Inspection on 12/04/07 for 5 George V Avenue

This inspection was carried out on 12th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

5 George V Avenue 16/02/06

5 George V Avenue 07/10/05

5 George V Avenue 18/01/05

5 George V Avenue 07/07/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 5 George V Avenue 5 George V Avenue Westbrook Margate Kent CT9 5QA Lead Inspector Clair Brown Key Unannounced Inspection 12th April 2007 15:30 5 George V Avenue DS0000023747.V335928.R01.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 5 George V Avenue DS0000023747.V335928.R01.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. 5 George V Avenue DS0000023747.V335928.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 5 George V Avenue Address 5 George V Avenue Westbrook Margate Kent CT9 5QA 01843 227003 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) Ms Amanda Jane Rackley Mrs Margaret Lydia Parish, Mr Kevin George Rackley, Mr Benjamin Albert Parish Ms Amanda Jane Rackley Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 5 George V Avenue DS0000023747.V335928.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th February 2006 Brief Description of the Service: 5 George V Avenue provides long term care for four Service Users with learning disabilities. The Home is a large semi-detached property that has been extended. The Home is situated close to the local amenities and is on the bus route. The Registered providers live in the Home, contributing to the family atmosphere. Service Users attend a variety of clubs and activities. The home also has its own minibus. The fees are £323.00 to £360.00 per week. 5 George V Avenue DS0000023747.V335928.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection consisted of an unannounced key inspection visit to the home on 12th April 2007 by one inspector. The visit lasted approximately 3.5 hours. The inspection takes account of information received from a variety of sources including written information from the registered provider and all of the service users. There were no previously made requirements and all key standards were inspected. Comment cards were completed by 3 service users. The inspector spent time talking to service users and the registered providers to gain their views. A tour of the premises was conducted. Documents and records were seen and service users files were case tracked. What the service does well: The home provides a welcoming homely environment. A variety of activities are provided including regular annual holidays. The service users lead busy social lives going out on trips, attending day centres, clubs and socializing with their friends. Service users are actively encouraged to expresses their wishes, this is then considered, risk assessed and arranged if possible, with appropriate support provided, for example going to pop concerts. The ethos of the home is about providing a good quality of life for those who live at the home and this is reflected by the approach taken with providing care and the promotion of choice. Service users have an active voice within the home. Care plans clearly show, service users are actively involved in the production of these documents; they are personal and individual. There are practices in place, which monitors service users health, with appropriate action taken to ensure that health care needs are met. Service users attend the doctors for their annual health checks and are supported to attend hospital appointments. Service users are supported to maintain an appropriate level of independence with looking after their money and have the freedom to spend it as they wish. The building is well-maintained with the registered providers continuing to look at improving the environment. The service user contract / terms and conditions has been produced in a pictorial format. The registered providers ensure they keep their knowledge and skills up to date by attending training courses and respond quickly and appropriately to any requirements made. 5 George V Avenue DS0000023747.V335928.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. 5 George V Avenue DS0000023747.V335928.R01.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 5 George V Avenue DS0000023747.V335928.R01.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): 12345 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The statement of purpose and service users guide provides service users with details of the service provided, enabling an informed decision. The service user contract is produced in an appropriate format. EVIDENCE: The statement of purpose has recently reviewed and copies sent to the Commission. It was been previously assessed that it contains all of the required information. The Service Users Guide has been produced in picture format and large print in simplified language. The contract has also been produced in picture format. The home has not had a vacancy for several years, however, it has a pre-admission assessment tool and other admission documents available for use. 5 George V Avenue DS0000023747.V335928.R01.