Inspection on 02/11/05 for 340 Wilson Avenue

This inspection was carried out on 2nd November 2005.

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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

340 Wilson Avenue 12/10/06

340 Wilson Avenue 20/06/05

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 18-65 340 Wilson Avenue 340 Wilson Avenue Rochester Kent ME1 2ST Lead Inspector Sue McGrath Unannounced Inspection 2nd November 2005 10:00 340 Wilson Avenue DS0000064405.V261806.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 340 Wilson Avenue DS0000064405.V261806.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 340 Wilson Avenue DS0000064405.V261806.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 340 Wilson Avenue Address 340 Wilson Avenue Rochester Kent ME1 2ST 01622 769100 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 Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 340 Wilson Avenue DS0000064405.V261806.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th June 2005 Brief Description of the Service: 340 Wilson Avenue is registered to provide care and accommodation for three adults with learning and physical disabilities. It is managed by MCCH Society Ltd. The home is situated in a quiet residential area close to the town of Rochester. Local shops, a post office, and pubs are in walking distance. Service users accommodation includes one single bedroom and one shared room. Bedrooms have been adapted to meet their individual needs. In addition the building has several adaptations (a lift, grab rails, an assisted bath) and an open plan communal area on the ground floor to enhance accessibility and promote independence.There is a large landscaped garden at the rear of the building. 340 Wilson Avenue DS0000064405.V261806.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection under the terms of the Care Standards Act 2000 and was carried out by one inspector who was in the home from 10.00 to 13.00 on the 2nd November 2005. Many judgements about the quality of life for residents were taken from observations, speaking with staff, reviewing records and from direct discussion with service users. The Registered Manager was not on duty and the inspection was lead by Ann Lamb the senior support worker. As this report was made following an unannounced visit and may not cover the standards in sufficient depth for the reader to make a judgment about the home, it is recommended that a copy of the last announced inspection report dated 20th June 2005 be also obtained. What the service does well: What has improved since the last inspection? Staff have contacted KAB as advised in the last report and have gained valuable guidance to ensure that the residents communication skills have been improved. Staff appeared very enthusiastic over the very positive effect for the residents. One resident in particular was now feeding virtually unaided. A new kitchen floor has been fitted and a new cooker has been purchased and fitted. The obsolete bath hoist has also been replaced. 340 Wilson Avenue DS0000064405.V261806.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 340 Wilson Avenue DS0000064405.V261806.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 340 Wilson Avenue DS0000064405.V261806.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): No judgements made. Refer to report dated 20-06-05. EVIDENCE: The Registered Manager was not present during the inspection and as staff were unsure of the new Statement of Purpose etc, this section will be reassessed at the next inspection. All standards were inspected in June. 340 Wilson Avenue DS0000064405.V261806.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9,and 10 Residents benefit from having their assessed and changing needs reflected in their individual plans. Detailed risk assessments are in place to ensure identified risks are minimised. Resident’s benefit from a robust confidentiality policy. EVIDENCE: All of the care plans were viewed and were found to be comprehensive and regularly reviewed. The manager drew up the plans with the key worker from information gained from formal assessments and with working closely with the residents. The levels of communication difficulties experienced by the residents prevent verbal or written agreement from them regarding their individual plans. Residents were able to indicate on what they do and do not want to eat, but this can only be done by non-cooperation. Staff were aware of residents preferences over food. Staff had followed the recommendation made at the last inspection and contacted The Kent Association for the Blind and had discussed communication skills and other daily living skills. The advice offered had been greatly appreciated by staff and now improved methods of communication were being 340 Wilson Avenue DS0000064405.V261806.R01.S.doc Version 5.0 Page 10 used. These included raised and patterned fingerplates on doors, various hand contacts and raised dado rails. Staff appeared really enthusiastic with the new methods and felt residents had benefited greatly from KAB’s input. Staff displayed a good knowledge on confidentiality within and outside the home. 340 Wilson Avenue DS0000064405.V261806.R01.S.doc Version 5.0 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): These standards were met at the last inspection so will not be assessed until the next inspection. EVIDENCE: 340 Wilson Avenue DS0000064405.V261806.