Inspection on 29/06/05 for 356 Station Road

This inspection was carried out on 29th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

356 Station Road 21/02/06

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 18-65 356 Station Road 356 Station Road Rainham Gillingham ME8 7QY Lead Inspector Andrea Leverett Announced 29 June 2005 10.00am 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 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 Stationary 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. 20070221 H56-H06 S64366 356 Station Road V233238 290605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 356 Station Road Address 356 Station Road Rainham Gillingham Kent ME8 7QY Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Care Home 4 The Avenues Trust Limited Category(ies) of LD Learning Disability (4) registration, with number of places 20070221 H56-H06 S64366 356 Station Road V233238 290605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28/02/05 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. The is a semi-detached property,the accomodation is set over 2 floors with the upper floor consisting of 3 bedrooms,a bathroom and toilet. The ground floor has a lounge/diner,a kitchen,a laundry room and a W.C. The 3rd bedroom is very small and communal space is limited. There are gardens to the front and rear and limited off road parking facilities. The is located in a residential area and is convenient to Rainham town centre and other shops and amenities. 20070221 H56-H06 S64366 356 Station Road V233238 290605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, the first in the year running from April 1st 2005 to March 31st 2006. The visit lasted from 09.45am until 14.30pm. The visit was spent talking to support staff, and the manager. 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 evidencing records held at the home. A tour of the premises was undertaken. What the service does well: 356 Station Road provides a welcoming and homely environment, and is clean, bright and airy. Service users needs are being met and the support staff respect their right to make informed choices about the home and personal lifestyle. Service users benefit from the opportunity to take part in a range of community activities. Personal health care needs are well supported. Service users are encouraged to maintain regular contact with external agencies and professionals to managed their health care and personal preferences. The home benefits from a well trained stable support staff team and a motivated manager. 20070221 H56-H06 S64366 356 Station Road V233238 290605 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: The service users would benefit from bigger and separate communal spaces, this would improve privacy and choice for service users. The home would benefit from having a small office space to improve the ability of staff to maintain confidentiality at all times. The service user currently occupying the 3rd bedroom would benefit from being offered the larger back bedroom or having his own room extended to provide more appropriate private and personal space. Both service users 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. Service users’ rights would be better protected by having a standard form of contract of facilities and services by the registered provider. Service users would benefit from experimenting with a more varied range of fresh vegetables. Service users’ bedrooms would benefit from being decorated and having new carpets. Service users would benefit from having the homes rusted bath replaced or made good. 20070221 H56-H06 S64366 356 Station Road V233238 290605 Stage 4.doc Version 1.30 Page 7 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. 20070221 H56-H06 S64366 356 Station Road V233238 290605 Stage 4.doc Version 1.30 Page 8 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 Standards Statutory Requirements Identified During the Inspection 20070221 H56-H06 S64366 356 Station Road V233238 290605 Stage 4.doc Version 1.30 Page 9 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 standard(s) 1,2,3,5 Service users are given the information they need to be able to make an informed decision to live at 356 Station Rd but are put at a disadvantage by not currently being provided with an individual contract or statement of terms and conditions for the home. Service users benefit from a comprehensive assessment of their needs and prospective service users can be confident the home would meet their needs and aspirations. EVIDENCE: Service users have access to a reviewed statement of purpose and service users’ guide which give good representation of the service provided in the home. Avenues Trust has recently taken over the management of this service and are currently in the process of drawing up individual service user contracts. Information seen on care plans confirmed that current service users aspirations and needs had been assessed and documented. 20070221 H56-H06 S64366 356 Station Road V233238 290605 Stage 4.doc Version 1.30 Page 10 Staff were seen to communicate appropriately with service users and were aware, when spoken to, about the individual’s preferred mode of communication. Discussion with staff on duty at the time of the inspection and observation of their practice demonstrated that they had the skills and experience to care for service users at that home. 20070221 H56-H06 S64366 356 Station Road V233238 290605 Stage 4.doc Version 1.30 Page 11 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 standard(s) 6,7,8,9,10 Service users benefit from having their assessed and changing needs reflected in their individual plan and detailed risk assessments are in place to ensure identified risks are minimised. Service users are supported to make decisions and exercise choice as far as they are able. Service users know that staff try to ensure that information about them handled appropriately and that their confidences but on occasion lack of private spaces may compromise confidentiality. EVIDENCE: All of the care plans were viewed and