Inspection on 12/10/05 for 492 Maidstone Road

This inspection was carried out on 12th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

492 Maidstone Road 07/08/07

492 Maidstone Road 15/09/06

492 Maidstone Road 01/03/06

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

CARE HOME ADULTS 18-65 492 Maidstone Road 492 Maidstone Road Blue Bell Hill Chatham Kent ME5 9QN Lead Inspector Andrea Leverett Announced Inspection 12th October 2005 10:00 492 Maidstone Road DS0000064371.V260851.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 492 Maidstone Road DS0000064371.V260851.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. 492 Maidstone Road DS0000064371.V260851.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 492 Maidstone Road Address 492 Maidstone Road Blue Bell Hill Chatham Kent ME5 9QN 0208 3082900 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) The Avenues Trust Limited Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 492 Maidstone Road DS0000064371.V260851.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th March 2005 Brief Description of the Service: 492 Maidstone Road is a registered care home providing care and accommodation for a maximum of four younger people with learning disabilities. The home is situated in a pleasant residential area of Bluebell Hill village on the outskirts of Chatham town. It is within a few minutes reach of the M2 and M20 road links and is situated close to a bus route. The nearest shops, surgeries and other local amenities are to be found at Walderslade village, which is approximately 1 mile away. The home is one of a group of community homes that is owned by the Health Authority and managed and run by Avenues Trust. Services provided include support with personal care and accommodation, in house and community based leisure and educational activities. Health services are arranged and accessed via the local health care teams. The home is a bungalow, which includes single bedrooms for service users, a lounge, kitchen/diner, bathroom, laundry, and rear garden with patio area. There is parking to the front of the premises. There are sleeping in facilities for staff. 492 Maidstone Road DS0000064371.V260851.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place on the 12th of October at 10.00am. Some judgements about quality of life and choices were taken from direct observation of service users on the day followed by discussion with support staff and the manager and viewing evidencing records held at the home. The inspector concluded that although some improvements to community access and appropriate staffing levels were noted there is still considerable room for improvement. Staffing levels and consequently activities for service users were not always consistent. Given the complex and challenging needs of the service users this lack of consistency remains a cause for concern. What the service does well: What has improved since the last inspection? The Home has made some improvements in providing consistently adequate staffing levels. Service users now have better access to specialist health services appropriate to their needs. Service users will now benefit from holidays, which have been planned or are in the process of being planned. The Home has made some improvements in facilitating community access for service users. The Home now has its own transport for the benefit of service users. 492 Maidstone Road DS0000064371.V260851.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. 492 Maidstone Road DS0000064371.V260851.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 492 Maidstone Road DS0000064371.V260851.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): 5 Making improvements to the service user contract would better protect Service users rights and needs. EVIDENCE: The new service user contract was seen. This appeared to be generic and did not include the cost of an annual holiday, although the manager informed the inspector that holidays were included. A requirement has been made for the Home to clarify this and make amendments to the contract as necessary. 492 Maidstone Road DS0000064371.V260851.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): None of the above was inspected on this occasion. EVIDENCE: 492 Maidstone Road DS0000064371.V260851.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): 12,13,14,15,17 Service users have benefited from some improvements regarding access to the community and leisure activities, but these are not consistent and more must be done to broaden their choices in this area. Service users benefit from living in a Home that supports family contact and facilitates friendships. The Home ensures health and well being of service users is promoted by ensuring the supply of nutritious, varied, balanced meals that they have helped choose. EVIDENCE: The Home now has its own vehicle for the benefit of service users and it was evident that more community based activities were being provided. There were still concerns about consistency of activities, which appeared in part to be related to inconsistent staffing levels. Given the complex and challenging needs of this service user group the inspector remains concerned that the Home is not meeting service users basic needs in this area. 492 Maidstone Road DS0000064371.V260851.R01.S.doc Version 5.0 Page 11 The Home continues to support service users to see family and friends. There was evidence that parents visited the Home regularly and the manager and staff communicated with families in the interests of service users. An inspection of the homes kitchen and menus was undertaken. The kitchen was well stocked with varied and nutritious food and it was evident that promoting choices around food was given consideration. The Home has a menu board, which was being used effectively by one service user. 492 Maidstone Road DS0000064371.V260851.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): 19 Service users benefit from access to specialist health services that meet their needs. EVIDENCE: Records seen and discussion with the manager evidenced that a range of health care professionals were engaged with service users as appropriate. The manager felt that staff were now being given the specialist support they needed from health care professionals to carry out their roles. 492 Maidstone Road DS0000064371.V260851.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): None of the above was inspected on this occasion. EVIDENCE: 492 Maidstone Road DS0000064371.V260851.