Inspection on 12/11/05 for Adisham House

This inspection was carried out on 12th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Adisham House 24/04/07

Adisham House 24/06/05

Adisham House 04/09/04

Adisham House 24/05/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

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 08/07/2008.

CARE HOME ADULTS 18-65 Adisham House Adisham House Pond Hill Adisham Canterbury Kent CT3 3LH Lead Inspector Nicki Dawson Unannounced Inspection 12th November 2005 09:20 Adisham House DS0000023267.V254121.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 Adisham House DS0000023267.V254121.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. Adisham House DS0000023267.V254121.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Adisham House Address 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) Adisham House Pond Hill Adisham Canterbury Kent CT3 3LH 01304 840170 Mr Jamie Paul Bishop Mr William McGuinness Mrs Barbara Winifred McGuinness Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Adisham House DS0000023267.V254121.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th June 2005 Brief Description of the Service: Adisham House provides care for up to ten adults with a learning disability. The home is situated in the rural village of Adisham, near Aylesham. The village amenities include two churches, a pub and a village hall. There is a main line railway station and in addition, buses provide links to the surrounding villages. Residents are unable to walk to the village independently due to the route being partly paved and the danger of heavy traffic using the road. There is ample parking space in front of the property. Resident’s accommodation is provided on three floors. There are six single rooms and two double rooms. On the ground floor there is a toilet and shower room and on the first and second floors there is a bathroom. There is ample communal space consisting of a main lounge, small lounge and conservatory, which overlooks the garden. The home has extensive grounds, including an orchard. Chickens are also kept on the premises. Adisham House DS0000023267.V254121.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection commenced at 9.20am and concluded at 3.30pm. About two thirds of this time was spent socialising with residents and talking to the two senior staff on duty. Since the inspection took place at the weekend, the inspector was able to meet all of the residents. The rest of the time was spent in the office, looking at records and speaking with the registered manager. What the service does well: What has improved since the last inspection? 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. Adisham House DS0000023267.V254121.R01.S.doc Version 5.0 Page 6 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 Adisham House DS0000023267.V254121.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, and 4 In order to ensure that prospective residents ‘fit’ into the home life, their needs are assessed and they have opportunities to visit the home, prior to admission. EVIDENCE: The home has produced a ‘Statement of Purpose’ that sets out the aims, objectives and philosophy of the home, together with the services and facilities provided for residents. The home is also required to produce a ‘Service User’s Guide’, which clearly sets out for residents (in a format that has meaning to them) the services and facilities that they can expect if they move to the home. Each prospective and current resident should be given a copy of this guide. The registered manager could not access this document on the day of the inspection and had not sent the inspector a copy, by the time this report was completed. The registered manager explained the process for admitting new residents. First, the prospective resident completes an application form. Then the prospective resident is visited in their own home and an assessment of their daily living needs is undertaken with input from their relative or representative. Any assessment made by a care manager is obtained. The prospective resident may then come to visit the home, including an overnight stay. The registered manager stressed the importance of the prospective resident being compatible with the existing residents in the home. Adisham House DS0000023267.V254121.R01.S.doc Version 5.0 Page 8 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, 9 and 10 Staff have a good understanding of residents’ care needs, as recorded in their individual plans of care. Staff value keeping residents confidences as far as they are able, within the limitations of their own roles. EVIDENCE: The care provided for two residents was viewed in detail; by talking to the resident concerned, through discussion with the residents key worker and by looking at each care plan and the corresponding daily records. Staff were knowledgeable about residents specific needs. Each care plan contained an informative summary of the resident’s history and a ‘pen portrait’. Plans contained an assessment of each resident’s daily living needs, focusing on strengths, needs, goals and risk assessments. At the front of each care plan it states that, ‘ The role of the key worker is to form a deliberate association over and above that provided to the client group as a whole’. This is indeed the case at Adisham House. Both residents and staff had a good understanding of their roles and responsibilities. Each plan is regularly reviewed including a monthly summary. Adisham House DS0000023267.V254121.R01.S.doc Version 5.0 Page 9 There is a written procedure outlining the action to be taken if a resident goes missing. Residents, who may become confused if in unfamiliar places in the community, discretely carry details of their home address for their protection. There is a written policy on maintaining confidentiality. Staff clearly demonstrated that they valued maintaining