CARE HOME ADULTS 18-65
78 to 82 Park Road Sittingbourne Kent ME10 1DY Lead Inspector
Graham Cummings Key Unannounced Inspection 24th January 2007 09:45 78 to 82 Park Road DS0000023878.V299185.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 78 to 82 Park Road DS0000023878.V299185.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. 78 to 82 Park Road DS0000023878.V299185.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service 78 to 82 Park Road Address Sittingbourne Kent ME10 1DY 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) 01795 479166 www.caremanagementgroup.com Care Management Group Limited Acting Manager Paul Wickens Care Home 18 Category(ies) of Learning disability (18) registration, with number of places 78 to 82 Park Road DS0000023878.V299185.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 20th February 2006 Brief Description of the Service: 78/82 Park Road is registered to provide care and accommodation for eighteen adults with learning disabilities. Care Management Group Ltd owns the home. The Acting manager is Mr Paul Wickens. The home is located on a busy road in the centre of Sittingbourne, with all local amenities within easy walking distance, including the main line railway station. Parking is a problem, with restricted on-road parking only. The property comprises a pair of semidetached houses with one main front entrance, plus the adjacent detached house with its own front entrance. The rear garden, the laundry facilities and the staff are shared. There are nine single and three shared rooms, two alternative day rooms and a large dining room in the main house, plus another three single rooms, a kitchen/diner and a large sitting room in the adjacent house. The fees range from £600 to £900 per week. The overall quality of the service provided is good. 78 to 82 Park Road DS0000023878.V299185.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The site visit was carried out on the 24th January 2007 and completed the Key Inspection. The information in the report was gathered from past inspection reports, 5 Service User comment cards, viewing the property, speaking to the Manager, staff and Service Users. The Inspector also looked at three Service User and three staff files. There were no Requirements from the last inspection and the one recommendation made relating to employing a Deputy Manager is being implemented. Prospective Service Users have the information required to make a choice about living in the home. The home carries out Pre Placement Assessments and visits to the home for the Service User, relatives and care manager. The three files looked at all contained contracts. The care plans seen contained information to provide a good quality of care. There was evidence these had been evaluated on a regular basis but they were not dated. Service Users have regular meetings with the last one was on the 15th January 2007. A Service User wrote the minutes of the meetings on their computer. The Inspector was informed that a London Borough funding placement was looking to hold a Service User review over the phone by speaking to the Manager and Service User at separate times. The manager asked if this was acceptable as they were concerned that the Service User would not have any support from significant others in their life. The Inspector informed the Manager that it would be seen as poor practice and that they should be pro active in contacting the authority to questioning the validity of this procedure. The home has started to produce an A5 size ‘Park Road News’ for Service Users, relatives and staff that contains what has happened at the home since the last edition and plans for the future. Service Users have been on holiday, two groups went to Tenerife and one group to Butlins Holiday Camp. Activities available to Service Users were varied and age appropriate with a lot of use of local community facilities. All Service Users Personal and Healthcare support was provided in the way they prefer. Protection of Vulnerable Adults training had taken place for the Manager and some staff, the home had nor received any concerns or complaints since the last inspection. The Commission had received seven Regulation 37 notifications, one of these related to an error in administering medication. This
78 to 82 Park Road DS0000023878.V299185.R01.S.doc Version 5.2 Page 6 had been realised quickly and dealt with appropriately by the home and company. The environment was generally in good order and repair. However, the Inspector noted that the kitchen was in need of upgrading, the floor needs to be replaced and some of the equipment would also benefit from being replaced. The Inspector also noted that the access to the laundry meant dirty laundry going through the dining area thereby creating a risk of cross infection. The staff team is long standing and supportive of each other. The home employs 18 care staff and 9 staff have an NVQ Level 2 or higher. The Inspector looked at three staff files and found they all contained the required information set out in Schedule 2. All staff have job descriptions and are aware of their roles and responsibilities within the home. Service Users are supported by a competent well trained and supervised staff team and they are protected by the homes recruitment procedures. The Manager has been in post for almost 6 months now and has started to update some of the paperwork on their IT system. The evidence seen indicates that the home is well run and in the best interest of the Service Users. What the service does well: What has improved since the last inspection?
