Inspection on 11/11/08 for 6 Coleman`s Stairs Road

This inspection was carried out on 11th November 2008.

CSCI found this care home to be providing an Excellent service.

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

6 Coleman`s Stairs Road 13/12/06

6 Coleman`s Stairs Road 24/03/06

6 Coleman`s Stairs Road 11/10/05

6 Coleman`s Stairs Road 16/03/05

6 Coleman`s Stairs Road 22/09/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 6 Coleman`s Stairs Road 6 Coleman`s Stairs Road Birchington Kent CT7 9HJ     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sandra Crosby     Date: 1 1 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: 6 Coleman`s Stairs Road 6 Coleman`s Stairs Road Birchington Kent CT7 9HJ 01843841967 Telephone number: Fax number: Email address: Provider web address: colemans.stairsroad@theavenuestrust.co.uk Name of registered provider(s): Name of registered manager (if applicable) Mrs Daria Hudspeth Type of registration: Number of places registered: The Avenues Trust Ltd care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: The maximum number of service users to be accommodated is 4. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) Physical disability (PD). Date of last inspection Brief description of the care home 6 Coleman Stairs Road is a large detached bungalow situated in a quiet residential area. It provides accommodation and support for 4 adults with learning and physical disabilities. The level of care and support is given on the basis of fully assessed need. Support is given to enable service users to participate in leisure activities provided both inside and outside the Home. There is access to relevant health care professionals and specialist support as required. The fees for support from the home are set during the assessment period and are very individual to the needs of the service user, Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 0 4 4 Brief description of the care home depending on the level of support required and the staffing numbers provided. The average fee levels start at various levels and currently go up to £1614.00 per week. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 star. This means that people who use this service experience excellent, quality outcomes. This report contains the findings of the homes key inspection and takes account of information obtained from various sources since the last inspection of 13 December 2006, including an Annual Service Review dated 23 January 2008 and a visit to the home. The key inspection visit was unannounced and carried out on Tuesday 11 November 2008 between 10.00 and 15.30 hours. During the inspection the inspector spoke with the registered manager, staff on duty, and people supported by the home. Various Care Homes for Adults (18-65 years) Page 6 of 28 records were seen and an accompanied tour of some areas of the home was made. Following the inspection visit the inspector spoke with two relatives of people supported by the home on the telephone. Comments made by the relatives were all positive for example staff are very good, the home is run well by the registered manager, no complaints, absolutely wonderful, nice and caring ten out of ten. Information contained in the completed Annual Quality Assurance Assessment (AQAA), was comprehensive and information and observations made at the time of the inspection visit has been used when completing this report. The AQAA indicated that service users identified via the Avenues Our Say team that they wish to be addressed as People we support and this report has therefore addressed service users as people supported by the home. The findings of this inspection were discussed with the registered manager at the end of the visit, and overall indicate that this home provides sustained good quality outcomes provision for the residents and in line with CSCI ratings agenda this service has achieved an excellent 3* rating. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective service users would be provided with the information they need about the service. A full assessment of their needs would be undertaken to ensure that prospective service users needs could be met by the home. Evidence: The service user guide was seen for the home, and included a pictorial format. The pictures provided may enable people supported by the home to understand the guide in relation to the services provided. Although there have been no new admissions to the home, the company policy is that all initial assessments are undertaken with multi-agency participation, including care managers, service users and families/advocates if chosen by the service user. Assessments include risk assessments, full assessment of needs, what the prospective Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: service user wants to achieve and a detailed support plan. Any wishes expressed by a prospective service user are noted and subsequently worked towards, both short or long term goals are developed and supported. Currently people supported by the home would also be fully involved in any placement into the home, only after ensuring everyone is comfortable and happy, does a placement become permanent. