Inspection on 31/10/06 for 3 Lenham Road

This inspection was carried out on 31st October 2006.

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

3 Lenham Road 29/05/08

3 Lenham Road 29/11/05

3 Lenham Road 04/07/05

3 Lenham Road 15/03/05

3 Lenham Road 10/06/04

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 3 Lenham Road 3 Lenham Road Headcorn Ashford Kent TN27 9TU Lead Inspector Debbie Sullivan Key Unannounced Inspection 31st October 2006 09:40 3 Lenham Road DS0000024086.V309858.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 3 Lenham Road DS0000024086.V309858.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. 3 Lenham Road DS0000024086.V309858.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 3 Lenham Road Address 3 Lenham Road Headcorn Ashford Kent TN27 9TU 01622 891067 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) MCCH Society Limited Mrs Pauline Matthews Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 3 Lenham Road DS0000024086.V309858.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th November 2005 Brief Description of the Service: 3 Lenham Road is one of a group of small care homes managed by MCCH Society Ltd. The home provides care for three adults aged 18 -65 years with a Learning Disability. It is a 10-minute walk from Headcorn village centre and very close to a local shop. The accommodation is provided on two floors, with the three bedrooms occupied by service users on the first floor. All three bedrooms are single. The three service users share a first floor bathroom and toilet facilities. The staff sleep-in room is located on the ground floor adjacent to the entrance hall. The ground floor also has a toilet, an adapted shower facility, dining room, kitchen and lounge. The staff roster allows for one member of staff on a sleep in duty at night. The home has no staff employed to be responsible for catering and domestic duties, and the usual routine is for all staff and service users to undertake these duties. The cost of the service is £1,127.00 per week. 3 Lenham Road DS0000024086.V309858.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report of the Key inspection of 3 Lenham Road has been compiled using information gained on the site visit, discussion with residents and support workers, the pre inspection questionnaire was completed by the senior support worker, and information was also supplied on survey forms and comment cards. Due to the nature of the service some judgements regarding quality of life and choices have been made by speaking with staff and reading records and documentation. Since the last inspection the resident group in the house has completely changed, therefore although requirements and recommendations made in the last report were discussed and where possible progress inspected, those relating to care plans and the needs of residents were not all still relevant to the current service provided. At the time of the site visit all the residents were female. Comments made by residents during the site visit included, “I like going shopping” “I like the staff” “The other ladies are friends” Comments made by relatives on comment cards included, “Impressed with the care (resident) is being given. The staff keep me well informed of her welfare”. “She has settled in well”. A comment made by a health/social care professional was that, “My experience is that staff are always helpful and seem to have an excellent rapport with service users…….they are committed to their work” What the service does well: 3 Lenham Road DS0000024086.V309858.R01.S.doc Version 5.2 Page 6 The home provides a welcoming, homely, clean and well-maintained environment for residents to live in. Residents are supported in being able to participate in a wide range of activities at home and within the community and there is plenty of opportunity for one to one support. Support workers have good understanding of residents’ needs. The needs of residents as regards all aspects of their lives are well documented and reviewed; care plans are clear and easily accessible to residents and staff. Good health is promoted and any health concerns promptly dealt with. Staff are provided with plenty of training opportunities and are well supported. What has improved since the last inspection? The service users’ guide has been revised and includes clear user-friendly information and pictorial information. Care plans have been revised so that they are now set out in an accessible and clear format that includes detailed information on all aspects of each resident’s health, personal and social care needs, and their goals and aspirations. Person centred planning is in place. Risk assessments have been progressed in relation to personal and house activities, and clearly detail potential risk and actions to be taken to minimise them. Protocols are in place for the administration of PRN medication. The kitchen has been deep cleaned, fitted with new blinds, and there is some new living room furniture. Staff rotas now include the full names of staff. A review of most of the home’s recording and documentation has led to records being made accessible to residents where appropriate, and to clarity of information for staff and the information being current and relevant. 