Inspection on 09/08/07 for 38 Sandgate

This inspection was carried out on 9th August 2007.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

38 Sandgate 30/04/09

38 Sandgate 14/04/08

38 Sandgate 09/08/06

38 Sandgate 09/03/06

38 Sandgate 11/12/05

38 Sandgate 14/02/05

38 Sandgate 05/07/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 38 Sandgate Kendal Cumbria LA9 6HT Lead Inspector Ray Mowat Unannounced Inspection 9th August 2007 09:00 38 Sandgate DS0000036570.V343929.R02.S.doc Version 5.2 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 38 Sandgate DS0000036570.V343929.R02.S.doc Version 5.2 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. 38 Sandgate DS0000036570.V343929.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 38 Sandgate Address Kendal Cumbria LA9 6HT 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) 01539 733465 01539 773073 www.cumbriacare.org.uk Cumbria Care Lesley Watson Care Home 3 Category(ies) of Learning disability (3), Learning disability over registration, with number 65 years of age (2) of places 38 Sandgate DS0000036570.V343929.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. An application in respect of a registered manager for this home must be received by the Commission for Social Care Inspection within 28 days of the date of this notice. A maximum of three younger adults with a learning disability (LD3) may be accommodated two of whom may be older with a learning disability (LD(E)2). When single rooms of less than 12 sqm usable floor space become available they must not be used to accommodate wheelchair users, and where existing wheelchair users are in bedrooms of less than 12 sqm they must be given the opportunity to move to a larger room when one becomes available. Staffing levels for the home must meet the Residential Forum Care Staffing Formula for younger adults. 9th August 2006 2. 3. 4. Date of last inspection Brief Description of the Service: 38 Sandgate is a registered care home for up to three people with learning disabilities. The home is owned by Impact Housing Association and operated and managed by Cumbria Care, an independent business unit within Cumbria County Council’s contract services group. There were two residents in the home at the time of the inspection. Due to the high level of assessed needs of one of the residents, there is an additional sleep-in staff required, who is using the third bedroom. The home is in a quiet residential area on the outskirts of Kendal town, it is close to a bus route and local amenities. The home is a semi-detached property with a small front garden and a paved patio area to the rear. All the rooms are single occupancy with the bathroom and communal areas of the home being shared. However plans are in place to extend the downstairs bedroom to create an en-suite bathroom. The current fees for the home range from £501.50 to £2,095 per week. Information about the service is supplied to new and prospective residents in the service user guide. Inspection reports are made available to residents and their representatives and are displayed in the home. 38 Sandgate DS0000036570.V343929.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit took place over two days to enable me to spend time with the two people living in the home. I also spent time talking to care staff the acting manager and the newly appointed manager, who was completing an induction handover. I looked at records relating to the running of the home and records about how people like to live their lives and how they like to be supported by staff. Surveys were sent to people living in the home, their relatives and other professionals involved with the home. What the service does well: What has improved since the last inspection? Plans are now in place to create an en-suite bathroom in the downstairs bedroom, which will meet the needs of the individual who lives in that room. There is now a plan in place to make sure the home is well maintained at all times and work is completed as required. A new kitchen has been fitted 38 Sandgate DS0000036570.V343929.R02.S.doc Version 5.2 Page 6 including new none slip flooring. New carpets have been fitted in the lounge, hall and stairs and decoration of these rooms has been completed. 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. The summary of this inspection report can be made available in other formats on request. 38 Sandgate DS0000036570.V343929.R02.S.doc Version 5.2 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 38 Sandgate DS0000036570.V343929.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The ongoing monitoring and assessment of people ensures their needs can be met and their safety and well-being is maintained. EVIDENCE: There have been no new admissions to the home since the last inspection visit. Assessments are being regularly monitored and reviewed with care plans/person centred plans being updated. The staff work closely with a number of other professionals who provide guidance and support to ensure specialist needs are responded to accordingly. They also liaise with family members and significant others to review and update information. Through this ongoing process people feel reassured that their changing needs will be met within the home. The downstairs bedroom is being extended to include an en-suite bathroom facility that will enable one person to remain in the home in a safe and comfortable manner. There has been a stable staff team in place who are well trained and have a good understanding of people’s needs. 38 Sandgate DS0000036570.V343929.