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Persons supported by the home can be confident that their needs and goals are assessed and monitored. They can also be sure that they are involved in decisions and they will be supported to take risks if necessary. Evidence: The completed AQAA states that all people supported by the home have their personal care plan with holistic profile and culture needs assessment, ensuring equality and diversity through individual care plans and individualised approach to peoples needs and preferences. One plan of care was seen for a person supported by the home. The information seen was comprehensive and included the setting of realistic goals that are monitored with the person and appropriate advocates. Choices are given at all times with each day being spent as each individual wishes. Planned outings/activities are only undertaken if the person supported by the home wishes, if refused, alternatives are offered until a suitable activity is decided upon. The reason for not participating in certain activities is recorded to support the change and review of activities on care Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: plans. Other information on care plans includes a personal history, information on preferred lifestyle, risk assessments and step by step intervention guidelines. Relevant policies and procedures are presented in symbol and audio format and people supported by the home are consulted on the running of the home through regular meetings with their keyworker. Persons are supported to take reasonable risks to allow them to undertake the activities they wish to. All risk assessments are kept under review. The personal information in relation to persons supported by the home is kept secure. Staff are briefed on their responsibilities to maintain confidentiality as part of their induction into the home. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Persons supported by the home enjoy their chosen activities, many of which are undertaken in the community, providing both choice and control. Friends and family relationships are encouraged and supported by the home. Evidence: Persons supported by the home were included in this inspection process and individual support was appropriately given with due consideration for dignity and independence. The AQAA states that as a result of opportunity sessions persons supported by the home have new activities, purchasing of food and drinks they like, purchasing items for their bedrooms, decorating bedrooms (see environmental standards). All activities are decided through consultation with the individual and clearly set out in their person centred plan and supported by appropriate staffing levels. The registered manager Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: commented that the introduction of opportunity sessions has enabled staff to find out what the people supported like, and these choices have been documented and include for example flavour of milk shake, choice of cheese, choices in relation to bedroom decoration and furniture. Trips out, walks to local shops or the beach are part of daily activities and are recorded on each persons care plan. The home is close to the centre of town and has a library and a variety of shops, cafes and pubs, which the people supported are assisted to visit. Other activities undertaken include trips to the cinema, pub and aromatherapy sessions. All relationships that are important to people supported by the home is encouraged and constant contact supported. Events in the home are undertaken with involvement and support from friends and family this being confirmed by relatives spoken with. A variety of food choices are available and food storage areas showed a wide selection of healthy food, snacks and fruit. Coloured coded menus showing choices were seen on display. People feel their rights as citizens are recognised and promoted, including fairness, equality, dignity, respect, and autonomy over their chosen way of life. This service has consistently provided good outcomes enabling this to be viewed as an excellent service in line with Inspecting for Better Lives. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The healthcare needs of people supported are met. Staff consider the dignity of persons supported and treat individuals with respect. Medication is administered and stored appropriately. Evidence: Health professionals provide support that enables staff to give full care to each person supported. Healthcare visits are recorded and were evidenced in a sampling of records undertaken at this time. All persons supported have access to appropriate healthcare professionals and this is evidenced in care plans and notes of all healthcare visits. Medication is administered via a monitored dosage system (MDS) and all relevant policies and procedures are in place. Medication training and individual competencies are assessed within the home and regularly reviewed. Competencies are assessed through observations, discussions and questions regarding medication and its affects. One person supported has been assessed for a new hoist to aid moving and handling Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: transfers. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Persons supported are listened to and routines and practices in the home support and protect the people. Evidence: There is a complaints procedure in place that is also available to persons supported in CD and video format. The registered manager has previously explained that there is a good relationship with family and friends that encourages open discussions at all times. This has been confirmed through previous questionnaires received and also through direct discussions with family members. Staff receive training in abuse awareness as part of their induction. Where persons require support regarding agitated behaviour, clear guidance is contained in the individual plans. Incidents are recorded, monitored and appropriately reported to the Commission for Social Care Inspection. The home has a comprehensive system for the recording of persons supported finances that includes a daily check by staff on personal allowances and the retention of all receipts to cover any expenditure. If the seal is opened at any time, this is shown by a new seal number being allocated and staff double check all balances and two signatures are recorded at change over