Inspection on 08/11/05 for 9 Perrys Close

This inspection was carried out on 8th November 2005.

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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

9 Perrys Close 07/08/05

9 Perrys Close 03/08/04

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Insight - Eastchurch

Southfields

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33 St John`s Church Road

Dovedale Court

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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 9 Perrys Close 9 Perrys Close Faversham Kent ME13 7BX Lead Inspector Kim Rogers Unannounced Inspection 8/11/05 1:45 9 Perrys Close DS0000061748.V250193.R01.S.doc Version 5.0 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 9 Perrys Close DS0000061748.V250193.R01.S.doc Version 5.0 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. 9 Perrys Close DS0000061748.V250193.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 9 Perrys Close Address 9 Perrys Close Faversham Kent ME13 7BX 01634 405168 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) perrysclosetinternet.com The Kent Autistic Trust Grant Rodda Care Home 6 Category(ies) of Learning disability (6) registration, with number of places 9 Perrys Close DS0000061748.V250193.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7/8/05 Brief Description of the Service: 9 Perry’s Close is a detached purpose built modern property situated in a no through road in Faversham. The property was completed in June 2004. Service users and staff formally lived and worked at 1&2 New Houses, South Street, Faversham.The Home is registered to provide personal care and support to 6 younger adults (under 65 years) who have learning disabilities. The Kent Autistic Trust runs the Home. All six bedrooms are for single occupancy and have en suite shower and WC facilities. Accommodation is set over two floors accessed by stairs. There is a large reception area, lounge, dining room, kitchen, laundry room and private meeting room. There is a garden to the side and rear of the property accessed from the lounge and dining room. There is parking to the rear and front of the property.The M2/A2 motorways can access Faversham. There are local shops and a pub nearby as well as a train station and bus stops. 9 Perrys Close DS0000061748.V250193.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and carried out on a Tuesday afternoon. The Kent Autistic Trust runs the home. There are currently 4 service users living at the home with no change since the last inspection. The Inspector spoke to the manager, staff and service users, looked at records and had a look around the home. The manager, Emma Osgood was at the home and assisted the Inspector. Emma has been in post as manager for about 6 months and plans to apply to the Commission to be the Registered Manager. Most service users attend a day centre on weekdays. All four service users arrived home during the inspection. Service users arrived home to a relaxed atmosphere with staff on duty who although are not part of the permanent staff team are long standing and experienced. Service users appeared happy and relaxed. Staff showed knowledge and understanding of service users needs. The home was very clean and orderly. Records are well organised and held securely. Improvements have been made to assessments and care planning since the last inspection. This home provides a good quality service and meets the service users needs. Most of the National Minimum Standards were assessed at the last inspection of 7/8/05. Please see the report of the last visit for standards not assessed here. What the service does well: What has improved since the last inspection? 9 Perrys Close DS0000061748.V250193.R01.S.doc Version 5.0 Page 6 The process has started to update and organise service user plans and risk assessments. The manager has started to develop communication profiles for each service user. The communication profile seen was detailed and comprehensive. 3 permanent staff have been recruited. 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. 9 Perrys Close DS0000061748.V250193.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 9 Perrys Close DS0000061748.V250193.R01.S.doc Version 5.0 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 the following standard(s): 4 Prospective service users have the opportunity to visit the home before they make a decision to move in. EVIDENCE: The manager has met with a prospective service user and has started to carry out an assessment. Detailed information has been gathered and recorded. The prospective service user will visit the home depending on his needs. Stakeholders have visited the home on the service users behalf. The manager said that prospective service users have the opportunity to meet the staff and current service users and have an overnight stay before they make a decision about moving in. The needs and compatibility with current service users is considered. Prospective service users are given information about the home including the service user guide and Statement of Purpose. Please see the report of 7/8/05 for standards not inspected here. 9 Perrys Close DS0000061748.V250193.R01.S.doc Version 5.0 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 the following standard(s): 6,8,9 Service users know their changing needs and goals will be assessed and supported. Service users participate on all aspects of life at this home. Service users know they will be supported to take risks. EVIDENCE: The new manager has started to update and develop service user plans with service users and the staff team. The Inspector sampled a service user plan in detail. This was much improved since the last inspection with detail and information about the person’s life and their important people. Comprehensive individual communication profiles have been developed. Tools including Essential Lifestyle Planning have been used and adapted to suit individual’s needs. Plans were organised and easy to follow and are now more person centred. The manager said this format would be used for all service users. Other plans are in the process of being developed, reviewed and updated. At present plans are presented in written format. The manager said she is researching ways of making service users plans more meaningful and accessible to service users. Risk assessments are included in service user plans. These too have been reviewed and updated since the last inspection. 