Inspection on 24/04/07 for Adisham House

This inspection was carried out on 24th April 2007.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Adisham House 12/11/05

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 Kim Rogers Key Unannounced Inspection 24th April 2007 11:00 Adisham House DS0000023267.V321436.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 Adisham House DS0000023267.V321436.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Adisham House DS0000023267.V321436.R01.S.doc Version 5.2 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 01304 840170 adishamhouse@tiscali.co.uk Mr Jamie Paul Bishop Mr William McGuinness Mr Jamie Paul Bishop Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Adisham House DS0000023267.V321436.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th November 2005 Brief Description of the Service: Adisham House provides personal care and support 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. 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 overlook the garden. The home has extensive grounds, including an orchard and vegetable patch. Chickens are also kept on the premises. The fee for the home ranges from £479.06 to £607.80. For further information about the fee and what is included please contact the Provider. Adisham House DS0000023267.V321436.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection site visit was unannounced and carried out by one inspector over about 6 hours. Work was carried out before the inspection including surveying service users, care managers and relatives. A pre inspection questionnaire was supplied by the manager and other information was analysed. The inspector spent time with service users individually and as a group, spoke to staff, the manager and owner, and made observations. A service user and the owner showed the inspector around the home and some records were sampled. The requirements made at the last inspection have been met. Service users said ’ It really is nice here, you know’ ‘I could talk to staff if I had a problem’ ‘ I am able to go out. There is a nice garden, a lovely garden’ Staff said ’ We are privileged to come here to work’ ‘We care about the lifestyles of service users’ Care managers said ’People are encouraged to self medicate’ ‘The provider is committed to supporting people to make decisions about their care and listens to suggestions and takes action to improve’ What the service does well: Most people have lived at Adisham House for several years. The home is family run with service users included in all aspects of daily life. This leads to a relaxed, inclusive, homely atmosphere. Service users have opportunities to take part in meaningful activities including paid jobs. Staff support service users to take control over their lives including their money and medication. Service users said ’ Having my own room’ ‘Making cakes on Saturdays’ ‘Lots of social activities’ ‘All the staff are very helpful’ Care managers said ’The home provides a homely atmosphere and treats people with dignity and respect’ Adisham House DS0000023267.V321436.R01.S.doc Version 5.2 Page 6 ‘The home maintains a high standard of care and is willing to work with other agencies to provide a coordinated service’ 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. The summary of this inspection report can be made available in other formats on request. Adisham House DS0000023267.V321436.R01.S.doc Version 5.2 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 Adisham House DS0000023267.V321436.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Service users are given information about the home and can have trial stays before they decide to move in. Service users know their needs and aspirations will be assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a Statement of Purpose and Service user guide, which are given to prospective service users and their representatives. This is currently not produced in a format that all service users can understand although the provider said that this could be done to meet individual needs. The manager said that people could have trial visits and stays until they are ready to make a decision about moving in. Service users confirmed this, as did records. A person has moved in since the last inspection. People said that they had the opportunity to meet the person before they moved in and were able to give their thoughts. The manager said that compatibility with other people is always considered. A care management assessment was seen in a service user plan sampled as well as an assessment carried out by the manager. The assessment gives a Adisham House DS0000023267.V321436.R01.S.doc Version 5.2 Page 9 baseline and from this staff prioritise certain areas with the person that they would like to improve. These areas are then developed into a goal plan. The manager has introduced person centred planning to ensure aspirations and personal goals are identified and supported. Adisham House DS0000023267.V321436.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Service users know their personal goals will be supported in a person centred way and they’ll be supported to make choices and decisions. Risks are managed so as to enable people not restrict them. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service user plans were sampled and showed they are developed from initial assessments. Goal plans are developed to support needs and personal goals. These are detailed and regularly reviewed. Achievement is recognised and celebrated. The manager has introduced person centred plans which are individual and in a format more accessible to service users. Person centred plans ensure that service users have the support they need to lead the life they want. Service users told the inspector about their goals plans. One said ‘I have my own goal plan’ and ‘I do my own laundry’ Adisham House DS0000023267.V321436.R01.S.doc Version 5.2 Page 11 Each person has a named key worker and people knew whom this was when asked. Communication needs are assessed and detailed in individual plans. Staff were observed communicating with people effectively and supporting choice and decision making. Care managers said that needs are monitored and the provider is committed to supporting people to make decisions about their care. Risk assessments were sampled and are wide-ranging and detailed. The management of risks enables service users rather than restricting them with assessments linking to personal goals. Care managers said that accurate records are kept. Adisham House DS0000023267.V321436.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Service users enjoy meaningful activities and jobs in house and in the community. Service users enjoy a balanced diet and take part in planning and preparing, meals. Relationships are supported and service users are fully involved in the running of the home. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Most service uses were out when the inspector first arrived at day centres and at work. People started arriving home during the late afternoon and spoke to the inspector about work etc. People enjoy a wide range of activities and told the inspector about these. Some service users are preparing for their holiday, which they are looking forward to. Adisham House DS0000023267.V321436.R01.S.doc Version 5.2 Page 13 People have the support they need to access the community by way of public transport and a mini bus. Some people attend church and some enjoy being part of a church band. Service users said they discuss ideas for activities and outings at their monthly meetings and this was seen in the minutes. There was also mention of food and menu planning. People have support to make packed lunches for work and all are involved in the planning and preparing of other meals. Some people have goals plans in place to develop their cooking skills. There are no restrictions on access to the kitchen so people can help themselves to fruit and drinks when they want. The staff promote healthy eating and records of monitoring nutrition are good. The menu is displayed daily. People have the support they need to maintain contact with their family and friends. Service users told the inspector about visits to and from their families. Everyone is supported, to the best of their ability, to be involved in the day to day running of the home. This creates an inclusive atmosphere based on mutual respect for each other. Service users said they have support to clean their rooms and do their laundry. One person said he enjoys sweeping the patio and raking up leaves. Adisham House DS0000023267.V321436.