Inspection on 06/12/05 for 68 Milton Road (Welcome House)

This inspection was carried out on 6th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

68 Milton Road (Welcome House) 20/06/06

68 Milton Road (Welcome House) 19/01/06

68 Milton Road (Welcome House) 14/12/04

68 Milton Road (Welcome House) 10/08/04

68 Milton Road (Welcome House) 08/01/04

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

Crossways Community

Belle Vue Country House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 68 Milton Road (Welcome House) 68 Milton Road Gillingham Kent ME1 3AE Lead Inspector Robert Pettiford Unannounced Inspection 6th December 2005 10:30 68 Milton Road (Welcome House) DS0000028991.V271506.R01.S.doc Version 5.0 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 68 Milton Road (Welcome House) DS0000028991.V271506.R01.S.doc Version 5.0 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. 68 Milton Road (Welcome House) DS0000028991.V271506.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 68 Milton Road (Welcome House) Address 68 Milton Road Gillingham Kent ME1 3AE 01634 574644 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) Dr Toqeer Aslam Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places 68 Milton Road (Welcome House) DS0000028991.V271506.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th December 2004 Brief Description of the Service: 68 Milton Road is a terraced house situated in a residential area of Gillingham Kent. It is within walking distance of local shops and other amenities with bus stops nearby. Gillingham town centre and railway station is approximately 3/4 mile distance from the home. 68 Milton Road is one of three houses in the road that is owned by the registered provider all of which are registered as care homes. Staff at no 68 also support service users at the other two homes, being no 66 and 72 Milton Road. 68 Milton Road (Welcome House) DS0000028991.V271506.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 6th December 2005 at 11:30am. The home did not have any service users at the last inspection on the 14th December 2004. The front room of the home is used as a office for the three homes that are registered being no 66,68 and no 72 Milton Road. The home currently has one service user who has moved from another home belonging to the registered provider. The Inspector agreed and explained the inspection process with the Manager. Documentation and records were read, including care plans. Time was spent reading a sample of written policies and procedures, reviewing care plans and records kept within the home. A tour of premises was also undertaken. The focus of the inspection was to assess 68, Milton Road in accordance to the National Minimum Standards for Younger Adults. In some instances the judgement of compliance was based solely on verbal responses given by those spoken with. What the service does well: What has improved since the last inspection? What they could do better: The following areas have been identified as needing to be addressed. Statutory requirements were included within the report to address shortfalls with regard to care planning and staffing. 68 Milton Road (Welcome House) DS0000028991.V271506.R01.S.doc Version 5.0 Page 6 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. 68 Milton Road (Welcome House) DS0000028991.V271506.R01.S.doc Version 5.0 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 68 Milton Road (Welcome House) DS0000028991.V271506.R01.S.doc Version 5.0 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 the following standard(s): Not inspected on this occasion EVIDENCE: 68 Milton Road (Welcome House) DS0000028991.V271506.R01.S.doc Version 5.0 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 the following standard(s): 6,7,9 Service users benefit from having individual plans that identify their physical and medical needs, but not enough detail was given to social and personal goals. The service user can be confident that his rights to make decisions about his life is respected and he is consulted on, and participate in, all aspects of life within the home. Service users are supported to take risks within a risk assessed framework. EVIDENCE: The inspector viewed and discussed with the manager the care records relating to the service user. In the care plan viewed there were clear guidelines in respect to support needed. The home undertakes regular reviews. Formal reviews involving significant professionals are also undertaken. No evidence however was available that the service user is involved in drawing up his personal care plan in the documentation seen or that he is consulted in reviewing and amending such care plan. Although it was stated that the service user does attend reviews. 68 Milton Road (Welcome House) DS0000028991.V271506.R01.S.doc Version 5.0 Page 10 The home and its staff are committed to supporting the service user in accordance with his needs at 68, Milton Road. This was evidenced through the care plan which detailed the areas of support that the service user needed and how this support is provided by the staff. The manager was requested to review its care planning to include more in depth information concerning the preferred lifestyle, goals and choices of the service user. The plan also needs to demonstrate that the home uses positive planned interventions to support him with his mental health. It is evident through talking to members of staff that the emotional health of the service user is of a high priority to the home and that staff are pro-active in maintaining and supporting him with his emotional needs in order to maintain quality of life. This was not fully evidenced however within the care planning process as previously identified. Risk assessments were discussed and viewed. Documentation recorded risks and how to support the service user to minimise risks. However more detail should be included to support any judgements. The inspector visited the home while the service user was relaxing in his front room. It was evident that the service user makes choices in his life and is part of the decision process. A relaxed atmosphere was noted with the service user interacting with staff. The service user later spent time talking to the inspector telling him of his plans for the week. The inspector found that the home has a genuine commitment in evolving the service user in the day to day running of the home. Staff were responsive and receptive to the service user’s input. 