were found to be comprehensive and regularly reviewed. The levels of communication difficulties experienced by the service users prevent verbal or written agreement from them regarding their individual plans, but it was evident that the manager and key workers worked closely with service users and by using a variety of communication methods such as 20070221 H56-H06 S64366 356 Station Road V233238 290605 Stage 4.doc Version 1.30 Page 12 pictures, objects of reference and observation are able to form judgements regarding their needs and wishes. Records seen and discussion with staff also evidenced that service users participated in the life of the home and undertook activities such as shopping, cooking and gardening. The inspector viewed the home’s confidentiality policy, which was appropriate and discussion with the manager and staff evidenced that they understood the principles underpinning the need for confidentiality. It was noted, however that the home does not have a designated office space or a separate communal space where meetings and private discussions could be undertaken. 20070221 H56-H06 S64366 356 Station Road V233238 290605 Stage 4.doc Version 1.30 Page 13 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 standard(s) 12,14,15,16,17 Service users benefit from having the opportunity for personal development with their daily living skills and enjoy leisure activities in their local community. Leisure opportunities could be improved by exploring service users’ wishes regarding holidays. Service users are supported to maintain contact with family and friends, which ensures they continue to receive stimulation and emotional support. Whilst service users choices regarding food are respected and they benefit from a largely balanced diet, this could be improved by increasing the range of vegetables on offer. EVIDENCE: It was evident throughout the inspection that service users were supported to maintain their individual living skills, and their social and emotional skills. Records and discussion with staff and the manager evidenced that one service user was encouraged to be as independent as possible in some tasks such as cooking and gardening. On the day of the inspection service users went out for lunch and activity records evidenced that outings in the local community were 20070221 H56-H06 S64366 356 Station Road V233238 290605 Stage 4.doc Version 1.30 Page 14 undertaken regularly. The service users in this home have not had a holiday for many years and the manager explained that the home is being supported by the new organisation to explore service users wishes regarding this. An inspection of the home’s kitchen, food storage areas and the home’s menus was undertaken. Although it was evident that a balanced diet was provided the range of fresh vegetables offered was limited to carrots and peas. Records viewed and discussion with the manager evidenced that pictures, objects of reference and observation are used to ensure that service users choices regarding food are respected and are incorporated into the menu. 20070221 H56-H06 S64366 356 Station Road V233238 290605 Stage 4.doc Version 1.30 Page 15 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 standard(s) 18,19 Staff provide sensitive and flexible personal support which maximises service users, privacy, dignity, independence and control over their lives. The healthcare needs of service users are properly assessed and recognised and procedures are in place to address them which ensures the service users receive a good quality of care in this area. EVIDENCE: Staff were observed offering appropriate support and encouragement to service users. Care plans indicated individual preferences regarding how service users are to be supported with their personal care. Discussion with the manager and staff indicated that times for getting up and going to bed are flexible. Records viewed and discussion with staff and the manager evidenced that full assistance with all medical and healthcare needs are provided. On the day of the inspection one service user was undertaking an aromatherapy activity. Both service users are registered with a GP and the home is supported by other professionals including an epilepsy nurse, chiropody, dentist and opticians. 20070221 H56-H06 S64366 356 Station Road V233238 290605 Stage 4.doc Version 1.30 Page 16 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 standard(s) 22,23 Service users can be confident that their concerns and complaints are listened to and action taken to resolve them. Service users are protected from abuse through the training that staff receive in managing Adult Protection. EVIDENCE: The home has an appropriate complaints procedure in place, which is made available to service users and relatives. Discussions with the manager and staff showed that service users views regarding the service are sort and action is taken to resolve concerns promptly. Discussion with staff and records seen demonstrated that staff receive Adult Protection training and have an understanding of the principals and procedures needed to be followed in order to promote the protection of service users. The home is currently the subject of an Adult Protection investigation and evidence seen suggests that the home acted promptly and appropriately in bringing the concerns to the attention of Social Services and the Commission. The inspector is satisfied that the home has co operated fully with all subsequent enquiries and taken appropriate action to ensure the protection of service users in their care. 20070221 H56-H06 S64366 356 Station Road V233238 290605 Stage 4.doc Version 1.30 Page 17 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 standard(s) 25,26,27,28,30 Whilst service users 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 improvements in facilities are necessary. Service users would benefit from having access to additional separate communal space. The quality of care provided for one service user is compromised by having to occupy a room which is not fit for purpose. EVIDENCE: 