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): 24,26,30 Service users benefit from an environment that is reasonably well maintained but some improvements are needed. Service users benefit from living in a clean Home but improvements could be made to reduce the risk of cross infection. EVIDENCE: A tour of the Home was undertaken, it was evident that some furniture and fittings had been renewed since the last inspection but the Home still does not have a written planned programme of maintenance and renewal with budgets in place. The inspector was also concerned to be told that support staff are undertaking decorating in the Home. The inspector is not convinced that this is an activity that service users are partaking in and therefore are being left without the full support and stimulation that they should be getting. During the inspection the homes fire alarm was triggered whilst cooking was in progress. The inspector was told that this was a common occurrence and that staff forget to open the back door while cooking is being undertaken. Although the Home does have an extractor fan this clearly was not adequate and it is not acceptable that the back door should have to be left open in this way. The 492 Maidstone Road DS0000064371.V260851.R01.S.doc Version 5.0 Page 15 need to resolve this problem was discussed with the manager and a requirement has been made regarding it. All service users have there own rooms that are a good size. It was evident that furniture and fittings were being replaced but there is still work to be done to bring the bedroom environments up to standard. A sink in one service users room has had the tap heads removed because it has been risk assessed as unsafe for the service user to use. Although this seemed appropriate to the inspector there is an outstanding requirement to remove this sink altogether or box it in. Access to the homes laundry area is access via the kitchen and a recommendation has been made that risk of cross infection could be reduced by redesigning access to the laundry, so that access is via the hall. 492 Maidstone Road DS0000064371.V260851.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 Inconsistencies in staffing levels are having a negative impact on service users’ quality of life. EVIDENCE: Records seen and staff spoken to confirmed that the Home is overly dependent on agency staff and adequate staffing levels are not being consistently maintained. This is affecting service users access to the community and leisure activities. It was also noted that staff are being expected to undertake decorating in the home, which is taking them away from supporting service users. 492 Maidstone Road DS0000064371.V260851.R01.S.doc Version 5.0 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,42 Service users have benefited from some improvements to the running of the Home but more needs to be done to ensure an appropriate and consistent quality of life is achieved for them. On the whole service users benefit from living in a safe and appropriately maintained home. EVIDENCE: The manager is in the process if applying to be the registered manager of the service. She finishing the Registered Managers Award and informed the inspector that she will be starting the NVQ4 in Management and Care in December. Staff spoken to felt supported by her and it was evident that she did her best to ensure service users access to specialist health services. However as stated previously records showed that staffing levels were not consistent and service users activities were being negatively affected. It is also the inspector’s view that staff are being used inappropriately to decorate the Home when they should be free to support service users. 492 Maidstone Road DS0000064371.V260851.R01.S.doc Version 5.0 Page 18 Records showed that routine maintenance checks were being undertaken but a Gas maintenance check had not been undertaken since May 2004. The need to ensure that this is addressed was discussed with the manager. 492 Maidstone Road DS0000064371.V260851.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X 2 Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X 2 X X X 2 LIFESTYLES Standard No Score 11 X 12 1 13 1 14 1 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X X 1 X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 492 Maidstone Road Score X 3 X X Standard No 37 38 39 40 41 42 43 Score 2 X X X X 2 X DS0000064371.V260851.R01.S.doc Version 5.0 Page 20 NA Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA26 Regulation 23(2)(a)(f) Requirement The registered person must ensure that wash hand basins in service users’ rooms, which are not in use and have had tap heads removed, are removed altogether or boxed in. The registered person must ensure that action is taken to meet assessed needs of service users. The registered person must ensure that service users’ care plans are followed consistently. Timescale for action 21/12/05 2 YA14 14.1 (d) 21/12/05 3 YA6 15.1 21/12/05 4 YA24 16.2(g) The registered person must ensure 21/12/05 that the extractor fan in the home’s kitchen is working sufficient to ensure general cooking does not set off the fire alarm or that the back door has to remain open while cooking is in progress. The registered person must ensure that the service user contract accurately reflects the service provided. The registered person must ensure that access to adult education, leisure and other appropriate community based activities for service users is explored. DS0000064371.V260851.R01.S.doc 5 YA5 5.1(c) 21/12/05 6 YA13 16(2)(m) 21/12/05 492 Maidstone Road Version 5.0 Page 21 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 Refer to Standard YA24 YA30 YA39 YA7 Good Practice Recommendations It is recommended that the Home has a planned maintenance and renewal programme for the fabric and decoration of the premises, with records kept. It is recommended that the Home consider redesigning access to the laundry, so that access is via the hall and not the kitchen. It is recommended that the Home looks at ways of seeking the views of other professionals and family members regarding the quality of the service provided. A recommendation has been made that independent advocacy services are sort on behalf of service users. 492 Maidstone Road DS0000064371.V260851.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 492 Maidstone Road DS0000064371.V260851.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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