Inspection on 23/01/09 for 320 Hempstead Road

This inspection was carried out on 23rd January 2009.

CSCI found this care home to be providing an Good service.

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

Similar services:

Insight - Eastchurch

Southfields

Thorndene

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 20/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 320 Hempstead Road 320 Hempstead Road Gillingham Kent ME7 3QH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Joseph Harris     Date: 2 3 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: 320 Hempstead Road 320 Hempstead Road Gillingham Kent ME7 3QH 01634365201 01634234861 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): The Avenues Trust Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 4 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 4 The maximum number of service users to be accommodated is four (4). The registered person may provide the following category of service only: Care home only - (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning Disability (LD) Date of last inspection Brief description of the care home 320 Hempstead Road is a 4 bedded home situated in a residential area of Gillingham supporting up to 4 people with learning disabilities. The house is arranged over two floors and provides single en-suite rooms for all of the service users. There are a good-sized garden to the rear of the home and ample parking in the driveway. The home came under the management of The Avenues Trust in September 2008, which is an expanding organisation specialising in residential care for people with learning disabilities. The current fees for the service are 2572.56 pounds per week. Information about the Care Homes for Adults (18-65 years) Page 4 of 28 Brief description of the care home service and facilities of the home are available in the Service User Guide that is available on request from the service. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was the first key unannounced inspection process under the Care Standards Act 2000 for 320 Hempstead Road. The inspection process culminated in a site visit to the service on 23rd January 2009. The site visit commenced at 09:30 hours and lasted approximately 6.5 hours. During the course of the inspection discussions were held with the acting manager, a senior manager, staff and service users. The acting manager will be referred to as the manager for the purposes of this report. A tour of the premises was undertaken and a range of records and documentation was examined including information relating to service users, staff and the daily management of the home. Prior to the site visit the home returned their Annual Quality Assurance Assessment Care Homes for Adults (18-65 years) Page 6 of 28 (AQAA). We also reviewed information received relating to the home including notifications, complaints and other information people have told us. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Adults (18-65 years) Page 8 of 28 following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The needs of prospective service users are assessed prior to admission. Evidence: There have been no new service users admitted to the home since The Avenues Trust assumed ownership of the service in July 2008. The organisation has in place clear policies and procedures guiding the referral and admission of new and prospective service users. These processes were discussed with the manager who demonstrated a good understanding of a smooth transition for new service users. She stated that in all cases detailed background information would be sought from appropriate sources and service users would have the opportunity to spend time in the home before deciding whether or not to move in. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The individual needs, choices and risks of service users are assessed and planned for. Evidence: Two service user files were examined during the course of the inspection visit. In both cases plans of care and support had been developed in good detail using a personcentred format. The plans clearly describe the needs and wishes of service users providing good guidance to enable staff to consistently meet individual needs. Residents have been involved in the planning process working with their key workers to develop the plans. The support plans have been regularly reviewed and updated as needs change. The manager stated that she intends to continue to improve the support plans for all service users in a similar format as this process remains on going. People who use the service are able to make decisions affecting their day to day lives with support as required. The organisation does not take a financial appointee role for any individuals and this role is assumed by someone independent of the service. None of the current service users have been assessed as able to manage their own finances. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: Risk assessments have been developed and provide sufficient information to minimise perceived risks. The risk assessments have been reviewed on a regular basis. However, the format used is not ideal and is yet to be updated using the Avenues Trust documentation. The manager stated that a priority area for her is to update and review risk management plans for all of the service users ensuring risks are reassessed and a positive framework is put into place promoting responsible risk taking. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users have a lifestyle that suits their needs. Evidence: Service users have the opportunity to engage in a good range of activities both in and out of the home. This includes attending local groups such as the Gateway centre and No Limits drop-in centre. Activities are arranged from the home including ice skating, swimming, walks in the local area, shopping trips and visits to pubs amongst other things. The manager did acknowledge that this is an aspect of the home that she intends to improve in particular exploring more occupational and independent living activities. The home has a dedicated vehicle, but only a small number of designated drivers, which is an issue that is being addressed through training. During the visit service users were observed to be engaging positively with staff doing activities of their own choice. