Inspection on 22/09/05 for 5 Mierscourt Close

This inspection was carried out on 22nd September 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 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 Mierscourt Close 27/08/08

5 Mierscourt Close 04/10/06

5 Mierscourt Close 22/02/06

5 Mierscourt Close 10/03/05

5 Mierscourt Close 05/01/05

5 Mierscourt Close 30/03/04

5 Mierscourt Close 06/03/04

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 Mierscourt Close Rainham Kent ME8 8JD Lead Inspector Anne Butts Announced 22 September 2005 09:30 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 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 Stationary 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 Mierscourt Close H56-H06 S28861 5 Mierscourt Clse V242336 220905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 5 Mierscourt Close Address Rainham Kent ME8 8JD Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01634 372048 Mr Daniel Stanley Hobday Care Home 1 Category(ies) of Learning disability 30 years - 64 years (1) registration, with number of places 5 Mierscourt Close H56-H06 S28861 5 Mierscourt Clse V242336 220905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Learning disability Date of last inspection 10 March 2005 Brief Description of the Service: 5 Mierscourt is a small care home which provides care for one adult with a learning disability who resides there as part of the family. The home is situated in a quiet cul-de-sac in Rainham. It is situated close to the High Street and local amenities, with bus and train links close by which enables easy access to other areas. The accommodation is a dormer bungalow with the service users bedroom and main lving areas on the ground floor. 5 Mierscourt Close H56-H06 S28861 5 Mierscourt Clse V242336 220905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection carried out by Anne Butts. She was supported throughout the inspection by one of the Registered Providers. The service user was attending a day centre on the day of inspection and they were out on a trip, so the inspector was unable to speak to the service user on this occasion. Therefore, the main focus of the inspection was viewing relevant documentation and talking to the registered provider with regards to care and support provided. As the home only supports the one service user, and does not employ any staff, the inspection process took this into account. What the service does well: What has improved since the last inspection? What they could do better: There is still a need for some additional policies or procedures which would further the safeguard both the service user and the support that the home 5 Mierscourt Close H56-H06 S28861 5 Mierscourt Clse V242336 220905 Stage 4.doc Version 1.40 Page 6 provides and some of these were discussed during the inspection and recommendations on how to implement have been made. It is noted that these can detract in some way from allowing the service user to live as a member of the family, but in order to protect the service user and monitor his ongoing and changing needs they should be implemented. 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. 5 Mierscourt Close H56-H06 S28861 5 Mierscourt Clse V242336 220905 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection 5 Mierscourt Close H56-H06 S28861 5 Mierscourt Clse V242336 220905 Stage 4.doc Version 1.40 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 standard(s) 1, 3 and 5 The service user and the family can be confident that they are provided with enough information, review processes and contractual obligations that will meet and protect the service users ongoing and changing needs. EVIDENCE: The statement of purpose is suitable for the needs of the home and the service user and contained enough relevant information. The care manager supports the registered providers in the review of the service users needs through their own review process and support plan. These reports reflect the ongoing needs and they are then used as a basis for the provision of care and support provided by the home. These are usually carried out on a regular basis although the registered provider stated that the last review had been postponed and was currently outstanding. The inspector recommended that this review be re-scheduled as soon as possible. The contract had been updated since the previous inspection, but still did not contain information with regards to the fees charged and as the service user lives within the home as a member of the family, issues around sensitivity of approach were discussed. The home has a contract with Medway Social Services, which contains this information and it was recommended that the contract be updated to state that it reflects this. Standards two and four are not applicable in this case only. 5 Mierscourt Close H56-H06 S28861 5 Mierscourt Clse V242336 220905 Stage 4.doc Version 1.40 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 standard(s) 6, 8 and 9 The service user benefits from a comprehensive care plan that meets his individual needs and this is supported by full risk assessments that promote his daily living choices. EVIDENCE: The care plan was viewed and this sets out all the areas where support is required. The goals were specified and this is an ongoing process that changes as differing needs are identified. Records in the home, including a daily diary, evidenced that the service user is able to