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 20070221 H56-H06 S64366 356 Station Road V233238 290605 Stage 4.doc Version 1.30 Page 18 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. Although both service users benefit from their own room, one service user’s room is a particularly small box room, which does not have space for a wash hand basin and is not considered fit for purpose by the inspector. The home’s larger back bedroom is currently vacant and the need to ensure that the service user is given the option of moving to this room was discussed with the manager. The decoration in all the bedrooms was starting to look shabby and the manager explained that these had been identified as needing redecoration. The inspector also felt that the rooms lacked personality and suggested that more could be done to ensure that service users rooms are personalized. The upstairs bathroom was small and staff confirmed that the space feels very cramped when they are supporting service users with washing and bathing. The bath was rusted in places and the manager explained that estimates had been sought to repair it. 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 reduces the registration to 2 service users. 20070221 H56-H06 S64366 356 Station Road V233238 290605 Stage 4.doc Version 1.30 Page 19 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 Service users benefit from being supported by a sufficient number of staff at all times. EVIDENCE: Discussion with the manager and staff and evidenced seen on the day of the inspection showed that 2 staff are on duty at all times during waking hours. Activity and daily records viewed and discussion with staff evidenced that sufficient staff are provided to consistently support service users with a wide range of activities including in the evenings and at weekends. Staff also confirmed that they had sufficient staff to meet service users personal care needs at all times. 20070221 H56-H06 S64366 356 Station Road V233238 290605 Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,43 Service users benefit from a qualified, competent and experienced manager, who ensures a well run and accountable management of the service. EVIDENCE: The manager has now completed the NVQ 4 Management and Care Award and has several years experience of working with this client group as a support worker and later in a management capacity. Observation on the day, records viewed and discussion with staff evidenced that the manager delivered an effective client led service. He presented as a motivated and enthusiastic leader with an in depth understanding of service users needs. Staff spoke highly of the manager and felt that he was approachable and inclusive in his management style. It was noted that the manager is leaving to manage another home within the organisation and a new manager will be in post shortly. 20070221 H56-H06 S64366 356 Station Road V233238 290605 Stage 4.doc Version 1.30 Page 21 Discussion with the manager and evidence taken from the homes pre inspection questionnaire evidenced that the home has appropriate budgeting systems which are reviewed monthly. Appropriate insurance was also seen in place. The home has not yet received its new registration, which the commission will now process along side the new registered manager application. 20070221 H56-H06 S64366 356 Station Road V233238 290605 Stage 4.doc Version 1.30 Page 22 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 3 3 3 x 2 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 2 Score Standard No 24 25 26 27 28 29 30 STAFFING Score x 1 1 2 1 x 3 Standard No 11 12 13 14 15 16 17 x 3 x 2 3 3 2 Standard No 31 32 33 34 35 36 Score x x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 4 3 x x x x 3 20070221 H56-H06 S64366 356 Station Road V233238 290605 Stage 4.doc Version 1.30 Page 23 No Are there any outstanding requirements from the last inspection? 20070221 H56-H06 S64366 356 Station Road V233238 290605 Stage 4.doc Version 1.30 Page 24 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 AYA5 Regulation 5c Requirement The registered person shall produce a written guide to the care which shall include (c ) a standard form of contract for the provision of services and facilities by the registered provider. The registered person must ensure that a space is made available in order to conduct meetings in private. The registered person must consult service users regarding holiday activities and subject to risk assessments take action to provide them. The registered person must ensure that the service user currently occupying the small box room is given the option of moving to the larger back bedroom that is vacant. The registered person must ensure that service users rooms are reasonably decorated and have wash hand basins installed were appropriate. The registered person must replace or make good the rusted bath. The registered person must provide facilities for service users to meet visitors in communal accommodation and in private accommodation which is seperate from the service users own private rooms. Timescale for action Action Plan by 5th Sept 2. YA10 12(4)(a) Action plan by the 5th Sept Action plan by 5th Sept 3. YA14 16.2(n) 4. YA25 23.2 (f) Action plan by 5th Sept 5. YA26 23.2(d)& 23.2 (j) Action plan by 5th Sept 6. 7. YA27 YA28 23.2 (j) 23.2 (i) Action plan by 5th Sept Action plan by 5th Sept 20070221 H56-H06 S64366 356 Station Road V233238 290605 Stage 4.doc Version 1.30 Page 25 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 YA17 YA27 YA 24 Good Practice Recommendations It is recommended that the home provides the service users with a choice of a broader range of fresh vegatables 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. 20070221 H56-H06 S64366 356 Station Road V233238 290605 Stage 4.doc Version 1.30 Page 26 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane Maidstone Kent. 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 20070221 H56-H06 S64366 356 Station Road V233238 290605 Stage 4.doc Version 1.30 Page 27 - 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!