Inspection on 24/06/05 for Adisham House

This inspection was carried out on 24th June 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 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 24/04/07

Adisham House 12/11/05

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 Pond Hill Adisham Canterbury Kent CT3 3LH Lead Inspector Nicki Dawson Announced 24/06/05 at 09:30hrs 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 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 Stationary 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 H56-H05 S23267 Adisham House V224257 240605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Adisham House Address Pond Hill, Adisham, Canterbury, Kent. CT3 3LH Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01304 840170 Mr Jamie Bishop Mrs Barbara McGuinness Registered Care Home 10 Category(ies) of Adults with a learning disability registration, with number of places Adisham House H56-H05 S23267 Adisham House V224257 240605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th September 2004 Brief Description of the Service: Adisham House provides care for 10 adults with a learning disability. It is situated in the rural village of Adisham, near Aylesham. The village amenities include two churches, a pub and village hall. There is a main line railway station and buses provide links to the surrounding villages. Residents need staff support to walk to the village, due to the heavy traffic which uses the road and because not all of the route is paved. Ample car parking space is provided at the front of the Home. The home is on three floors. There are six single and two double bedrooms. There is one toilet and shower on the ground floor, and a bathroom on the first and second floors. There is ample communal space consisting of a main lounge, small lounge and conservatory. The grounds, which surround the home consist of a large garden and orchard. Adisham House H56-H05 S23267 Adisham House V224257 240605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection commenced at 9.30am and concluded at 5.30pm. The inspector spoke at length with seven of the residents and introduced herself to the other three residents. She interviewed two support staff and met a senior member of staff. Time was spent in the office looking at records and speaking with the registered manager and registered provider. One of the residents showed the inspector around their home and the inspector shared a meal with five residents. Because this was an announced inspection, the inspector received information about the service before the inspection. Some of this information was sent from the manger of the home. Comment cards, where people answer a number of questions about their satisfaction with the service, were also received. All of the residents and eight relatives responded via these comment cards and were very positive about the level of care at Adisham House. 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 Adisham House H56-H05 S23267 Adisham House V224257 240605 Stage 4.doc Version 1.30 Page 6 contacting your local CSCI office. Adisham House H56-H05 S23267 Adisham House V224257 240605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Adisham House H56-H05 S23267 Adisham House V224257 240605 Stage 4.doc Version 1.30 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 standard(s) 3 Putting the needs and happiness of residents first is an important priority in this home. EVIDENCE: Staff said that the most important part of their job was to ensure that residents were happy. Staff listened to residents and waited for their response, thereby demonstrating that they have good communication skills. All staff have recently attended a training course on dementia to understand the specific needs of one of the residents. The registered provider has introduced the ‘Person- Centred Planning’ approach to writing residents individual plans of care. The focus is on what matters and is important to from their point of view. Person-centred planning is central to the current good practice being developed for people with a learning disability. Adisham House H56-H05 S23267 Adisham House V224257 240605 Stage 4.doc Version 1.30 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 standard(s) 6,7, 8 and 9 Residents’ individual plans are working documents and staff understand their content. Residents are encouraged to participate in all aspects of life in their home and to take responsibilities according to their assessed levels of need. Valuing residents’ choices is central to everyday life for the residents that live here. EVIDENCE: Each resident has an individual plan of care. They are presented in an easy to read format. First there is a summary of the resident’ social history and a pen portrait. The goal that each individual is working towards is presented next. This is followed by an assessment of daily living needs, with focus on the resident’s strengths and support needs. Staff demonstrated that they were aware of residents’ needs, goals and current risk assessments. Staff said that they regularly checked plans and risk assessments and made any changes as necessary. Staff also said that they discussed with residents the content of individual plans and any important entries in the daily log. Residents confirmed this and individual plans contained the signatures of staff and residents’. The choices and independence of residents ‘ is paramount and it happens (here)’, explained a member of staff. Staff described a situation where they would ascertain a resident’s choices. Residents proudly spoke of the residents Adisham House H56-H05 S23267 Adisham House V224257 240605 Stage 4.doc Version 1.30 Page 10 meetings that take place regularly in the home. The minutes are written by one of the residents. Residents are involved in the interview process of prospective employees, by giving prospective employees a tour around their home. Residents are encouraged to take responsibility for their own monies. The degree of responsibility depends on the assessed needs of the resident. Records are kept of transactions and signed by each resident. Adisham House H56-H05 S23267 Adisham House V224257 240605 Stage 4.doc Version 1.30 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 standard(s) 11, 12, 16 and 17 Residents’ responsibilities within the home are recognised and promoted. They are supported to develop life skills and benefit from the respect they gain from working in the community. Residents’ enjoy eating their meals in a homely environment. EVIDENCE: Residents are responsible for certain daily tasks in the home and a rota is displayed in the kitchen. Residents were helping with washing up on the day of the inspection. Residents are encouraged to undertake additional daily tasks according to their abilities. Promoting personal development such as learning the value of money and confidence building is integral to residents’ individual plans of care. Residents spoke proudly of the work responsibilities that they have at the day education centre and in the community. Staff and residents eat their meals together, which gives them the opportunity to chat informally about their day. Residents are involved in planning the menu and said that staff get to know their likes and dislikes. If they do not like what is offered on the menu, they are offered an alternative. The menu offers Adisham House H56-H05 S23267 Adisham House V224257 240605 Stage 4.doc Version 1.30 Page 12 residents a balanced diet and a relative observed that fresh fruit and vegetables are available daily. The menu