Inspection on 08/08/08 for 85 Heath Road

This inspection was carried out on 8th August 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

85 Heath Road 09/08/07

85 Heath Road 09/08/06

85 Heath Road 13/12/05

85 Heath Road 05/08/05

85 Heath Road 13/01/05

85 Heath Road 14/09/04

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOME ADULTS 18-65 85 Heath Road Barming Maidstone Kent ME16 9LD Lead Inspector Jenny McGookin Unannounced Inspection 8 August 2008 09:40 th 85 Heath Road DS0000023800.V368960.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 85 Heath Road DS0000023800.V368960.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. 85 Heath Road DS0000023800.V368960.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 85 Heath Road Address Barming Maidstone Kent ME16 9LD 01622 729946 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) heathrd@mcch.org.uk www.mcch.co.uk MCCH Society Ltd Ms Karen Gowers Care Home 3 Category(ies) of Learning disability (0) registration, with number of places 85 Heath Road DS0000023800.V368960.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Learning disability (LD). The maximum number of service users to be accommodated is 3. Date of last inspection 9th August 2007 Brief Description of the Service: 85 Heath Road is one of a group of small care homes managed by MCCH Society Ltd. The home provides care through encouraging independent living and support for a maximum of 3 ladies with a Learning Disability, one of whom is over 65 years of age. The home does not provide 24 - hour care or nighttime sleep-in cover. The home’s care staff work on a roster basis to cover identified key care times. The home currently has 99.9 direct care hours over 7 days per week. The service users in the home are required to be semi independent and can access activities within the local community and day services in the area. 85 Heath Road is situated in Barming, with good local amenities near by. It is on a main bus route to Maidstone town centre. The house has two bedrooms, a communal bathroom/toilet and small office/staff room on the first floor. The third bedroom with en-suite facilities is on the ground floor, alongside the lounge, kitchen/dining area. The home has car parking to the side of the property (but further car parking is available on the main road) there is a ramped pathway entrance to the front door and a garden to the rear of the property. The current weekly fees are £323.01 per week. Additional charges may be made for personal items such as clothes; toiletries and magazines; leisure and social activities (e.g. pub, cinema) though the fee does include some staff costs; extra furniture or fittings not listed; own possessions such as TV, music 85 Heath Road DS0000023800.V368960.R01.S.doc Version 5.2 Page 5 system, and holiday costs (though MCCH makes a small contribution). Information on the Home’s services and the CSCI reports for prospective service users should be detailed in the Statement of Purpose and Service User Guide. The e-mail address for this home is: heathrd@mcch.org.uk 85 Heath Road DS0000023800.V368960.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This report is based on an unannounced site visit, which was used to inform this year’s key inspection process; to check progress with matters raised from the last inspection (August 2007); and to review findings on the day-to day running of the home. The inspection process took five and three quarter hours. It involved meetings with the support worker in charge (in the absence of the manager, which was off duty) and all three service users over lunch. We provided a selection of feedback questionnaires for distribution to service users, relatives and visiting professionals. Feedback was obtained from all three service users (in two cases facilitated by the manager), one member of staff and a GP, in time for the issue of this report. Any other will be used to inform the Commission’s intelligence in due course. Consideration was given to the Annual Quality Assurance Assessment submitted by the manager in June 2008, ahead of its due date. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gives some numerical information about the service. The inspection also involved an examination of records, and the assessment of one service user’s case files, who moved into this home from another home in the MCCH group in 2007, to track her care. We were unable to reach any findings on recruitment practice because this aspect is managed by MCCH’s Human Resources department, which keeps the documentation at its head office. The CSCI has an arrangement whereby one it own senior officers carries out annual inspections of these records at head office, but there was no report available on this. The only personnel files available to us were training records, and interactions between the staff and residents were observed throughout the day. All three service users’ bedrooms were checked for compliance with the National Minimum Standards on this occasion, along with the communal areas. What the service does well: The service provides a homely and comfortable place to live and promotes independence and well-being. Service users feel involved with the day-to-day 85 Heath Road DS0000023800.V368960.R01.S.doc Version 5.2 Page 7 running of the home and choices are offered on a wide range of daily living skills. Service users’ individual likes and dislikes are always taken into account and they are involved in their care plans. Residents are encouraged and supported to participate in social and community activities The home is well maintained and the resident’s rooms are individually personalised to the service users’ liking. Regular house meeting ensures that service users’ views are listened to. Equality and diversity within the service is promoted by regular reviews of service users’ needs. What has improved since the last inspection? What they could do better: 85 Heath Road DS0000023800.V368960.R01.S.doc Version 5.2 Page 8 MCCH needs to show a sustained commitment to carry out its own unannounced inspection visits at least once a month. The reader is advised that breach is an offence and that enforcement action may become warranted. The contract needs to be made available in formats accessible to service users. The complaints procedure will require amendment to take account of the new inter-agency arrangements and the lead now taken by Social Services. The siting of the home’s washing machine in the kitchen is not compliant with good infection control practices. Quality Assurance initiatives should be extended to other interested parties such as relatives and visiting health and social care professionals and reflected in MCCH’s business plans to ensure a fully rounded approach to quality assurance. 