Inspection on 08/10/07 for 72 Milton Road (Welcome House)

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 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) 20/06/06

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 Joseph Harris Key Unannounced Inspection 8th October 2007 10:00 72 Milton Road (Welcome House) DS0000028998.V352542.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.V352542.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.V352542.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) amanda@welcomehouse.co.uk 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.V352542.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 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. 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 £545.00. 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.V352542.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection process culminated in a site visit to the home on 8th October 2007. The site visit commenced at approximately 10am and concluded at 2.30pm, lasting for around 4.5 hours. During the course of the visit a tour of the premises was undertaken and discussions were held with the manager and service users. A range of documentation was examined relating to the residents, staff, medication, health and safety and the day-to-day running of the home. What the service does well: What has improved since the last inspection? What they could do better: 2 recommendations have been made as a result of this inspection process. The manager was advised to concentrate on the development of clear support plans addressing activities of daily living and aspects of independent living. 72 Milton Road (Welcome House) DS0000028998.V352542.R01.S.doc Version 5.2 Page 6 With regard to medication issues the manager should also review the selfadministration assessments to include more open-ended questions. The manager should also now consider applying for registered manager status through the Commission for Social Care Inspection. 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. 72 Milton Road (Welcome House) DS0000028998.V352542.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.V352542.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): 2 Quality in this outcome area is good. Prospective service user’s individual needs and aspirations are assessed prior to admission. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has assessment processes in place for service users referred. It was reported that information is requested from care managers and professional care teams prior to admission and that the home conducts it’s own assessment, which includes trial visits to the home. A number of the service users have previously lived in Welcome House homes, which ensures that a good process of assessment is in place and current information and readiness for the placement can be closely assessed. The manager stated that good support is also received from the local community mental health services supporting the admission process. 72 Milton Road (Welcome House) DS0000028998.V352542.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 and 9. Quality in this outcome area is good. An individual plan of care is developed for each service user and the decision making process is facilitated. Risks are managed appropriately. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two service user files were examined, which are securely stored in the office of one of the adjacent homes. An individual plan of care has been developed for each individual based on the assessed needs, information from healthcare professionals and the aspirations of each service user. Aspects of care and support are detailed within the plan and suitable guidance is in place to enable staff to meet needs consistently. The manager was advised to develop the rehabilitative areas of need building in measurable targets and clear guidance to ensure that achievement towards goals particularly concerning activities of 72 Milton Road (Welcome House) DS0000028998.V352542.R01.S.doc Version 5.2 Page 10 daily living and independence can be measured. Refer to recommendation 1. The plans are reviewed regularly and updated as required. The nature of the service is to provide support for residents to live their lives as independently as possible. To that end, service users are supported and encouraged to make decisions affecting all aspects of their daily lives. Residents manage their own finances and are responsible for organising their own time. Risks are suitably assessed through risk assessments. Residents are encouraged and supported to take responsible risks and are an integral part of the assessment process. Appropriate measures are recorded and reviewed to enable risks to be managed. 72 Milton Road (Welcome House) DS0000028998.V352542.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 and 17. Quality in this outcome area is good. Service users have a lifestyle that suits individual needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents are responsible for organising their own activities and managing their time. Staff provide support in this as and when necessary. Regular 1:1 sessions are held between staff and service users to discuss future plans, activities and any other health or social issues. Both residents spoken to said that they have suitable support from the staff and that they keep themselves busy. One resident is currently attending a college course and does voluntary work. Another service user has developed a regular daily routine. The service users said that that they tend to participate in individual activities, but all said that they have enough to do during the week. There is a parade of local shops nearby and the town centre is a manageable walk from the home. 72 Milton Road (Welcome House) DS0000028998.V352542.R01.S.doc Version 5.2 Page 12 There is a good public transport nearby. Residents said that they access local facilities on a regular basis. Visitors are welcome to the visit the home at any reasonable times. It was not possible to speak to any visitors during the site visit. Service users are provided with one main meal per day, which is cooked by staff in one of the neighbouring homes. Residents are responsible for all other meals and shopping. It was reported that staff do work with individual residents to help plan, prepare and cook meals where required or as part of a rehabilitation programme. A record of food cooked for service users is maintained. 