Inspection on 20/06/06 for 72 Milton Road (Welcome House)

This inspection was carried out on 20th June 2006.

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 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

72 Milton Road (Welcome House) 08/10/07

72 Milton Road (Welcome House) 03/03/06

72 Milton Road (Welcome House) 06/12/05

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

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

72 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 72 Milton Road (Welcome House) 72 Milton Road Gillingham Kent ME7 5LW Lead Inspector Sarah Montgomery Unannounced Inspection 20th June 2006 10:00 72 Milton Road (Welcome House) DS0000028998.V301185.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 72 Milton Road (Welcome House) DS0000028998.V301185.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. 72 Milton Road (Welcome House) DS0000028998.V301185.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 72 Milton Road (Welcome House) Address 72 Milton Road Gillingham Kent ME7 5LW 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 72 Milton Road (Welcome House) DS0000028998.V301185.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd March 2006 Brief Description of the Service: 72 Milton Road is a registered care home for three adults with mental health problems. It is one of nine homes owned and managed by the Welcome House Group. At present one service user lives at the home. He is supported by a small team of staff consisting of a manager and two support workers. The service user guide, statement of purpose, and reports from the Commission for Social Care inspection are available to service users and are kept in the lounge. Weekly fees are £545. Purchasers of the service will be given a full breakdown of the fees charged. Staff are not on duty in the evening or overnight. During these times service users have access to an on-call staff member. The home is situated in a residential area with easy access to public transport and local shops. Gillingham town centre is approximately one mile away. 72 Milton Road (Welcome House) DS0000028998.V301185.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Sarah Montgomery conducted this unannounced inspection on the 20th June between 11.25am and 3pm. Evidence was gathered from reading documents, talking to staff and management, and speaking with service users. Twelve standards were inspected. 11 standards were assessed as being met, with one standard assessed as being almost met. The home has made significant improvements following the inspection in March 2006, and has clearly demonstrated a commitment to compliance in meeting national minimum standards. What the service does well: What has improved since the last inspection? What they could do better: No improvements to note. 72 Milton Road (Welcome House) DS0000028998.V301185.R01.S.doc Version 5.2 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. 72 Milton Road (Welcome House) DS0000028998.V301185.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 72 Milton Road (Welcome House) DS0000028998.V301185.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users can be confident that their individual aspirations and needs will be assessed. EVIDENCE: All Welcome House homes have undergone a process of developing and changing their recording systems to ensure accuracy and compliance in meeting service user’s assessed needs. One part of this change has been the area of reassessment. Although no new service users have been admitted to the home, Welcome House has revisited the area of assessment with the service users. This assessment process includes; a personal profile, mental health relapse signs, case history, capabilities, likes and dislikes. Re-assessments have also been completed on individual service user’s independent living skills, and on individual’s mental health needs. These assessments give a clear indication of support needs and provide a baseline for care planning. The service user has signed all individual assessment documentation. 72 Milton Road (Welcome House) DS0000028998.V301185.R01.S.doc Version 5.2 Page 9 All future prospective service users will benefit from the new pre-assessment package. 72 Milton Road (Welcome House) DS0000028998.V301185.R01.S.doc Version 5.2 Page 10 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confident that their assessed and changing needs are reflected in their individual plan. Service users can be confident they will be supported to take risks as part of an independent lifestyle. EVIDENCE: Care plans were inspected. The detail in individual care plans demonstrated the clear relationship between assessment and care planning. Care plans were spilt into five main headings; stabilise mental health, support with independent living, general health, education, and social needs. Each care plan gave a description of the need and of how support should be offered. All care plans have been signed by the individual service user. Service users are supported by staff to achieve goals set by them in their care plans. They are assisted to do this by having reminders in the form of a weekly 72 Milton Road (Welcome House) DS0000028998.V301185.R01.S.doc Version 5.2 Page 11 planner and a weekly task rota. Goals and aspirations are reviewed during a weekly 1-1 session with the keyworker, and any changes to care plans are made in consultation with the service user. Service users have a mental health risk assessment, in which historical and upto-date details of their mental health status and risks are described, and general risk assessments. All risk assessments are detailed and inform both the staff and service user about methods to reduce risk in an independent environment. Following the previous inspection, all service users have been given training and support on how to contact the out of hours on call service. 72 Milton Road (Welcome House) DS0000028998.V301185.R01.S.doc Version 5.2 Page 12 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): 12 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confident that they will be supported and encouraged to take part in appropriate activities. EVIDENCE: The inspector spent some time talking with the service user. He spoke about the activities he likes to do, and told the inspector he has been doing the same activities for years because he enjoys them. He recognises that from time to time staff will offer a range of suggestions for other activities. He does not want this, and is happy and content with the lifestyle he has developed for himself. The service user has daily contact with staff, and undertakes household chores with prompting. The service user is offered regular (at least weekly) 1-1 keyworker meetings. Most of the time, these are declined by the service user. 72 Milton Road (Welcome House) DS0000028998.V301185.R01.S.doc Version 5.2 Page 13 His care plan is written by him with staff support. Observations on the day of inspection evidenced that the service user is satisfied with the support he receives. 