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9, 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed care plans ensure individual needs are recorded and responded to appropriately. People’s rights and choices are respected and their independence is encouraged. EVIDENCE: Staff are developing Person Centred support plans with the involvement of other agencies and professionals, ensuring individual needs and personal preferences are recorded. This helps staff to provide personalised care and encourage and support people to lead independent and fulfilling lifestyles. People living in the home are encouraged to make choices in all aspects of their lives with staff taking on an enabling role. The plans include very detailed pen pictures, which provides staff with valuable information about what is important to people and significant events in their lives. There is also practical information about how people like to be supported 38 Sandgate DS0000036570.V343929.R02.S.doc Version 5.2 Page 10 and their individual needs and preferences including family contacts and friendships, community involvement, leisure pursuits and cultural and religious beliefs. How people communicate is another important area that is recorded, which helps staff to understand people and respond to them in a consistent manner. The plans included photographs, which makes the information more accessible to people and easier for them to understand. A record of people’s likes and dislikes and daily routines that are important to them, helps to guide staff in providing an appropriate service that supports people to achieve their personal goals. Risk assessments have been completed to ensure all activities undertaken are safe. These covered both in-house and community activities and they have been recently reviewed and updated, which is good practice. Staff have a positive attitude to risk taking, which helps to promote people’s independence. There is evidence people are making everyday choices in their lives. Staff work closely with a range of other professionals to ensure people’s individual needs are responded to appropriately including a Speech and Language therapist, Occupational Therapist, Psychologist and Community Nurse. 38 Sandgate DS0000036570.V343929.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are leading a full and active lifestyle and are well supported by staff to pursue their individual hobbies and interests. EVIDENCE: Both residents continue to attend the local day service five days each week, Monday to Friday. This provides them with a good range of social and leisure activities and community involvement. One resident talked to me about how much they enjoyed a “weekly sailing session” and has now joined another specialist sailing club enabling them to enjoy their hobby more often. Both have enjoyed recent visits to a multi-sensory facility, which provides them with an opportunity to exercise and relax in a safe environment that meets their individual needs. 38 Sandgate DS0000036570.V343929.R02.S.doc Version 5.2 Page 12 There was evidence in the home’s daily records of both residents enjoying a varied social life including going out for trips in the car, going out for meals or being involved in other leisure activities such as swimming or attending a social club. One person particularly enjoys cycling, which he is able to do with staff support. A record of activities is maintained including photos, which help people to make informed choices. There are plans in place to meet more regularly with day services staff to review activities undertaken including holidays. With having a settled staff team there is a good level of awareness of individual idiosyncrasies and lifestyle preferences, which are closely monitored by staff. Based on discussions with staff they have a good awareness of individual likes and dislikes and provide unobtrusive support to residents to pursue their individual interests and hobbies. One person living in the home requests to attend church periodically, which is supported by staff. The use of person centred care plans to record people’s needs and preferences in all aspects of their lives also ensures individual and diverse needs are responded to appropriately Families and visitors are welcomed in the home as well as getting involved in formal meetings and consultation. One person has specific dietary needs which are well documented with staff ensuring agreed plans are followed. Menus are based on people’s likes and dislikes and provide a varied and nutritious diet. 38 Sandgate DS0000036570.V343929.R02.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. On the whole personal health care needs are closely monitored and responded to appropriately. EVIDENCE: Plans have been agreed and a builder commissioned to complete the work on an extension to the downstairs bedroom creating an en-suite bathroom that will meet people’s individual needs. This will be completed by 19th October 2007. One person is having additional personal care provided by the day service to ensure their needs are met whilst awaiting the improvements to their home environment. 38 Sandgate DS0000036570.V343929.R02.S.doc Version 5.2 Page 14 There are clear care plans and strategies that have been developed with input from other professionals that guide staff in providing personalised support. Despite the temporary arrangements in place staff ensure that people’s privacy and dignity are respected at all times. Specialist advice and support is sought when needs are identified ensuring staff provide appropriate support and respond consistently. Regular meetings are held with other agencies that are involved as well as routine appointments and health checks being attended. It is recommended all relevant health related information is recorded in people’s health action plans All staff have attended a one day course on medication administration. Regular checks of the systems take place with records maintained. They have also had specialist training in supporting people with Epilepsy. 38 Sandgate DS0000036570.V343929.R02.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The policies and procedures ensure good practice is followed and people’s safety and welfare are maintained. EVIDENCE: There have been no complaints made since the last visit but there has been very positive feedback from families and other professionals involved with the home. Staff receive appropriate training ensuring they are familiar with the policies and procedures of the home and are able to deal effectively with concerns, complaints or abuse. Incidents of self harm had been recorded and appropriate referrals had been made to other professionals to safeguard both the person and staff supporting them. Strategies had then been developed to guide staff and ensure a consistent approach. 38 Sandgate DS0000036570.V343929.R02.