for the evening meal is displayed in the kitchen. Adisham House H56-H05 S23267 Adisham House V224257 240605 Stage 4.doc Version 1.30 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 standard(s) 18, 19, 20 and 21 The health and personal care needs of residents are assessed and promoted. Systems are in place for the safe administration of medication. EVIDENCE: Privacy was respected when supporting the personal care needs of residents’ during the inspection. Personal support needs are detailed in each resident’s’ individual plan. The main health care needs of residents’ are clearly listed in their individual plan. Any appointments with healthcare professionals are clearly recorded, with any action to be taken. A named staff member is allocated to accompany the resident to health appointments. It was a very hot day during the inspection and residents were encouraged to increase their fluid intake accordingly. Staff that administer medication have been assessed as competence to do so by the registered provider and demonstrated their knowledge at the inspection. Medications are listed in each resident’s individual plan together with any side effects. The administration, storage and recording of medicines was observed and inspected as in accordance with the homes policies and procedures. Signed authorisation from the GP has been obtained for residents Adisham House H56-H05 S23267 Adisham House V224257 240605 Stage 4.doc Version 1.30 Page 14 who self-medicate. They keep their medication safe in a locked facility in their room. Staff check regularly to ensure that these residents have taken their medication. The registered manager and provider discussed the implications of caring for a resident who is ill. They explained that this involves extra staff support and training for the whole staff team. A relative described staff as ‘dedicated’ in their care of a resident who was in ill health. Adisham House H56-H05 S23267 Adisham House V224257 240605 Stage 4.doc Version 1.30 Page 15 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 standard(s) EVIDENCE: Adisham House H56-H05 S23267 Adisham House V224257 240605 Stage 4.doc Version 1.30 Page 16 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 standard(s) 24, 26, 27 and 28 Adisham House is a beautifully presented property that provides a safe and comfortable home for the residents that live there. EVIDENCE: Adisham House is ‘welcoming and well-kept’, commented one relative. The furnishings are to a good standard and there is a regular maintenance and renewal programme. Residents enthusiastically showed me around their home and were eager to point out all the new furniture they had brought for their rooms. Each bedroom is decorated to individual tastes and preferences. There are three communal rooms, consisting of a main lounge, small lounge and conservatory. There is a toilet and a shower or bath on each floor of the home. The conservatory overlooks a well presented garden, with a seated area, large lawn, and an orchard. It is also home to a number of chickens. Adisham House H56-H05 S23267 Adisham House V224257 240605 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35 and 36 Arrangements for the recruitment of staff are good with the residents’ needs central to the process. Staff are clear about their roles, have good understanding of residents support needs and feel well supported. EVIDENCE: The staff files examined revealed that in the recruitment process, application forms are completed, an informal interview is undertaken and the necessary pre-employment checks are carried out. Induction for new staff is completed in-house, and also to sector skills council standards. The registered provider stated that the home was committed to training staff to NVQ level 2. Currently 37 of staff have completed NVQ level 2 or above. Staff stated that the role they provide for the residents is clearly outlined in their job description. They demonstrated through discussion, that they knew when to involve a more experienced member of staff. Staff showed that they were motivated and enjoyed their job. One staff member explained that ‘if you cannot understand what a resident is saying, then you get them to show you’; highlighting that they have good communication skills. The staff team consists of the registered manager, two registered providers, three senior support staff, three support staff and one domestic staff. There is always a minimum of two staff on duty between the hours of 8am and 9pm Adisham House H56-H05 S23267 Adisham House V224257 240605 Stage 4.doc Version 1.30 Page 18 with one staff on sleeping in duty. Since the last inspection, two members of staff have left, one new staff has commenced and one staff member has returned; thus making a stable staff team. The registered provider stated that the home has a low staff sickness record. Formal staff meetings are not currently held, but the registered manager said that this was under review. Staff cited the fact all staff views are listened to that any changes to residents care are recorded, as effecting good communication in this home. A senior member of staff supervises all staff. Records show that this is a regular occurrence. Staff receive an annual appraisal. Adisham House H56-H05 S23267 Adisham House V224257 240605 Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 and 42 The management approach of the home promotes the well-being of the residents and staff. Systems are in place to ensure the health, safety and welfare of all residents. EVIDENCE: Staff and relatives were positive about the management processes within the home. Adisham House is ‘a home and not just a place to live’ said one staff member and another described it as having a ‘good aura’. When the registered manger spoke to one of the resident’s their face lit up with interest and enjoyment. An inspection of records revealed that maintenance of gas, electrical and fire fighting equipment had been undertaken. There is a staff training programme which details mandatory training that has been completed and that which is booked to be completed. Any accidents or incidents are appropriately recorded and staff demonstrated that they would take the appropriate action in the event of a fire or accident. A relative stated that residents at Adisham House are ‘relaxed…happy and safe’. Adisham House H56-H05 S23267 Adisham House V224257 240605 Stage 4.doc Version 1.30 Page 20 Adisham House H56-H05 S23267 Adisham House V224257 240605 Stage 4.doc Version 1.30 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 3 x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 3 3 x x Standard No 11 12 13 14 15 16 17 3 3 x x x 3 3 Standard No 31 32 33 34 35 36 Score 2 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Adisham House Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score x 3 x x x 3 x H56-H05 S23267 Adisham House V224257 240605 Stage 4.doc Version 1.30 Page 22 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 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. 2. 3. 4. Refer to Standard 20 34 42 42 Good Practice Recommendations A sample signature of all staff who administer medication to be recorded To record and retain notes written at employee interviews To keep an up to date list of the contents of the first aid box To obtain data information sheets for all substances that are hazardous to health Adisham House H56-H05 S23267 Adisham House V224257 240605 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 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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