Inspection on 09/08/06 for 85 Heath Road

This inspection was carried out on 9th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

85 Heath Road 08/08/08

85 Heath Road 09/08/07

85 Heath Road 13/12/05

85 Heath Road 05/08/05

85 Heath Road 13/01/05

85 Heath Road 14/09/04

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

CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 85 Heath Road Barming Maidstone Kent ME16 9LD Lead Inspector Debbie Sullivan Key Unannounced Inspection 09:45 9th August 85 Heath Road DS0000023800.V303315.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.V303315.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 Older People and 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.V303315.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) MCCH Society Limited Post Vacant Care Home 3 Category(ies) of Learning disability (2), Learning disability over registration, with number 65 years of age (1) of places 85 Heath Road DS0000023800.V303315.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Care for one older person with learning disabilities is restricted to one person whose date of birth is 3 July 1929 13th December 2005 Date of last inspection 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 night time 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. 85 Heath Road DS0000023800.V303315.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place over three and three quarter hours and was conducted largely in the company of the two support staff on duty and the two service users currently living at the home. Time was spent speaking with the service users individually and in the company of staff, speaking with the support workers together and individually, touring the house, reading records and other documentation and direct observation. The manager was on annual leave; a telephone discussion took place with the area manager of the service during the visit that was helpful in clarifying some information. Throughout the site visit support staff were helpful in providing information. Due to the nature of the service, it is difficult to reliably incorporate accurate reflections of the service users views in this report. Therefore some judgements about quality of life and choices have been made from discussion with staff and information supplied on records. The current weekly fee for the service is £323.01 per week. Comments made by service users during the inspection included, “ The meals are very nice” “It is a bit quiet, only two of us now” “I like the new staff” “I would like the staff to be at the home more” What the service does well: The home provides a comfortable, clean, welcoming and homely environment. 85 Heath Road DS0000023800.V303315.R01.S.doc Version 5.2 Page 6 Potential new service users have the opportunity to visit the home before deciding to move in. Service users are supported to live as independently as possible and encouraged and enabled to participate in social and community activities. Good links are maintained with health professionals, friends and relatives. Staff are well supported and there is plenty of training available. What has improved since the last inspection? What they could do better: Medication and medication records must be stored more securely. Confidential records and other information must be kept more securely. The fitting of assisted technology to reduce risk to service users when the house is unstaffed should be actioned as soon as possible. House meeting to include service users should be reinstated. The garden needs to be made safer and accessibility improved for those with mobility difficulties. 85 Heath Road DS0000023800.V303315.R01.S.doc Version 5.2 Page 7 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. 85 Heath Road DS0000023800.V303315.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Outcomes Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) 85 Heath Road DS0000023800.V303315.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 and 5 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Prospective service users are able to access information about the home before making a decision to move in. Existing service users are involved in introductions to the house. EVIDENCE: The home has a Statement of Purpose and Service User’s Guide; original contracts were in place on care plans and these are being updated. 85 Heath Road DS0000023800.V303315.R01.S.doc Version 5.2 Page 10 Since the last inspection one service user has moved out due to a change in health needs and a prospective new service user has visited the home on several occasions. The service users spoke of the visits, were clearly involved in the process and visits were documented in the house diary. The two current service users are well established at the home. It was not yet clear if the admission would definitely take place or what the timescale for a decision would be. The vacancy has led to a change of dynamics in the house between the service users and staff felt that it would be helpful for a suitable third service user to be there again. One service user said they were looking forward to having more company again. 85 Heath Road DS0000023800.V303315.