CARE HOME ADULTS 18-65
4 Malham Drive 4 Malham Drive Margate Kent CT9 Lead Inspector
Brenda Pears Unannounced Inspection 09:30 7 March 2006
th 4 Malham Drive DS0000035614.V271784.R01.S.doc Version 5.0 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 4 Malham Drive DS0000035614.V271784.R01.S.doc Version 5.0 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. 4 Malham Drive DS0000035614.V271784.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service 4 Malham Drive Address 4 Malham Drive Margate Kent CT9 020 8541 1147 01843 232952 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) Sense South East Vacant Care Home 2 Category(ies) of Learning disability (2), Sensory impairment (2) registration, with number of places 4 Malham Drive DS0000035614.V271784.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 19th October 2005 Brief Description of the Service: 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. 4 Malham Drive DS0000035614.V271784.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken with a focus on the well being, safety and quality of life of service users living in the home. The methods of inspecting the home included speaking to staff, both service users and observations of the environment and discussing the routines of the home. This report reflects the findings at this and at the previously announced inspection. What the service does well: What has improved since the last inspection?
Vibrating alerts have been provided for both service users to ensure they are aware of the door bell ringing, telephone ringing or any alarms being sounded, supporting full awareness at all times plus control, safety and independence. Since the last inspection, a medicine fridge has been obtained to fully comply with the safe storage of medication. 4 Malham Drive DS0000035614.V271784.R01.S.doc Version 5.0 Page 6 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. 4 Malham Drive DS0000035614.V271784.R01.S.doc Version 5.0 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 4 Malham Drive DS0000035614.V271784.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 A Person Centred Plan is developed for each service user and reviewed yearly, to develop and support goals and aspirations. EVIDENCE: 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. Any wishes expressed by a service user are noted and subsequently worked towards. Both short or long term goals are developed and supported. 4 Malham Drive DS0000035614.V271784.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 All activities are undertaken following discussion with each service user, supporting choice and autonomy. EVIDENCE: This was clearly evidenced when discussing recent events with one service user at the time of this inspection. Activities and outings are led by service user choice and by planning goals for each person in the home. Staff constantly included both service users in this inspection and in all discussions being undertaken at this time. 4 Malham Drive DS0000035614.V271784.R01.S.doc Version 5.0 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,16 Service users enjoy their chosen activities, many of which are undertaken in the community, supporting both choice and independence. EVIDENCE: All activities are decided through consultation with the individual and clearly set out in both person centred plan and supported by appropriate staffing levels. Both service users undertake work experience on Friday of each week. Enjoying chosen activities and college is part of three days every week and these activities include swimming, drama and cooking. Both service users enjoy a close relationship with their families and the home works closely with all relations/friends to ensure contact is maintained.
4 Malham Drive DS0000035614.V271784.R01.S.doc Version 5.0 Page 11 4 Malham Drive DS0000035614.V271784.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 Medication records and storage comply with requirements. EVIDENCE: A new medication fridge has been purchased to ensure medication is stored at an appropriate temperature and can also be locked for safety. Information is on medication files regarding the reason for medication being taken and any side effects that may occur. All service users have access to appropriate healthcare professionals and visits are recorded in care plans. 4 Malham Drive DS0000035614.V271784.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 A complaints policy is in place and this has been developed in picture form to ensure service users have a full understanding of how to express themselves. EVIDENCE: Staff and service users interact in a relaxed manner and both people living in the home appeared confident and comfortable when discussing recent events that have been enjoyed. Families work closely with staff to support service users, ensuring continuity and appropriate support is agreed. A recent matter regarding some storage of booklets and leaflets has been discussed with the service user and also with family members, concluding in an agreed outcome with all concerned. 4 Malham Drive DS0000035614.V271784.R01.S.doc Version 5.0 Page 14 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 25,26 The home provides spacious, safe and homely accommodation. Service user rooms are personalised and respected as an individual’s own space. EVIDENCE: Individual bedrooms, the lounge area, kitchen/dining area and garden space are all large, comfortable and suitable for the needs of both service users. Each room is regarded as a private space and both service users are consulted with regard to all routines. Appropriate equipment is in place for both service users to ensure full independence and to also respect privacy. One service user has recently purchased a videophone and this enables contact with both family and friends. Appropriate vibrating alerts have also been provided for both service users to ensure they are aware of the door bell ringing, telephone ringing or any alarms being sounded, supporting full control, safety and independence. 4 Malham Drive DS0000035614.V271784.R01.S.doc Version 5.0 Page 15 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 Service users are supported and protected by the staff competencies. EVIDENCE: 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 in the home are only made after gaining the opinion of both service users. 4 Malham Drive DS0000035614.V271784.R01.S.doc Version 5.0 Page 16 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 The home is run in the best interests of the service users at all times. EVIDENCE: The inspector observed staff behaving in an open and inclusive manner throughout this inspection. The safety, health and well being of service users is considered at all times and the home was found to be clean and fresh in all areas. Staff are trained in core skills that support service user needs and well being. Life skills and goals are supported by staff and the routines in the home are dictated by serviced user needs and wishes. 4 Malham Drive DS0000035614.V271784.R01.S.doc Version 5.0 Page 17 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 X X 3 X x Standard No 22 23 Score 3 x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 4 X X x Standard No 24 25 26 27 28 29 30
STAFFING Score X 3 3 X X X x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 X 16 4 17 Standard No 31 32 33 34 35 36 Score X X 3 X X x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
4 Malham Drive Score X X 3 x Standard No 37 38 39 40 41 42 43 Score 3 X 4 X X X x DS0000035614.V271784.R01.S.doc Version 5.0 Page 18 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 4 Malham Drive DS0000035614.V271784.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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