resident’s confidentiality. They were also aware of situations when information given to them would need to be shared with other people. In this situation they stressed that it was important to inform the resident of this decision. Adisham House DS0000023267.V254121.R01.S.doc Version 5.0 Page 10 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): 12, 13, 14 and 15 Residents participate in a wide variety of activities, which are appropriate to their age and abilities. EVIDENCE: Residents discussed the many activities and events that they are involved in the community. The majority of residents attend the day opportunities centre in Canterbury. Some residents explained their current programme of activities at the centre and stated that they enjoyed the variety of activities that were on offer. A number of residents undertake work experience at Age Concern and a local supermarket. Some residents have strong links with the local church and also regularly attend a church music group called ‘joyful noise’. Residents, who spend more time at home, whether due to age or disability, are encouraged to take part in house activities. One staff member said that she often has “an audience” when she is cooking in the kitchen and gives residents small tasks to help her. Residents said that one staff member regularly paints their fingernails and massages their hands, which they really enjoy. The day of the inspection was a weekend and residents were talking, watching television, spending time in their rooms and one person was busy in the Adisham House DS0000023267.V254121.R01.S.doc Version 5.0 Page 11 garden raking leaves. Three residents left the home before lunch and took the train to Canterbury to take part in a group activity called ‘Oasis’. One resident pointed to the photographs of the resident’s holiday to Centre Parks, on the lounge wall. He was particularly keen to show the photographs of celebrations of his 50th birthday, which was celebrated by a meal and drinking champagne. Residents said that they are able to keep in contact with their relatives and that their relatives are able to visit them in their home. Residents are able to speak to relatives and friends in private by use of the home’s hands-free telephone. Adisham House DS0000023267.V254121.R01.S.doc Version 5.0 Page 12 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): 19 and 20 The health care needs of residents continue to be met. The home’s practice in relation to dealing with medicines is generally good, but some aspects of the recording of the administration of medications need to be changed to minimise the potential for administration errors. EVIDENCE: Resident’s main health care needs are clearly listed in their individual plan. Regular healthcare appointments are made for residents and each appointment is recorded, together with any action to be taken. Selected aspects of the recording, storing and administration of medication was inspected. Staff said that they had received external training in the administration of medication. They were also clear about the action to take if there was an error in the administration of medication. The recording of the administration of medication was generally good, with a list of resident’s current medication at the front of the medication administration records. However, the frequency of one resident’s medication had been changed by hand without a signature and countersignature. Also, one resident’s medication had been discontinued, but this had also not been countersigned. A statutory requirement was made in relation to this practice. Adisham House DS0000023267.V254121.R01.S.doc Version 5.0 Page 13 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 and 23 Residents are encouraged to make their views known. Staff would challenge any suspicion of abuse. In order to ensure that staff would follow the correct procedure in such situations, guidance needs to be obtained from the local social services department. EVIDENCE: Residents said that if they had a problem they would discuss it with their key worker. Staff said if a relative made a compliant that they would try and resolve the issue with the relative and resident concerned. If this could not be achieved, they would pass the details onto the manager. The home has a written complaints policy. Staff demonstrated through discussion that they would report and challenge any suspected abuse of residents. The registered manager stated that some staff have received external training around the issues of adult protection. Staff said that they were aware of the home’s policy on ‘whistle-blowing’. The homes policy on adult protection correctly lists the social service department as one of the agencies to contact if there is a suspected case of adult abuse. The registered manager said that the home has not received a copy of the current guidance from social services on adult protection. A statutory requirement was made that this important document is obtained, that staff are aware of the main content and that the home’s adult protection policy is amended as necessary. Adisham House DS0000023267.V254121.R01.S.doc Version 5.0 Page 14 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, 26, 28, 29 and 30 Adisham House is a beautifully presented property that continues to provide a safe and comfortable home for the residents that live there. The home needs to update its policies and procedures in one area to help minimise the spread of infection. EVIDENCE: One of the residents proudly gave a tour of the main areas of the home. There is ample communal space consisting of a lounge, small lounge, conservatory and kitchen and dining room. A large garden surrounds the home, which contains an orchard and it is also home to a number of chickens that provide freshly laid eggs for the residents. The home is furnished with fixtures and fittings of good quality. Individual rooms are furnished