9 Perrys Close DS0000061748.V250193.R01.S.doc Version 5.0 Page 10 The risk assessments seen in one file were comprehensive. Risks are supported and managed to enable service users to lead ordinary independent lives. Service users were observed making choices and decisions. Staff give support where necessary to facilitate decision making. Service users chose for example how to spend their evening, which pub to go to, what to have for dinner. Service users are involved where possible in the recruitment of new staff. The manager said that prospective staff are invited to spend some time at the home to meet service users during the recruitment process. Service users are asked to give feedback about the prospective staff after these visits. The home has some information about advocacy services displayed on a notice board. The manager said she would be researching this provision further on behalf of service users. Please see the last report for standards not assessed here. 9 Perrys Close DS0000061748.V250193.R01.S.doc Version 5.0 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 the following standard(s): 11,14,15 Service users know they will have the opportunity for personal development. Service users enjoy various leisure activities. Service users know their relationships will be supported. EVIDENCE: All 4 service users are out during the day Monday to Friday. Some attend day centres others have support to access other facilities. Each individual has their own weekly activity programme, which includes trampolining, trips out to restaurants and local pubs and other activities. Two service users were planning to go to the local pub that evening. The Inspector met some day centre staff who arrived home with service users during the inspection. Some day centre staff (employed by the KAT) are also part of the bank staff for the home giving some continuity when covering staff shortfalls. The home has a minibus to enable access to community facilities. Communication has been supported by the development of individual communication profiles. The manager also plans to develop individual pictorial activity planners. The Inspector saw evidence that service users relationships are supported. This includes relationships with families, friends, housemates and care 9 Perrys Close DS0000061748.V250193.R01.S.doc Version 5.0 Page 12 managers. Families and friends are welcomed into the home and invited to meetings if service users agree. Service users are involved in the local community by using local pubs, restaurants, shops etc so have the opportunity to make new friends. The manager thought that no service user was registered to vote. A requirement was made to address this. Please see the last report for standards not assessed here. 9 Perrys Close DS0000061748.V250193.R01.S.doc Version 5.0 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 the following standard(s): 18,19 Service users health needs are met. Service users know they will be supported with their personal care in a way they prefer. EVIDENCE: Health needs are included in service user plans with actions by staff to meet those needs. A record is kept of health appointments and health advice sought. All service users are registered with a GP and have access to a range of health professionals. The manager spoke with understanding and knowledge of how to seek health advice and support when necessary. Since the last inspection personal care needs and preferences have been reviewed and are now much more detailed. This ensures that staff are aware of how service users prefer to be supported. Each bedroom has it’s own en suite shower and WC. Times for getting up and going to bed are flexible. Service users were dressed in their own clothes and have individual styles. Individual medication protocols should be developed for each service user including service users consent to medication as required at the last inspection. Please see the last report for standards not assessed here. 9 Perrys Close DS0000061748.V250193.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Service users know their views will be listened to and acted on. Service users are protected from abuse. EVIDENCE: The home has a corporate complaints policy and procedures. There is also a leaflet produced aimed at service users although the majority is written. The manager said that service users have the opportunity to bring up any issues with staff or their key workers and that individual meetings work well. During the visit service users raised issues, which were discussed and addressed. Relatives and others who attend review meetings are asked for items for the agenda before the meeting. This enables a forum for open discussion. The home has had no complaints since the last inspection. There is a whistle blowing policy and adult abuse policy. Staff attend training about how to recognise and respond to abuse during their induction. Any physical and verbal aggression by service users is understood and supported in a positive way, which protects service users rights and best interests. Guidelines are in place detailing what support is needed to manage and diffuse potentially aggressive situations. These guidelines are based on good practice and are kept under review. 9 Perrys Close DS0000061748.V250193.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,28,29,30 This home is safe, comfortable and well maintained, although some showers drains need attention. Service users are happy with their rooms, which promote their independence. This home is clean and hygienic. Service users enjoy the shared space. Service users have the adaptations they need to maximise independence. EVIDENCE: The premises are new and purpose built. It is light and spacious with sufficient heating and ventilation. The home was clean and suitably fragranced on the day of the inspection. The new premises were registered as a residential home with the Commission for Social Care Inspection in June 2004. Because it is new the premises is safe and well maintained although there has been a problem with water not draining away properly from showers. The manager was coping with a flood from an en suite shower in the staff room when the Inspector arrived. The manager said she has contacted the housing association that say they will address the problem. At the last inspection, the Inspector noted that the back garden needs some attention. Some parts of the garden are overgrown with weeds. The manager said she is negotiating with the housing association about the back garden. There is attractive patio and seating areas 9 Perrys Close DS0000061748.V250193.R01.S.doc Version 5.0 Page 16 and a vegetable patch. Service users have grown a variety of vegetables. The home is sited close to local amenities including shops and is in keeping with the local community. New furniture has been provided throughout the home from sofas to beds and wardrobes. All is of good quality and domestic in nature. The house has a homelike feel with pictures and ornaments helping to support this. The Inspector understands that the home meets the requirements of the local fire service and environmental health department. The home has a separate laundry, which is of a good standard. All bedrooms are single and have en suite facilities. Bedrooms are personalised by service users and meet their needs. There is also a separate bathroom and WC. There are some aids and adaptations around the home to help support service users and maximise their independence. Please see the last report for standards not assessed here. 9 Perrys Close DS0000061748.V250193.