Inspection on 08/10/07 for 60 Celtic Road

This inspection was carried out on 8th October 2007.

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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

60 Celtic Road 30/05/06

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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 60 Celtic Road 60 Celtic Road Deal Kent CT14 9EG Lead Inspector Mrs Penny McMullan Key Unannounced Inspection 8th October 2007 3:00 60 Celtic Road DS0000066871.V352539.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 60 Celtic Road DS0000066871.V352539.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 60 Celtic Road DS0000066871.V352539.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 60 Celtic Road Address 60 Celtic Road Deal Kent CT14 9EG 01304 389294 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) The Robinia Care Group Ltd Post Vacant Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 60 Celtic Road DS0000066871.V352539.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30 May 2006 Brief Description of the Service: The home is owned and run by Robinia Care Group Ltd. The home is registered to provide personal care and support to three adults between the ages of 18-65 who have a learning disability. The house is set in a residential road of Walmer near Deal. There are pleasant gardens to the front and rear of the property, which has three single bedrooms for service users. One bedroom has an en suite shower room and is on the ground floor. There is an attractive lounge and kitchen/ dining room. There is a bathroom with a shower and separate ground floor WC. There is off street parking at the front of the property. The current charges for this home are £100,000 per year. The email address is celtic.road@Robina.co.uk There is a notice in the home to inform people that they can access the current inspection report in the office. 60 Celtic Road DS0000066871.V352539.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was carried out over a period of time and concluded with an unannounced visit to the home of 5 hours. The Deputy Manager assisted throughout. Residents and staff were spoken to. Observations included interactions between residents and staff. Information in this report also includes feedback from telephone surveys sent to Residents, Relatives, and staff. The Annual Quality Assurance Assessment had not been completed at the time of the visit. The post of Registered Manager is currently vacant however the organisation Robinia Care have held interviews and a new Manager has been appointed and will take up post in December 2007. The home has made progress in meeting the requirements and recommendations from the last inspection, and is in the process of achieving the outcomes. The timescales for the compliance of the requirements have slipped due to the shortage of staff and the vacant Managers post; however as the home has started to address these issues further requirements have not been made in this report. Overall feedback from residents, relatives, staff and health care professionals is positive and they are satisfied with the service being provided. What the service does well: Comments taken from the agency’s questionnaires/discussion with people who receive services included: Resident’s comments: ‘I am happy living her, the staff are good’ ‘I enjoy doing the garden’. Relative’s comments: ‘The home is very good at supporting residents, they are very caring people’. ‘I am perfectly happy with all aspects of care being provided’. ‘The Manager supporting the home is absolutely brilliant, very approachable.’ Staff comment: ‘We support and provide a good programme of activities for each resident’. ‘This is the nicest service I have worked in’ The home communicates with relatives and visiting professionals very well. There is clear evidence that the home have a good understanding of equality and diversity and promoting resident’s rights and choices. 60 Celtic Road DS0000066871.V352539.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 60 Celtic Road DS0000066871.V352539.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 60 Celtic Road DS0000066871.V352539.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Arrangements are in place to carry out a detailed and through assessment of needs of residents prior to admission to the home. EVIDENCE: A full care needs assessment is carried out when residents move into the home. The assessment form covers all of the required information. There is evidence that aspirations have been identified throughout the document, however further detail as to how staff take action to support residents in this area requires clarification. Information from the placing authority is also in place. There is evidence of resident’s participation in all aspects of their care including any restrictions, which may affect their daily life. 60 Celtic Road DS0000066871.V352539.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The new person centered plans will ensue service users needs are met. Plans are in place to ensure residents aspirations are met and they are supported to make choices and take risks to lead an independent life. EVIDENCE: The home is in the process of introducing person centered planning and detailed and thorough information is in place. The plans have improved since the last inspection and one plan has been developed to include resident’s dreams and aspirations. There is clear evidence that the staff and multi agencies are supporting the service user to achieve his goals. The home needs to ensure that all residents’ plans are updated to this format. Plans have been reviewed and agreed with the individual residents. 60 Celtic Road DS0000066871.V352539.R01.S.doc Version 5.2 Page 10 Staff and residents are aware of risk assessments, which ensure residents maintain their independence. Risks are identified and agreed with the resident and if required health care professionals. The risks are monitored and reviewed. It was evident that the residents have choice and are supported to make decisions. Staff were seen talking to and encouraging residents in a positive respectful manner. Residents say they are able to choose which activity they wish to do and if they do not wish to participate on the day they are able to choose an alternative. They gave lots of examples of choice in their daily lives. 