The home is implementing the recommendation made at the last inspection regarding the appointment of a Deputy Manager in the near future. There is an updated IT system in the home now and all of the paperwork is being evaluated and renewed.
78 to 82 Park Road DS0000023878.V299185.R01.S.doc Version 5.2 Page 7 Seventeen of the eighteen bedrooms have been redecorated and new furniture has been purchased. The rota has been changed to accommodate more 1-1 staff time for Service Users so that individual work on life skills can take place. 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. 78 to 82 Park Road DS0000023878.V299185.R01.S.doc Version 5.2 Page 8 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 78 to 82 Park Road DS0000023878.V299185.R01.S.doc Version 5.2 Page 9 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): 1,2,4,5 Quality in this outcome area is Good Service Users have access to information they need to make an informed choice. Service Users’ individual needs are assessed prior to living at the home. Service Users can visit the home and are given written contracts when moving in. EVIDENCE: The home has a Statement of Purpose and Service User Guide that cover all aspects stated in Schedule 1. The Inspector looked at three Service User files and noted that all had Pre Placement Assessments to ensure the home could meet their needs. The Manager informed the Inspector that any Prospective Service User would be invited to visit the home with their family and care manager prior to moving into the home. The Inspector when looking at the files found that written contracts in place, where ever possible these had been signed by the individual Service User. 78 to 82 Park Road DS0000023878.V299185.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): 6,7,8,9 Quality in this outcome area is Good Service Users have their changing needs assessed and reflected in their individual plans. Service Users, wherever possible, are consulted with regard to decisions about their lives and the daily running of the home. Service Users are supported to take risks as part of daily living. EVIDENCE: The Inspector looked at three care plans and found them to be detailed and contained the individual’s needs and described how the care required should be provided. Whilst there was evidence to show that the plans had been evaluated, they were not dated. The plans seen contained Risk Assessments around the environment and behaviour. The individual Service User risk assessments were signed by all staff to say that they had read and understood them.
78 to 82 Park Road DS0000023878.V299185.R01.S.doc Version 5.2 Page 11 The Manager, who has been in post for approximately six months, has started to update the majority of the homes documentation and is transferring it onto a computer so that evaluations are easier. Service User meetings are held on a monthly basis with the last one taking place on the 15/1/07. A Service User writes the minutes of the meeting on his computer, they are then photocopied and distributed. A new rota has been made following consultation with all staff that will allow for more 1-1 day care to take place, the company have another home in Essex that has a sports hall and trampoline. It is hoped that the new rota will allow for trips to the home to use the facilities. Service users are encouraged to be as independent as possible and take responsibility for the cleaning of their rooms and the preparation and cooking of the meals. 78 to 82 Park Road DS0000023878.V299185.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): 11,12,13,14,15,16,17 Quality in this outcome area is Good Service Users have the opportunity for personal development and take part in age appropriate activities. Service Users are part of the local community and use local leisure facilities. Service Users have good family contact and their rights are respected in their daily lives. Service Users have a healthy and nutritious diet. EVIDENCE: Service Users are encouraged to be as independent as possible and their suggestions and requests regarding activities and responsibilities are given serious consideration. One Service User asked to help paint a bathroom and under supervision completed the task themselves, they have also decorated another Service User bedroom, with their consent and in the colours of their choice.