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18-21 Residents benefit from having clear and in-depth care plans that identify their individual needs and give clear guidance to staff. Care plans are regularly updated to ensure changes are recorded and acted upon. Health needs are met and service users benefit from having full access to all professional health care services as required. Residents are protected by the home’s policies and procedures for dealing with medicines. EVIDENCE: Staff were observed offering good support for personal care and encouragement was given where possible. All of the care plans indicated individual preferences about how the residents are to be supported with their personal care. Discussion took place again regarding the bedtime of the residents. Staff stated that all of the residents now like to be in bed before 8pm and sometimes earlier. When the manager returns from sick leave she is advised that she can reassess the need to have two staff until 10pm. However, if residents change their minds and do prefer to go to bed at a later time, then their wishes and needs must be taken into consideration when planning rotas. Rotas need to be flexible to meet the needs of the residents. 340 Wilson Avenue DS0000064405.V261806.R01.S.doc Version 5.0 Page 13 Residents required full assistance with all medical and healthcare needs and evidence seen during the inspection confirmed that full support is offered as required. The home had developed a very good relationship with the local GP, which benefited all the residents. Regular visits from other professionals included physiotherapists, epilepsy nurses, district nurses, chiropody, dentist, reflexologists, Opticians and Psychologists. The manager had completed a recognised course on the safe administration of medication and monitored all staffs practise and tested their competencies on a regular basis. With the manager off sick, no one in the home had completed any recognised course for the safe administration of medication. It will be recommended that more staff complete this course so that this situation does not occur again. Evidence was seen of PRN protocols being in place that gave clear instructions to staff over the use of PRN medications. All staff were trained in the correct use of rectal diazepam. The medication administration was inspected and found to be following the guidelines from the Royal Pharmaceutical Society of Great Britain. Prescription were now collected directly from the GP, signed by senior staff and then sent to the Pharmacist for dispensing, as discussed at the last inspection. MCCH had a policy on bereavement, which would be followed in the case of any death of a resident. The senior support worker explained that they would always endeavour to keep a resident, who had a terminal illness, for as long as it was medically possible. 340 Wilson Avenue DS0000064405.V261806.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The home has a clear and effective complaints system in place and residents are protected by robust adult protection policies and procedures. EVIDENCE: MCCH has a comprehensive complaints policy that was clear and if used correctly would be effective. A timescale for responding to complaints was included. There had been no complaints since MCCH had responsibility for the home. A basic policy was seen in pictorial form. The home had adopted Kent and Medway’s Adult Protection Policy and staff were familiar with the issues around adult abuse and were able to discuss the types of abuse in detail. 340 Wilson Avenue DS0000064405.V261806.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 - 30 Residents benefit from living in a clean, safe environment and have safe access to indoor and outdoor communal areas. Not all of the areas are well maintained and some re-decoration and replacement of equipment and furniture is necessary. Whilst service users’ rooms are fairly homely and reasonably comfortable not all service users benefit from living in single rooms that meet the requirements for space. EVIDENCE: The general layout of the home could be described as homely but remains in need of refurbishment. Part of the kitchen had been repainted but staff were waiting for some wallpaper to finish the job. The kitchen floor had been replaced and a new cooker had been purchased. A new hoist has also been provided in the bathroom as required from the last inspection. One resident had a specialised chair and another had one on order. The décor and furniture in the lounge remains the same as it was at the last inspection and again it will be a requirement that the decorative state and furnishings must be reviewed and action taken as required. 340 Wilson Avenue DS0000064405.V261806.R01.S.doc Version 5.0 Page 16 The one shared bedroom on the upper floor still did not have a dividing curtain as required from the last inspection. The home was clean and hygienic on the day of the inspection. Some effort had been made to personalise the resident’s rooms and they appeared reasonably comfortable. The bedrooms do not have washing facilities. 