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. 85 Heath Road DS0000023800.V368960.R01.S.doc Version 5.2 Page 9 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 85 Heath Road DS0000023800.V368960.R01.S.doc Version 5.2 Page 10 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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. 1, 3, 4, 5 Prospective service users and their representatives have most of the information needed to decide whether this home will meet their needs. They have their needs assessed and each admission is safeguarded by contracts, which tell their representatives about the service they will receive. But these need to be clearer and more accessible, if service users are to benefit from them. EVIDENCE: The home has a Statement of Purpose and a Service Users Guide, each of which uses illustrations to help describe the home’s facilities, staffing arrangements and service principles. The last inspection quality rated this aspect of the home’s operation as “good”, subject to some details being updated. We were shown a copy of the latest Statement of Purpose (updated in December 2007) and judged it largely compliant with all the elements of this standard, and we judged some aspects (like the listing of local community resources) likely to be of some interest to prospective service users from different cultural and ethnic backgrounds. However, some other details assumed a level of understanding about the way the National Minimum 85 Heath Road DS0000023800.V368960.R01.S.doc Version 5.2 Page 11 Standards operate, and may need further explanation for these service users. Some recommendations were made to further improve the document and these were reported back to the manager separately. Two of the three current service users were admitted before the emergence of the National Minimum Standards and told us that they could not remember their admission in any real detail. So we did not assess this aspect of the home’s operation in respect of either of them. The third service user, however, was admitted in 2007 and the last inspection found that she was being properly introduced and supported to settle. We were shown records of meetings, preadmission visits and overnight stays. She told us “I was helped by my advocate. I wanted to move for a long time”. She also told us “I stayed over lots of times before I moved in”. There have been no further admissions since then and none are planned. So this element of the National Minimum Standards was not inspected on this occasion, other than to establish that the existing service users were content with their placement. The placement of each of the three current residents is funded by Kent County Council, which has its own contractual arrangements, which are outside the scope of this inspection. But the file selected for case tracking had other contractual documents in place. There were three tenancy agreements between the landlord (for whom MCCH acts as its agent) and the service user. And there was a support contract, which is intended to be read in conjunction with the tenancy agreement - though this required updating to take into account the service user’s transfer from one MCCH house to another. None of these documents was in an accessible format - the tenancy agreements, in particular, were written in very legalistic terms. And none had been signed and/or dated by the service user or their representative. The support contract had not been updated to take into account all the provisions of the National Minimum Standards in respect of facilities (e.g. wash hand basins and a second comfortable chair in bedrooms – the reader is advised that non provision would need to be justified by documented risk assessment or “opt out” consultation). 85 Heath Road DS0000023800.V368960.R01.S.doc Version 5.2 Page 12 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): Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Individuals benefit by being actively involved in decisions about their lives, and they can play an active role in planning the care and support they receive. EVIDENCE: “The service is Person-Centred. Service users make informed choices about their home, activities and life style. They are given as much support as needed while also maintaining their independence. All service users are happy to talk to staff about any issues that concern them. They trust the staff and are very open and honest about how they feel” – member of staff This home’s care planning processes are designed to ensure that all the assessed health, social and personal care needs of the service users can be met and then further developed. They assess each service user’s strengths and weaknesses and the extent to which they need support. And they are properly underpinned by risk 85 Heath Road DS0000023800.V368960.R01.S.doc Version 5.2 Page 13 assessments, which focus on the individuals, their activities and environments (on and off site), to keep people safe while promoting their independence. These service users are on the periphery of residential care, as they do not require 24-hour care. They are able to self care and carry out light domestic tasks for themselves. The care plans include instructions for staff, which are clear and practical. And they set goals and step-by-step instructions for the service users to learn the skill or task. We were particularly interested to see the systematic way staff evaluate the extent to which they need to support service users to undertake these instructions, which can be used to measure their progress. Many of these care planning documents are written in the 1st person, to help ensure the service users’ perspective is kept central, and they are subject to regular review – 4-weekly and 6-monthly. The review documents are signed in each case by the service users’ key workers and the manager. Observed interactions between the service users and staff were judged appropriately familiar and respectful. Service users were supported to make choices and their feedback questionnaires confirmed this was representative. We were satisfied with this home’s arrangements for keeping records confidential and secure. There are lockable storage facilities and access to them is restricted. The home also holds computer records and access to these is password protected. 