68 Milton Road (Welcome House) DS0000028991.V271506.R01.S.doc Version 5.0 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 the following standard(s): Not inspected on this occasion EVIDENCE: 68 Milton Road (Welcome House) DS0000028991.V271506.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 The service user is supported by the level of help given and any healthcare needs are addressed. EVIDENCE: The service user is supported to participate and contribute to meeting his own self care needs and help with day to day chores around the house. Thus providing him with opportunities to maintain and develop, communication and independent living skills. The care plan also fully documented all physical and emotional healthcare needs. Within the care plan records of health care provided by G.P, chiropodist, dentist, and opticians was evident. The service User’s physical and emotional health is monitored on a daily basis. It is evident through records that the emotional health support is of a high priority and that staff are pro-active in maintaining and supporting the service User. 68 Milton Road (Welcome House) DS0000028991.V271506.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 The Service user’s rights are protected by a complaints procedure. However the service user was unaware of his rights with regard to making a formal complaint and whom to complain too other than the manager. The service user cannot always feel confident that he is protected from the risks of abuse. EVIDENCE: A copy of the Home’s complaints procedures was reviewed along with the manager. The complaints procedure contained details of referring a complaint to the Commission for Social Care Inspection was found to be in a format which could be easily understood by the service user. The inspector also recommended that the home introduce a low - level complaints book to enable the home to monitor concerns raised by the service user. It was also requested that the service user be made more fully aware of whom to contact should he have any concerns / complaints that he feels can not be addressed by staff within the home. The home’s Policy for the Protection of Service Users and staff “Whistle blowing” procedure at 68, Milton Road was discussed. These include procedures for the reporting of suspicion or evidence of abuse with a format for the recording of any allegations and action to be taken. Full training has been provided in protecting service users from abuse. However it was recommended by the inspector that further training be given to fully ensure that staff are aware of the procedures and protocols contained in the Kent and Medway Adult protection procedures. 68 Milton Road (Welcome House) DS0000028991.V271506.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,30 Service users benefit from living in a clean comfortable home, which is suitable for their overall needs. EVIDENCE: The Inspector undertook a tour of the home, bathroom/toilet facilities and communal areas. All areas viewed appeared bright. Fixtures and fittings and general decoration were seen to be of a good standard, The house was homely and central to amenities. The living areas and kitchen were found to be clean and tidy. The number of toilet and bathroom facilities provided by the Home meets current required standards. The toilet and bathroom was lockable offering the service user privacy, although staff are able to access toilets/bathrooms in an emergency if required. 68 Milton Road (Welcome House) DS0000028991.V271506.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,36 The service user benefits from staff who are clear about their roles and responsibilities. The service user’s care, social and emotional needs are promoted by the employment of caring and suitably trained and supervised staff. The home does not have an effective staff team with sufficient staffing hours to fully support the service users assessed needs at all times due to staff also supporting other service users at 66, and 72, Milton Road Service users are protected from potential abuse by the home’s robust staff recruitment procedures. EVIDENCE: Staff benefit from having contracts of employment and clear job descriptions that outline their roles and responsibilities. The staff training records indicated planned and undertaken training. The manager evidenced that individual and group staff training needs had been identified. A wide range of training has been identified for all staff over and above core skills courses. 