and decorated according to residents’ choices and preferences. The home was well presented and clean throughout on the day of the inspection. A handrail has been fitted to the step by the front door to aid residents with mobility problems. The home’s policy to control infection states that the one of the registered providers provides training for staff annually on issues of infection control. Staff demonstrated that they were aware of the main actions to take to prevent the spread of infection. However, not all staff were aware of the correct procedure for dealing with soiled laundry. The infection control policy Adisham House DS0000023267.V254121.R01.S.doc Version 5.0 Page 15 needs to be updated; to include the procedure for dealing with soiled laundry; and staff need to be aware of the correct procedures. Adisham House DS0000023267.V254121.R01.S.doc Version 5.0 Page 16 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 and 33 Residents are supported by competent staff that understand their individual needs. EVIDENCE: Staff demonstrated throughout the inspection that they were good at communicating effectively with the residents. In order to speak with one resident with hearing difficulties, one staff member, first ensured that the resident had their hearing aid switched on and then positioned themselves so that the resident could clearly see their face when they were talking to them. During the inspection there were two staff on duty at all times. Staff were effective in dividing their time between household jobs and offering support to residents. Staff clearly enjoyed their roles and responsibilities within the home and their attitude had a positive effect on the residents in the home. One staff explained that since the quality of care within the home is always good, “it makes you feel proud when relatives come to visit the home”. Adisham House DS0000023267.V254121.R01.S.doc Version 5.0 Page 17 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, 41, 42 and 43 Residents and staff benefit from a well-run home with an open management style. The views of residents and staff about the running of the home are continuously sought and acted upon. The welfare and safety of residents continues to be promoted as far as possible. EVIDENCE: The registered manager trained as an RMN and has experience nursing adults with learning disabilities. She set up Adisham House as a residential care home for adults with learning disabilities over 21 years ago and has managed the home since it opened. The National Minimum Standards state that the registered manager needs to achieve the NVQ 4 in Management and Care. This has been successfully completed by one of the registered providers. The management approach of the home is very open. One staff member commented that, “decisions are not made for us, we are asked our opinion about everything”. Regular, recorded staff and residents meetings are held. Residents and some relatives recently completed some questionnaires about Adisham House DS0000023267.V254121.R01.S.doc Version 5.0 Page 18 the quality of care provided at Adisham House. All responses were positive and therefore no action needed to be taken. A selection of policies and procedures were sampled and some statutory requirements were made in respect of the policy on infection control and adult protection. Staff said that the homes policies and procedures were accessible and that they dipped into them from time to time and when necessary. Records that staff used on a daily basis were available to staff and those records that were confidential were appropriately locked away. In line with the Data Protection Act, it is recommended that before a resident is admitted to the home that they or their representative, sign a consent form that relevant professionals may access information about them. At the last inspection the home’s maintenance records were checked and were up to date. On this occasion the record of fire checks was inspected and had been appropriately completed. The home has a valid insurance certificate and the registered manager said that the home keeps annual accounts and that it is financially viable. Adisham House DS0000023267.V254121.R01.S.doc Version 5.0 Page 19 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 2 3 X 3 X Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X 3 X 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 X X X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Adisham House Score X 3 2 X Standard No 37 38 39 40 41 42 43 Score 2 4 3 3 3 3 3 DS0000023267.V254121.R01.S.doc Version 5.0 Page 20 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 Standard YA20 Regulation 13 (2) Requirement The registered person must ensure that when any changes are made to residents medication, that all hand-written entries are countersigned and dated The registered manager must obtain a copy of the ‘Kent and Medway Adult Protection Guidance’; make it available to all staff and up date the home’s adult protection policy as necessary The registered person must amend the infection control policy to include the procedure for dealing with soiled laundry and to ensure that all staff are aware of the correct procedures to prevent to spread of infection Timescale for action 21/12/05 2 YA23 13 (6) 21/02/06 3 YA30 13 (3) 21/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations DS0000023267.V254121.R01.S.doc Version 5.0 Page 21 Adisham House 1 2 Standard YA20 YA41 The registered person should ensure that a sample signature is kept of all staff who administer medication The registered person should ensure that each resident or their representative gives written consent that their personal sensitive data may be accessed by relevant professionals Adisham House DS0000023267.V254121.R01.S.doc Version 5.0 Page 22 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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