72 Milton Road (Welcome House) DS0000028998.V352542.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 and 20. Quality in this outcome area is good. The health and personal care needs of service users are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users attend to their own personal and healthcare needs, generally requiring encouragement and minimal support to ensure that these aspects of life are met. Residents spoken with said that staff do encourage them appropriately, but that they want to maintain their independence in these areas. Residents are responsible for keeping their medical and healthcare appointments and staff assist in this area as required. The manager maintains records relating the healthcare needs of service users including the nature of the visit and outcomes. All service users are registered with local GPs and it was reported that the home receives good support from the local community mental health services. Residents organise any required visits to 72 Milton Road (Welcome House) DS0000028998.V352542.R01.S.doc Version 5.2 Page 14 complimentary health practitioners independently such as dentists and opticians. All service users are self-medicating and are assessed with regard to competence in this area on a periodic basis. Issues such as knowledge of medications and history of compliance are taken into consideration within this process. The home is advised to further develop their self-administration assessment to include ‘open-ended’ questions. Refer to recommendation 2. 72 Milton Road (Welcome House) DS0000028998.V352542.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 and 23. Quality in this outcome area is good. Service user’s views are listened to and they are protected from forms of abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a clear complaints process in place, which service users stated that they were aware of. Additionally one resident spoken to said that if he had any concerns or complaints he would feel able to raise them with staff or senior managers who visit the home. One recorded complaint has been made since the last inspection, which, it was reported, has been satisfactorily resolved. There are clear policies and procedures and procedures in place across the organisation relating to adult protection issues and abuse awareness. Staff have received training through the induction programme and additional training covering this topic. There have been no adult protection concerns since the last inspection. 72 Milton Road (Welcome House) DS0000028998.V352542.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 and 30. Quality in this outcome area is good. The premises are suitable for the needs of the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: 72 Milton Road is a terraced house on a residential road on the outskirts of Gillingham. There is one main lounge and a kitchen, which are domestic in size. There is a small, enclosed garden to the rear of the property with an outbuilding, which now acts as a smoking room. There are toilets and bathrooms on both floors and all bedrooms are single occupancy. Both residents spoken to said that they like the house and it comfortably meets their needs. The lounge has been redecorated since the last inspection. The home was generally clean and tidy. Residents are responsible for the household chores and stated that they sometimes need prompting from staff to do these tasks. 72 Milton Road (Welcome House) DS0000028998.V352542.R01.S.doc Version 5.2 Page 17 72 Milton Road (Welcome House) DS0000028998.V352542.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 and 35. Quality in this outcome area is good. Staff are appropriately trained and recruited ensuring that service users are protected and that their needs can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff in the home have obtained or are working towards National Vocational Qualifications and demonstrated a good understanding of the needs of the service. The organisation operates a thorough recruitment process ensuring that all required checks are completed and records obtained prior to appointment. Staff have received all required mandatory training and work through an induction programme covering all key aspects of the service. The organisation has recently introduced an Induction programme in line with the Skills for Care Common Induction Standards. 72 Milton Road (Welcome House) DS0000028998.V352542.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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. The home is well run and developed in the best interests of the service users. Health and safety issues are appropriately managed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has been in post for sometime and is currently studying towards her NVQ level 4/RMA. She has demonstrated good competency with regard to administrative and managerial duties in the home and reportedly provides good leadership. She has yet to be registered with the Commission for Social Care Inspection, which needs to be addressed in the near future. 72 Milton Road (Welcome House) DS0000028998.V352542.R01.S.doc Version 5.2 Page 20 The organisation has introduced a developing quality assurance structure, which includes regular monthly monitoring visits and satisfaction questionnaires. All health and safety information is maintained and up to date with service certificates and fire safety records in place. Accidents and incidents are recorded and reported appropriately. There are policies and procedures in place addressing safe working practices. 72 Milton Road (Welcome House) DS0000028998.V352542.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 3 25 X 26 X 27 X 28 X 29 X 30 3 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 3 X 3 X 3 X X 3 X 72 Milton Road (Welcome House) DS0000028998.V352542.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. No. Standard Regulation Requirement Timescale for action 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 YA6 YA20 Good Practice Recommendations To develop care plans addressing activities of daily living. To develop self-administration of medication assessments. 72 Milton Road (Welcome House) DS0000028998.V352542.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: 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 72 Milton Road (Welcome House) DS0000028998.V352542.R01.S.doc Version 5.2 Page 24 - 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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