Inspection on 02/09/05 for 57 Pembury Road

This inspection was carried out on 2nd September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

57 Pembury Road 17/10/06

57 Pembury Road 14/12/05

57 Pembury Road 19/10/04

57 Pembury Road 26/07/04

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Southfields

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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 57 Pembury Road Tonbridge Kent TN9 2JB Lead Inspector Paul Stibbons Unannounced 2 September 2005 10:30 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. 57 Pembury Road H56-H06 S23887 57 Pembury Road V246549 020905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 57 Pembury Road Address 57 Pembury Road Tonbridge Kent TN9 2JB 01732 354949 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) The Avenues Trust Limited Doreen Phylis Forward CRH Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 57 Pembury Road H56-H06 S23887 57 Pembury Road V246549 020905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Age range 40 - 65 2.Care of one service user is restricted to one older person whose date of birth is 05/02/1940 Date of last inspection 19 October 2004 Brief Description of the Service: 57 Pembury Road is a detached house within walking distance of Tonbridge town centre. The Avenues Trust Ltd are the registered providers. The home provides accommodation and care for 4 men who have learning disabilities, one of whom also has mental health difficulties. The accommodation is arranged on 2 floors with one ground floor bedroom. There is a small bathroom and separate toilet on the first floor and a shower room on the ground floor. There is a lounge and kitchen/diner access to the laundry and shower room is via the kitchen. The home has steep stairs to the first floor and is therefore not suited to the needs of severely disabled people and/or wheelchair users. There is a patio area and small garden to the rear and parking for up to five vehicles to the front. 57 Pembury Road H56-H06 S23887 57 Pembury Road V246549 020905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Regulatory inspector Paul Stibbons carried out this unannounced inspection and in the absence of the manager was assisted by the senior on duty. A tour of the building was conducted and various records were viewed. Three service users were home during the inspection and the inspector had the opportunity to speak with two of them. What the service does well: What has improved since the last inspection? Since the last inspection the home has installed a new fire alarm system for the protection of service users. Quotes have now been obtained for the fitting of wash hand basins in bedrooms and submitted for approval. Due to a room becoming vacant there is now a facility for service users to hold private visits. 57 Pembury Road H56-H06 S23887 57 Pembury Road V246549 020905 Stage 4.doc Version 1.40 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. 57 Pembury Road H56-H06 S23887 57 Pembury Road V246549 020905 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 57 Pembury Road H56-H06 S23887 57 Pembury Road V246549 020905 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) 3, 4, 5 Service users have an assessment of their needs and know that the home will meet these needs. EVIDENCE: Service users have an assessment of their needs through person centred planning covering their physical, social and emotional requirements. Service user plans viewed evidenced this approach. One service user who used to live at the home, whose mobility had deteriorated has been re-assessed and after a trial period has transferred to a more suitable placement within the Trust that is better able to meet their needs. Service user guides were seen to contain individual contracts and statements of terms and conditions. 57 Pembury Road H56-H06 S23887 57 Pembury Road V246549 020905 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, 7, 8, 9, 10 Service users are supported in making decisions and participate in all aspects of life in the home within a risk assessed framework to promote an independent lifestyle. Their rights to confidentiality are upheld. EVIDENCE: Service user care plans that were viewed were comprehensive and daily reporting ensures their current needs are met. Individual plans should reflect the personal goals of service users and it is recommended that goal action plans be completed with short, medium and long-term goals as part of the person centred planning for individuals. Recent specialist assessments have been conducted on one service user’s use of the bath. Quotes for the recommended adaptations have been forwarded to head office. Service users have choice of when to get up and when to retire, evidenced by one service user having a late breakfast and who informed me “I had a lay-in”. The home holds meetings for service users to express their views and wishes; a copy of the minutes of one meeting was viewed during the inspection. Support plans evidenced risk assessments for activities undertaken by service users to promote their independence. The home has a confidentiality policy in place and records of service user information were seen to be securely stored thus protecting their rights to confidentiality. 57 Pembury Road H56-H06 S23887 57 Pembury Road V246549 020905 Stage 4.doc Version 1.40 Page 10 57 Pembury Road H56-H06 S23887 57 Pembury Road V246549 020905 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) 11, 12, 13, 14, 15, 17 Service users participate in a range of activities that meet their spiritual, educational, social, and leisure needs. They are supported in maintaining friendships and family contacts and enjoy a healthy diet according to their choices. EVIDENCE: Service users have the opportunity to attend a local adult centre for art classes; one service user has works of art on display in his room. This service user spoke at length with the inspector about his interest in steam engines and also stated he attended Larkfield for gardening, woodwork and pottery. One service user is supported to attend a local church and fellowship at Hildenborough old people society to meet his spiritual and social needs. All of the service users enjoyed a holiday at the New Forest this year and will be going to Eastbourne for a weekend. All service users attend day centre facilities at Horizons and riverside at differing times; this is recorded in their daily reports. All service users telephone relatives and receive incoming