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14, and 33 (Older People) 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 and 10. The quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to the service. Service users are supported to be independent and to make daily choices about their lives. Care plans contain comprehensive information. Confidential records need to be stored more securely. EVIDENCE: Care plans included comprehensive information regarding needs, personal information, interests and activities and health information although, there was 85 Heath Road DS0000023800.V303315.R01.S.doc Version 5.2 Page 12 no evidence that a review had taken place for the service user aged over 65 since May 2006. It was clear that service users are well supported in maintaining contact and appointments with health professionals. One spoke of attending appointments for regular blood tests. The number of care and support hours allocated to the house has again increased, and as there are only two service users this allows for plenty of time for support staff to take them out and spend time with them individually. The hours will not again increase with a third service user in the house. Support staff said that currently the preference of the service users is for them to be present during the day and to be on their own from early evening until the next morning. The distribution of the care hours was said to be under review and may change slightly. One service user said they felt well supported by staff and the relationship observed between them was friendly and comfortable, whilst professional. Service users were given choices as to what to do during the day; one service user is very keen on going out, whilst the other can need some persuasion. Staff explained how they regularly offer options for going out and manage personal preferences, a lot of the time this was possible due to the current staffing hours, so that one staff member could remain at the house whilst the other is out with a service user if necessary. Service users are supported to take risks and risk assessments are completed. Information was available on care plans relating to risk taking activities such as self medication. The house is intended to promote independence and as such risks are an inherent part of the service, for instance when no staff are on duty, going out independently, preparing food independently. Measures are put into place to minimise risk and a lifeline system is fitted so that service users can call out of hours duty staff if necessary, although they have not always used it when it would have been needed. House meetings were not being held, it is recommended these be reinstated. Records are kept in the office that is locked when staff leave, although service users have keys to the room. A review is needed of confidential record storage so that personal information is secure. 85 Heath Road DS0000023800.V303315.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. Service Users find the lifestyle experienced in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. Service users find the lifestyle experienced in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16 and 17 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users are supported and encouraged to participate in a range of activities in the community and the house. 85 Heath Road DS0000023800.V303315.R01.S.doc Version 5.2 Page 14 Individual preferences are respected and service users are treated with dignity. Meals are varied with plenty of choice on offer. EVIDENCE: Service users have the opportunity to take part in a wide range of community activities. One service user’s weekly programme includes bowling, voluntary dog walking at an animal rescue centre, attending a gardening day activity, attending a social club, going to church, shopping independently and with staff, and going out for lunch or coffee. Service users sometimes go out together with staff and one can go out locally independently. One service user was expecting a visit on the day of the inspection from a friend who lives in another MCCH house; this is a regular occurrence, and they also spoke of a relative visiting them. Support staff were concerned that one of the service users who has mobility problems may miss out on some opportunities to socialise or access community activities due to the restrictions on available transport (staff use their own cars) and the need for a wheelchair to be used when out. The service users were happy with the opportunities offered to go out, although one said they go to bed early as it can be boring in the evenings. In the house service users watch TV, listen to music and one service user likes to spend a lot of time in their room. There is an expectation that service users will assist with the daily chores, when needed support and encouragement are given with these. The house has a cat who comfortably settled in the lounge. Since the third service user moved out earlier in the summer, the dynamics in the house have changed and one service user can tend to rely on the other. This has caused some friction and it is hoped the inclusion of a new person will ease this. The weekly shop was due to take place later on the day of the inspection, service users can be involved in this if they wish and one was keen to go. Service users are consulted over meal choices which are recorded, support staff are usually present to prepare three meals a day, if they are not present for the evening meal they prepare food ready or the service users can prepare simple meals independently; service users said they enjoyed their lunch, that meals were good and they had choice. 85 Heath Road DS0000023800.V303315.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) 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. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) 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 and 20. The quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to the service. The personal and healthcare needs of service users are met in a flexible way with independence promoted. Medication and medication records are not securely stored. EVIDENCE: The service users require differing amounts of assistance with their personal care; both are as independent as possible. The service users are now 85 Heath Road DS0000023800.V303315.R01.S.doc Version 5.2 Page 16 supported by an all female staff group having expressed a wish for this and are happier with the arrangement. Support offered is very flexible, one service user had a lie in on the day of the inspection choosing to have a bath when they got up, staff explained that times to have a bath or to get up were personal choice. Evidence was seen on care plans of medical appointments such as chiropody being supported and good contact with health professionals. One service user is supported to self medicate, staff oversee this and check with the service user that they have taken an evening medication the next morning if no staff are present at the time it is taken. Medication storage is in an unlocked cupboard in an area accessible to service users, the actual medication cabinet was also not locked. The Nomad system is used. The MAR sheets were left open in the unlocked staff office and there was no record of the use of an eczema cream independently by a service user, this had recently been prescribed. 85 Heath Road DS0000023800.V303315.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16-18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are safeguarded. (OP NMS 35) The Commission considers Standards 22-23 (Adults 18-65) and Standards 16-18 and 35 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to the service. Service users remain more confident in making their views known and have access to a complaints procedure. Safety and security will be enhanced with the installation of assisted technology, whilst service users may continue to be at some risk during the times they are unsupported. EVIDENCE: The views of service users have been taken account of in respect of the review of staffing arrangements prior to the last inspection. In conversation the service users said they were still happy with their support, although one said they were lonely in the evenings. Staff spoken with said that the views of service users are listened to and they are able to speak of any concerns. The home has a complaints procedure, following a recent disagreement between the service users they were both offered the opportunity to complain, 85 Heath Road DS0000023800.V303315.R01.S.doc Version 5.2 Page 18 the area manager spoken with on the phone had not yet received any complaint. An Adult Protection alert relating to staffing levels that was opened following an inspection August 2005 was closed in February 2006.There have been no further alerts. The safety of the service users remains a concern during the periods when they are alone; one service user said they would open the door to a caller at night. A system to improve security is to be installed. Staff stated that the response of service users to people calling at the door can be inconsistent and at least once an unknown person was admitted. Service users manage their personal finances with support and transactions are well documented. 85 Heath Road DS0000023800.V303315.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29 and 30. The quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users live in a comfortable, clean and homely environment. Bedrooms are personalised and promote independence. Access to the garden for service users with limited mobility, needs to be improved upon. 85 Heath Road DS0000023800.V303315.R01.S.doc Version 5.2 Page 20 EVIDENCE: The home was clean, well decorated and homely. One bedroom with an en suite is downstairs, the other two are upstairs. A service user said that they had recently had some new bedroom furniture; the empty bedroom will need some redecoration and refurbishment prior to a third service user moving in. Bedrooms were personalised and the ground floor room leads onto a patio area with patio furniture and ramping to the garden. The garden requires work to make it fully accessible to those with mobility problems, as it is uneven with various hazards. Ramps provide easy access to the front door from the road. Communal areas comprise of a lounge and large kitchen/dining area, the dining area is sectioned off the main kitchen, laundry is done in the kitchen at times when food is not being prepared or eaten. Aids and equipment are in place for the service user with mobility problems, who is restricted to accessing the ground floor. Service users said they liked their rooms, one said they had recently helped to change round the furniture in the lounge. The house is located near to local shops and facilities and one service user goes to the shop on their own. 85 Heath Road DS0000023800.V303315.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 32, 34 and 35 (Adults 18-65) and Standards 27, 28, 29 and 30 (Older People) 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 and 36. The quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The changes to the staff team and allocated hours have led to a more suitable service being provided and service users have more confidence in staff. Staff are competent and well supported. EVIDENCE: An agreement is now in place that CSCI’s Performance Relationship Manager audits MCCH staff records centrally at least once a year, therefore standard 34 was not inspected on this occasion. The results of the Performance 85 Heath Road DS0000023800.V303315.R01.S.doc Version 5.2 Page 22 Relationship Managers’ initial audit were received in July 2006,findings were that recruitment documentation and vetting of potential staff was in place. Recommendations included improvement to application forms and the interview process. The changed staffing arrangements that were quite new when the last inspection took place are now established. The area manager confirmed via telephone that 99.9 staff hours are now provided weekly. The staff team comprises of the manager and three fulltime support workers, one member of MCCH bank staff was on duty during the inspection with a fulltime member of staff, and although is part of the bank only currently works at Heath Road and has dome for some time. At weekends only one support worker is on duty and leaves the house at 3.30 pm as opposed to 6pm on weekdays. Service users stated they liked the staff and those on duty were competent, confident with the service users, very aware of their personal preferences and needs and genuinely concerned that they were offered equal opportunities to access the community and for their safety when staff were not present. As the manager was not present standard 35 was not inspected although a member of staff stated that MCCH offered good training opportunities and support, regular supervision and staff meetings were held. NVQ training is available and the pre inspection questionnaire completed by the manager states that all staff have obtained NVQ 2 or above in care. 85 Heath Road DS0000023800.V303315.