72 Milton Road (Welcome House) DS0000028998.V301185.R01.S.doc Version 5.2 Page 14 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): 19. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confident that their physical and emotional health needs are met. EVIDENCE: All healthcare needs of service users are detailed in assessment documentation. Any support needs with physical or emotional health are then described in a care plan, and if necessary, a risk assessment. Service users at the home require minimal or no support with physical health needs (for example; making and attending doctor’s appointments). However, a record of all appointments are made, and service users generally choose to share the outcomes of these appointments with the manager. All shared outcomes are recorded. Service users are supported to maintain their mental health. This is through informal daily 1-1 discussions with staff, and formal (recorded) weekly 1-1 sessions with their keyworker. Service users have access to mental health professionals, and a record of appointments and meetings are kept by the home. 72 Milton Road (Welcome House) DS0000028998.V301185.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confident their views are listened to and acted on. Service users can be confident they are protected from harm. EVIDENCE: Discussion with a service user regarding making a complaint or voicing a concern evidenced the service user had knowledge about the complaints procedure, and felt comfortable and confident in talking to staff if necessary. No complaints have been recorded. The manager demonstrated competence in her knowledge of the complaints procedure, and detailed what steps would be taken should a complaint be made. The complaints procedure is displayed on a notice board in a communal area. Service users are encouraged to talk about any concerns they may have in weekly 1-1 keyworker meetings. Documents viewed and discussion with staff evidenced knowledge and competence in adult protection procedures. All staff have received training in adult protection. 72 Milton Road (Welcome House) DS0000028998.V301185.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users live in a comfortable environment but would benefit from the lounge being redecorated. EVIDENCE: An inspection of communal areas and the service user’s bedroom evidenced a homely, clean and safe environment. The service user was enthusiastic and proud of his home, and told the inspector he felt comfortable and happy there. The lounge has signs of wear and tear, particularly the wallpaper. The registered provider and manager informed the inspector that it would be decorated before November 2006. 72 Milton Road (Welcome House) DS0000028998.V301185.R01.S.doc Version 5.2 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 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): 32 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from being supported by competent staff. Service users benefit from well supported and supervised staff. EVIDENCE: The Milton Road homes (66, 68 and 72) are supported by one staff team. This consists of a manager and two part time support workers. The manager works Monday to Friday from 9am to 5pm, one support worker works Monday to Friday 10am to 2pm, and the other support worker works from 10am to 1pm on a Saturday and Sunday. The above hours evidence an increase in staffing hours following the previous inspections. This increase has enabled staff to provide more support to service users, particularly in teaching independent living skills, and in providing more keyworker support. Support staff are supervised by the manager. Evidence of these supervisions (recorded notes) was seen during the inspection. 72 Milton Road (Welcome House) DS0000028998.V301185.R01.S.doc Version 5.2 Page 18 The manager receives regular supervision from the Head of Home. These are not recorded. It is recommended that all supervision is recorded for reasons of good practice and as an aid memoir for actions to be taken. 72 Milton Road (Welcome House) DS0000028998.V301185.R01.S.doc Version 5.2 Page 19 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 and 39. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from living in a well run home. Service users can be confident their views underpin all self monitoring, review and development by the home. EVIDENCE: The inspector was assisted by the manager throughout the inspection. The manager presented as professional and knowledgeable throughout the inspection process. Welcome House have worked hard to developed and improve the way in which service users are supported to lead valued and fulfilling lives. Most notably, improved documentation and information in the way of pre-assessment, assessment, care planning, risk assessment, and quality audit documentation have been successfully implemented and demonstrate Welcome House’s commitment to providing a service which meets the needs of the service users. 72 Milton Road (Welcome House) DS0000028998.V301185.R01.S.doc Version 5.2 Page 20 The Regulation 26 monitoring form (‘internal home audit form’) gathers information on working practice within the home, and policy and procedures. Inspection of recent internal home audit forms evidenced a comprehensive system of ensuring standards are met, while at the same time including views and opinions of service users. The audit form would benefit from including an ‘action by’ column, and for completion of the action to be dated and followed up at the next month’s audit. 72 Milton Road (Welcome House) DS0000028998.V301185.R01.S.doc Version 5.2 Page 21 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 2 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 X 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 X X 3 X 3 X X X X 72 Milton Road (Welcome House) DS0000028998.V301185.R01.S.doc Version 5.2 Page 22 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. 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 2 Refer to Standard YA24 YA36 Good Practice Recommendations The lounge is redecorated. The Head of Home records all supervision with the Manager. 72 Milton Road (Welcome House) DS0000028998.V301185.R01.S.doc Version 5.2 Page 23 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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