3 Lenham Road DS0000024086.V309858.R01.S.doc Version 5.2 Page 7 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. 3 Lenham Road DS0000024086.V309858.R01.S.doc Version 5.2 Page 8 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 3 Lenham Road DS0000024086.V309858.R01.S.doc Version 5.2 Page 9 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): 1,2,3,4,5 and 6 The quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. Prospective residents are able to access information about the home and visit before making a decision to move in their needs are assessed prior to admission. EVIDENCE: The service users’ guide has been revised and is presented in a format accessible to residents with clear pictorial information, the statement of purpose continues to be under review and will need to include the name of the new registered manager. Since the last inspection a new group of residents has moved into the house, the resident group is still all female, two residents moved in in February 2006, with a third joining them in June. Introductory visits took place and two residents who had been supported by staff to complete survey forms had commented on them that they had visited and met staff and the other residents/s. Needs had been fully assessed prior to admission, and one resident who had moved from another MCCH service that did not have so many staff hours provided stated on their survey form that they preferred living at Lenham Road as they had more company and support. 3 Lenham Road DS0000024086.V309858.R01.S.doc Version 5.2 Page 10 Residents spoken with on the site visit liked living at the home, and it was clear from speaking with them and staff and reading care plans that every effort was being made to meet their needs. Each resident has a contract with the service. 3 Lenham Road DS0000024086.V309858.R01.S.doc Version 5.2 Page 11 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): 6,7,8,9 and 10 The quality in this outcome area is excellent. This judgement has been made using available evidence, including a visit to the service. The health, social and personal care needs of residents are set out in detail on care plans. Residents are supported to take risks and make decisions, and are consulted as regards the running of the home. EVIDENCE: With the new group of residents at the house, and review of documentation individual care plans have been developed that clearly reflect health, personal care and social needs, and provide up to date and background information in a format that is easy to access for residents and staff, and that has plenty of pictorial information. Person centred planning is in place and the work that has been done on care plans this year is to be commended. Risk assessments are held separately from the care plans and also of a high standard. The senior support worker undertaking some management responsibilities regularly audits care plans. 3 Lenham Road DS0000024086.V309858.R01.S.doc Version 5.2 Page 12 Evidence was in place of initial placement reviews and contact with health and social care professionals on a regular basis or when there were any concerns. A support worker was requesting a second placement review with a care manager during the site visit. It was clear that in depth work had taken place to gain as much information as possible on each resident before they moved in, and during their initial months at the home. A daily log is kept and transferred onto the care plan that gives a full picture of each resident’s day. Residents are supported in taking decisions about their lives and are included in decisions about the home through participation at house meetings and day to day discussion, for example about choice of meal. Records are held confidentially and securely. 3 Lenham Road DS0000024086.V309858.R01.S.doc Version 5.2 Page 13 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): 11,12,13,14,15,16 and 17 The quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. Residents have opportunities to take part in a range of activities at home and in the community. The rights of residents are promoted and the home is run flexibly so that individual choice is respected. Meals are varied and healthy. EVIDENCE: Residents are provided with support to access a range of activities in the community and at home. Care plans contain a weekly planner detailing the planned or flexible daily activities for each person, free time is built in to allow time for domestic tasks and for residents to choose what to do at home e.g. watch television or spend time in their room. Planned activities include swimming, bowling, horse riding, a jewellery making class and shopping. Regular leisure activities and outings include going out for meals, to a wildlife park, a funfair and participating in local and regular MCCH social events. During the site visit two residents went bowling and the other was supported to go out for a walk, later in the day they were attending a 3 Lenham Road DS0000024086.V309858.R01.S.doc Version 5.2 Page 14 Halloween party with other MCCH service users and had bought special costumes for the event. Residents had all been on holidays this year. Regular contact is maintained with relatives, and