60 Celtic Road DS0000066871.V352539.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents have a flexible programme of stimulating activities that take account of their preferences. Visitors are welcomed in the home and arrangements are in place to ensure residents feel part of the community and are supported with their personal relationships. The meals in this home are good offering both choice and variety. EVIDENCE: Each resident has a structured activity plan which is flexible to choice. One resident says he sometimes changes his plan but he always keeps his college days in place. There is a wide range of interests, gardening, snooker, bowling, 60 Celtic Road DS0000066871.V352539.R01.S.doc Version 5.2 Page 12 clubs, watching TV, playing videos and various evening activities. Residents confirm that they enjoy their activities and there is always enough staff on duty for them to do the things they choose. One resident attends college twice a week and another one talked of accessing another college course. Residents are able to go the local shops and are supported to access the local community. One resident delivers newspapers locally and is also trying to get a job. He has printed out his CV and with the help of staff is going to visit local supermarkets to seek employment. Visitors are welcome in the home and staff ensure that relationships are well supported. Residents talked about their visits to their family and how often they see them. All contact with family and friends is recorded. One resident is looking forward to seeing his father and talked about his plans to see his new caravan. Relatives confirm they are welcome in the home and are invited to reviews and meetings. Some residents have a key to their bedroom and two have a front door key. If residents do no hold a key clear documentation must be in place as to why this restriction has been agreed. The home needs to implement a risk assessment. A recommendation has been made in this report. There is a rota for domestic chores and residents participate with staff to keep the home clean and tidy. Residents are encouraged to help with meal times and are supported to plan and discuss the menu. One resident was aware of the four weekly rolling rota and talked about the flexibility in the menu. Residents say the food is good and snacks are available. There is a large kitchen with a dining area. The mealtime on the day of the inspection was relaxed with residents talking and discussing what was for dinner. 60 Celtic Road DS0000066871.V352539.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Arrangements are in place to ensure that resident’s personal and health care needs are met. Service users are supported to control their own medication however there are minor shortfalls in the storage and recording of as and when required medication. EVIDENCE: Residents confirm that they feel supported by the staff in all aspects of their care and social life. The residents have recently enjoyed a holiday being supported by the staff and they said how much they enjoyed themselves. They also confirm that they have been able to go to the pub, disco and two residents have been to a club in London. All residents health is monitored through the care plan and the home have introduced a health action plan. This clearly details preferences when visiting doctor and dentist and any health appointments. Residents say health care need are met and they are 60 Celtic Road DS0000066871.V352539.R01.S.doc Version 5.2 Page 14 supported to attend health care appointments. Any additional specialist support is provided, monitored and reviewed. There are minor shortfalls in the storage of medication and the home needs to review the security of the cabinet currently in use. A new medication cabinet has now been ordered and therefore a requirement will not be made in this report. There have been improvements in the recording of ‘as and when required’ and ‘over the counter medication’ however further evidence is required to ensure clear guidelines and protocols are in place. There is documentation within the new care plans to address these issues but these have not been fully completed. One residents is able to self medicate and has appropriate storage facilities. Another resident is assisted to administer his medication. Residents are able to sign that they have received their mediation and records are in good order. Risk assessments and recording systems are in place to ensure good practice. All staff have received medication training and are assessed as competent. 60 Celtic Road DS0000066871.V352539.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents can be confident complaints will be listened to and dealt with appropriately. Arrangements are in place to ensure residents are protected from abuse. EVIDENCE: Any complaints, concerns are recorded in the complaints folder and appropriate action taken. All residents spoken to do not have any concerns or complaints and issues are talked about at weekly residents meetings. One resident says that he feels staff would listen to what he says and take notice of what was said. One relative says that there have never been any complaints or concerns raised since she has been visiting her relative. Most of the staff has received protection of vulnerable adult (POVA) training and further courses are booked. Policies and procedures in place and staff are aware of adult protection protocols. Staff recruited is thoroughly vetted to ensure residents are safe. The home has also introduced new financial profiles to ensure that resident’s finances are protected. Staff confirm that all checks are made prior to employment. 60 Celtic Road DS0000066871.V352539.