68 Milton Road (Welcome House) DS0000028991.V271506.R01.S.doc Version 5.0 Page 16 First Aid, Food Hygiene, Health and Safety and other core courses are undertaken to maintain current qualifications and for protection of service users. From discussions with the Manager, observations and reviewing the staff rotas in-sufficient staffing hours were shown on the rota to meet the service users needs and that of the other service users who live at the other two registered homes supported by staff from 68. Currently one member of staff works 9 – 5 Monday to Friday and another staff member 10 – 1 Saturday and Sunday. This provides 46 hours of care. On the 10th August 2004 no 72, Milton Road was inspected with regard to staffing for all three homes. At that date the home maintained two staff, one working 9-4 and 3-6 Monday to Friday and one member of staff 10-1 Sat and Sunday. This amounted to 56 hours. The staffing levels at 10th August 2004 were based on their assessed need according to the manager at the time, whist acknowledging that service users do not require constant supervision or support. Whilst it is accepted that the needs of the service users within 66,68 and 72 Milton Road is minimal based on their assessed needs and levels of independence, a further reduction in staffing hours in the view of the inspector from 56 hours to 46 was not acceptable. The provider company was requested to increase staffing levels to previous levels and continue to monitor to ensure that they are meeting the needs of the service users at their homes at no 66,68 and 72 Milton Road. The Operations Manager who was present at the inspection agreed to address this within the homes action plan. The inspector viewed details of the home’s recruitment procedure and a number of records relating to staff members recruited. The home undertakes a recruitment practice including submission of an application form detailing all previous work history, requests proof of I.D and copies of qualification certificates, seeks written references. All staff appointments are subject to a probation period, which is subject to review. The manager reported all staff had received statements of terms and conditions of employment, evidence of which was seen in the file. Members of staff receive regular supervision. Evidence of which was noted. 68 Milton Road (Welcome House) DS0000028991.V271506.R01.S.doc Version 5.0 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 Whilst the quality of care offered to the service user overall is sound, it will be better promoted once a Registered Manager is appointed to run the home. EVIDENCE: The home currently does not have a Registered Manager. The management of the home is supported by a manager who was a deputy manager at another of the homes owned and run by the provider. The provider intends to put forward the manager for registration to ensure that the home meets with the Care Home Regulations 2001. In the mean time the home is supported by the Registered Provider company to ensure that standards are maintained. 68 Milton Road (Welcome House) DS0000028991.V271506.R01.S.doc Version 5.0 Page 18 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 x x x Standard No 22 23 Score 2 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 x 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 x 3 LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score 3 3 2 3 x 3 CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 68 Milton Road (Welcome House) Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 2 x x x x x x DS0000028991.V271506.R01.S.doc Version 5.0 Page 19 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 6 Regulation YA6 Requirement Timescale for action 06/03/05 2 22 YA22 15.—(1) Unless it is impracticable to carry out such consultation, the registered person shall, after consultation with the service user, or a representative of his, prepare a written plan (“the service user’s plan”) as to how the service user’s needs in respect of his health and welfare are to be met. 22.—(1) The registered person 06/01/06 shall establish a procedure (“the complaints procedure”) forconsidering complaints made to the registered person by a service user or person acting on the service user’s behalf.(2) The complaints procedure shall be appropriate tothe needs of service users.(3) The registered person shall ensure that any complaint made under the complaints procedure is fully investigated.(4) The registered person shall, within 28 days after the date on which the complaint is made, or such shorter period as may be reasonable in the circumstances, inform the person DS0000028991.V271506.R01.S.doc Version 5.0 68 Milton Road (Welcome House) Page 20 3 23 YA23 who made thecomplaint of the action (if any) that is to be taken.(5) The registered person shall supply a written copy of the complaints procedure to every service user and to any person acting on behalf of a service user if that person so requests.(6) Where a written copy of the complaints procedure is to be supplied in accordance with paragraph (5) to a person who is blind or whose vision is impaired, the registered person shall so far as it is practicable to do so supply, in addition to the written copy, a copy of the complaints procedure in a form which is suitable for that person. 13.—(6) The registered person 06/01/06 shall make arrangements, by training staff or by other measures, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. 18.— (1) The registered person 06/01/06 shall, having regard to the size of the care home, the statement of purpose and the number and needs of service users— (a) ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users; 9.—(1) A person shall not manage a care home unless he is fit to do so. (2) A person is not fit to manage a care home unless— (b) having regard to the size of the care home, the statement of DS0000028991.V271506.R01.S.doc 4 33 YA33 5 37 YA37 06/03/05 68 Milton Road (Welcome House) Version 5.0 Page 21 purpose, and the number and needs of the service users— (i) he has the qualifications, skills and experience necessary for managing the care home; RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 68 Milton Road (Welcome House) DS0000028991.V271506.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone 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. 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