85 Heath Road DS0000023800.V368960.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users are supported to make choices about their life style, and to develop their life skills. Social, educational, cultural and recreational activities meet each individual’s expectations. EVIDENCE: The care planning processes properly identify each service user’s strengths and weaknesses in a range of activities on and offsite. This process is then followed through with weekly planners, which are applied flexibly, according to individual choice and staff availability, and subject to review and amendment thereon. We understand one service user likes to spend time on her own in her room and this is respected. 85 Heath Road DS0000023800.V368960.R01.S.doc Version 5.2 Page 15 Examples of light housekeeping tasks include cooking and meal preparation, changing bedding, operating the washing machine, washing up, vacuuming, polishing and ironing clothes. The service users are also actively involved in shopping (for the house as well as personal shopping) and the management of their money. They have opportunities to access educational and daytime opportunities. One attends college and two attend horticultural sessions with “Growing Concern”. And one attends Keep Fit classes at a local village hall. Skills development is properly balanced by a range of leisure and social activities like Club Connect, Gateway Club, bowling, pub visits, holidays and meals out i.e. community resources not necessarily associated with or confined to the service users’ learning disability. One told us “I like to go shopping and out for lunch”. Another told us she would like to go swimming and we understand this is being arranged. The home has a TV for communal use but two service users have their own TVs so that they can usually have a choice of channel. Special events such as birthdays, Christmas etc are celebrated and we understand relatives are invited to be involved. Since the last inspection, the home has obtained a full staff complement, and changes to staffing levels at key times – all of which means service users can be individually supported with activities and to go out more. One told us “I go out in the evenings more now and I like that” The home has open visiting arrangements, though visitors are asked to give advance notice of their visits so that someone can be there to receive them. There is a large button phone on the ground floor of this home and it is one of the service user’s goals to answer the phone. There is no charge for outgoing calls and the home’s phone can be connected to a loud speaker unit, if required. Another service user has her own mobile phone and will ring her relative. Catering needs and preferences are properly identified as part of the care planning process and are amended thereon. The home holds regular house meetings with the service users and meal planning features in each one. The service users told us they liked the meals. 85 Heath Road DS0000023800.V368960.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. 18, 19, 20 The health and personal care that service users receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: As reported earlier, this home’s care plans assess each service user’s strengths and weaknesses and the extent to which they need support e.g. verbal or visual prompts, gestures, independent etc. And the care plans are properly underpinned by risk assessments to keep people safe, while promoting their independence. Service users told us they could decide what to do every day, including when to get up and go to bed. And they told us they felt the staff treated them well. All three bedrooms are single occupancy and the bedroom doors are lockable so privacy can usually be assured. 85 Heath Road DS0000023800.V368960.R01.S.doc Version 5.2 Page 17 Feedback from one of the home’s GP confirmed that each service user’s personal and healthcare support was being properly attended to, and we judged the records used to detail their contact with healthcare professionals well annotated and person centred. The home uses the Nomad system of medication administration, which is prepared and delivered by a local pharmacy. Since the last inspection, the home has obtained a lockable medication cabinet to keep the medication secure. We were concerned to see that although the key was concealed from view, it was readily accessible but we were assured that this arrangement was not representative and that it was more normally kept secured. We were shown the home’s copy of The Royal Pharmaceutical Society Guidance, which is judged a reliable reference source for best practice standards. The medication administration record (MAR) sheets we looked at showed no apparent gaps or anomalies. And we are able to confirm that no medication errors have been reported to us since the last inspection (August 2007). Three personnel training files, selected at random, indicated that staff are trained to administer medication and we were interested to see that training was in two cases subject to competency assessment by the manager, to keep people safe. 85 Heath Road DS0000023800.V368960.R01.S.doc Version 5.2 Page 18 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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. 