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: Most of the service users have active family involvement and visitors are welcomed into the home at all reasonable times. The manager stated that the home liaises with families to keep them informed of events and occurrences. There is a lot of space in the home to enable people to meet in private should they wish to. Residents were observed being supported and enabled by staff to choose how they spent their time. Service users can choose when to get up and go to bed and have control over other aspects of their daily lives including what pastimes they would like to do. The manager has recently developed a new menu plan involving the likes and preferences of service users and providing choices at each mealtime to suit individual wishes. The kitchen is suitable for the needs of the home and there were good quality food stocks available. Residents are able to have drinks and snacks throughout the day as they wish. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The personal and healthcare needs of service users are met. Evidence: Service users personal care needs are clearly described within individual files. They provide good guidance and promote personal strengths, preferences and abilities. Care staff on duty were observed to treat residents respectfully and have a good understanding of individual needs and wishes in this area. The home maintains healthcare records showing appointments and consultations and the outcomes of these visits. The manager stated that she is in the process of developing more detailed healthcare action plans that will provide an in-depth and complete profile of individual health care needs, issues and outcomes. This development would be beneficial as the current information is not easily accessible. Refer to recommendation 3. It was reported that the home receives good support from local community healthcare professionals and learning disability teams. All service users are registered with local GPs and evidence was on file of care management reviews and input. Complimentary healthcare needs are met through regular appointments with chiropodists and dentists, etc. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: Medication records and storage were examined. Medication administration records were up to date and records of the receipt, disposal and return of medications are maintained. The home has policies and procedures in place covering medication issues. The manager stated that she has reviewed medication processes in the home since coming into post. This includes a spring clean of the storage facilities. Medication storage is appropriate for the needs of the home and was seen to be well organised. All staff who administer medication have undertaken an in-house competency assessment and have received necessary training. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home listens to and responds to concerns and complaints effectively. Service users are protected from abuse. Evidence: There is a complaints process in place and this is displayed in the home and provided with introductory literature about the service. There have been two complaints regarding the home and there is evidence within the complaints records that both of the issues have been addressed and dealt with effectively. Staff are provided with training in Adult Protection and abuse awareness issues both through the induction process and additional training. The manager and care staff spoken to demonstrated a good awareness of issues surrounding this area. There has been 1 Adult Protection alert raised in connection with service, which arose through a complaint from a family member and resulted in the suspension of a staff member. It was reported that the Adult Protection alert has now been resolved and closed. Care Homes for Adults (18-65 years) Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The premises are suitable for the needs of the service users. There are, however, limited shower and bathing facilities. Evidence: The home is situated in a residential area on the outskirts of Gillingham close to the Hempstead Valley Shopping Centre. There is a bus route nearby providing a public transport link into Gillingham. The house has been furbished and decorated to a good standard providing a clean, hygienic and homely environment for the service users. At the entrance to the drive there is an electronic gate operated by an intercom. This is not in keeping with the local neighbourhood and should be reviewed. Refer to recommendation 4. On the ground floor there is a very good range of communal space comprising of 5 separate areas to enable residents to spend time alone or in company depending on their wishes. There is a good sized, accessible garden to the rear of the building. On the upper floor all of the residents have their own rooms with en-suite facilities. It was noted however that the shower fittings are fixed and cannot be moved to enable service users to use them adequately. Consequently all of the residents currently have to share one bathroom, which has an impact on their daily lives. Refer to requirement 1. Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: The kitchen and laundry facilities in the home are sufficient for the needs of the service users and staff. It was reported that all equipment is in good working order and that the requirements of the fire and environmental health departments are met. The organisation has recently reviewed arrangements for addressing maintenance issues and the manager reported that any maintenance required is now completed in a timely manner. Care Homes for Adults (18-65 years) Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient numbers of staff, but shortfalls in the training of staff that are being addressed. Recruitment practices could not be fully assessed. Evidence: The Avenues Trust assumed the management of 320 Hempstead Road in July 2008 and issued all existing staff with new contracts in September 2008. It was acknowledged that there are areas for improvement required in relation to staff training thabt the organisation is addressing. A plan is in place to address these shortfalls. None of the current staff team have achieved National Vocational Qualification at level 2 or above. However, over 50 of the staff team have