Inspection on 09/03/06 for 34 Lancaster Gardens

This inspection was carried out on 9th March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

34 Lancaster Gardens 14/08/06

34 Lancaster Gardens 01/11/04

34 Lancaster Gardens 28/06/04

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 34 Lancaster Gardens 34 Lancaster Gardens Herne Bay Kent CT6 6PU Lead Inspector Kim Rogers Unannounced Inspection 9th March 2006 10:30 34 Lancaster Gardens DS0000023297.V285133.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 34 Lancaster Gardens DS0000023297.V285133.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 34 Lancaster Gardens DS0000023297.V285133.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 34 Lancaster Gardens Address 34 Lancaster Gardens Herne Bay Kent CT6 6PU 01227 368915 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) sharon.fch4@virgin.net Family Care Homes Limited Mr Scott Thompson Care Home 7 Category(ies) of Learning disability (7) registration, with number of places 34 Lancaster Gardens DS0000023297.V285133.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th October 2005 Brief Description of the Service: 34 Lancaster Gardens is a detached house situated in a quite residential road of Herne Bay. ‘Family Care Homes Ltd’ runs the home The home is registered to provide personal care and support to up to 7 adults between 18 to 65 years of age. All rooms are for single occupancy and most have a wash hand basin. One room has en suite facilities. There are 2 bathrooms. There are 2 lounges and a separate dining room. There is a garden to the front and rear with plenty of off street parking at the front. 34 Lancaster Gardens DS0000023297.V285133.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and carried out one Inspector, Kim Rogers between 10.30am and 4.15pm on a Thursday. The Inspector spoke to the manager, service users and staff. The Inspector sampled some records and had a look around the home. Two service usesr showed the Inspector their bedrooms. The Inspector made observations throughout the visit. There are currently 7 service users living at the home. Information was organised and readily available to the Inspector. The home was clean and orderly. The Inspector made an unannounced visit to the home on 24/08/05 as part of an adult protection investigation. This adult protection matter is now closed. A pharmacy Inspector made a visit to the home on 31/8/05. Requirements were made following both of these visits. The Inspector assessed the homes progress towards meeting these requirements. An announced inspection was made on 28/10/05. Some improvements were noted in service users plans and other areas during this visit. Work has started towards making service user plans more person centred and accessible to service users with photographs being used. After talking to staff and service users and making observations the Inspector concluded that the home is meeting the care and support needs of the service users. Following this visit some requirements were made relating to the environment, recruitment, staff induction and assessments of service users, medication What the service does well: What has improved since the last inspection? Service users plans have been reviewed. Work has started towards making service user plans more person centred and accessible to service users with photographs being used. 34 Lancaster Gardens DS0000023297.V285133.R01.S.doc Version 5.1 Page 6 Risk assessments have been reviewed. Both service user plan and risk assessments are now reviewed more often. Behaviour management guidelines have been reviewed. A third senior member of staff has been recruited ensuring there is always a senior either on duty or available. There is now a permanent full complement of staff. Most of the staff have attend training on non aggressive physical interventions. New sofas for the lounge have been purchased. 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. 34 Lancaster Gardens DS0000023297.V285133.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 34 Lancaster Gardens DS0000023297.V285133.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,4 Service users know their needs will be assessed but not their aspirations. EVIDENCE: The Inspector sampled service users plans. The manager said that the company take referrals and enquiries for placements and pass on the information to the client care department. Staff from the client care department meet the prospective service user and carry out an assessment of their needs. The prospective placement is then discussed with the manager. An assessment was seen. This was very detailed and covered most of the areas under the standard. However, the person’s aspirations had not been assessed and there was no mention of this on the assessment pro forma in use. A requirement was made to address this. The manager said that prospective service users are able to make visits to the home to meet the current residents and staff and to have a look around. Trial visits enable service users to make more of an informed choice about the home. The Inspector saw a record of visits made by the last service user to move in. 34 Lancaster Gardens DS0000023297.V285133.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,9 Service users know their changing needs will be recognised and supported. Service users know they will be supported to take risks. EVIDENCE: Each service user has an individual service user plan. Currently service users have 2 files each containing their service user plan. One file is recorded onto a corporate format and is needs lead. The second file is called a ‘Key worker’ file and is more person centred and produced in an accessible format for service users with photographs etc. The Key worker file focuses on what is important to the person. Risk assessments are included with strategies recorded to reduce risks. This is an improvement since the last inspection however the manager should look at having all of a person’s information in one place. The manager said that Key workers plan to share their work done with service users on their person centred plans with the staff at staff meetings. It is essential that all staff are aware of and are involved in the development, implementation