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Service users personal care needs are met with service users supported to develop their skills. People have support to maintain good health and to take control of their medication. Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. EVIDENCE: Personal care needs are detailed in service user plans and goals plans. These are reviewed regularly and support people to develop and increase their independent skills. Care managers commented that staff respect service users privacy and dignity. Service users said they are happy with the toilets and bathrooms and that they have the support they need. Health needs are assessed and monitored with good records kept of appointments and any changes. The manager said he plans to introduce individual health action plans, which are person centred, and allow service users to take more control of their health. Adisham House DS0000023267.V321436.R01.S.doc Version 5.2 Page 15 One service user said they are having staff support to see a consultant and in the meantime have pain relieving medication. There is a private quiet room, which can be used for consultations. Aspects of medication practice were looked at. Some service users control their own medication following an assessment and told the inspector about this. A care manager commented this was a strength of the home in that they support people to take maximum control of their medication. There are good systems for checking in, administering and returning medication. Storage is adequate and safe and records were in order. Medication reviews were being carried out on the day of the site visit and people were seen individually to discuss and issues they have. Guidelines for medication used on a ‘when needed’ basis are in place and the manager said he plans to update the homely remedies protocol. Staff administer medication after they have attended training and shadowed more experienced staff. The manager said he assesses staff as competent and plans to develop a more formal competency assessment/appraisal. Adisham House DS0000023267.V321436.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Service users are encouraged to make their views known and are confident any complaint would be listened to and acted on. Service users are safeguarded from harm. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a complaints procedure, which is in written format. This is given to service users with the Statement of Purpose and service user guide. Regular meetings with key workers and group meetings ensure that service users have a forum to bring up concerns and complaints. This was evident in minutes taken. The long-standing staff team know service users well enabling an open and approachable environment. Service users said they knew who to talk to and that staff would do something about any issues they had. There have been no complaints since the last inspection. The home has an adult protection and whistle blowing policy. Staff attend adult protection training and complete units relating to adult protection when completing NVQ awards. The local authority guidance on protecting vulnerable adults has been obtained as required at the last inspection. Service users finances are safeguarded with service users having the support they need to manage their own money. Adisham House DS0000023267.V321436.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 The homely, relaxed environment, which is safe and well maintained, enhances service users lives. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A service user and the owner showed the inspector around the home. There is ample communal space consisting of two lounges, small private lounge, conservatory, kitchen and dining room. A large garden surrounds the home, which contains an orchard, vegetable plot and it is also home to some chickens. 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. Adisham House DS0000023267.V321436.R01.S.doc Version 5.2 Page 18 Service users all said they are happy with their rooms and commented about the ‘lovely garden’. Occupants of the two double rooms said they are happy to continue with this arrangement. Two care managers said a strength of the home was the homelike environment. There are no imposed restrictions and people that want them have front door and bedroom door keys. People said they are supported to keep their rooms clean and to do their laundry. Observations showed that everyone is included in the day-to-day running of the home. Adisham House DS0000023267.V321436.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Service users are supported by sufficient numbers of experienced, trained staff. Robust recruitment checks protect service users. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff demonstrated throughout the inspection that they were good at communicating effectively with the service users. During the inspection there were two staff on duty at all times with the manager and owner. 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. The majority of the staff team is long standing and experienced, some having known service users for over twenty years. A service user said ‘All the staff are very helpful’. Care managers felt staff have the right skills and are ‘willing to work with other agencies to provide a coordinated service’ Adisham House DS0000023267.V321436.R01.S.doc Version 5.2 Page 20 New staff complete an induction which currently consists of a checklist which is dated and signed. This was discussed with the manager as there is no evidence of how competency is assessed and what is covered in detail and how. The manager agreed to audit the induction against the National Minimum Standard requirements. Short courses are attended to meet mandatory requirements and service users needs. Some staff are trained nurses and one is training to be a nurse. Service users said there are always staff around when they need them. A staff file was sampled which showed that thorough recruitment checks are carried out before a person takes up a post at the home. A record of visits made to the home was seen and service users said they had met the staff before they started. Minutes from service user meetings showed that people have the opportunity to give their views about new staff. Adisham House DS0000023267.V321436.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Service users benefit from a consistently managed well run home. Service users know their views underpin the review and development of the service and that their health and safety is protected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The management has been consistent since the last inspection. The registered manager has the qualifications, experience and skills required to manage the home. The manager spoke with understanding and awareness of people’s needs and keeps up to date with good practice by attending short courses and by accessing the internet and publications. The management approach is open with staff, stakeholders and service users views sought about all aspects of the home. Quality surveys are sent out Adisham House DS0000023267.V321436.R01.S.doc Version 5.2 Page 22 yearly and action taken to address any issues. Currently the results are not published and the manager agreed to address this. Regular management meetings monitor aspects of the service including training, the environment etc. Outcomes from service users meetings are also discussed and addressed. The manager said he monitors staff performance through regular supervisions and feedback sessions. The pre inspection questionnaire showed that the required health and safety checks are carried out. The home is safe and well maintained. Accidents and incidents are recorded and reported appropriately The homes fire risk assessment has been reviewed following recent changes to legislation. Adisham House DS0000023267.V321436.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 3 X 3 X X 3 X Adisham House DS0000023267.V321436.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 YA35 Good Practice Recommendations The induction should be reviewed to ensure it meets the requirements of the minimum standard and staff get the underpinning knowledge they need. 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