78 to 82 Park Road DS0000023878.V299185.R01.S.doc Version 5.2 Page 13 The home also has a newsletter that includes a section for a Service User to be involved, either with an achievement, joke or hobby. The home has gone on holiday in three groups, two went abroad to Tenerife at separate times and another group went to a Butlins resort in England. Service Users chose the holiday destinations and were offered the choice of whether they wanted to go abroad or stay in England. The Manager has already got a number of new holiday brochures for this year and they will be discussed over the coming weeks and a decision made at a Service User meeting in the future. Service Users attend the day centre at another company home near Sittingbourne, they also go bowling, pictures, swimming, attend college, pantomimes, shopping, picnics, cafes, pubs and restaurants. The home also employs a Music and Movement therapist to visit once a week and also every other Saturday an option of having a foot massage, nails painted or eyebrows plucked. The Inspector noted that throughout the site visit that Service Users were spoken to with respect and when staff went to enter any rooms they would knock before entering, this applied to the staff office as well. Family members are welcome to visit the home at any time and the home do also transport Service Users to their family home if this is in the contract of placement. The home provides a healthy and nutritious diet for Service Users who have an input into the menu, they also assist in the preparation and cooking of the meals. The kitchen is in need of refurbishment and this is commented on in the Environment section. 78 to 82 Park Road DS0000023878.V299185.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): 18,19,20,21 Quality in this outcome area is Good Service Users receive support in the way they prefer and their health needs are met. Service Users can be confident that heir wishes regarding illness and death will be respected. EVIDENCE: All Service Users are registered with a local Doctor, Dentist and Optician, the home also has a chiropodist that visits the home on a regular basis. Service Users’ files list their likes and dislikes and they have been fully involved in the writing of their plans that includes the preferred way they receive their individual support. None of the current Service Users self medicate. The incident of wrong medication being administered was discussed. The staff member had recognised their error immediately and contacted the Doctor and Manager. Following medical advice the Service User was observed to ensure there were no ill effects. The home acted immediately to minimise this happening again by putting large notices in prominent places on and by the medication cupboard
78 to 82 Park Road DS0000023878.V299185.R01.S.doc Version 5.2 Page 15 and dispensing area. The Inspector looked at the Medication Administration Records and found them to be completed and up to date. The Inspector when looking through the Service User files saw evidence of their wishes regarding illness and death were recorded. 78 to 82 Park Road DS0000023878.V299185.R01.S.doc Version 5.2 Page 16 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 Quality in this outcome area is Good Service Users are listened to and are protected from abuse. EVIDENCE: The Manager and two staff are to attend a Protection of Vulnerable Adults training course in the near future. Staff have also attended training on Risk Assessment, First Aid and Care and Administration of Medication. The Company is, commencing February 2007, starting a course that Managers have to attend two days a week for six weeks covering Recruitment, Person Centred Planning, H&S Maintenance, Protection of Vulnerable Adults and Regulation 37 Reports. The home has not received any complaints but there was a concern over a staffing issue that was discussed and recorded with the outcome agreed to everyone’s satisfaction. The Inspector evidenced the paperwork. 78 to 82 Park Road DS0000023878.V299185.R01.S.doc Version 5.2 Page 17 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): 24,25,26,28,30 Quality in this outcome area is Good Service Users live in a homely, comfortable and clean environment. Service Users’ bedrooms suit their needs and communal areas complement their individual personal spaces. EVIDENCE: The home is welcoming and comfortable with a friendly and relaxed atmosphere. Seventeen of the eighteen bedrooms have had new furniture and some have been redecorated. A Service User asked to help with the decoration and was supported to decorate a bathroom which they did by themselves with minimal support. They also decorated another Service User bedroom with their permission. The bedrooms viewed with Service Users’ permission were comfortable and well furnished and had personal belongings and family photographs on display. 78 to 82 Park Road DS0000023878.V299185.R01.S.doc Version 5.2 Page 18 The Inspector was shown the kitchen and was of the view that it was in need of total refurbishment. The Inspector was informed that the company was aware of the condition of the kitchen and work was being planned to renovate it as soon as possible. An area of concern was that the access to the laundry meant walking through the dining area. The Inspector was informed that all laundry is carried through in laundry baskets and never when food is around. However, these were not sealed and there was a risk of cross infection. It would be beneficial for the home and company to look at this issue and try and resolve it as soon as possible. The home was clean and free from any offensive odours. 