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable and very pleasant environment for residents to live in which is maintained to a high standard. EVIDENCE: The lighting and pathway at the front of the home has been repaired and a new flat roof installed on the extension on the ground floor. The home is well maintained clean, tidy and comfortable. The home is spacious and there is a small quiet room for private meetings. The garden and premises is well maintained. One of residents is supported with the garden to ensure the grounds are maintained to a high standard and the home is well furnished. Residents are happy with their rooms and take pride in keeping their home clean. The rear garden has a vegetable plot and greenhouse. Residents have grown things in the past and have changed some areas to take advantage of the sunniest areas of the garden. The garden is private with trees at the back 60 Celtic Road DS0000066871.V352539.R01.S.doc Version 5.2 Page 17 and a new fence has been erected. All bedrooms have locks fitted. Two residents have keys to the front door one is being risk assessed. Residents are supported to wash their clothes and the home has a domestic washing machine in the kitchen. This is suitable for current service users. There is a dishwasher and other appliances. Paper towels and liquid soap is provided. 60 Celtic Road DS0000066871.V352539.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There is sufficient skilled and trained staff on duty to meet residents needs and arrangements are in place for the safe recruitment of staff. EVIDENCE: At the time of the site visit there was two staff on duty plus the Team Leader. There is currently two full time vacancies and one part time position. The vacant shifts are being covered by staff that are employed to work at other Robinia homes and with overtime from the permanent staff. The team leader is also working on some shifts providing direct care and support to the residents. There is a recruitment drive to fill the vacancies and at this time there are two possible candidates interested in the job. Staff were observed supporting and encouraging service users in a positive manner. Service users were comfortable and relaxed with staff. The team leader said that the rota is planned in a month in advance and extra staff are on duty when needed. Staffing is flexible to meet service users needs. One relative comments that the home is very careful when choosing the staff to work there. 60 Celtic Road DS0000066871.V352539.R01.S.doc Version 5.2 Page 19 Staff files viewed contained thorough checks with all relevant documentation in place. The files are up to date and in good order. The home has introduced a new on call/emergency response system. The device is worn on the wrist and once activated will automatically dial for assistance. There are three contacts to ensure an effective response. There is also an on call procedure, which enables staff to speak to a manager for advice. There is an ongoing training programme in place. All of the staff have been employed with the organisation for a while so there was no evidence of a recent induction programme. The home has a training matrix in place and staff confirm that there has been lots of training this year. Over 50 of the staff group have achieved NVQ 2 or above and the team leader attended a Certificate in Working with People with Learning Disabilities assessor course in August. 60 Celtic Road DS0000066871.V352539.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is well run in the best interests of the residents; however further development in the quality assurance programme is required to evidence that resident’s views influence the development of the home. Arrangements are in place to ensure that resident’s health and safety is protected. EVIDENCE: The post of Registered Manager is currently vacant; however the organisation has now appointed a new Manager who is due to commence duty in December. The Team Leader/Deputy Manager has been with the organisation for over 12 years. He has worked in other Robinia homes and is experienced. He is currently in day to day charge of the home and is supported by another 60 Celtic Road DS0000066871.V352539.R01.S.doc Version 5.2 Page 21 Registered Manager if required. The home is managed well and outcomes for residents are good. Residents meetings are carried out on a weekly basis and recorded. There was one quality assurance questionnaire on file, which was sent to a resident’s family in June of this year. There is no evidence at this time to indicate how resident’s views influence the development of the home or how the home gives residents feedback on the outcome of the surveys. There is an overall strategic plan for the organisation and the home has a service development plan in place, with clear objectives and monitoring processes. This has yet to be fully implemented to ensure that there is evidence that the home contacts other stakeholders, care managers, health care professionals for their views on the services being provided. Although there are gaps in the programme residents feel that they are supported in all aspects of the service and overall are receiving a good service. Staff have completed mandatory training and there is an ongoing update/training programme. The maintenance team carries out water temperature and health and safety checks in the home. Accidents are recorded and appropriately actioned. Smoke alarms are fitted in the home together with emergency lighting fitted throughout the property. Fire alarms are tested weekly and fire exits are clearly marked. There is a first aid box in the kitchen. Environmental risk assessments are also in place. 60 Celtic Road DS0000066871.V352539.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 x 26 x 27 x 28 x 29 x 30 4 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 x 2 x x x 3 60 Celtic Road DS0000066871.V352539.R01.S.doc Version 5.2 Page 23 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 YA20 Regulation 13(2) Requirement To complete the individual guidelines and protocols for ‘when required’ and ‘over the counter medication’ Timescale for action 30/11/07 2. YA39 24 To complete the quality 31/12/07 assurance programme to reflect residents and other stakeholder’s views and ensure that residents receive feedback and outcomes of the survey is published. 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 YA16 Good Practice Recommendations If residents do no hold a key clear documentation must be in place as to why this restriction has been agreed. 60 Celtic Road DS0000066871.V352539.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 60 Celtic Road DS0000066871.V352539.R01.S.doc Version 5.2 Page 25 - 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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