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 excellent. This judgement has been made using available evidence including a visit to this service. The care plans are individual and provide information on each service users needs and how to meet them. Service users are supported to make choices and decisions about their everyday life. EVIDENCE: The registered manager/provider has recently completed person centred planning training. She has decided to implement this form of care plan within the home. The service users are actively involved in the production of the person centre file, and expressed how much they liked doing them. The individual files contained, details of care needs, risk assessments and personal goals and achievements. To enable service users full involvement with the production of the new style of care plan, the original care plans are being used in conjunction with these. Service Users stated they are actively supported to make decisions and choices. The daily records confirm service users are actively supported to fulfil 5 George V Avenue DS0000023747.V335928.R01.S.doc Version 5.2 Page 10 their wishes, with recognition of potential risks being recorded. Any possible limitations and potential risks are acknowledged and recorded appropriately. All of the comments cards completed by service users stated they felt well cared for and treated with respect and dignity. 5 George V Avenue DS0000023747.V335928.R01.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): 12 13 14 15 16 17 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Leisure activities are appropriate and individual. Daily routines are flexible. EVIDENCE: All of the service users spoke with the inspector. They confirmed that they continue to have very active social lives, attending day centres, clubs, day outs, special trips, socializing with friends and going on holiday. These also include: music club, drama club, visits to the local pub and restaurants, bowling, the theatre, discos, day trips. They also attend clubs, which teach; computer skills, woodcraft, leather craft, arts & crafts, newsletter skills, travel training, swimming, exercise classes, healthy living and personal care. The annual holiday is to Norfolk this year. The home also benefits from having it’s own new minibus, which is used daily. 5 George V Avenue DS0000023747.V335928.R01.S.doc Version 5.2 Page 12 One service user stated that she now does voluntary work in a local charity shop and another works in the daycentre kitchen. One service user is also on the student committee voicing her views and those of her fellow students. Others said how they like to use the computer the home has made available for their use. This includes access to the internet, during the tour of the home the inspector was shown the computer and the pile of computer games they enjoy playing. Family and friends are encouraged, where appropriate, to maintain contact and to be involved. One service user showed pictures and spoke of the special surprise holiday their family had arranged for their 50th birthday. There is a varied balanced diet offered, with alternative offered when appropriate, such as dislikes the meal or has an activity to attend. Some evenings they may enjoy a take away or go to a restaurant for a meal. All of the service user have nutritional assessments completed and are weighed regularly. 5 George V Avenue DS0000023747.V335928.R01.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 21 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The health needs of service users are well met with evidence of good multi disciplinary working taking place. EVIDENCE: Through the regular observations and assessing of health care needs by the registered persons, service users have received the appropriate treatment when required. Records provided evidence of accessing a variety of healthcare professional when appropriate and needed. The learning disability community nurse, who has, in conjunction with the service users, written individual health action plans. The medication audit showed practices continue to a good standard and found no errors. The registered manager/provider has reviewed and amended the homes care of the dying policy to bring it into line with current practices. The observations made during the visit showed that the service users are treated respectfully and with dignity. They are encouraged to be themselves and to allow their own personalities to be expressed. 5 George V Avenue DS0000023747.V335928.R01.S.doc Version 5.2 Page 14 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 excellent. This judgement has been made using available evidence including a visit to this service. The home has a complaints procedure and evidence that service users views are listened to and acted upon. EVIDENCE: The home has produced its complaints procedure in three different formats to meet the individual needs of the Service Users. The Commission and the home have not received any new complaints. The registered manager/provider acknowledges all concerns raised however small. The home has an Adult Protection policy. When meeting with service users they were able tell the inspector who they would go to if they had a problem or were upset about something, this included telling the registered manager/provider. The all of the inspection service user comment cards said they knew who to go to if they had a complaint. The service users supported each other to complete these comment cards. Their care managers recently assessed the Service Users financial records and no concerns were raised. There has been no changes made to the procedures for handling service users money. Service users confirmed they have their own money to spend each week and showed the inspector some of things they 5 George V Avenue DS0000023747.V335928.R01.S.doc Version 5.2 Page 15 like to buy with it, such as painting by number sets, DVD’s, disco lights, CD’s etc. 5 George V Avenue DS0000023747.V335928.R01.