Inspection on 11/12/08 for 4 Malham Drive

This inspection was carried out on 11th December 2008.

CSCI found this care home to be providing an Excellent service.

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

4 Malham Drive 09/01/07

4 Malham Drive 07/03/06

4 Malham Drive 19/10/05

4 Malham Drive 09/03/05

4 Malham Drive 23/06/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 4 Malham Drive 4 Malham Drive Margate Kent CT9 2LW     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sandra Crosby     Date: 1 6 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: 4 Malham Drive 4 Malham Drive Margate Kent CT9 2LW 01843231359 01843229641 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Samantha Gillett Type of registration: Number of places registered: Sense, The National Deafblind and Rubella Association care home 2 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability sensory impairment Additional conditions: Date of last inspection Brief description of the care home 4 Malham Drive is a small home for two people with a sensory disability and works in conjunction with registered services at 89 Hastings Avenue and 136 Newington Road, part of Sense South East. The home provides ample communal space and single room accommodation for the service users. There is off road parking for two cars and there is a small but pleasant garden to the rear of the property. The home is close to public amenities, shops and public transport. The fees for support from the home are set during the assessment period and are very individual to the needs of the service user, depending on the level of support required and the staffing numbers provided. This home has been chosen specifically for the service users currently living at 4 Malham Drive and fees are agreed for the appropriate support of both individuals in the home. 2 2 Over 65 0 0 Care Homes for Adults (18-65 years) Page 4 of 27 Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 star. This means that people who use this service experience excellent, quality outcomes. This report contains the findings of the homes key inspection and takes account of information obtained from various sources since the last inspection of 09 January 2007, including an Annual Service Review dated 24 February 2008 and a visit to the home. The key inspection visit was unannounced and carried out firstly on Thursday 11 December 2008 at 13.00. Unfortunately at this time both service users were going to attend a prize giving at the local college and the inspector arranged to call again on Tuesday 16 December 2008 when both service users would be at home. During the Care Homes for Adults (18-65 years) Page 6 of 27 inspection the inspector spoke with the registered manager, staff on duty, and was enabled to speak to the two service users with the assistance of staff who communicated with service users via sign language. Various records were seen and an accompanied tour of some areas of the home was made. Information contained in the completed Annual Quality Assurance Assessment (AQAA), was comprehensive and information and observations made at the time of the inspection visit has been used when completing this report. The AQAA states that both service users are very happy and proud of their home and their independence, confidence and ability to make life choices continue to grow. The findings of this inspection were discussed with the registered manager at the end of the visit, and overall indicate that this home provides sustained good quality outcomes provision for the residents and in line with CSCI ratings agenda this service has achieved an excellent 3* rating. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective service users would be provided with the information they need about the service. A full assessment of their needs would be undertaken to ensure that prospective service users needs could be met by the home. Evidence: All service users have remained in this placement since 2002. At that time it was identified that both service users would like to live more independently. The registered manager worked closely with the service users and their families to support the smooth transition to this home. Service users were actively involved for example from choosing where the house would be, to choosing staff to help in painting, decorating and personalising their new home. The home operates in a flexible, relaxed and comfortable way. Service users have any professional support that is required and the home has pictures on display and certificates showing the achievements of service users. Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: The AQAA states that all information is available regarding Sense and the home to prospective service users in their preferred form of communication should there be a vacancy in future time. The carrying out of full assessments to identify needs and establish an appropriate placement would be undertaken. Visits would be arranged and carried out depending on the individual needs and a full transition period would be worked out amongst all parties. Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Detailed service user plans have been developed and are reviewed regularly to support any changing needs. Risk assessments support all activities and appropriate activities and manageable risks are undertaken as part of the development process. Evidence: Staff members ensure the wishes of service users are sought and that inclusion is undertaken at all times. This was evidenced at this time by staff constantly asking the preference of the service users present and full inclusion was ensured during this inspection. A Person Centred Plan is developed for each service user and reviewed yearly. Files contain clear goals that are agreed prior to being set and person centred plans contain clear information of aspirations, life history and the level of support required. Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: The AQAA states service users are supported to take on responsibility for the whole process of their Person Centred Plan meetings, from choosing, who where and when the meeting is to be held, to preparing for and then presenting their own personal meeting. The service users use boards to display visually with photographs depicting what is important to them and the service user is the person who leads and presents information at reviews. The display boards for one of the service users were seen at the inspection visit, this clearly demonstrating the input from the service user to indicate their views and wishes. Realistic goals are set and monitored with service users and appropriate advocates. Choices are given at all times with each day being spent as each individual wishes. All records evidence consultation regarding any activities, meals or outings. Daily and weekly programmes were seen in use, the daily programme was seen in one of the service users bedrooms. Care Homes for Adults (18-65 years) Page 13 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users enjoy their chosen activities, many of which are undertaken in the community, providing both choice and control. The rights and responsibilities of service users are recognised in their daily lives. Evidence: The AQAA states that the aim is not only to help service users choose courses at college, but to also encourage service users to be as independent as possible and develop their life skills. Examples of learning new skills at home include learning through sessions of cooking, laundry, housework, arts and crafts etc. Any interests the service users have in different activities is encouraged and followed up, for example gardening undertaken in the greenhouse at the home, and a service user gaining work experience at a local gardening centre. Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: All activities are decided through consultation with the individual and are clearly set out in their person centred plan and supported by appropriate staffing levels. The AQAA states that a Christmas Pantomine and overnight stay in a London Hotel has been booked and all service users and staff are looking forward to this. This was discussed at the time of the inspection visit and the inspector was told that a large party were going that included service users and staff from the other two homes in the local area owned by the company. Other activities currently being enjoyed include visits to the local pub, swimming, meals taken out, gardening and horse rising and walks by the sea. All relationships that are important to service users are encouraged and constant contact supported. Special events in the home are undertaken with involvement and support from friends and family and photographs on display around the home show holidays, outings and special events that have been enjoyed. Both service users are looking forward to spending time with their families over the Christmas period. Families are very much part of the ongoing process of development and planned goals for both people living at the home. Shopping, meals and keeping the home tidy and clean are part of daily activities for both people living there, thus supporting independence, responsibility and ownership. A varied and nutritious diet is provided, with service users assisting in meal preparation. Pictures of the weeks meals were seen set out on the fridge door, this enables the service users to know what they have chosen for dinner each day. This service has consistently provided good outcomes enabling this to be viewed as an excellent service in line with Inspecting for Better Lives. Care Homes for Adults (18-65 years) Page 15 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff do ensure healthcare needs are met, consider the dignity of service users and treat individuals with respect. Medication is administered and stored appropriately. Evidence: The AQAA states that health care plans have been set up in the last year. All service users have access to appropriate healthcare professionals and this is evidenced in care plans and notes of all healthcare visits. Discussions with staff indicate a good knowledge of health needs of each service user. One service user was attending a dental check appointment during the day of the inspection visit. Contact is maintained with family and friends and key workers speak to family members on a weekly basis. Regular meetings take place with families to discuss any concerns or developments and the results of any healthcare appointments are relayed to families with consent from service users. Service user plans show the individual personal support assessed for each service user Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: and how independence is promoted. Risk assessments are completed to support and develop independence. The Inspector observed staff at the time of this inspection behaving in a supportive and appropriate manner with due consideration for independence and choice. Medication was seen appropriately stored in a locked area at the last inspection visit. The home has a medication fridge for any medication requiring cold storage. Medication records were clearly completed with details of what was given, at what time and records were also clearly signed. Information is on file regarding the reason for medication being taken and any side effects that may occur. Medication is currently under review for one service user and adjustments are showing an improvement in health for this person. The AQAA states that personal care guidelines have been written with the service users to meet their own needs and preferences. The homes guidance on gender sensitivity states that where at all possible, females should be helped by females and males helped by males. Dignity is upheld at all times and service users are encouraged to do as much as they can themselves. Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are listened to and routines and practices in the home support and protect service users. Evidence: The AQAA states that all service users have a comprehensive complaints procedure and guidelines in their preferred form of communication easily accessible in their bedrooms. One was seen in one of the service users bedrooms. Service users can also express concerns in their service user meetings. The service users have built up good relationships with staff and this enables them to express how they are feeling. The registered manager explained that there is a good relationship with family and friends that encourages open discussions at all times. This has been confirmed through previous questionnaires received and also through direct discussions with service users, who confirmed they can speak to staff or family if they have any worries. The AQAA states that all staff have been trained in adult protection and environment of honesty and total transparency has been encouraged in staff meetings. Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides spacious, safe and homely accommodation. Service user rooms are personalised and respected as an individuals own space. Evidence: The home was found to be clean, odour free and benefiting from a welcoming atmosphere. Staff continue to provide support and encourage development in a relaxed way that ensures inclusion and independence for both service users. The AQAA states that new carpets have been fitted to lounge, hall, stairs and the office. Also through listening to the ideas of a service user a new kitchen has been fitted including an eye level cooker. It was reported at the last inspection visit that the lounge had been redecorated together with new furniture, carpet, a new television and video payer and a large picture on display that belongs to one service user. Service users have been involved in the choosing the colour schemes of their bedrooms, and helping to decorate their rooms. Each room is regarded as a private space and both service users are consulted with regard to all routines in the home. Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: Photographs and proof of personal achievements are on display around the home, ensuring that the home is regarded very much as belonging to the service users themselves. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are supported and protected by the staff competencies, by the programme of training and the recruitment process. Evidence: There is a good solid base of experienced staff at Malham Drive, along with a diverse team, including a deaf staff member, and by all working and learning from each other, this produces some excellent team work. Over recent months there has been staff shortages, and extra shifts have been covered by existing staff or staff from one of the other local homes owned by the company. The registered manager explained that staff are very supportive and always ensure staffing levels are appropriate for service users. A new member of staff is due to start work at the home in the New Year. Any prospective staff member is asked to spend time with service users giving the person an idea of requirements and service user needs. This also enables staff to observe interaction and service users are able to give their impression of the person themselves. Decisions are made after gaining the opinion of both service users. Previous sampling of staff files has shown that all paperwork is obtained to ensure the Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: protection of service users. The AQAA states that all staff undergo induction into Sense which covers most aspects of national and local training requirements. All core training is refreshed regularly including health and safety, fire safety, manual handling, safe dispensing of medication and health and hygiene. All staff have British Sign Language stage one and the registered manager is currently looking for an appropriate training course for level two. National Vocational Qualifications are undertaken. Staff are both flexible and long serving. People are well supported by a staff team that recognises and responds appropriately to their diverse needs and human rights. This service has consistently provided good outcomes enabling this to be viewed as an excellent service in line with Inspecting for Better Lives. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service user preferences and wishes are the basis of all daily routines and activities. Staff have clear lines of responsibility and work as a team to provide safety and support to service users in the home. Evidence: People enjoy as good a quality of life as possible because the home is managed in a way that takes into account and promotes their human rights and equality and diversity needs. The AQAA states that staff and service users can openly express any issues or concerns that they might have and it was observed that the registered manager encourages both openness and respect. Service user opinions and wishes are considered in current and future plans. The safety, health and well being of service users is considered at all times and the home works in a relaxed and inclusive way. It was reported in the last inspection report that Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: checks are carried out to ensure the well being of service users. These checks are included on the rota sheet and checks include the temperature of the mediation fridge, water temperature, checks on emergency alerts including carbon monoxide and smoke detectors. Alerts and fire signs are in place throughout the home for the safety and support of service users and staff. Appropriate equipment is also installed to alert and support service users. All personal reports and documents are kept locked away and only available to the registered manager. Quality assurance monitoring is regularly undertaken to assess the level of care being given and also the quality of the environment in the home. Managers meetings are held every two months where they share experience and knowledge with other house managers in the region. Regulation 26 visits are carried out by the Locality Manager to ensure the service is running properly. The registered manager receives regular supervisions via the Locality Manager. and staff receive regular supervision from the registered manager. This service has consistently provided good outcomes enabling this to be viewed as an excellent service in line with Inspecting for Better Lives. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 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!