Inspection on 03/11/05 for 56-58 Turnbull Close

This inspection was carried out on 3rd November 2005.

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

56-58 Turnbull Close 14/06/07

56-58 Turnbull Close 10/05/06

56-58 Turnbull Close 24/05/05

56-58 Turnbull Close 20/12/04

56-58 Turnbull Close 13/07/04

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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 56/58 Turnbull Close 56/58 Turnbull Close Greenhithe Kent DA9 9EB Lead Inspector Eamonn Kelly Announced 03 November 2005 14:00 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. 56/58 Turnbull Close H56-H06 S23873 56-58 Turnbull Close V248384 031105 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 56/58 Turnbull Close Address Greenhithe Kent DA9 9EB 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) 01322 381568 01322 381852 turnbullclose@walsingham.com Walsingham Mr John Henderson Care Home 12 Category(ies) of Learning disability (12) registration, with number of places 56/58 Turnbull Close H56-H06 S23873 56-58 Turnbull Close V248384 031105 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24 May 2005 Brief Description of the Service: 56/58 Turnbull Close residential home (part of Walsingham which has some thirty-four homes in the group across the UK) provides care and accommodation for up to twelve people with physical and learning disabilities. The premises were purpose built. Accommodation is divided into two units, each with its own communal areas. All service users have single bedrooms that are individually furnished and equipped with significant support from relatives and supporters. Some service users have “motability” vehicles. Other organisations (e.g. Yew Tree Centre and Social Education Centres) supplement the homes’ own transport provision in enabling service users to attend specialist day centres. The premises have safe landscaped gardens used by service users. Twenty-four hour care is provided (at night there are two support workers on duty, one sleeping and one awake). A registered manager, who has achieved the Registered Manager’s Award, runs the home with assistance from Walsingham support network. The home is within easy reach (by car) of a range of local amenities and public transport. There are good parking facilities. 56/58 Turnbull Close H56-H06 S23873 56-58 Turnbull Close V248384 031105 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection (between 2.00-5.30 pm) consisted of meeting the manager, deputy manager, members of staff and service users. Part of the premises was inspected. Some of the home’s policies and procedures were reviewed. A number of CSCI “comment cards” (completed questionnaires) were received from relatives and GP’s. The report also uses information provided by the home via a detailed questionnaire. What the service does well: What has improved since the last inspection? What they could do better: 56/58 Turnbull Close H56-H06 S23873 56-58 Turnbull Close V248384 031105 Stage 4.doc Version 1.40 Page 6 Objectives set for the home each month by the visiting operations manager and the constant reviewing and improving of procedures by the manager and deputy manager are evidence of good quality assurance measures in place. 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. 56/58 Turnbull Close H56-H06 S23873 56-58 Turnbull Close V248384 031105 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 56/58 Turnbull Close H56-H06 S23873 56-58 Turnbull Close V248384 031105 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, 2 & 5 Prospective service users and their supporters receive the information they need to make informed choices at admission stage. EVIDENCE: Prospective service users and their supporters receive good written information about the home’s services and facilities. Full pre-admission assessments are carried out. The home obtains as much information as possible at pre-admission stage to try to ensure that the disability needs of service users can be met. Service users receive an agreement that outlines in broad terms what they can expect from the home. 56/58 Turnbull Close H56-H06 S23873 56-58 Turnbull Close V248384 031105 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 & 9 Service users receive good support from members of staff. EVIDENCE: Following initial assessment to determine the suitability of the home for a potential service user, an individual written service user plan is begun. This is added to as on-going reviews of service user’s needs require. The new process now underway requires care plans to be written in the 1st person (ie. as if the resident were describing personal needs). Service users live within a fairly rigid framework as a set of activities during weekdays between 09.00 am and 04.00 pm has been determined for them [ie. they are transported to either of 2 day centres (2/3 use Gravesend SEC and 9/10 use Dartford Yew Tree centre)]. A member of staff is always at the home in case a service user has to return home. Some service users visit their family homes and stay there for agreed periods of time. Service users have opportunities to participate in some activities insofar as their level of disabilities permit. Members of staff help them to take responsible risks (eg by taking part in activities outside and within the home and by moving about the premises with help as needed). 56/58 Turnbull Close H56-H06 S23873 56-58 Turnbull Close V248384 031105 Stage 4.doc Version 1.40 Page 10 56/58 Turnbull Close H56-H06 S23873 56-58 Turnbull Close V248384 031105 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13, 14 Service users have good opportunities for personal support and development and access to appropriate leisure activities within and outside the home. EVIDENCE: 56/58 Turnbull Close H56-H06 S23873 56-58 Turnbull Close V248384 031105 Stage 4.doc Version 1.40 Page 12 The home has the use of three vehicles for transport; a minibus that can accommodate two wheelchair users, a car that can accommodate one wheelchair user and a smaller car. The 2 main day centres co-operating with the home (Yew Tree and Gravesend SEC) also pick up and return residents each weekday. Members of staff also arrange a variety of outings for service users (eg. local Thames ferry trips, escorted trips within the UK and abroad, smaller group outings by car). A service user has a “Motability” vehicle funded from personal mobility allowance. A member of staff is in control of the vehicle (on behalf of the service user) during the week and the service user’s family has responsibility for it at weekends. A record book accompanies service users going to the Yew Tree Centre and Gravesend SEC to record the types of leisure activities, living/educational skills or difficulties experienced that day. An annual holiday for service users is facilitated for which each service user receives a non-returnable grant of £500 from Walsingham. 