calls; one service user visits their family home twice weekly. Menus were viewed 57 Pembury Road H56-H06 S23887 57 Pembury Road V246549 020905 Stage 4.doc Version 1.40 Page 12 that showed service user choice and they accompany staff on food shopping trips, the menu reflected a healthy and balanced diet. 57 Pembury Road H56-H06 S23887 57 Pembury Road V246549 020905 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 user health needs are met and monitored through the local GP and relevant specialists. A competent staff team administers medication, however, monitoring and recording sheets need reviewing for the safety of service users. EVIDENCE: Various charts are used to monitor service users health and support plans evidence GP visits and input from relevant specialists. Appropriate equipment was observed to be in place to manage specific medical conditions. Service users are unable to manage their own medication and are supported by staff. Medication is stored and administered in line with recognised legislation and guidance by named staff that have undergone appropriate training and have been assessed as competent. Records are accurately completed and securely stored, it is required however, that a request be made to the prescribing GP to remove any medication no longer required from the recording charts and that “when required” medication have more specific written directions for use, that have been agreed and signed by the GP, this is to avoid confusion and for the protection of service users. A room thermometer and hand washing facilities must be installed to comply with current guidance on the storage and administering of medication. 57 Pembury Road H56-H06 S23887 57 Pembury Road V246549 020905 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 Service user complaints are listened to and action is taken to resolve concerns. EVIDENCE: Service user guides contain a copy of the complaints procedure and they are supported by staff and relatives to express their concerns. Staff gave the inspector an example of how one service user raised concerns about another and the action that was taken to resolve the issue. 57 Pembury Road H56-H06 S23887 57 Pembury Road V246549 020905 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, 25, 26, 27, 28, 29, 30 Service users live in a homely, safe and clean environment. Bedrooms suit their needs and lifestyles and there is adequate communal space. All areas of the home are adequately furnished to meet the needs of service users. EVIDENCE: The home has recently been fitted with a new fire alarm system for the protection of staff and service users. Although the building is not ideal for individuals with mobility difficulties, service users were observed negotiating the stairs with little difficulty. All doorways with steps have “grab rails” fitted to aid service users. Specialist assessments have been carried out on the first floor bathroom and quotes obtained for the work have been submitted for approval to head office. One service user whose mobility needs could no longer be met has moved on to a more suitable home within the Trust. There is no designated room for private visits but the vacant bedroom can be used for this purpose at present. All of the bedrooms are single, spacious and reflect the interests and lifestyles of the service users, two service users spoken with confirm their rooms meet their needs; there is however, a requirement to provide wash hand basins as identified in previous inspections. The location of the ground floor shower room is not ideally situated to provide 57 Pembury Road H56-H06 S23887 57 Pembury Road V246549 020905 Stage 4.doc Version 1.40 Page 16 privacy for service users. Staff informed the inspector that the facility is only used by one service user who is in agreement with the arrangement. The inspector was unable to speak with the individual service user to confirm this. The laundry room is small but meets the needs of service users and procedures are in place to minimise the risk of cross-infection. 57 Pembury Road H56-H06 S23887 57 Pembury Road V246549 020905 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, 35 An appropriately trained and effective staff team meet the individual and joint needs of service users’. EVIDENCE: At the time of the inspection two staff members were on duty to meet the needs of three service users. Discussions with a staff member demonstrated a good knowledge of the disabilities and specific conditions of service users. Observations during the inspection indicated that staff respect service users and there was positive interaction with them. 57 Pembury Road H56-H06 S23887 57 Pembury Road V246549 020905 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, 38 Service users benefit from living in a home that is run by a qualified, approachable and competent manager. EVIDENCE: The homes manager is qualified in The Registered Managers Award and NVQ level 3 in Care. Staff state that the manager is approachable, shows good leadership and fully supports the staff team in meeting the needs of service users. 57 Pembury Road H56-H06 S23887 57 Pembury Road V246549 020905 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 x x 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 2 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 x 3 Standard No 31 32 33 34 35 36 Score x x 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 57 Pembury Road Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x x x H56-H06 S23887 57 Pembury Road V246549 020905 Stage 4.doc Version 1.40 Page 20 YES 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 YA20 Regulation 13(2) Timescale for action A thermometer and handwashing By 22 facilities must be installed in the December medication room and a review of 2005 monitoring and recording charts Bedrooms should be fitted with By 22 wash basins. Previous timescale December 30 December 2004 2005 Requirement 2. YA26 16(2) c 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 YA6 Good Practice Recommendations Goal action plans for service users should be completed showing short, medium and long-term goals and how they will be achieved 57 Pembury Road H56-H06 S23887 57 Pembury Road V246549 020905 Stage 4.doc Version 1.40 Page 21 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 57 Pembury Road H56-H06 S23887 57 Pembury Road V246549 020905 Stage 4.doc Version 1.40 Page 22 - 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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