CARE HOME ADULTS 18-65
356 Station Road 356 Station Road Rainham Gillingham Kent ME8 7QY Lead Inspector
Ruth Burnham Unannounced Inspection 21st February 2006 10:00 356 Station Road DS0000064366.V283794.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 356 Station Road DS0000064366.V283794.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. 356 Station Road DS0000064366.V283794.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service 356 Station Road Address 356 Station Road Rainham Gillingham Kent ME8 7QY 0208 3082900 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) The Avenues Trust Limited Vacant Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 356 Station Road DS0000064366.V283794.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 29th June 2005 Brief Description of the Service: 356 Station Road is a residential service providing 24-hour support for Younger Adults with Learning Disabilities. The home is registered to provide service for 4 service users but currently only provides a service for 2. The service is part of a group of homes managed by Avenues Trust. This is a semi-detached property; the accommodation is set over 2 floors with the upper floor consisting of 3 bedrooms, a bathroom and toilet, the third bedroom provides staff and office accommodation. The ground floor has a lounge/diner, a kitchen, a laundry room and a W.C. communal space is limited. There are gardens to the front and rear and limited off road parking facilities. The home is located in a residential area and is convenient to Rainham town centre and other shops and amenities. 356 Station Road DS0000064366.V283794.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, the second in the year running from April 1st 2005 to March 31st 2006. The visit lasted from 09.30am until 12.00pm. The visit was spent talking to support staff. Due to the nature of the service, it is difficult to reliably incorporate accurate reflections of the service users in the report. Some judgements about quality of life and choices were taken from direct observation on the day followed by discussion with support staff and examining records held at the home. A tour of the premises was undertaken. What the service does well: What has improved since the last inspection? What they could do better:
People who live in the home would benefit from bigger and separate communal space, this would improve privacy and choice for service users. Both residents and staff would benefit from having the home’s bathroom extended, this would enable personal support in the bathroom to be provided in a less cramped space, the rusted bath should be replaced and service users rooms should have wash hand basins installed were appropriate. Heating should be provided in the ground floor toilet. Safety certificates should be available to demonstrate that all electrical installations are safe and records which evidence sound recruitment procedures should be available for inspection. It is recommended that management support should be present in
356 Station Road DS0000064366.V283794.R01.S.doc Version 5.1 Page 6 the home for a reasonable proportion of each week and that consideration is given to extending the property to provide a more spacious bathroom. Although this home is currently registered for 4 service users the inspector strongly recommends that the organisation look to extending the premises before any new service users are admitted to the home. Alternatively the inspector recommends that the organisation voluntarily reduce the registration to 2 service users. 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. 356 Station Road DS0000064366.V283794.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 356 Station Road DS0000064366.V283794.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): 4&5 Service users are given the information they need to be able to make an informed decision to live at 356 Station Rd EVIDENCE: Avenues Trust has recently taken over the management of this service and have drawn up individual contracts with the people who live in the home, these are awaiting signature. There have been no residents admitted to the home for a long time however the Trust has clear admissions policies in place which make provision for prospective service users to visit and try out what it is like to live in their homes before any decision is made. 356 Station Road DS0000064366.V283794.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): 10 People who live in the home have benefited from the provision of office space where staff can meet and ensure that confidentiality is respected. EVIDENCE: Since the last inspection considerable improvement has been made; the small third bedroom has been converted to a staff sleep in room and office space where personal records can be stored and staff meetings and handovers can take place in private to ensure that the confidentiality of the people who live in the home is maintained. 356 Station Road DS0000064366.V283794.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): 11, 13, 14 & 17 People who live in the home benefit from having the opportunity for personal development through encouragement to try a range of activities and experiences. EVIDENCE: People who live in the home are involved in the running of the home to the level of their individual abilities, assessments and care programmes reflect careful assessment to promote independence and maximise potential, staff support each person with a variety of tasks which are designed to enable them to improve daily living skills such as cleaning, food preparation, gardening and laundering clothes. Residents benefit from the opportunity to interact with the local community through being provided with support to access local shops, banks, the library and local pubs. Since the last inspection both residents enjoyed a holiday at Camber Sands and further holidays are being planned in consultation with service users. People who live in the home are benefiting from having their own transport, which has opened up additional possibilities for leisure activities. Records indicate that people who live in the home enjoy a balanced diet which now includes a range of fresh vegetables and residents are being actively