and review of person centred plans. Since the last inspection behavioural management guidelines have been reviewed as well as guidelines for any physical intervention. However, one record showed that following certain behaviours a service user was ’sent to her 34 Lancaster Gardens DS0000023297.V285133.R01.S.doc Version 5.1 Page 10 room’ this happened on several occasions over a long period of time although the behaviours continued. It was discussed with the manager whether this strategy was working and the manager agreed to review it. Service user plans and risk assessments are now reviewed more regularly. It was evident that goals are identified and supported with referrals made for specialist support and advice where necessary. All service user plans are kept in the office, which is outside in a wooden summerhouse type building. This is kept locked when not in use. 34 Lancaster Gardens DS0000023297.V285133.R01.S.doc Version 5.1 Page 11 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): 14,15 Service users have opportunities to engage in leisure activities. Service users now their relationships will be supported. EVIDENCE: Details about service users family and friends are recorded in their service user plans. Friends and family are welcome to visit at reasonable times. The manager said that the home maintains good relationships with service user’s friends and families. One service user told the Inspector that he telephones his family regularly. Service users have the opportunity to make friends in the local community. Staff support service users to access local facilities like shops, post office and pubs. Service users access a range of leisure facilities. There were individual activity planners in service users files. On the day of the inspection one service user was attending a health appointment. Another went out for a walk in the afternoon. Most service users were in the lounge with the television on. Some were watching the black and white film on the television. Some service users were walking around in the hallway, others were waiting outside the kitchen. The manager said that in house activities are not planned in advance but 34 Lancaster Gardens DS0000023297.V285133.R01.S.doc Version 5.1 Page 12 happen on an ad hoc basis. The Inspector spoke to the manager about planning shifts around service users. This ensures effective staff deployment and will increase service users levels of participation and engagement. There is a magnetic board with pictures in the hallway. This tells service users about the days meals, staff etc. 34 Lancaster Gardens DS0000023297.V285133.R01.S.doc Version 5.1 Page 13 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 Service users know their personal care needs will be met. Service users health needs are met. Medication have improved but needs to improve further. EVIDENCE: Service users personal care needs are recorded in service user plans. Service users told the Inspector about how they like staff to support them with hair washing. The home has 2 bathrooms. Most bedrooms have a wash hand basin although this was removed from one bedroom due to the service users needs. The Inspector recommended that this now be reviewed since the service user appears to be more settled. This could give the service user more independence, choice and control. Some health needs are assessed as part of the assessment process. The inspector recommended that this assessment cover a fuller range of needs and that a health action plan be developed with each individual. A record is kept of health appointments. Medication storage and practice has improved since the last inspection. Medication administration records were sampled. Some gaps in the records were seen with no reason or code recorded. It was not clear of the medication 34 Lancaster Gardens DS0000023297.V285133.R01.S.doc Version 5.1 Page 14 had been given or not. The manager was not clear about why there were gaps and agreed to investigate the matter. 34 Lancaster Gardens DS0000023297.V285133.R01.S.doc Version 5.1 Page 15 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): 23 Staff are trained to recognise suspected abuse. EVIDENCE: The home has a policy in place to protect vulnerable adults and procedures in place for staff to follow when abuse is suspected. There has been an investigation following an adult protection alert, which is now closed. The manager said he has reflected over his management practices and processes since the investigation and feels he has made improvements. Staff attend training to recognise and respond to suspected abuse. As mentioned in this report, some environmental restrictions have been made. These must be reviewed to ensure restrictions are made on the best interests of service users and do not become institutionally accepted. 34 Lancaster Gardens DS0000023297.V285133.R01.S.doc Version 5.1 Page 16 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): 24,26,27,30 Service users are happy with their bedrooms, which are personalised. Bedrooms do not promote independence and control. Improvements to the décor will enhance service users lives. The laundry facilities fall short of the minimum standard required. EVIDENCE: Accommodation is provided on one floor and all rooms are single rooms. Two service users showed the Inspector their bedrooms. Both were individual and personalised. There are some environmental restrictions in place for example one wardrobe was locked and had no handle and a wash hand basin had been removed. The kitchen is fitted with a stable door the bottom half of which is kept locked. These restrictions appear to have been made in the best interests of one or more service user. However any restriction must be minimal and must be the less restrictive alternative. The Inspector required that the manager review all of the restrictions in place to establish if they are still necessary and to ensure they are the least restrictive option. 