22, 23 Service users are able to express their concerns, and have access to a robust, effective complaints procedure. They are protected from abuse, and have their rights protected. EVIDENCE: MCCH has a clear complaints procedure, which is detailed in the home’s Statement of Purpose, and is illustrated to help service users understand how to use it. It will, however, require amendment to take account of the new inter-agency arrangements and the lead taken by Social Services. The home’s AQAA told us there had been no complaints registered since the last inspection This would not normally be judged a realistic reflection of communal living, except that feedback from the service users confirmed they knew who to talk to if they had any concerns. The service user’s file we selected for case tracking had information on an independent advocacy service and the service user told us that her advocate had been involved in her transfer from another home in the MCCH group, to good effect. Otherwise, families and friends tend in practice to be relied on to represent the interests of these service users. 85 Heath Road DS0000023800.V368960.R01.S.doc Version 5.2 Page 19 We were told that since the last inspection staff have all had training in the new mental capacity legislation, to ensure rights are properly promoted. We were satisfied with the systems in place to check, balance and account for service users’ financial transactions. MCCH has a range of policies and procedures to ensure that service users are safeguarded from abuse in all its forms, including police and criminal record checks on prospective staff - and staff confirmed their commitment to challenge and report any incidences of abuse, should they occur. In the event, this has not been warranted. We can confirm that no complaints or adult protection proceedings have been raised against the home since the last inspection (August 2007). 85 Heath Road DS0000023800.V368960.R01.S.doc Version 5.2 Page 20 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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. 24, 25, 26, 27, 28, 29, 30 The physical design and layout of the home enables service users to live safely. This is a well-maintained and comfortable environment, which encourages independence. EVIDENCE: This home is within five minutes’ walk of two bus routes and two stations on a train route, which link it to Maidstone, with all the community and transport links that implies. There are local shops and a larger superstore a short distance away. We were told that these had all become regular walking routes for the service users. 85 Heath Road DS0000023800.V368960.R01.S.doc Version 5.2 Page 21 There is on-site car parking for one vehicle at the front (though it is on a steep gradient), and there is unrestricted kerb-side parking along Heath Road. Measures are in place to keep the premises secure against unauthorised access, including an intercom system, without infringing on the service users’ freedom of movement. The layout of this home is judged generally adequate for its stated purpose (though see below for our findings in respect of laundry arrangements), and it is safe and generally well-maintained. Comfortable temperatures and lighting levels were being maintained throughout. The residents have a choice of communal areas (a lounge and kitchen/dining area), and they are each reasonably spacious. The furniture tends to be domestic in style and of good quality, and there were homely touches everywhere. Since the last inspection, the home has installed a new dishwasher as well as a new medication cabinet and an intercomm system to offer more protection when there are no staff on site. A new recliner chair was purchased for one service user, and an Occupational Therapist was used to support one service user in the purchase of a new bed. And the gardens have benefitted from the regular attention of a gardener. The ground floor corridors and doorways are wide enough to allow the passage of wheelchairs and mobility aids. There is an extensive ramp at the front, and a smaller ramp at the rear as well as grab rails in the bathroom facilities. So that service users can move about as independently as possible. But there is no shaft or chair lift to the 1st floor. This home is currently registered to provide care for up to three service users, and all three bedrooms are used for single occupancy. Two bedrooms on the 1st floor have the use of a WC / bathroom (with an electric shower attachment so that service users have some element of choice). But the ground floor bedroom has its own spacious adapted en-suite WC/bathroom facility. So that service users can generally be assured of privacy. All three bedrooms were inspected on this occasion, and judged reasonably well maintained and personalised, although curtains and bed-linen in two appeared faded and worn. In terms of their furniture and fittings, moreover, they were generally complaint with most of the provisions of the National Minimum Standards, though two did not have a wash hand basin, one did not have two comfortable chairs (the service users said she did nit want any) and, when asked, one service user said she did not have a mirror, but would want one. The reader is advised that these should all be standard provision - nonprovision must be justified in each case by a properly documented risk assessment or consultation. 85 Heath Road DS0000023800.V368960.R01.S.doc Version 5.2 Page 22 All the maintenance records seen were up to date and systematically arranged. However, in common with other homes in the MCCH the kitchen is where the home’s domestic washing machine is sited. The MCCH has taken the view that this arrangement is in keeping with most domestic settings but we do not judge this compliant with good infection control practices. 85 Heath Road DS0000023800.V368960.R01.S.doc Version 5.2 Page 23 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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. 