Inspection on 07/07/05 for 78 - 82 Park Road

This inspection was carried out on 7th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

78 - 82 Park Road 18/12/08

78 - 82 Park Road 24/01/07

78 - 82 Park Road 20/02/06

78 - 82 Park Road 09/03/05

78 - 82 Park Road 12/05/04

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

CARE HOME ADULTS 18-65 78 to 82 Park Road 78 to 82 Park Road Sittingbourne Kent ME10 1DY Lead Inspector Lucy Ansell Unannounced 7 July 2005 10:00 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 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 Stationary 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 H56-H06 S23878 78 to 82 Park Road V234746 080705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 78 to 82 Park Road Address 78 to 82 Park Road Sittingbourne Kent ME10 1DY 01795-479166 nil nil Care Management Group Limited Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Margot Carter Care Home only 18 Category(ies) of Learning Disability registration, with number of places 78 to 82 Park Road H56-H06 S23878 78 to 82 Park Road V234746 080705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: nil Date of last inspection 9 March 2005 Brief Description of the Service: 78/82 Park Road is registered to provide care and accommodation for eighteen adults with learning disabilities.The home is owned by Care Management Group Ltd. The registered manager is Ms Margot Carter.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. 78 to 82 Park Road H56-H06 S23878 78 to 82 Park Road V234746 080705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection under the terms of the Care Standards Act 2000 carried out by one inspector Lucy Ansell who was in the home from 09.30 to 13.00 on the 30th June 2005. During the inspection the owner/manager represented the home, and a member of staff was also present for some of the time. Documentation and records were read, including care plans. A tour of the premises was undertaken. The inspectors spent time talking with all the residents, to ensure standards are being met and a good quality of life is being enjoyed by the residents. What the service does well: What has improved since the last inspection? The home had no requirements or recommendations from the last report, but the home has now employed a deputy manager, which should help relieve the manager of growing administration duties. 78 to 82 Park Road H56-H06 S23878 78 to 82 Park Road V234746 080705 Stage 4.doc Version 1.40 Page 6 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 H56-H06 S23878 78 to 82 Park Road V234746 080705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection 78 to 82 Park Road H56-H06 S23878 78 to 82 Park Road V234746 080705 Stage 4.doc Version 1.40 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 standard(s) 1, 5 Residents have enough information to make an informed decision about moving into the home, and are confident the home can meet their needs. EVIDENCE: The home’s Statement of Purpose and Service Users Guide are being reviewed yearly and contained the required information. It is clear and concise with all relevant information included. The service users guide is produced in a format that is suitable for the residents with pictorial prompts and simpler language. Residents are provided with a statement of terms and conditions when moving into the home. Evidence was seen of the homes contract in the care plans, which were very detailed and signed by the resident. All contracts between the home and the Local Authority are kept at their head office. 78 to 82 Park Road H56-H06 S23878 78 to 82 Park Road V234746 080705 Stage 4.doc Version 1.40 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 standard(s) 6-10 Resident’s individual needs and choices are well met. Residents are well supported to take risks as part of an independent lifestyle. EVIDENCE: Residents care plans were looked at. These were very detailed documents that contained, updated risk assessments; individual plans for daily living, support plans and some health needs. The home completes comprehensive preassessments, which are used to ensure the care accurately reflects their needs. It was evident through reading the plans and discussion with the owner that resident’s care plans were drawn up in joint agreement from all concerned individuals and service users signatures were seen on all paperwork. Regular individual reviews are taking place six monthly or for new clients three monthly. However the home were not aware that monthly reviews also needed to be taking place. The care plans should reflect long and short-term goals being set for residents that are achievable and within their scope by being broken down into smaller tasks. 78 to 82 Park Road H56-H06 S23878 78 to 82 Park Road V234746 080705 Stage 4.doc Version 1.40 Page 10 The care plans viewed showed clear guidance on how to care for the resident, where rights to make decisions are limited, and clear evidence of making informed decisions. The risk assessments were very clear on the risks and how these could be avoided without loss of freedom to the resident. The homes daily communication logs were lacking in key information. They should detail the time, be signed by the respective staff, ensure no spaces / gaps are not left between each recording to ensure an accurate picture is maintained on the resident’s daily activities. The information kept on residents is handled with sensitivity and residents know their confidentiality is maintained. The manager if discussing any client or looking at their file, obtained permission which is signed on care plans or made them