recording of contacts or visits was seen on care plans. Residents are supported to manage their own finances and time is set aside each week for budgeting. Throughout the site visit it was clear from the views expressed by support staff, observation and recording that the rights of residents are respected and independence and choice are promoted. Residents are consulted about choice of meals and help with the food shopping. The menus are varied and healthy and residents spoken with said they liked the meals at the home. 3 Lenham Road DS0000024086.V309858.R01.S.doc Version 5.2 Page 15 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 and 21 The quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. Residents’ personal care needs are well recorded, and staff are aware of individual preferences. The health care needs of residents are well met and promoted, and contact is maintained with relevant health care professionals. EVIDENCE: The personal preferences of residents in respect of their personal care needs are recorded on care plans, support workers are aware of individual needs and privacy and dignity are respected. Care plans contain detailed information on health care needs and evidence of contact with a range of health care professionals such as an audiologist, neurologist, speech therapist and chiropodist. Any health concerns are promptly actioned, the senior support worker gave an example of recent action to request an appointment with a consultant. Residents have visual and hearing impairments so staff have received some training from a sensory specialist. Regular health checks are undertaken and staff are working on encouraging a resident who is reluctant to visit the dentist to attend an appointment. 3 Lenham Road DS0000024086.V309858.R01.S.doc Version 5.2 Page 16 Medication policies and procedures are in place and all staff have received medication training, MAR sheets were correctly filled in and PRN protocols had been put into place. Each resident has a medication file, it is a recommendation that the files be relabelled, as the labelling was misleading and could give the impression that residents were prescribed controlled medication which is not the case. A section for the inclusion of wishes in the event of death is provided in care plans, although due to the sensitivity of the issue and fairly recent arrival of the residents they had not yet been fully completed. The residents are all in their mid fifties and any possible age related health issues such as weight gain or high blood pressure are recorded and action taken, such as blood pressure checks and weight monitoring. 3 Lenham Road DS0000024086.V309858.R01.S.doc Version 5.2 Page 17 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 and 23 The quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. Residents are offered opportunities to express any concerns, and others are able to raise any concerns on their behalf. Policies and procedures are in place to protect residents from abuse. EVIDENCE: The home has a complaints procedure that is available to residents and others. One complaint had been recorded since the last inspection in relation to the service before the current group of residents moved in. Residents have opportunities to raise any concerns individually with staff and at house meetings, due to the nature of the service they mainly require support to do so or rely on others to advocate on their behalf. Support staff are able to gauge by the non verbal communication of the residents if they are not happy about anything as verbal communication skills vary. There were no adult protection alerts in relation to the service, as was the case at the last inspection. Staff receive adult protection training and the home has an adult protection procedure. 3 Lenham Road DS0000024086.V309858.R01.S.doc Version 5.2 Page 18 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): 24,25,26,27,28,29 and 30 The quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. Residents live a well-maintained, clean, safe and homely environment that meets their needs although repainting of the laundry walls will improve infection control. Individual bedrooms are personalised. EVIDENCE: The home is warm, clean, comfortable, well maintained and has a homely atmosphere. Since the last inspection some new living room furniture has been provided, the kitchen has been deep cleaned, minor refurbishments required have been attended to, and the new residents have personalised their bedrooms. There is a separate dining room and the living room is light and airy. The senior support worker said that work is due to take place to refurbish bedrooms. The ground floor has an adapted shower room, and there is a bathroom on the first floor, it was noted that a bottle of cleaning material had been left in a cupboard in the bathroom that was accessible to service users. The home has 3 Lenham Road DS0000024086.V309858.R01.S.doc Version 5.2 Page 19 a small secluded and well-kept garden to the front and back of the property, and there is a patio area that can be used in good weather. The small laundry is separated from other areas of the home by a door; flaking paint on the laundry walls must be attended to. The home does not employ any domestic staff, support staff and residents are responsible for cleaning and laundry, and staff support residents to a level that suits their abilities. One resident was being supported with doing the dusting on the day of the inspection. 