56/58 Turnbull Close H56-H06 S23873 56-58 Turnbull Close V248384 031105 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 & 20 Service users have good access to medical services and their health needs are identified and met. EVIDENCE: There is a good range of disability aids and equipment available. Service users have access to their GP (seven GPs have patients at the home). Each service user has an allocated care manager. KAB (Kent Association for the Blind) and a Dartford optician provide services on request. Community practice nurse, district nurse, physiotherapy, occupational therapy, dietician, and speech therapy services are provided. Previously the home requested advice from the CSCI pharmacist. The medication administration system includes (in addition to MAR sheets) very clear information about each service user’s medicines including information on the effects of drugs and possible side affects. 56/58 Turnbull Close H56-H06 S23873 56-58 Turnbull Close V248384 031105 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 Service users are protected through surveillance by staff and understanding of their disabilities. EVIDENCE: The completed questionnaires indicated that relatives and supporters had confidence in the skills and knowledge of staff. Many have been associated with the home for many years. Members of staff are aware of Kent & Medway adult protection procedures. Full pre-employment checks are carried out for all members of staff. 56/58 Turnbull Close H56-H06 S23873 56-58 Turnbull Close V248384 031105 Stage 4.doc Version 1.40 Page 15 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 & 29 The home provides excellent accommodation for service users and there is a wide range of specialist equipment for the safe and efficient care of people with significant physical dependency needs. EVIDENCE: All bedrooms have been furnished in a different way, sometimes with direct support from service user’s family. Some bedrooms are equipped with ceiling track hoists. Each service user has a bedroom that has furniture and fittings sufficient and suitable to meet individual needs and lifestyles. There are excellent toilet and bathroom facilities. There is a separate kitchen, dining and lounge areas for each group of 6 residents. The home was purpose built for the care and accommodation of people with learning and physical disabilities. It is suitable for use by wheelchair users. Disability aids include four ceiling track hoists (in bedrooms and bathrooms), a battery powered hoist, ‘Parker’ baths, two shower beds, three specialist reclining chairs and a toilet chair. At care reviews, the need for additional adaptations is carefully considered. 56/58 Turnbull Close H56-H06 S23873 56-58 Turnbull Close V248384 031105 Stage 4.doc Version 1.40 Page 16 56/58 Turnbull Close H56-H06 S23873 56-58 Turnbull Close V248384 031105 Stage 4.doc Version 1.40 Page 17 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) 33 & 36 The home has a staff team that receives good training and on-going support and supervision. EVIDENCE: Appendix 1 of the service user’s guide indicates that there are 18 members of staff (including 10 support workers, 4 awake night support workers and a domestic worker). It shows the qualifications/training received and qualifications staff are working towards. Two support workers are working towards NVQ Level 2 and one towards NVQ Level 3 in Care. A support worker has achieved NVQ Levels 2 & 3 in Care. The deputy manager has GNVQ Level 3 (Health & Social care). All support workers receive induction and core training, and recorded supervision. The minimum staffing levels comprised 2 2 support workers for service users with another available between the two sections of the premises. The reasoning is that this member of staff would, for example, be additionally available to assist with hoisting operations that always needed 2 members of staff. 56/58 Turnbull Close H56-H06 S23873 56-58 Turnbull Close V248384 031105 Stage 4.doc Version 1.40 Page 18 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 & 42 Service users benefit from the experience of the management team and the good management approach of the home. EVIDENCE: 56/58 Turnbull Close H56-H06 S23873 56-58 Turnbull Close V248384 031105 Stage 4.doc Version 1.40 Page 19 The manager has obtained the Registered Manager’s Award. The deputy manager is completing NVQ Level 3 in Promoting Independence and the NVQ Assessors Award. The operations manager submits comprehensive monthly reports to the CSCI that cover every aspect of policy and procedures for the safe and effective care of the home’s residents. The manager and deputy manager have reviewed and improved many of the home’s procedures and policies (eg. service user’s guide, service user’s agreement, medication records). These are examples of good quality assurance measures. They implement the objectives stated in monthly inspection reports carried out by the operations manager. The pre-inspection questionnaire includes a declaration by the manager that all required safety checks have been made. Certificates and records of the sample seen during the inspection were satisfactory. 56/58 Turnbull Close H56-H06 S23873 56-58 Turnbull Close V248384 031105 Stage 4.doc Version 1.40 Page 20 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 3 x x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 4 x x x x 4 x Standard No 11 12 13 14 15 16 17 x x 3 3 x x x Standard No 31 32 33 34 35 36 Score x x 3 x x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 56/58 Turnbull Close Score x 4 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x 3 x H56-H06 S23873 56-58 Turnbull Close V248384 031105 Stage 4.doc Version 1.40 Page 21 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 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. Refer to Standard Good Practice Recommendations 56/58 Turnbull Close H56-H06 S23873 56-58 Turnbull Close V248384 031105 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane Maidstone Kent DA9 9EB 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. 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