CARE HOME ADULTS 18-65
Amber House 33 Shorncliffe Road Folkestone Kent CT19 5LG Lead Inspector
Lois Tozer Unannounced 26 April 2005 15:40 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. Amber House H56-H05 S59808 Amber House V223448 260405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Amber House Address 33 Shorncliffe Road, Folkestone, Kent CT19 5LG 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) 01303 254459 Mrs Maryanne Swaffer CRH 2 Category(ies) of Care Home for Younger Adults 18-65 - Learning registration, with number disability (2) of places Amber House H56-H05 S59808 Amber House V223448 260405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 8th March 2005 Brief Description of the Service: Amber House was first registered on 26th July 2004 to provide accommodation and personal care for a maximum of 2 service users between the ages of 18 to 65 who have learning disabilities. The building is suitable to those who are physically mobile within the home envirnonment. Situated on the Shorncliffe Road area of Folkestone, it is ideally placed for access to public transport, with rail and bus stations being approximately 10 minutes walk away. The local Adult Education Centre and South Kent College are a very short distance and the main shopping centre of Folkestone is around 15 minutes walk. Pleasant gardens and walks overlooking the sea are within easy reach. Accommodation is provided on the ground and first floor. There are two communal toilets, one communal bathroom and one, currently unregistered, bedroom has a full en-suite with shower facility. Communal space comprises of a large lounge / diner and domestic kitchen. There is an office space with laundry facilities to the side of the premises. A reasonably sized, secure rear garden with patio is accessible for all service users. The home has access to a 7 seater vehicle. The registered manager currently lives within the premises and aims to eventually register the en-suite bedroom and move out. Amber House H56-H05 S59808 Amber House V223448 260405 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place between 3.40pm and 5.50pm on 26th April 2005. The home is currently registered to provide personal care and support to 2 people. One resident was in and was being supported by the manager and a staff member; the other resident was on holiday. The resident at home was happy to receive visitors and was just about to go out for a walk with staff (as planned day activities had needed to be cancelled). The inspector joined in the activity and was able to chat freely with the resident and staff throughout. After the outing, the resident made refreshments and continued with activities within the home whilst helping the inspection process take place by indicating answers to questions. The atmosphere in the home was relaxed and positive with lots of interactions taking place between staff and resident. The resident expressed happiness living at the home and said that it was nice to have seen a close relative earlier that day. Activities seen were trip out, snack and drink making, hair care, communication and the start of model making. What the service does well: What has improved since the last inspection?
The development of a simpler, more meaningful care plan is taking place, this will help any new staff to carry on supporting residents in the way they prefer. Records of money spent by residents in advance of receiving personal allowance have improved; the manager now documents personal expenditure and retains the receipts. Recruitment procedures have been revised and the manager is now clear on what level of information is needed before a new staff member is able to start work. The record of food consumed by residents has also improved to take into account the frequent meals out, as has the storage of medicine. The procedure for assessing and accepting potential residents for a trial stay at the home has been reviewed to account for the current residents personal wishes and feelings.
Amber House H56-H05 S59808 Amber House V223448 260405 Stage 4.doc Version 1.30 Page 6 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. Amber House H56-H05 S59808 Amber House V223448 260405 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 Amber House H56-H05 S59808 Amber House V223448 260405 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 The residents living at the home are having their needs met. EVIDENCE: Residents are very happy and stimulated living at the home, one resident said it was really good fun and the staff were nice. The manager has worked with social services and an independent advocate has assisted to ascertain the placement suitability, with a positive outcome. Amber House H56-H05 S59808 Amber House V223448 260405 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, 9, 10 Residents are supported to understand and take decisions and are actively encouraged to participate in many aspects of home life within a risk-assessed framework. Information is stored in a safe and secure manner. EVIDENCE: Care plans are being reviewed as required at the previous inspection, and are being simplified and made more ‘user friendly’. Residents were happy to voice their opinions and take decisions within the home; which were supported by staff. Participation in day-to-day activities is encouraged, and staff also encourage tasks to be completed with gentle, effective and persuasive communication. Participation in chores was rewarded by preferred activities. Staff keep risks to health and safety in mind, observing residents from a distance to enable independence but to be available to offer assistance. Records are kept stored in the ‘staff’ area of the home, keeping the home itself free from un-homely looking documents. Amber House H56-H05 S59808 Amber House V223448 260405 Stage 4.doc Version 1.30 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 standard(s) 11, 12, 13, 14, 15, 16, 17 Residents are supported to develop their skills in communication and independence. Age and culturally appropriate activities are offered, accepted and enjoyed. Support to access the local community is good. There are lots of leisure opportunities that have been chosen by residents. Personal relationships are supported with advocacy assistance as required. Residents are encouraged to take an active role in acknowledging their responsibilities. The ranges of foodstuffs offer residents a healthy diet. EVIDENCE: Support was provided to a resident in a positive manner that stretched communication skills and encouraged greater independence. Examples of this were the decisions taken by the resident where to go for the afternoon outing, what to wear, negotiation as the best coat for the weather. During the activity, conversation took place about the past, present and the future, with lots of reference to using memory with cues and praise. Upon returning home, the resident was encouraged to make hot drinks with minimum staff support, verbal prompts and praise. Requests to engage in favourite activities were supported and less favoured chores were included (such as tidying up items back to bedrooms) in such a way that a favoured activity followed. Advocacy