of shifts. Care Homes for Adults (18-65 years) Page 18 of 28 Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was found to be, in the main, clean, bright and free from odours at this inspection. The home provides spacious, safe and homely accommodation. Persons supported rooms are personalised and respected as an individuals own space. Evidence: The accommodation at 6 Coleman Stairs is all on ground level to enable wheelchair access to the front and rear of the building. Rooms are spacious, light, airy and personalised with pictures of activities and holidays that have been enjoyed. There are gardens to the rear, side and to the front of the property and adequate off street parking. The completed AQAA documentation states improvements in the last twelve months include the re-decoration of some bedrooms, better seating, new wheelchairs and hoist, hi-lo beds and the hallway carpet has been replaced. Rooms are very individual, pictures and ornaments decorate bedrooms including some models and paintings that have been produced by service users. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: Discussion took place in relation to the outside laundry and health and safety issues for persons supported and staff when accessing this area especially if used during night time hours. The registered manager gave assurance that staff would not be using this area and leaving the home unattended during the night. The completed AQAA documentation confirms that all maintenance contracts are up to date and that the building complies with the fire safety requirements. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff undertake appropriate training, are competent and qualified to work in the home. The homes recruitment policy and practices protect the people supported. Evidence: The AQAA states that as a result of personal care planning and the people supported changing needs, extra funding has been obtained from the PCT to allow additional staffing to support people with their complex needs and activities and also looking into a possibility of relocation in future. All new staff undertake a full induction programme within the first six weeks of employment and statutory training is completed within the first six months. Staff training is identified by the registered manager during the appraisal process. This process forms the basis of training provided throughout the organisation. The training schedule was seen and staff spoken with confirmed that the company provides ongoing training. The registered manager said that all staff are NVQ trained. The AQAA states that all staff attend Diversity training and policies and procedures are in place to address equality and diversity. Equality of opportunity, fairness and Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: consistency of treatment are at the centre of everything the company does not only for employees but more importantly for the people supported by the home. The company has a robust recruitment procedure that includes gaining full CRB checks prior to any staff commencing work. New employees are required to visit the home prior to their start date to meet people supported by the home and staff. Staff have regular supervision and staff spoken to at this time confirmed that they feel supported by the registered manager and the staff team. A board in the hallway clearly identifies staff on shift and large photographs of each member of staff support this information enabling the people supported to be aware of who will be in the home and providing support. People are well supported by a staff team that recognises and responds appropriately to their diverse needs and human rights. This service has consistently provided good outcomes enabling this to be viewed as an excellent service in line with Inspecting for Better Lives. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff and routines in the home protect the people supported and promote their safety and well being at all times. Evidence: The registered manager holds the NVQ 4 qualification in both care and management and the Registered Managers Award. It was evident through discussion with staff that they are well supported and involved in the running of the home. Relatives also spoke highly of the registered manager for example runs the home well. During the last twelve months the completed AQAA documentation states that the registered manager has completed couching skills training and other management skills training workshops. Quality assurance monitoring is regularly undertaken to assess the level of care being given and also the quality of the environment in the home and the AQAA states that stakeholders questionnaires are sent to relatives and professionals in order to gain their opinion about the services provided. Opportunity sessions are carried out to find Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: out preferences and wishes, likes and dislikes of people supported. The opinions and wishes of people supported are considered in current and future plans. The safety, health and well being of the people supported is considered at all times and the home works in a relaxed and inclusive way. Staff are trained in core skills that support the peoples needs and well being. Life skills and goals are supported by staff and the routines in the home are dictated by the people supported needs and wishes. People enjoy as good a quality of life as possible because the home is managed in a way that takes into account and promotes their human rights and equality and diversity needs. This service has consistently provided good outcomes enabling this to be viewed as an excellent service in line with Inspecting for Better Lives. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - 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!