aware of the fact. 78 to 82 Park Road H56-H06 S23878 78 to 82 Park Road V234746 080705 Stage 4.doc Version 1.40 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 standard(s) 11-15 Resident’s are encouraged to make choices about all aspects of their daily lives, through the support of a range of activities in the home and local community. Resident’s opportunities for personal development are good with ample chances to maintain and develop independent living skills. EVIDENCE: The care plans and direct observation clearly evidence that residents are encouraged to learn, maintain and develop practical life skills to the best of their abilities. Residents spoken to on the day attend college or have work placements; one works in a local charity shop and is really well supported by the staff there, and other resident works for the home as a domestic. The home also has its own day center run by the management company which residents attend. It was apparent through discussion with the owner and the resident’s that they had control over the activities they did or did not participate in. The residents accessed the local community to do their shopping, go to the local shopping centre, and use the cinema, pubs and restaurants. The residents go out on activities with the staff or their own family, and recent trips 78 to 82 Park Road H56-H06 S23878 78 to 82 Park Road V234746 080705 Stage 4.doc Version 1.40 Page 12 include going to see, The king and I in London, visit to Cadbury world, trips to Manchester United football ground, France and a weekend camping. Evidence was seen in the care plans of a range of leisure activities that they choose to participate in. The manager explained that they have family contact or visits when they wish, and risk assessments had been undertaken to assist staff in supporting residents maintain appropriate personal relationships. The residents had just had a week’s holiday in a local camping site. This appeared to be successful and the manager and residents are looking at the next group to go on holiday, one has booked a villa in Minorca, which looked very luxurious, and another group is going to Fuerta Ventura. The home as part of the group of homes run by the management company produces a monthly newsletter. The newsletter showed lots of photos of the events, which had been held. One was a Christmas party that was a Victorian themed Ball with every one in costume, Summer garden party and trips out and about. 78 to 82 Park Road H56-H06 S23878 78 to 82 Park Road V234746 080705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 21 The personal and health care needs of residents are well met, promoting and protecting resident’s privacy, dignity and independence. Resident’s wishes regarding ageing, illness and death are handled with respect and sensitivity. EVIDENCE: It was evident from speaking to the manager and looking through the documentation that they are very aware of the needs of their residents. The manager indicated that all support offered was aimed to maximise the resident’s independence. The manager described how routines of the home were flexible to suit the needs and wishes of the residents; this was backed up by the documentation. Some of the residents who are very independent with their personal care needs are only offered guidance and supervision, whilst other residents may need more assistance, and this is offered in a sensitive way as possible. The home promotes and maintains residents health through supporting and facilitating medical appointments as required. The health needs of residents are well met with evidence of good multi-disciplinary working taking place on a regular basis. The home is able to access the Start team, which is made up of 78 to 82 Park Road H56-H06 S23878 78 to 82 Park Road V234746 080705 Stage 4.doc Version 1.40 Page 14 speech and language therapist, psychiatrists, psychologists, C.P.N and occupational therapists. The Manager stated that all service users are registered with a GP of their choice. Resident’s health plans showed that speech and language assessments had been obtained as required. There was also clear evidence of medication reviews happening and optician and dentist appointments. The manager was observed indirectly throughout the inspection, and was seen to interact in a positive and respectful manner with clear affection and genuine regard from both parties, she operates an open door policy and many residents came in and out to say hello and gave her drawings and paintings they had just completed. Many residents gave me positive feedback during the inspection about the approach of the home, commenting about how much they love living there. At the first review details on death and dying are asked for from family members and residents with a sensitive approach being used by the home so that all concerned can discuss and then write back to the home. The details are then kept on the care plans and evidence was seen of this. 78 to 82 Park Road H56-H06 S23878 78 to 82 Park Road V234746 080705 Stage 4.doc Version 1.40 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 standard(s) 23 The homes policies and procedures ensure residents are protected from abuse, neglect and self-harm. EVIDENCE: The home has policies and procedures that are used in conjunction with Kent and Medways Adult protection policy, which the home uses as its guidelines. Staffs spoken to were clear on the procedures to follow and the training for all staff on Adult Protection is happening on a yearly basis. 