340 Wilson Avenue DS0000064405.V261806.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36 The residents benefit from being cared for by staff who have a good understanding of their needs and receive regular supervision. EVIDENCE: Staff spoken with on the day of the inspection were very enthusiastic, particularly over the recent developments in communications with the residents. They appeared very sensitive to the residents needs. Although no new staff had been recruited recently, the senior support worker understood the procedure that would be used. Staff stated they had job descriptions. Staff were normally supervised by the manager of the home, however she was currently on sick leave and staff were being supervised by the senior support worker. Whilst the work she was doing was commendable, she had not received training in giving supervision and she was currently not supervised herself. It will be a requirement that any staff that offer supervision are trained and deemed competent. Discussion with staff confirmed they had the necessary skills and a good understanding to care for the residents at the home. 340 Wilson Avenue DS0000064405.V261806.R01.S.doc Version 5.0 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39- 42 Residents benefit from a clear management and organisational structure, which recognises the expectations of residents with both sensory loss and learning disabilities. EVIDENCE: The Manager was on sick leave so standards 37 and 38 will be assessed at the next inspection. Although the manager was not available, staff did benefit from having an organisational structure that supported them. The home was not carrying out any effective quality assurance or monitoring based on seeking the views of residents or their representatives. This needs to be part of the development plan for the home and should include feedback from other professional that are involved with the residents. A requirement will be made to ensure this standard is complied with. A selection of the organisation policies and procedures were viewed and were found to be comprehensive. It was noted that staff sign to say they had read and understood each policy. All policies and procedures should be signed by 340 Wilson Avenue DS0000064405.V261806.R01.S.doc Version 5.0 Page 19 the registered manager and should be dated, monitored, reviewed and amended as required. Records seen in the home were secure, up to date and in good order. The home had an accident book in place and any incidents would be reported back to headquarters and any other appropriate authority. All staff had completed a basic food hygiene course as well as an infection control course. Staff had also completed First Aid courses. Evidence was seen that the fire alarm system was regularly monitored and serviced but fire drills were not as regular as they should be. It will be a requirement that all staff participate in regular fire drills. It was also advised that the fire instruction notice be updated and sited in a prominent position. The home was also advised to complete a Fire Risk Assessment and ensure the Local Fire Officer approves it. 340 Wilson Avenue DS0000064405.V261806.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 2 2 2 2 3 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 2 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 340 Wilson Avenue Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score X X 1 3 3 2 X DS0000064405.V261806.R01.S.doc Version 5.0 Page 21 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA25 Regulation 16(2) Requirement Timescale for action 31/12/05 2 YA28 3 YA36 4 YA39 5 6 YA42 YA42 The home must provide screening in the shared bedroom or provide clear reasons why this is not provided. This has been carried over form the last report. 23(2)(d) The decorative state of the lounge must be reviewed and action taken as required. This has been carried over form the last report. 18(2) Staff who supervise colleagues are trained and are supported/supervised by senior staff. Action Plan required. 24(1)(a)(b) Effective quality assurance and (2)(3) quality monitoring systems, based on seeking the views of service users, are in place to measure success in achieving the aims, objectives and statement of purpose of the home. Action Plan required 23(4)&(5) All staff must undertake regular fire drills. 23(4)&(5) A fire risk assessment should be submitted to the local Fire DS0000064405.V261806.R01.S.doc 31/12/05 31/12/05 31/12/05 31/12/05 31/12/05 340 Wilson Avenue Version 5.0 Page 22 Officer for approval. Action Plan required 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 YA20 Good Practice Recommendations All senior staff to complete an accredited course on the safe administration of medication. 340 Wilson Avenue DS0000064405.V261806.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 340 Wilson Avenue DS0000064405.V261806.R01.S.doc Version 5.0 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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