78 to 82 Park Road DS0000023878.V299185.R01.S.doc Version 5.2 Page 19 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): 31,32,33,34,35, Quality in this outcome area is Good Service Users benefit from the clarity of staff roles and responsibilities. A competent and appropriately trained staff team supports Service Users. Service Users are protected by the home’s recruitment process. EVIDENCE: The Inspector looked at three staff files and found that they all had individual job descriptions. The Manager is looking to go through the files and get staff to sign their individual job descriptions to ensure they fully understand their roles and responsibilities. The majority of the staff team have been working at the home for a long time and have a strong and supportive working relationship. The home has a team of bank staff, most of who have left the home but want to remain in touch. The three staff files viewed contained all of the information set out in Schedule 2 of the Care Homes Regulations 2001. 78 to 82 Park Road DS0000023878.V299185.R01.S.doc Version 5.2 Page 20 At present the Manager carries out the staff supervision though this will change when the new rota is implemented. Care staff supervision will be delegated to the seniors The company have a good internal training department and also uses external trainers where necessary. Staff are attending a Boots medication training course on the 2nd February 2007 and the Manager and five senior staff are attending Canterbury College for a Medication Legislation course. Fifty percent of staff employed have an NVQ level 2 qualification or higher. The recommendation from the last inspection regarding the appointment of a Deputy Manager is being addressed and will be in place in the near future. 78 to 82 Park Road DS0000023878.V299185.R01.S.doc Version 5.2 Page 21 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): 37,39,41,42 Quality in this outcome area is Good Service Users live in a home that is well run and their views are listened to in the development of the home. Service Users are protected by the homes record keeping. The health, safety and welfare of Service Users are promoted and protected. EVIDENCE: The Manager has been in post for just six months and follows a Manager that had been in the position for almost 28 years. The Manager has spoken to and listened to the staff team and Service Users before starting to implement any changes. Most of the changes so far have revolved around paperwork and getting forms and documentation onto the computer. 78 to 82 Park Road DS0000023878.V299185.R01.S.doc Version 5.2 Page 22 The first major change is due to commence in February with the change to the rota and make more staff available during the day to allow for an increase in 1-1 work and day care activities. The Manager holds regular staff and senior meetings with the last one being held on the 16/1/07. The recording keeping was good and the daily notes contained activities, appointments and food intake. Service Users spoken to said that ‘the home is nice and all rooms have central heating’, ‘we all have a busy time and go bowling, swimming and pictures’ and ‘the food is great and there’s always lots’, ‘I now feel more valued my self confidence has grown’. 78 to 82 Park Road DS0000023878.V299185.R01.S.doc Version 5.2 Page 23 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 3 2 3 3 X 4 3 5 3 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 3 26 3 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 X 3 X 3 3 X 78 to 82 Park Road DS0000023878.V299185.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO 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 YA24 Regulation 13(4)(b) Requirement The registered person shall ensure that- any activities in which Service Users participate are so far as reasonably practicable free from avoidable risks – in that the company replace the flooring in the kitchen and equipment upgraded. (The company is already planning this) Timescale for action 30/04/07 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 YA41 YA24 Good Practice Recommendations That all documentation is signed and dated by the person completing the form. That serious consideration be given to how the laundry is transported to the laundry room as it presently goes through the dining area The home does need to employ a deputy manager, which should help relieve the manager of growing administration
DS0000023878.V299185.R01.S.doc Version 5.2 Page 25 3. YA33 78 to 82 Park Road 4. YA34 duties. That the Manager/Company ensure that all staff application forms contain a 10 year working history or go back as far as education. That the Manager protects the Service Users from the poor practice of any funding authorities trying to carry out the yearly reviews by telephone. 5. YA42 78 to 82 Park Road DS0000023878.V299185.R01.S.doc Version 5.2 Page 26 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
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