Inspection on 31/08/05 for Anderida

This inspection was carried out on 31st August 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Anderida 04/09/07

Anderida 16/08/06

Anderida 18/01/06

Anderida 20/01/05

Anderida 01/06/04

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 Anderida Church Road Mersham Ashford, Kent TN25 6NT Lead Inspector Julian Graham Announced 31 August 2005 9:30 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. Anderida H56-H05 S23151 Anderida V240172 310805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Anderida Address Church Road, Mersham, Ashford, Kent, TN25 6NT 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 262524 Counticare Limited Sara Michelle Durban Care home only 3 Category(ies) of Learning Disability x 3 registration, with number of places Anderida H56-H05 S23151 Anderida V240172 310805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 20/01/05 Brief Description of the Service: Anderida is situated in the village of Mersham and provides 24 hour care for a maximum of three residents who have mild learning disabilities. The home is a spacious bungalow set in approximately a quarter acre of ground. They allow pets (within risk assessment framework and with the agreement of other residents). The aim of the service is to maximise independence of the residents, and staff are required to support by guidance rather than by direct care. There is a low staff ratio at the home due to the risk assessed level of independence that the residents have. This can be adjusted immediately if any resident requires additional support. Anderida H56-H05 S23151 Anderida V240172 310805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and took seven hours to complete. All three residents were at home during the course of the visit and took a full part in the inspection process. Two of the residents were spoken with individually, with one choosing to speak to the inspector in a group situation. Time was spent with the manager, and the deputy manager and a team leader were interviewed in private. A tour of the premises and grounds was undertaken which included being shown bedrooms by two of the residents. Lunch was shared with one of the residents. Some records were examined, including residents’ Life Plans, staff files and complaints records. The residents, manager and staff are thanked for their welcome and assistance during the inspection. What the service does well: The home is very good at realising its aim of supporting residents to become more independent. Residents said that staff know what is the right amount of help to offer, and when to let them do things entirely by themselves. One resident said that staff “help my life.” Residents are fully involved in the running of their own home, including planning and helping to prepare the meals, and taking care of routine household chores like cleaning and doing the laundry. Staff rotas are drafted with the residents, and based on how much staff input is needed to enable residents to carry out their preferred activities. Residents are given a lot of support from staff in the home and from external support services in developing intimate personal relationships with people of their choice. Good relationships have developed between staff and residents, and there is an open and inclusive atmosphere in the home. One resident said about staff “they’re the best”. Another said that staff “don’t leave me out”, and that “all staff look out for me.” Anderida H56-H05 S23151 Anderida V240172 310805 Stage 4.doc Version 1.40 Page 6 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. Anderida H56-H05 S23151 Anderida V240172 310805 Stage 4.doc Version 1.40 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 Anderida H56-H05 S23151 Anderida V240172 310805 Stage 4.doc Version 1.40 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) 1,2,5 There needs to be a Needs Assessment form which covers all the matters listed in the Standards, so that prospective residents’ aspirations and needs are properly assessed. EVIDENCE: There have been no recent admissions to the home, the last resident moving in over four years ago. The manager said that she and the company’s placement co-ordinator would undertake any future assessment should a vacancy in the home arise. For individuals who are self funding, there must be a Needs Assessment that covers matters listed in the Standard, and a form for the purpose is required. A Statement of Purpose and Service Users Guide are in place, and it is recommended that these are reviewed on an annual basis. As required from the previous inspection, there is now greater clarity in the statement of terms and conditions regarding residents contributing to staff entry fees to events in the community. Anderida H56-H05 S23151 Anderida V240172 310805 Stage 4.doc Version 1.40 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, There is an excellent care planning system in place which provides staff with the information they need to meet residents’ needs. Residents are supported to make decisions and are offered opportunities to participate in the life of the home. EVIDENCE: The Life Plan (care plan) folders of two of the residents were viewed and these contained a wide range of information, and give a very clear picture of the person and how they can best be supported. They include a very detailed strengths and needs section covering areas such as self care, communication, social skills and so on. Guidelines on managing behaviours and other issues were in place as appropriate, although these need to be dated and signed. Some of these are drawn up in consultation with the Community Learning Disability Team. There are also a number of risks that have been identified and assessed, and as with the Life Plans, these are subject to periodic review. Each resident has a goal or two which they are currently working on with staff support. As with some of the guidelines, these need to be dated and signed. Residents said that they are receiving a lot of support from staff to make decisions about their lives. One said, for example, that she chose the person she wanted to be her key worker. The manager said that the other two Anderida H56-H05 S23151 Anderida V240172 310805 Stage 4.doc Version 1.40 Page 10 residents made the decision not to have a key worker. A resident said that she decided at the present time to continue with assistance from staff in looking after her money, and that she is not quite ready to take on a more independent role in this activity. Residents were seen during the inspection taking part in routine household chores like washing up. They said that they agreed amongst themselves how they would like to share out tasks like hovering, clearing up and so on. Anderida H56-H05 S23151 Anderida V240172 310805 Stage 4.doc Version 1.40 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) 11,12,13,14,15,16,17 Personal development and leading active and fulfilling lives, including having appropriate personal relationships, are strongly promoted in the home. EVIDENCE: Residents were very clear in saying how helpful the staff are in the development of their independent living skills. Some