78 to 82 Park Road H56-H06 S23878 78 to 82 Park Road V234746 080705 Stage 4.doc Version 1.40 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 standard(s) 28 and 30 Residents generally live in a clean and homely environment however some of the décor, furnishings and fittings need to be renewed or replaced. EVIDENCE: The home’s location and layout is suitable for its stated purpose; it provides a homely environment for the residents. The residents have two communal lounges one quieter and smaller which is light, airy and domestic in nature. The other larger lounge and dinning room has recently been decorated but the carpet looked in bad repair and is due to be changed this year along with the stair carpet in 78 Park road. A good practice recommendation would be for the office carpet to be replaced. The homes decor and furnished are to a good standard and the resident’s room have been personalised to their own tastes. The home has sufficient toilet and bathroom facilities for the number of service users. The home has very high standards of cleanliness and no odours were detected anywhere in the house. Laundry facilities were sited outside in an outhouse attached to the building, this was appropriate for the style of service as industrial in nature. There 78 to 82 Park Road H56-H06 S23878 78 to 82 Park Road V234746 080705 Stage 4.doc Version 1.40 Page 17 needs to be adequate hand washing facilities prominently sited in areas where infected materials are handled. Residents are encouraged to tidy their room and do their own washing in line with ordinary living principles. The home has an infection control policy. The procedures for dealing with soiled articles need to be changed with a red sack policy in use for foul laundry. The clinical waste is now disposed of in the appropriate waste containers. Coshh sheets and procedures are up to date. 78 to 82 Park Road H56-H06 S23878 78 to 82 Park Road V234746 080705 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35, 36 The resident’s benefit from an effective and well-trained staff team, who are supported and supervised. EVIDENCE: The home has a training and development plan supplied by its management company. This appeared very comprehensive with good structured induction training and training relevant to the service user group. A senior staff member has taken responsibility for training and needs to settle into that role to become aware of what training is yearly and what is less often. The home has a training matrix on the wall for an overview as well as individual records to inform staff development. The manager and a senior staff member are both completing NVQ 4; two other staff are working to complete NVQ 2 and two staff to complete NVQ 3. Only two staff already holds NVQ 2 and this will mean they are probably not able to reach over the 50 required. Supervision is taking place every eight weeks, and the manager also documents any informal supervision that takes place. 78 to 82 Park Road H56-H06 S23878 78 to 82 Park Road V234746 080705 Stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38, 40, Overall the home is managed excellently with the residents’ rights and best interests safeguarded by the management’s leadership and the homes policies and procedures. EVIDENCE: The registered manager is very experienced both as a manager and as a practitioner, and has amply demonstrated her ability in both areas. Over the years she has undertaken a wide range of training relevant to the care of people with learning disabilities. The manager does not however hold a formal management qualification but has over twenty years experience. The home thrives under her management and leadership skills and the residents benefit from a well run home. The inspector therefore recommends that this standard is exceeded and the work of the manager is recognised as commendable. The homes policies and procedures are meeting the required standards, it was evidenced these are reviewed and updated annually. 78 to 82 Park Road H56-H06 S23878 78 to 82 Park Road V234746 080705 Stage 4.doc Version 1.40 Page 20 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 3 x x x 3 Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x 3 x 2 Standard No 11 12 13 14 15 16 17 3 3 4 4 3 x x Standard No 31 32 33 34 35 36 Score x x x x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 78 to 82 Park Road Score 3 3 x 3 Standard No 37 38 39 40 41 42 43 Score x 4 x 3 x x x H56-H06 S23878 78 to 82 Park Road V234746 080705 Stage 4.doc Version 1.40 Page 21 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. Standard YA6 YA6 YA30 Regulation 15 15 13, 16 Requirement The care plan is reviewed and updated to reflect changing need. The daily log is accurate and records times, signatures and has no gaps. Soiled laundry is handled with the correct procedures for the control of infection. Hand washing facilities are sited in close proximity. Timescale for action Sept 2005 Sept 2005 Dec 2005 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 YA 28 Good Practice Recommendations It is a good practice recommendation that the paperwork contained in the care plan contains no gaps if information not known to be recorded as this. It is a good practice recommendation that the carpet in the office be replaced. 78 to 82 Park Road H56-H06 S23878 78 to 82 Park Road V234746 080705 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane Maidstone Kent, 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. Extracts may not be used or reproduced without the express permission of CSCI 78 to 82 Park Road H56-H06 S23878 78 to 82 Park Road V234746 080705 Stage 4.doc Version 1.40 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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