3 Lenham Road DS0000024086.V309858.R01.S.doc Version 5.2 Page 20 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): 31,32,33,35 and 36 The quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. Residents are supported by a well trained and enthusiastic staff team. Staff are well supported and supervised. EVIDENCE: Standard 34 was not inspected, an agreement is in place that the CSCI Performance Relationship Manager for MCCH inspects staff records at least once a year, the results of the inspection in July 2006 were that recruitment documentation and vetting of staff was in place. Improvement was needed to application forms and the interview process. Since the last inspection there have been some changes in staffing, two new members of staff have joined the team and the manager has become registered. As well as the manager a senior support worker and five support staff work at home, (although the manager is currently absent from work due to sick leave); existing or MCCH bank staff cover any gaps in the rota. Staff observed during the site visit and spoken with were confident with the residents and had a very good rapport with them, staff liked working at Lenham Road and were genuinely committed to providing residents with a 3 Lenham Road DS0000024086.V309858.R01.S.doc Version 5.2 Page 21 good quality service and enthusiastic about their roles. A keyworking system is in place. Staff spoken with said that the organisation offers good training opportunities and that thorough induction is provided. Three members of staff had achieved an NVQ qualification in care at level 2 or above and a further three were undertaking NVQ 3. Staff receive regular documented supervision and are well supported by the organisation. 3 Lenham Road DS0000024086.V309858.R01.S.doc Version 5.2 Page 22 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): 37.38,39,40,41,42 and 43 The quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. The home is well run in the best interests of residents and staff. The health, safety and welfare of residents are protected by the home’s working practices and policies and procedures. EVIDENCE: The home has undergone changes since the beginning of the year with the arrival of a new group of residents, overhaul of much documentation, employment of new staff and the registration of the manager. The last report commented that there had been five changes in manager in two years and the new manager had brought about improvements in the ethos of the staff team. This clearly continues and although the manager was not present during the site visit, the senior support worker who was in charge had carried on this work and some documentation introduced was being rolled out into other MCCH properties in the area. 3 Lenham Road DS0000024086.V309858.R01.S.doc Version 5.2 Page 23 The atmosphere in the home is open and friendly, and residents are given opportunities to contribute to it’s running, a quality assurance survey had very recently been sent out Safety checks and monitoring take place regularly, fire equipment tests were up to date and fire practices had been held monthly. Fridge and freezer temperatures are recorded daily and a daily staff handover check sheet includes safety and financial checking tasks. Staff team meetings are also regularly held and are minuted. Records and documentation is held safely and securely. Following a gap in Regulation 26 visits taking place these are now reinstated with an organisational review of the arrangements for the visits. 3 Lenham Road DS0000024086.V309858.R01.S.doc Version 5.2 Page 24 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 3 2 3 3 3 4 3 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 3 26 3 27 3 28 3 29 3 30 2 STAFFING Standard No Score 31 3 32 3 33 3 34 X 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 3 3 3 3 3 Lenham Road DS0000024086.V309858.R01.S.doc Version 5.2 Page 25 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. 1. Refer to Standard YA1 Good Practice Recommendations It is strongly recommended that the name of the current Registered Manager is included in the Statement of Purpose at the earliest opportunity if it is not to be fully revised in the near future. It is strongly recommended that residents’ medication files be relabelled so that they do not give misleading information on the medication prescribed. Work took place on this during the site visit. 3. 4. YA30 YA42 It is strongly recommended that the laundry paintwork that is flaking be sanded down and repainted. It is strongly recommended that staff be reminded that all cleaning materials that could cause a hazard to residents are safely stored when not in use. 2. YA20 3 Lenham Road DS0000024086.V309858.R01.S.doc Version 5.2 Page 26 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 3 Lenham Road DS0000024086.V309858.R01.S.doc Version 5.2 Page 27 - 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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