been enrolled on these courses and are due to start working towards these qualifications in the near future. Staff spoken to demonstrated a good awareness of the needs of service users and issues relating to the running of the home. Refer to requirement 2. The service operates with 4 care staff on duty throughout the day in addition to the manager who is present during office hours. At night there are two waking staff. All staff spoken to confirmed that there are sufficient numbers to meet the needs of the service users and staff are able to provide 1:1 time for residents throughout most of the day. The staffing rotas examined confirmed the numbers of staff on duty. There Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: has been a relatively high turnover of staff over the past 6 months and the home currently uses regular agency staff to cover staffing shortfalls. It was reported that these agency staff work consistently at the home and are aware of residents needs. The organisation has recently completed a recruitment drive to employ a permanent staff team, which would be beneficial for the service users and the running of the service. The organisation has a human resources department at a central office that retains all records relating to recruitment. They provide a checklist of information stating that all required checks are completed and noting CRB disclosure numbers. It is advised that the organisation provides copies of all recruitment records to be stored securely in the home. Refer to recommendation 5. The organisation uses a version of the Common Induction Standards that all staff work through when employed. It was stated that there is a good training package provided by the company and staff are currently being provided with updated training covering all mandatory topics and additional courses such as medication, de-escalation techniques and the mental capacity act amongst other courses. All staff are within their first 6 months of employment, but it was noted that there are gaps in the required training for some staff, which are being addressed. An action plan has been developed and appropriate training courses booked. Refer to recommendation 6. Care Homes for Adults (18-65 years) Page 22 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well run, but does not have a registered manager. The service is run in the best interests of the service users. Health and safety issues are addressed. Evidence: The home does have a registered manager, but it was stated that she is due to leave the employment of the organisation in February 2009. Prior to her departure the home has appointed an Acting Manager who has now been working in the home for 3 weeks. She is currently the registered manager for a similar Avenues Trust service and has a number of year of management experience and all required qualifications. Care staff were positive about her impact on the home and there is clear evidence that she has positively begun to address shortfalls in service provision. A discussion was held with the Area Manager for the service who stated that the organisation hopes to make a permanent management appointment in the near future and are monitoring the progress of the home closely. Refer to recommendation 7. There was clear evidence that the quality monitoring processes in the home and organisation are effective. An area manager completes a monthly monitoring visit and Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: the last two of the reports relating to these visits were examined. They highlighted a range issues that require addressing and set out timescales and responsibilities for these to be addressed. The second monitoring report demonstrated that many of the issues raised had been fully or partially addressed and the action plan reviewed and updated. It was also reported that the organisation complete service user and stakeholder surveys annually. The home is due to complete this exercise after the first year of managing the service. The manager has reviewed and improved monitoring and auditing systems relating to service users finances following two recent errors that were rectified immediately. Records and receipts are maintained and double checked for all personal finances retained for safekeeping by the home. Health and Safety issues are addressed by the home. All service and maintenance certificates examined relating to the service were up to date and in place. The home has completed environmental and fire risk assessments. Records are kept of all accidents and untoward occurrences. The fire safety logs have been sporadically completed over the past 6 months. However, the manager has now appointed a health and safety rep responsible for this and checks had been completed routinely over recent weeks. Refer to recommendation 8. Care Homes for Adults (18-65 years) Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 27 23 The responsible person shall ensure that there are sufficient shower and bathing facilities for the number and needs of the service users. To replace shower fittings in all of the en-suite facilities attached to service users bedrooms. 04/04/2009 2 32 18 The registered person shall ensure that staff have the required competencies to meet service users needs. To ensure at least 50 of staff achieve an NVQ level 2 or above in care. 04/05/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 6 To continue to develop care and support plans using a person centred approach for all service users. Page 26 of 28 Care Homes for Adults (18-65 years) 2 3 4 5 6 7 8 9 19 24 34 35 37 42 To continue to develop risk management plans for all service users in a more accessible format. The home should continue to develop comprehensive and easily accessible health care action plans. To review the use of the electronic gate at the entrance to the drive of the home. To securely retain copies of all staff recruitment information on file in the service. To continue to update and provide all required training for care staff. To appoint a permanent manager for registration with the Commission for Social Care Inspection. To ensure fire safety records are kept up to date and facilities monitored. Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - 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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