32, 33, 35 Staff in this home are trained, skilled and in sufficient numbers to support the people who use the service, and to support the smooth running of the service. EVIDENCE: MCCH’s staffing arrangements are designed to ensure that Heath Road’s core staff team can be supported and supplemented by individual staff who also support another home in the group – this arrangement is applied flexibly, to avoid reliance on agency staff and to support service users with outings or one-to-one activities. This effectively means that one should always expect to find a member of staff on site from 8am till 3.30pm, or 9am till 4.30pm. Once a week there is a second member of staff from 2.30 till 9.30pm to support service users going out or with evening activities. There are no staff on site overnight, but there is an on-call arrangement in the event of an emergency. 85 Heath Road DS0000023800.V368960.R01.S.doc Version 5.2 Page 24 The manager works from 8am till 3.30pm and does sleep-in shifts at another home in the group twice a month. Team working has been identified as a key strength and feedback from all three service users generally confirmed a high level of satisfaction with the care and rapport. We were unable to assess this home’s recruitment practices because this aspect of service is managed by MCCH’s Human Resources department, which keeps the documentation at head office. We have an arrangement whereby one of our senior officers carries out annual inspection at the head office, but there was no report on their findings available on site. Feedback from two staff told us that they were generally satisfied with the level of investment in their training, and we saw some evidence of mandatory training in respect of three others (e.g. moving and handling, medication, food hygiene, First Aid and Health and Safety, COSHH and infection control) to keep the service users safe, but the home’s records showed some gaps. The AQAA told us that almost all the six staff either have NVQ Level 2 or above, or are working towards this. We were unable to assess this home’s arrangements for supervising staff, as there was no means of access to these records, in the absence of the manager. 85 Heath Road DS0000023800.V368960.R01.S.doc Version 5.2 Page 25 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): Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The management and administration of this home is based on openness and respect. There are effective quality assurance systems developed by a qualified, competent management. EVIDENCE: The Commission’s own registration processes have established that the manager had the relevant qualifications (currently NVQ3, NVQ4 and Registered Manager’s Award) and experience and she is said to be approachable and supportive. The rapport between staff and residents was judged appropriately familiar and relaxed. 85 Heath Road DS0000023800.V368960.R01.S.doc Version 5.2 Page 26 All three current service users are white British females. All the staff are also female, to respect the service users’ expressed wishes, but shows slightly more ethnic diversity – one is a non British white and one is of mixed race – the rest are white British. MCCH has a Business Plan and records confirm a good investment in house meetings and questionnaires for service users to evidence how feedback can influence the way services are delivered. This process should be extended to other interested parties such as relatives and visiting health and social care professionals and reflected in MCCH’s business plans to ensure a fully rounded approach to quality assurance. We were satisfied with the home’s arrangements for recording, checking and accounting for service users’ financial transactions and we understand these accounts are subject to periodic scrutiny by a finance officer from MCCH, but there were no reports available to evidence this. MCCH needs to show a sustained commitment to evidence its own unannounced inspection visits at least once a month, as we found a number of gaps in the records available on site. The reader is advised that breach of this regulation is an offence and that enforcement action may become warranted. All the maintenance records seen were up to date and systematically arranged. 85 Heath Road DS0000023800.V368960.R01.S.doc Version 5.2 Page 27 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 X 3 3 4 3 5 2 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 3 26 3 27 3 28 3 29 3 30 2 STAFFING Standard No Score 31 X 32 2 33 3 34 X 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 3 3 3 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 X 3 3 2 X 3 3 1 85 Heath Road DS0000023800.V368960.R01.S.doc Version 5.2 Page 28 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 YA5 Regulation 5 (c) Requirement The contract needs to be made available in formats accessible to service users. The registered person shall supply a copy of this document to the Commission, for assessment against the provisions of the National Minimum Standards. 2 YA43 26 MCCH needs to show a sustained commitment to evidence its own unannounced inspection visits at least once a month. Breach is an offence. 30/09/08 Timescale for action 30/11/08 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 Refer to Standard YA22 Good Practice Recommendations The complaints procedure will require amendment to take account of the new inter-agency arrangements and the lead now taken by Social Services. DS0000023800.V368960.R01.S.doc Version 5.2 Page 29 85 Heath Road 2 3 4 YA24 YA30 YA39 It is recommended that the sealant around the bath be replaced. The siting of the home’s washing machine in the kitchen is not compliant with good infection control practices. Quality Assurance initiatives should be extended to other interested parties such as relatives and visiting health and social care professionals and reflected in MCCH’s business plans to ensure a fully rounded approach to quality assurance. 85 Heath Road DS0000023800.V368960.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Text phone: 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 85 Heath Road DS0000023800.V368960.R01.S.doc Version 5.2 Page 31 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!