Amber House H56-H05 S59808 Amber House V223448 260405 Stage 4.doc Version 1.30 Page 11 has been introduced to aid communication of long-term wishes. A resident said that they liked to do the cooking (and had their own set of overalls); records of food eaten showed a varied and nutritious diet. Amber House H56-H05 S59808 Amber House V223448 260405 Stage 4.doc Version 1.30 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 standard(s) 18, 19 Residents benefit from continuity of support for personal care. Healthcare needs are well supported, assessed and monitored. EVIDENCE: With such a small group of staff supporting residents with personal care, a high degree of continuity is assured. Reviews of the personal support needs were reported to be close to completion, this should enable future staff to provide the same level of support currently enjoyed. A resident was observed being gently reminded to remember personal hygiene in a discreet and sensitive way. Next of Kin or family members the residents wish information to be passed to are kept informed of any changes to healthcare. Medical advice is sought without delay for any issues of concern. Amber House H56-H05 S59808 Amber House V223448 260405 Stage 4.doc Version 1.30 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 standard(s) 22 There is an open complaints process within the home. EVIDENCE: Complaints received by the home have been handled appropriately, where this involved reporting to the Commission or Social Services this has taken place. The manager has supported residents to meet with advocates to ascertain their own views into life at the home. Amber House H56-H05 S59808 Amber House V223448 260405 Stage 4.doc Version 1.30 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 standard(s) 24, 25, 26, 27, 28, 29. The home is comfortable, homely and safe, providing bedrooms that are suitable for each individual. Toilets and bathing facilities are suitable. There is one communal room and a large garden with patio. Adaptations to enable access to the first floor are in place. EVIDENCE: Residents have chosen their own furniture and had input in decoration. A resident said that they really liked the house and could get up and down the stairs easily. The premises are well maintained, furnished to a high standard and is comfortable. Requirements to fit a radiator guard in one bedroom has been met, work is underway to fit over-riding locks on bedroom and bathroom / toilet doors. There is an attractive, secure rear garden with patio and picnic furniture. There is a problem with a neighbours plumbing, resulting in the lawn requiring re-landscaping that is currently preventing use of part of the garden; the manager is negotiating a date for resolution. There is a stair lift in place to enable a resident to reach the bathing facilities on the first floor and there is also a ground floor toilet in easy reach. Amber House H56-H05 S59808 Amber House V223448 260405 Stage 4.doc Version 1.30 Page 15 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) 34 The recruitment practices in the home are improving. EVIDENCE: Records were not checked, but the manager said that both staff members criminal records bureau disclosure (CRB) checks had now been submitted. Potential staff have also had their CRB checks sent off in advance of employment. Records needed to be held regarding staff previous employment history and training certificates were said to now be in place. Amber House H56-H05 S59808 Amber House V223448 260405 Stage 4.doc Version 1.30 Page 16 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) 42 The home is safe and residents are protected by checks carried out, but one requirement remains outstanding from the previous inspection. EVIDENCE: The manager said that COSHH (care of substance hazardous to health) data was now in place and that weekly documented checks are taken to monitor the hot water delivery temperature of the bath. An electrician has checked all portable appliances, a copy of the certificate was sent to the Commission. The electrical wiring certificate needs to be obtained by the manager and be copied to the inspector to demonstrate this safety check has taken place. Amber House H56-H05 S59808 Amber House V223448 260405 Stage 4.doc Version 1.30 Page 17 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 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 2 3 3 3 3
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 2 2 3 3 x Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x x 2 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Amber House Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x H56-H05 S59808 Amber House V223448 260405 Stage 4.doc Version 1.30 Page 18 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. Standard YA19 Regulation 12 (1, a & b) 13 (1,b) 12 (4, a) 12 (4,a) 18 13 (4,c) Requirement In consultation with care management / community learning disability team, support service user to overcome healthcare fears. Fit locks that can be over-ridden to service user bedroom doors that they are able to operate. Fit locks that can be over-ridden to communal toilet & bathroom doors. Develop induction training to meet the National Minimum Standards (35.8) Submit copy of Electrical Wiring Certificate Timescale for action 01/06/05 2. 3. 4. 5. YA26 YA27 YA35 YA42 YA42 01/03/06 01/09/05 01/10/05 01/05/05 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 Good Practice Recommendations Amber House H56-H05 S59808 Amber House V223448 260405 Stage 4.doc Version 1.30 Page 19 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
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