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,35 EVIDENCE: Staff spoke with knowledge and understanding of service users needs. Staff were aware of their role and responsibilities when asked. The line management is clear. There was one staff on duty from an agency and one permanent KAT relief staff. A third member of staff was due in that evening to support a visit to the local pub. The agency member of staff has previously worked for the KAT and knows the service users well. The agency staff is currently working full time hours at this home due to staff vacancies although three permanent staff have been recruited since the last inspection. Although this home has some staff vacancies by using permanent relief or bank staff and the same agency staff they have managed to be flexible and effective. Shifts are planned around the needs of the service users, which means staff work split shifts. Staff support service users first thing on the morning and go home when service users leave for the day around 09.30 to 10.00am. Staff then return for the second part of their shift at about 15.30 to 22.00. At night there is one waking staff and one sleep in staff. The Inspector concluded there are sufficient competent staff on duty to meet service users needs. Staff are issued with job descriptions and have contracts of employment and are clear about their roles and responsibilities. Regular staff meetings are held to which all staff including agency and bank staff are invited. Staff use a communication book which is kept in the office and have handovers to help communication between the staff team. Staff were observed interacting with 9 Perrys Close DS0000061748.V250193.R01.S.doc Version 5.0 Page 18 service users in a positive respectful manner. One service user was anxious and spent some time in the office talking to the manager. The manager showed empathy and understanding of the service users needs and listened effectively. Staff promote independence and were observed encouraging service users to be involved in all aspects of life at Perry’s Close. Please see the last report for standards not assessed here. 9 Perrys Close DS0000061748.V250193.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 43 EVIDENCE: The manager has been in post for six months and plans to apply to the Commission to register as the manager. The manager is a qualified nurse specialising in learning disabilities with several years experience. The manager has attended an introduction to management day and plans to attend further periodic training. This knowledge and experience should be consolidated with the completion of a management qualification to level 4 NVQ. The manager was observed communicating effectively with staff and service users. The manager seeks the views of staff about the running of the home at staff meetings. Relatives and stakeholders are able to comment on issues at review meetings. Care managers usually attend yearly reviews and are asked for their comments. The manager said that service users bring up issues on a daily basis, which are addressed quickly. The Inspector observed service users asking about things and making choices, which were supported by staff. However, at present there is no formal means to seek the views of service users about how the service is doing. The manager suggested one to one 9 Perrys Close DS0000061748.V250193.R01.S.doc Version 5.0 Page 20 meetings might work well with key workers and plans to introduce these. Feedback should be actively sought from service users about the service by way of these meetings, surveys, questionnaires etc. Results from any surveys should be published. The Inspector understands that the home is financially viable. The home has sufficient public liability insurance. Under Regulation 26 a responsible person who is not in day-to-day charge must make at least monthly-unannounced visits to the home and speak to service users and staff then produce a report. A copy of the report must be sent to the Commission. The Commission have only received one report since February 2005 dated 8/9/05. A requirement was made to ensure at least monthly visits are carried out and a report supplied to the Commission. The home has corporate and local policies and procedures. These are kept in the duty office so are available to staff and service users. The policies and procedures are not presented in an accessible format for all service users. Thought should be given to developing more accessible policies and procedures. Records are held securely and individually in line with the Data Protection Act 1998. The home has adequate insurance including public liability. Please see the last report for standards not assessed here. 9 Perrys Close DS0000061748.V250193.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x X X 3 X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 X 3 3 3 LIFESTYLES Standard No Score 11 3 12 X 13 X 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score x 3 3 X 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 9 Perrys Close Score 3 3 2 X Standard No 37 38 39 40 41 42 43 Score 2 3 2 2 X X 2 DS0000061748.V250193.R01.S.doc Version 5.0 Page 22 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 2 Standard YA6 YA20 Regulation 15 13(2) Requirement Timescale for action 31/12/05 3 4 YA24 YA39 23 26 The review ad update of service user plans and risk assessments should continue. Service Users plans must contain 31/12/05 individual medication protocols. Service Users consent to medication must be obtained and recorded in Service User plans. Service users showers should all 31/01/06 be in good working order. At least monthly unannounced 30/11/05 visits should be made by a responsible individual and a report supplied to the Commission. 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 YA31 YA39 Good Practice Recommendations 50 of staff, including agency staff should be qualified to at least level 2 NVQ by 31/12/05. The manager should seek feeback from service users about the service provided. Results of any surveys etc DS0000061748.V250193.R01.S.doc Version 5.0 Page 23 9 Perrys Close 3 4 5 YA37 YA40 YA24 should be published. The manager should be qualified to NVQ 4 in care and NVQ 4 in management. Policies and procedures should be more accessible to service users. The back garden needs attention. 9 Perrys Close DS0000061748.V250193.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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. 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