participate in making decisions about his daily living. He also participates in a number of household duties, which the family support him with. There are comprehensive risk assessments in place to protect the service user and promote his individuality and independence as far as is possible. The service user needs constant supervision and risk assessments reflected this. 5 Mierscourt Close H56-H06 S28861 5 Mierscourt Clse V242336 220905 Stage 4.doc Version 1.40 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 standard(s) 11, 12, 13, 14, 15, 16 and 17. The service user can be confident that he can lead a varied and fulfilling lifestyle in which his rights and choices are respected and recognised. The service user benefits from a balanced diet and home cooked meals. EVIDENCE: The service user was not available to talk to on the day of inspection as he was out on a bowling trip with the day centre that he attends on a daily basis. Any judgements and evidence gathered are taken from conversations with the registered provider and documentation viewed. The registered provider stated that the service user lives as a member of the household and takes part in all their activities. He helps out in the home and takes part in the shopping and general daily living tasks. He develops and maintains his social skills through participating in social events with the family, this includes going to music events, social evenings at the local pub and participates in darts matches with the registered provider. They also go out for meals on a regular basis and have been on holiday. Other 5 Mierscourt Close H56-H06 S28861 5 Mierscourt Clse V242336 220905 Stage 4.doc Version 1.40 Page 11 activities include going to theme parks including ‘Diggerland’, where the service user hold his own ‘licence’. The registered provider was able to show receipts for outings and places that they had visited. He attends a day centre on a daily basis where he follows a varied activities programme. The registered providers encourage the service user to maintain contact with his family, as they do not live local regular phone calls are made and the registered providers take him to Brighton, where his family lives, approximately four to five times per year. The service user lives as a member of the family and follows the usual routines of the house - he has unrestricted access to all parts of the home. As he is unable to go out unsupervised he does not have a key to the front door. He eats all his meals with the registered providers and records showed that he has a varied and balanced diet. His diet needs to be monitored to ensure that he did not have too much ‘fast’ food. 5 Mierscourt Close H56-H06 S28861 5 Mierscourt Clse V242336 220905 Stage 4.doc Version 1.40 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 standard(s) 18, 19, 20 and 21. The service user benefits from his personal, healthcare and medication needs being well met and he can be confident that this overall well being is safeguarded. EVIDENCE: The registered provider supports the service user with any personal care needs and the care plan evidenced how these support needs are met. The service user receives regular checks with his doctor and records were maintained to evidence this. Medication is kept in a small locked metal cabinet that is discreetly placed, and the key is kept separate and secure. MAR sheets were viewed and these were completed appropriately and accurate. A weekly nomad box is used to dispense medication and this is collected on a regular basis. There were no surplus stocks. An agreement has been placed on the service users file from his father about the wishes with regards to any arrangements that would need to be made in the event of the service users death. 5 Mierscourt Close H56-H06 S28861 5 Mierscourt Clse V242336 220905 Stage 4.doc Version 1.40 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 standard(s) 22 and 23 There are complaints and adult protection procedures in place which ensure that the service user is protected from harm and that his views will be listened to and acted upon. EVIDENCE: There is a complaints procedure in place, and the service user has regular contact with a range of professionals and social contacts through the day centre with which he could raise any concerns and who could act on his behalf if necessary. There have been no complaints or concerns raised. The home has the Kent & Medway Adult Protection protocols and has implemented their own procedure that is in line with this. 5 Mierscourt Close H56-H06 S28861 5 Mierscourt Clse V242336 220905 Stage 4.doc Version 1.40 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 standard(s) 24 - 30. The service user benefits from living within a family home that meets his needs. EVIDENCE: This is a family home that is safe and well maintained throughout. All areas of the bungalow are accessible to the service user and he is able move freely around the home. The bungalow is spacious, very clean and tidy. The registered proprietors have recently added a conservatory onto the rear of the building – this has allowed for extra space - and the garden has also been renovated. The serviced user only uses his bedroom for sleeping in, as he spends his time with the family in the main living areas. His bedroom was nicely decorated and had plenty of storage space and contained personal possessions and pictures. Standard 29 does not apply, as the service user has no need for specialist equipment. 