CARE HOME ADULTS 18-65
35 Beaconsfield Avenue Dover Kent CT16 1LS Lead Inspector
Julie Sumner Unannounced Inspection 13th February 2006 10:00 35 Beaconsfield Avenue DS0000023167.V263385.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 35 Beaconsfield Avenue DS0000023167.V263385.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. 35 Beaconsfield Avenue DS0000023167.V263385.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service 35 Beaconsfield Avenue Address Dover Kent CT16 1LS 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) 01304 206448 01304 206448 Robinia Care South East Ltd Mrs Yvette Hanlon Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 35 Beaconsfield Avenue DS0000023167.V263385.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 3 People with a learning disability. 18 to 65 years. Date of last inspection 24th October 2005 Brief Description of the Service: 35 Beaconsfield Avenue is a large terraced property located in a residential road in Dover town centre. The house has been sympathetically maintained and is in keeping with surrounding domestic residential properties. It is within walking distance of local shops, and leisure facilities. The accommodation is laid out over three floors, and provides three single resident bedrooms, a staff sleep-in room, lounge, laundry/smoking room, kitchen diner and a small courtyard garden is located to the rear of the property. Limited street parking is available. The accommodation is domestic in character and this is reflected in the decoration and furnishings of the home, which are of good quality. The property is unsuitable for any service user with significant mobility problems. The home offers a service to learning disabled adults who have additional complex needs, and require long term support, staffing is provided on a 2:3 basis throughout the day with a sleep in staff member at all times, additional staffing is available if needed and will reflect the level of support and supervision required. This is a female household. 35 Beaconsfield Avenue DS0000023167.V263385.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out during one morning in February and about two hours were spent in the home. The home was clean, fresh and welcoming and all the service users were in carrying out their usual activities. As with previous inspections, they all participated, very ably saying what they like about living at 35 Beaconsfield avenue and how they like to spend their time. Service users spoke about the home and their life throughout the inspection a sample of comments about the home and staff: “its nice here”, “we like to keep it clean here”, “good staff”, “staff are helping me…” and about the activities offered “I really like art”, “I’ve learnt to type with two hands”, “I’m going out on my own now…with staff near…” and “I’m learning to budget” about the food were: “a member a staff cooked a really good Sunday roast, it was the best!”, “we eat what we feel like”, and. The following methods of inspection and information gathering were used: One-to-one and group discussion with service users and staff, observing activity in the home, reading and discussing plans and records including individual service user plans. What the service does well:
The home has won an award within the company for “most improved home” and one of the carers won “best carer”, staff and service users were very proud of this. As stated in the previous inspection report and still found to be very evident: The ethos in 35 Beaconsfield Avenue is that this is the service users’ home and staff are there to support them with their chosen lifestyle. There is a really good supportive philosophy to maintain and develop independence skills. Service users explained how they were supported with coping with emotional issues and about their hobbies, interests and college courses. They also spoke about Christmas, their birthdays and families. There are good assessment and planning processes to guide service users in developing independence skills including building confidence and experience going out, budgeting, preparing meals and managing a healthy lifestyle. Choices of activities and what has been chosen and participated in are recorded clearly. There is a quality assurance system within the home. Feedback from service users is actively sought and there are questionnaires available for anonymous
35 Beaconsfield Avenue DS0000023167.V263385.R01.S.doc Version 5.1 Page 6 feedback. Service users hold meetings to discuss issues and ideas. The audits and feedback are incorporated into the company annual report. Service users felt that staff listen to them and that they do have a say in what happens. What has improved since the last inspection? 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. 35 Beaconsfield Avenue DS0000023167.V263385.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 35 Beaconsfield Avenue DS0000023167.V263385.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 Service users have assessments when they move into the home and these are reviewed and amended as needs change and skills develop. EVIDENCE: Service user plans were viewed containing assessment information. Service users have lived in Beaconsfield Ave for several years and the original assessment formed the basis of the care provided initially. Review meetings are held annually and assessments are carried out by other professionals when the need arises. A sample of assessments and review notes were viewed. 35 Beaconsfield Avenue DS0000023167.V263385.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): 7 Service users are supported to make decisions about their own lives. Service users are given support and tuition to enable them to manage their own finances. EVIDENCE: Service users talked about how they manage their money and what support they are given. One service user described the progress she was making with budget skills and there was a conversation with examples of where they have made decisions to make sure they can attend all planned activities and buy refreshments etc. Documentation supporting this was viewed in the service user plan. 35 Beaconsfield Avenue DS0000023167.V263385.R01.S.doc Version 5.1 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15, 16, 17 Service users are supported to maintain contact with their friends and families. Routines in the home are flexible and lead by the service users. Service users are very happy with the meals provided and have autonomy with what and how it is prepared. EVIDENCE: Service users described what they did over Christmas. One service user had gone home and spent Christmas with her family. One service user had had a surprise visit from her family for her birthday and described her experience and how delighted she had been. Service users described their lifestyle. One service user has a front door key and has been assessed as independent enough to go out on her own and be in the house on her own. She showed the inspector her identity and contact badges that she takes with her in case she gets into difficulty. Another service user is working towards independence and one of the intended outcomes is to