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. Service users live in a home which is run and managed by a person who is fit to be in charge of good character and able to discharge his or her responsibilities fully. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) 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 homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 37, 39 and 42 (Adults 18-65) and Standards 31, 33, 35 and 38 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,40,41 and 42 The quality in this outcome area is adequate; this judgement has been made using available evidence including a visit to the service. The home is well run and service users and staff have benefited from a permanent manager being in post and changes in staffing. 85 Heath Road DS0000023800.V303315.R01.S.doc Version 5.2 Page 24 The safety and security of confidential information must be reviewed and improved upon. EVIDENCE: The manager has been in post since late 2005 and staff and service users are benefiting from more stability, previously there had been several changes of manager. The manager is not yet registered with CSCI; the area manager stated the application was imminent. The home is well run and the atmosphere friendly and welcoming. The Commission is receiving Regualtion 26 visit reports and regular safety checks take place. Records were evidenced of equipment safety checks, including fire equipment, taking place at correct intervals, house risk assessments, walking route checks taking place and of fridge and freezer temperatures being checked twice daily. The pre inspection questionnaire states a fire practice took place on 31.7.06. Policies and procedures are kept in the office and are accessible to staff. The storage of confidential personal, medical and financial information is not secure and a review must take place of these arrangements. Whilst this is the case the processes for recording and monitoring information have improved. 85 Heath Road DS0000023800.V303315.R01.S.doc Version 5.2 Page 25 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. Where there is no score against a standard it has not been looked at during this inspection. 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 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 2 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 2 30 2 STAFFING Standard No Score 31 3 32 3 33 2 34 X 35 X 36 3 CONDUCT AND MANAGEMENT Standard No Score 37 2 38 3 39 2 40 3 41 1 42 3 43 X 2 3 3 2 1 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 85 Heath Road Score 3 3 1 X DS0000023800.V303315.R01.S.doc Version 5.2 Page 26 YES 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. YA20 OP9 Standard Regulation 13(2) Requirement “The registered person shall make arrangements for the recording, handling, safe keeping, safe administration and disposal of medicines received into the care home” In that a review must take place of medication and MAR sheet storage and accessibility to the storage area so that storage is secure and confidential. 2. YA6 OP7 15(2)(b) “The registered person shall keep the service users’ plan under review” In that the care plan of any service user over the age of 65 must be reviewed at least once a month. 3. YA23 OP18 13(1)(a) “The registered person shall ensure that the care home is conducted so as to promote and make proper provision for the health and welfare of service users” DS0000023800.V303315.R01.S.doc Timescale for action 14/10/06 14/10/06 14/10/06 85 Heath Road Version 5.2 Page 27 In that the proposed fitting of an environmental control system to improve the safety and security of service users take place at the earliest opportunity. 4. YA37 OP31 8(1) “The registered provider shall appoint an individual to manage the care home where there is no registered manager” In that the manager must apply for registration with the CSCI. The Manager telephoned following the inspection and expressed intention to apply for registration as soon as possible. This requirement is repeated from the previous inspection. 5. YA41 OP37 17(1)(b) “ The registered person shall ensure that records are kept securely in the care home” In that care plans, financial records in respect of service users, daily logs, medical information and other confidential information must be kept securely and confidentially. 14/10/06 14/10/06 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 YA8 OP33 Good Practice Recommendations It is recommended that house meetings involving service users be reinstated and held regularly. 85 Heath Road DS0000023800.V303315.R01.S.doc Version 5.2 Page 28 2. 3. 4. YA28 OP20 YA33 OP27 YA42 OP38 It is strongly recommended that the garden be made safer and more accessible for service users with limited mobility. It is recommended that a review of the distribution of staffing hours throughout the week be undertaken. It is recommended that opened jars and other foodstuffs be labelled with the date of opening, as per instruction on the house fridge. 85 Heath Road DS0000023800.V303315.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI. 85 Heath Road DS0000023800.V303315.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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