34 Lancaster Gardens DS0000023297.V285133.R01.S.doc Version 5.1 Page 17 The manager said that no service user has a key to their bedroom as suitable locks are not fitted and no one has a key to the front door. Again this must be reviewed to ensure that choice control and independence is maximised. The home is in keeping with the other properties in the road. The Inspector noted that there was an advertising board in the service users front garden. The manager said that the company had placed it there and was unsure if service users had been consulted or planning permission sought. The Inspector required that the advertising board be removed in the meantime. The home was clean on the day of the visit although some parts are quite stark and do not have a homelike feel. The manager said he agreed and plans to address this. Some parts of the home, especially the 2 bathrooms are shabby and need some improvements. The Inspector required that an audit be carried out of existing décor, furniture and fittings and a development plan produced. The laundry is housed in an out building and falls well short of the National Minimum Standard. The manager must have this building checked for asbestos. A requirement was made to bring the laundry up to the minimum standard. Staff have the use of 2 company vehicles which they use to access community facilities and amenities. Staff certificates are displayed around the service users hallway. None of the certificates relate to service user’s achievements. The Inspector recommended that service users be appropriately consulted about this and if necessary a more appropriate place be found for the staff certificates. 34 Lancaster Gardens DS0000023297.V285133.R01.S.doc Version 5.1 Page 18 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): 33,34,35 There are sufficient staff on duty. Staff induction is not in line with the minimum standard. Recruitment checks must be carried out before staff start in post. EVIDENCE: After making observations and looking at staff rotas the Inspector judged that there are enough staff in duty to meet the service users needs. The staff team is made up of males and females of a wide age range. Vacancies have been recruited to so the staff team is now made up of all permanent staff. The manager works Monday to Friday and is on call at other times. Another senior staff has been recruited so there is always a senior staff on duty or available for advice. Some service users are funded on a one to one or two to one basis. It was evident that this allocated staffing is provided. One staff was observed talking to a service user in a positive respectful manner. Staff were observed in the kitchen, in the lounge and walking about the house. There were no organised in house activities going on. The Inspector spoke to the manager about shift planning around the service users to enable service users the chance to dip in and out of activities. This will increase levels of participation and engagement. The Inspector sampled the staff file of the latest staff member. It was evident that this staff member started in post before references were applied for. 34 Lancaster Gardens DS0000023297.V285133.R01.S.doc Version 5.1 Page 19 The induction record was sampled for the newest member of staff. There was no evidence of how learning was gained or how competency was then assessed. The induction must be in line with the National Minimum Standard and should be accredited to the Learning Disability Awards Framework. 34 Lancaster Gardens DS0000023297.V285133.R01.S.doc Version 5.1 Page 20 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 The manager has the required qualification to manage the home. Service users cannot be sure their views underpin the homes review and development. EVIDENCE: The manager is currently working towards completing an outreach course on supervisory management. The manager has also completed a registered managers award qualification. The manager has developed and improved parts of the service since the last inspection. There is no formal periodic service review. This means that the home has set no standards to which it is working towards to improve. At present no yearly audit is carried out as required. This means that the home falls short of standard 39. Senior managers visit the home and carry out an audit on a monthly basis as required. 34 Lancaster Gardens DS0000023297.V285133.R01.S.doc Version 5.1 Page 21 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 2 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 2 27 2 28 X 29 X 30 1 STAFFING Standard No Score 31 X 32 X 33 3 34 2 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X 3 X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 3 15 3 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 X 3 X 2 X X X X 34 Lancaster Gardens DS0000023297.V285133.R01.S.doc Version 5.1 Page 22 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 2 3 4 5 Standard YA2 YA20 YA30 YA23 YA39 Regulation 14 3(2) 13 12 24 Requirement Assessments must include personal aspirations. The manager must investigate the gaps in medication administration records. The laundry must be in line with the minimum standard. All environmental restrictions must be reviewed and the least restrictive option used. The service must be reviewed at appropriate intervals in consultation with service users and a report produced. Staff induction must be in line with the Minimum Standard. An audit of décor, furniture and fittings should be carried out and shortfalls addressed. The advertising board must be removed from the front garden. The required recruitment checks must be carried out on all staff before starting in post. Timescale for action 31/05/06 31/03/06 31/07/06 31/05/06 31/07/06 6 7 8 9 YA35 YA24 YA24 YA34 18 23 23 18, schedule 2 31/07/06 31/05/06 31/03/06 31/03/06 34 Lancaster Gardens DS0000023297.V285133.R01.S.doc Version 5.1 Page 23 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 YA16 YA19 YA6 Good Practice Recommendations Shifts should be planned around service users to maximise participation and engagement levels. Health assessments should be more detailed and all service users should be supported to develop their own health action plan. Staff should have person centred planning training. 34 Lancaster Gardens DS0000023297.V285133.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 34 Lancaster Gardens DS0000023297.V285133.R01.S.doc Version 5.1 Page 25 - 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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