356 Station Road DS0000064366.V283794.R01.S.doc Version 5.1 Page 11 encouraged to try new foods, pictures, objects of reference and observation are used to ensure that service users choices regarding food are respected and are incorporated into the menu. 356 Station Road DS0000064366.V283794.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): 20 & 21 People who live in the home are protected through good policies and procedures. EVIDENCE: The homes policies and procedures about handling medication protect people who live in the home from harm and promote their health and well being. Medication is stored securely and records are well maintained and up to date. They are supported by staff who have received appropriate training in the safe handling of medication and can be confident that their own or their families wishes in relation to death will be respected in that these issues have been addressed within individual care plans. 356 Station Road DS0000064366.V283794.R01.S.doc Version 5.1 Page 13 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): These standards were examined at the previous inspection and were found to have been met. EVIDENCE: 356 Station Road DS0000064366.V283794.R01.S.doc Version 5.1 Page 14 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28 & 29 The quality of life for people who live in the home has been improved through changing the upstairs accommodation however further improvements in facilities are necessary. EVIDENCE: People who live in the home benefit from a clean and safe environment and has gardens to the front and rear, a tour of the home was undertaken and all areas were clean, safe and free from offensive odours. Procedures and equipment for ensuring appropriate infection control was evident throughout the home. The home’s lounge/diner was decorated in a homely style and was nicely furnished. The lounge /diner is small and open plan and the home does not have a separate communal space where additional activities or privacy could be provided for service users. The quality of life for the two people who live in the home has been greatly improved in that each now has one of the larger bedrooms which have been redecorated to their own taste, the small room is now used for staff and office accommodation. One of the bedrooms still has no wash hand basin. The upstairs bathroom is small and staff confirmed that the space feels very cramped when they are supporting service users with washing and bathing. The bath is rusted in places, staff confirmed that estimates for a new bathroom
356 Station Road DS0000064366.V283794.R01.S.doc Version 5.1 Page 15 suite were being sought, it was of further concern that there is no heating in the ground floor toilet which is located in the single story extension which is extremely cold. Neither of the residents have physical disabilities which require specialist equipment or installations. 356 Station Road DS0000064366.V283794.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 & 35 People who live in the home are supported by competent and qualified staff however records were not available in the home to enable a judgement to be made about recruitment practices. EVIDENCE: People who live in the home are supported by competent and qualified staff however agency staff are regularly used to cover and it was of concern that the manager was on sick leave and the senior carer was acting up in another home. At the time of the inspection there was one member of permanent support staff and a member of staff from an agency on duty. Having said that the commitment, knowledge and enthusiasm of the permanent member of staff was impressive and residents benefit from the fact that regular agency staff are used who know them and provide continuity of care. It was not possible to inspect the recruitment practices of the home, as relevant records were not available in the home at the time of the inspection. It was clear that people who live in the home benefit from the support of well trained staff and records and certificates were seen which demonstrated this. 356 Station Road DS0000064366.V283794.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): 39 & 42 People who live in the home will benefit from a quality assurance system which is being introduced, they are protected through safe working practices and safety checks however there may be risk of harm in that no safety certificate in relation to electrical installations was available. EVIDENCE: People who live in the home will benefit from a quality assurance system which is being introduced, this includes regular consultation with service users and their representatives and will ultimately generate a report to the Commission in line with the regulations. People who live in the home are protected through having support from staff who are trained in safe working practices including first aid, basic food hygiene, infection control, moving and handling and fire safety. The fire log book was examined and was well maintained and up to date, there was a safety certificate in place for gas installations and appliances however no safety certificate for the electrical installations could be found, People who live in the home will benefit from a quality assurance system which is being 356 Station Road DS0000064366.V283794.R01.S.doc Version 5.1 Page 18 introduced it was agreed that this would be provided to the commission as soon as possible. 356 Station Road DS0000064366.V283794.R01.S.doc Version 5.1 Page 19 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 x 3 x 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 x 23 x ENVIRONMENT Standard No Score 24 3 25 3 26 2 27 2 28 2 29 3 30 x STAFFING Standard No Score 31 x 32 3 33 x 34 2 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score x x x x 3 LIFESTYLES Standard No Score 11 3 12 x 13 3 14 3 15 x 16 x 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x 3 3 x x 3 x x 2 x 356 Station Road DS0000064366.V283794.R01.S.doc Version 5.1 Page 20 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 YA26 Regulation 23.2(d)& 23.2 (j) 23.2 (j) Requirement Timescale for action 30/06/06 2. YA27 3. YA28 23.2 (i) 4 YA42 23(2) (C) The registered person must ensure that service users rooms have wash hand basins installed were appropriate. The registered person must 30/04/06 replace or make good the rusted bath and provide heating in the ground floor toilet. The registered person must 30/06/06 provide facilities for service users to meet visitors in communal accommodation and in private accommodation which is separate from the service users own private rooms. The registered person shall 31/03/06 having regard to the number and needs of the service users ensure that equipment provided at the care home for use by service users or persons who work at the care home are maintained in good working order; specifically safety certificates should be available to demonstrate that all electrical installations are safe. Records which evidence sound recruitment procedures should
DS0000064366.V283794.R01.S.doc 5 YA34 Schedule 2 31/03/06 356 Station Road Version 5.1 Page 21 be available for inspection 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 YA32 YA27 YA24 Good Practice Recommendations Management support should be present in the home for a reasonable proportion of each week. It is recommended that the home consider extending the property to provide a more spacious bathroom. Although this home is currently registered for 4 service users the inspector strongly recommends that the organisation look to extending the premises before any new service users are admitted to the home. Alternatively the inspector recommends that the organisation voluntarily reduce the registration to 2 service users. 356 Station Road DS0000064366.V283794.R01.S.doc Version 5.1 Page 22 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 356 Station Road DS0000064366.V283794.R01.S.doc Version 5.1 Page 23 - 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!