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 good. This judgement has been made using available evidence including a visit to this service. The building is well maintained providing a homely environment for service users. The home was clean and free from offensive odours. EVIDENCE: A tour of the premises was conducted with the service users. The registered provider continues to strive to improve the standard of accommodation provided. There is a maintenance programme identifying both small and major tasks to be undertaken. The home provides a large communal room, which is a lounge and dinning room, providing more than the minimum space of 4sqm per Service User. A kitchen was refurbished last year. There is an enclosed rear garden were they enjoy BBQs. Each bedroom has been personalised by the service user with their possessions and is fitted with an appropriate style of lock that service users can use independently. When bedrooms are decorated the service user helps to 5 George V Avenue DS0000023747.V335928.R01.S.doc Version 5.2 Page 17 choose the paint and wallpaper. There are bathrooms and toilets situated next to every bedroom. The home is set over three floors and would not be suitable for those with impaired mobility. 5 George V Avenue DS0000023747.V335928.R01.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 excellent This judgement has been made using available evidence including a visit to this service. Sufficient care hours are provided by appropriately trained carers. EVIDENCE: Two of the registered providers work full-time to provide the care required, they also live within the home. The lifestyle structure is similar to a family unit. The other two registered providers are retiring from providing some additional support and holiday relief. Therefore the registered providers/manager are in the process of employing two part-time carers. There are also two volunteers. The registered providers and volunteers attend training courses. The registered provider/manager has attended person centred planning training and is currently planning the coming years training programme, which will include mandatory subjects. 5 George V Avenue DS0000023747.V335928.R01.S.doc Version 5.2 Page 19 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 40 41 42 43 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The service users benefit from a well run home, the management style ensures their welfare & safety whilst living in a family atmosphere. The home has quality assurance procedures to assess and maintain standards. EVIDENCE: The registered manager/providers are appropriately qualified and continue to develop professionally through training. They also research changes that are happening with legislation, such as the new mental capacity Act and how this will impact the service users living in the home. The registered manager/provider has implemented a mental capacity policy in response to this new Act. Records, documents, policies and procedures have been produced and implemented to meet the needs of a small home. 5 George V Avenue DS0000023747.V335928.R01.S.doc Version 5.2 Page 20 The electrical certificate had expired however the registered providers/manager had made the appointment for this to be renewed but the electrical engineer cancelled the appointment, this is now due to be done in the near future. The fire risk assessment and environmental risk assessment are due their reviews; the registered provider/manager stated these would be reviewed the next day. There have been no significant changes to the building since the last review. All other environmental certificates were in date. The registered provider lives at the Home and is actively involved in providing care and has daily conversations with the service users, this forms the core of their quality assurance procedure, as any issues are acted upon promptly. The registered provider/manager stated that they had started work on this year’s current quality assurance programme, to date relatives and professional people involved with the home have surveyed. The registered providers/manager have been asking Social Services for a review, to increase the service users fees for the last 2-3 year, without any success to date. With the impending retirement of two of the providers and so the need to recruit staff for the first time, they have anticipated this to have an impact on the homes future finances. 5 George V Avenue DS0000023747.V335928.R01.S.doc Version 5.2 Page 21 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 4 2 3 3 3 4 3 5 4 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 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 4 3 4 3 LIFESTYLES Standard No Score 11 3 12 4 13 3 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 4 3 3 3 3 3 5 George V Avenue DS0000023747.V335928.R01.S.doc Version 5.2 Page 22 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. Refer to Standard YA42 YA42 Good Practice Recommendations To review the fire risk assessment and environmental risk assessments annually. To inform the CSCI when the electrical inspection has been completed. 5 George V Avenue DS0000023747.V335928.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 5 George V Avenue DS0000023747.V335928.R01.S.doc Version 5.2 Page 24 - 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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