5 Mierscourt Close H56-H06 S28861 5 Mierscourt Clse V242336 220905 Stage 4.doc Version 1.40 Page 15 He has full access to the bathroom and kitchen. Any cupboards in the kitchen, which are used to store cleaning materials etc, have a safety lock. 5 Mierscourt Close H56-H06 S28861 5 Mierscourt Clse V242336 220905 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards do not apply as the home does not employ any staff. EVIDENCE: 5 Mierscourt Close H56-H06 S28861 5 Mierscourt Clse V242336 220905 Stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39, 40 and 42. The service user benefits from living within a family environment and is supported by individuals who are committed to ensuring that his safety, rights and best interests are safeguarded and promoted. EVIDENCE: The registered persons have supported and cared for the service user for a considerable amount of time. As previously stated the service user lives within the home as a member of the family and is treated as such. The home has not implemented an actual quality assurance survey to gain the views of the service user and other interested parties. As the service user fully participates in day-to-day life and has an input as to activities and general living, which was fully recorded in his daily diary, it was felt that it was not appropriate for a survey to be carried out. To ensure that other interested parties could give feedback it was recommended that a compliment or comment book was introduced in which feedback could be left from the doctor, 5 Mierscourt Close H56-H06 S28861 5 Mierscourt Clse V242336 220905 Stage 4.doc Version 1.40 Page 18 care manager for example and this could be monitored and any appropriate action taken as a result. The registered providers have worked well with the Commission in order to ensure that they meet the National Minimum Standards and Regulations and have worked hard at ensuring that they comply with any suggestions that have been made. Their records of care and the service user plan are very comprehensive as are the risk assessments. They have implemented policies and procedures that are tailored to meet the needs of the service user. There are still some policies and procedures that need to be introduced in order to protect both the service user and the registered persons and some of these were discussed at inspection. It had previously been recommended that a Health & Safety policy be implemented – on viewing the current policies that are in place it was identified that most of these policies and procedures are aimed at the overall health and safety of the service user. It was recommended at this inspection that the registered persons prepare a Health & Safety policy statement that states how the policies and procedures reflect health and safety needs and issues. Safety records were viewed and the home largely ensure that these are up to date and protect all those living within the home – it was noted that the yearly gas safety check was not up to date and the registered person was advised that this must be carried out as soon as possible. Overall the registered persons have worked hard at meeting the standards in order to provide care to the one service user who lives within the home as a member of the family. 5 Mierscourt Close H56-H06 S28861 5 Mierscourt Clse V242336 220905 Stage 4.doc Version 1.40 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 3 N/A 3 N/A 2 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x 3 x 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 N/A 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 5 Mierscourt Close Score x x x x Standard No 37 38 39 40 41 42 43 Score 3 x 2 2 x 2 x H56-H06 S28861 5 Mierscourt Clse V242336 220905 Stage 4.doc Version 1.40 Page 20 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. 1. Standard 42 Regulation 13 [4 (a)] Requirement The registered person must ensure that all gas appliances within the home are safe - in that a service is carried out by an appropriately competent professional (CORGI), and maintained regularly thereafter. Timescale for action 5th November 05 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. Refer to Standard 3 Good Practice Recommendations It is recommended that the registered providers ensure that regular reviews are held with the care manager in order to ensure that the service users ongoing and changing needs are met. It is recommended that the contract reflects that it is supported by the contract the home holds with Medway Council. It is recommended that in order to monitor any views or feedback from any interested parties a Compliment or Comment book is introduced and used to measure how the home achieves in meeting the service users needs. It is recommended that a Health & Safety Policy Statement is prepared that reflects how all policies and procedures are aimed at the overall health, safety and well being of H56-H06 S28861 5 Mierscourt Clse V242336 220905 Stage 4.doc Version 1.40 Page 21 2. 3. 5 39 4. 40 5 Mierscourt Close the service user. 5 Mierscourt Close H56-H06 S28861 5 Mierscourt Clse V242336 220905 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane Maidstone Kent 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 5 Mierscourt Close H56-H06 S28861 5 Mierscourt Clse V242336 220905 Stage 4.doc Version 1.40 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. 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!