35 Beaconsfield Avenue DS0000023167.V263385.R01.S.doc Version 5.1 Page 11 have her own front door key. Relevant parts of the service user plans and daily records were viewed and supported what was being said. Service users described the mealtimes and that they take it in turns to help prepare the meals. The menu is planned but is very flexible as individuals change their minds. One service user explained that they have a practice day where they go out and buy the ingredients then cook the meal with whatever assistance they need. The menus were viewed. A record of what has been eaten including what was on the menu and alternatives offered is kept. 35 Beaconsfield Avenue DS0000023167.V263385.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 Staff support service users with encouragement and sensitivity to pursue their chosen lifestyle. Service users feel well supported to maintain a healthy lifestyle and attend routine health/medical appointments. EVIDENCE: Service users talked about their lifestyle in the home. Times for getting up and going to bed are flexible and arranged around what they intend to do during the day. They said they get up in time to go to college or planned activities. Service users explained that they need support with different aspects of personal care and staff praised them for their achievement in independence now needing help with amounts of shampoo to use rather than actual help washing hair. The current level of support needed was documented in the service user plan. Health records were viewed in a sample of service user plans. All the service users chose their own GP depending what factors were important to them. One service user said she wanted the surgery to be nearby so that she could walk there. Service users explained that they make their own appointments and attend them independently and the staff said they are supported depending on assessed needs. Service users described their experiences at the Drs and Dentists.
35 Beaconsfield Avenue DS0000023167.V263385.R01.S.doc Version 5.1 Page 13 35 Beaconsfield Avenue DS0000023167.V263385.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 The home has a clear and accessible complaints system with evidence that service users feel that their views are listened to and acted on. Staff have a sound knowledge and understanding of adult protection issues which protects service users from abuse. EVIDENCE: All service users are aware of the complaints procedure and are able to use it if needed. Service users said there was plenty of opportunity to voice any concerns and that they are resolved quickly. All complaints have been logged and action to resolve was well documented. There are no outstanding complaints and none have needed to be passed to CSCI. Adult protection training has been completed by 4 out of 7 staff. One staff is booked to attend. There is a clear adult protection process with guidelines for staff and a whistle blowing policy. The induction training and NVQ training also cover adult protection issues. 35 Beaconsfield Avenue DS0000023167.V263385.R01.S.doc Version 5.1 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 The home is well maintained and clean providing residents with an attractive and homely place to live. EVIDENCE: Service users participate in the housework and all have allocated jobs around the house that are organised on a turn taking basis. They enthusiastically described what they do and what support they have with some of the tasks. There is also an incentive scheme linked to this. There was a discussion about the window covering and that after review it was going to be removed. 35 Beaconsfield Avenue DS0000023167.V263385.R01.S.doc Version 5.1 Page 16 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 Staff morale is high resulting in an enthusiastic workforce that works positively with service users to improve their whole quality of life. Staff are multi skilled ensuring good quality care and support. There is a robust recruitment process to employ suitable staff and protect the service users There is a robust recruitment process to employ suitable staff and protect vulnerable adults.. EVIDENCE: This group of standards was inspected in more depth at the previous inspection. There are 6 full time and 1 part time staff in the team. 5 staff have achieved the NVQ 3 and one member of staff is studying NVQ 3. One new member of staff to this home is studying the LDAF foundation course. There is a good range of training offered to staff. There is a training matrix and certificates are on display. The company’s recruitment process includes the routine request for CRB and POVA checks and references prior to employment. It was not possible to view recruitment documentation at this time. The company’s documentation has been viewed at previous inspections. Staff confirmed that these checks had been carried out prior to them working. The policy is for staff to have some experience working in a more closely supervised home prior to being based in 35 Beaconsfield Ave.
35 Beaconsfield Avenue DS0000023167.V263385.R01.S.doc Version 5.1 Page 17 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 The manager is supported well by the senior staff in providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. EVIDENCE: The manager was not in the home at the time of the inspection. The staff on duty said that the manager had recently achieved the Registered managers Award and it was confirmed over the telephone that this included all NVQ 4 management elements required to meet the standard. 35 Beaconsfield Avenue DS0000023167.V263385.R01.S.doc Version 5.1 Page 18 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 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 x 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score x 3 x x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 x x 3 x 3 x x 3 x 35 Beaconsfield Avenue DS0000023167.V263385.R01.S.doc Version 5.1 Page 19 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. 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 YA26 Good Practice Recommendations Review the type of special window covering in service users bedroom and whether there is an alternative that will not prevent the service user from being able to see out of the window. 35 Beaconsfield Avenue DS0000023167.V263385.R01.S.doc Version 5.1 Page 20 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 35 Beaconsfield Avenue DS0000023167.V263385.R01.S.doc Version 5.1 Page 21 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