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29, 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The current arrangements for the downstairs bedroom are not ideal, however once the planned improvements are completed the home will be safe and comfortable and will meet people’s individual needs. EVIDENCE: Improvements to the environment have continued with the hall, lounge and kitchen being decorated. A new kitchen has been fitted including new non-slip flooring. Also the lounge, hall and stair carpets have been replaced. There is now regular contact with the landlord to ensure the home is well maintained and safe. 38 Sandgate DS0000036570.V343929.R02.S.doc Version 5.2 Page 17 All areas of the home were safe and hygienic and were in good order. Plans have recently been approved for the alterations to the downstairs bedroom to create an en-suite bathroom. It is recommended the manager develop a plan to ensure the safety and comfort of people whilst the work is completed. There is a maintenance plan in place for all planned work and improvements this includes the new bathroom, replacement of the central heating system and painting of the outside of the home and decoration of the two bedrooms. 38 Sandgate DS0000036570.V343929.R02.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a stable and competent staff team who provide a flexible and reliable service. They have developed good relationships with people and ensure a good continuity of care is maintained. EVIDENCE: There is a stable staff team in place with no new staff being appointed since the last visit. Staff training has taken place for all the staff team in relation to responding to challenging behaviour that was specific to the people living in the home. This ensures a consistent and safe approach is maintained. There is also a regular team of relief staff, who ensure a continuity of care when the regular staff are absent, which is good practice and beneficial to the people living in the home. 38 Sandgate DS0000036570.V343929.R02.S.doc Version 5.2 Page 19 Staff are very committed and have developed positive relationships with the people they support. Staff said they got “regular supervision and support” and the acting manager was “always available and responded to their requests.” Monthly staff meetings are held with an open agenda, which enables staff to raise any issues or concerns they may have. The manager provides formal supervision on a one to one basis, which is recorded and any actions agreed. Based on examination of the staff rotas there are sufficient staff to meet the needs of the people currently living in the home. Sound systems are in place to ensure new staff are fully inducted to the policies and procedures and routines of the home. All staff have a continuous professional development file and annual appraisal. An audit of staff training has been completed the results of which need to be developed into a training plan to ensure staff have the skills and knowledge they require. Over 50 0f both the permanent and relief staff have achieved their NVQ2. 38 Sandgate DS0000036570.V343929.R02.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 41, 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. It is evident the home is being run in the best interests of the people living their, ensuring their safety and welfare at all times. Some records are in need of review to ensure they are up to date and in line with new guidance. EVIDENCE: A new manager has been appointed called Ms Lesley Watson. She has 10years management experience and has completed appropriate care qualifications. She must now complete the registration process with the Commission for Social Care Inspection. The acting manager is currently supporting her through an induction to the role. 38 Sandgate DS0000036570.V343929.R02.S.doc Version 5.2 Page 21 An annual quality assurance survey is issued to all interested parties in addition to ongoing consultation on a one to one basis. There was evidence that people’s views were being listened to and incorporated into future plans. Also the Person Centred Planning process ensures individual views are recorded and responded to. House meetings are also held on a regular basis, which provides another opportunity for staff and people living in the home to contribute to the running of it. All areas of the home were safe and well maintained with routine safety checks completed as required. A risk assessment to ensure the safety and comfort of the people living and working in the home during the building work should be completed and forwarded to the Commission. Fire equipment was regularly serviced and the fire log was up to date and accurate. It is recommended the fire risk assessment is reviewed and updated in line with the new Fire Regulations. COSHH substances were securely stored and relevant documentation and risk assessments in place. However these are in need of review to ensure they are up to date and accurate. 38 Sandgate DS0000036570.V343929.R02.S.doc Version 5.2 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 Standard No Score 1 X 2 3 3 3 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 2 25 3 26 3 27 2 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 3 3 3 X 3 2 X 38 Sandgate DS0000036570.V343929.R02.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO 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. 2. 3. 4. 5. Refer to Standard YA19 YA35 YA42 YA42 YA42 Good Practice Recommendations All relevant health related information should be recorded in people’s health action plans. A training plan for the home should be produced to make sure staff receive relevant training for their role. The manager should complete a risk assessment to ensure the safety and comfort of people whilst building work is completed. The fire risk assessment for the home should be reviewed and updated in line with the new Fire Regulations. COSHH risk assessments should be reviewed to ensure they are up to date and accurate. 38 Sandgate DS0000036570.V343929.R02.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 38 Sandgate DS0000036570.V343929.R02.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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