home is run well. EVIDENCE: The manager has several years experience of working with this client group as a support worker and later in a management capacity. Observation on the day, records viewed and discussion with staff evidenced that the manager delivered an effective service user led service. Service users and staff spoke highly of her and felt that she was approachable and inclusive in her management style. Records seen included the Home’s quality assurance file, which showed that regular staff team and service user meetings took place, as did providermonitoring visits. Information taken from the Home’s pre-inspection questionnaire, records seen at the Home and a tour of the premises showed that the Home was maintained appropriately. 2A Higham Road DS0000064373.V307589.R01.S.doc Version 5.2 Page 19 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 4 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 2 29 X 30 4 STAFFING Standard No Score 31 X 32 4 33 X 34 4 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 4 X 3 X X 4 X 2A Higham Road DS0000064373.V307589.R01.S.doc Version 5.2 Page 20 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. 1 Standard YA20 Regulation 18(1)(c ) (i) Requirement The registered person must evidence that staff have received appropriate medication administration training. Action plan by The registered person must ensure adequate communal spaces are provided that are in keeping with service users needs. Improvement plan required by: Timescale for action 29/09/06 2 YA24 23.2(a) 29/09/06 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.V307589.R01.S.doc Version 5.2 Page 21 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.V307589.R01.S.doc Version 5.2 Page 22 - 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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