of the residents are clearly aiming to move on at some stage to more independent living. Being able use public transport with confidence and taking their own medication safely are examples of skills that staff are supporting residents in developing further. All of the residents have a varied and fulfilling activity programme, including working at and attending the Martello Day Centre. One resident said she will be returning to her college course in the autumn. Another resident said she used to attend college but prefers not to return. Other activities include visits to a local nightclub, discos, pub and so on, some of which require assistance from staff. Anderida H56-H05 S23151 Anderida V240172 310805 Stage 4.doc Version 1.40 Page 12 A resident said how much support she has received with regards making contact with family, and it was clear that family and friends are made very welcome. Staff support and where appropriate specialist guidance, is provided to help the residents make appropriate decisions regarding developing and maintaining intimate personal relationships. A referral to the Community Learning Disability Team was seen in one folder in this regard. The house car used by staff to transport residents has “Counticare Ltd “ in large letters painted on it. One of the residents felt that this was stigmatising and said she did not like it. In line with the principles of social role valorisation, it is a recommendation of this report that this signage is removed. Anderida H56-H05 S23151 Anderida V240172 310805 Stage 4.doc Version 1.40 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 Staff have a very good understanding of residents’ support needs and residents’ healthcare is promoted. Medication is being managed safely. EVIDENCE: Residents confirmed that they are receiving the help they need to meet their individual aims in life. Health needs are monitored closely, and records were seen of all contacts with healthcare professionals. A lot of work is currently being undertaken to support a resident with her dietary needs with input from the community dietician. Arrangements for the control and administration of medication were examined and safe systems are in place. The manager said that all staff administering medication have received training and that their competence is assessed periodically. Records confirming this were not viewed on this occasion. One resident is self medicating and her skills in this area are developing step by step with close monitoring. Anderida H56-H05 S23151 Anderida V240172 310805 Stage 4.doc Version 1.40 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 Residents know their complaints will be listened to and acted upon. Residents are being protected from abuse, although the whistle blowing policy still requires amendment. EVIDENCE: Residents said that staff listen to what they have to say, and if they were to have any concerns or complaints, staff would take them seriously and take action to put things right. Residents said that they have had no reason to complain. The complaints procedure is displayed prominently in the home and as required from the last inspection has been updated to include the name and address of the commission. Complaints records must be made separately and kept on individual residents’ files, with a copy in a file or folder for the purpose for ease of reference and kept confidentially. The two staff who were interviewed privately demonstrated good understanding of how residents in care homes could be abused, and of the action to take in the event of any allegation or suspicion of abuse. The company’s policy on whistle blowing has still to be amended to reflect the DOH paper “No Secrets”. Anderida H56-H05 S23151 Anderida V240172 310805 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,30, The standard of the environment is good within the home providing residents with an attractive, comfortable and homely place to live. EVIDENCE: A tour of the premises revealed good standards of hygiene and cleanliness and the home was free from offensive odours. The home is domestic is style and size and has sufficient space for the three residents living there. Two bedrooms were viewed and these were spacious, comfortable, and individually personalised. The conservatory/smoking room has been redecorated and furbished as required from the last inspection and is suitable for the purpose. The Environmental Health Dept required a sink to be fitted in the kitchen some time ago, and this remains outstanding. The manager understands that this will be actioned during the course of the refurbishment of the kitchen which is due shortly. Anderida H56-H05 S23151 Anderida V240172 310805 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33,3435,36 Staff have a good understanding of residents’ support needs and of their own role. Staff are well trained and feel valued and supported. Recruitment practice is sound. EVIDENCE: The deputy manager and team leader were interviewed in private, and demonstrated a very positive approach and attitude to their work, and were clear as to their role and responsibilities. They had a very good understanding of the principles of care underpinning their work, and they evidently enjoy working in the home and feel motivated and enthusiastic. Owing to the low dependency needs of the residents, there is a small staffing complement, but which is sufficient to meet residents’ needs. When extra support is needed for a specific activity, additional hours are provided by the existing staff team. The files of the two most recently appointed staff were viewed, which revealed sound recruitment practice that protects the residents. The requirements of Schedule 2 of the Regulations are being complied with, which includes two written references and satisfactory CRB and POVA checks. Training records are being maintained, and courses attended include First Aid, adult abuse and epilepsy. A training matrix enables the manager to identify when staff need to attend specific courses including refresher training in safe Anderida H56-H05 S23151 Anderida V240172 310805 Stage 4.doc Version 1.40 Page 17 working practice. New staff now receive a two day TOPSS induction in addition to the in house induction programme. Formal one to one supervision is being provided but not in a consistent way. The manager is aware of this shortfall. Staff interviewed nonetheless feel supported in their work, and consult regularly with the manager on an informal basis. Anderida H56-H05 S23151 Anderida V240172 310805 Stage 4.doc Version 1.40 Page 18 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) 37,38,39,40,41,42 Residents are benefiting from a well run home. Regulation 26 visits are not however being undertaken to a satisfactory standard. EVIDENCE: A friendly and welcoming atmosphere was noted in the home, and the manager’s open, positive and inclusive approach is one to which both residents and staff are responding well. Residents spoke well of the manager and the staff team, and it was evident that a clear sense of direction is being communicated. Feedback is actively sought from the residents in the form of three monthly meetings, the minutes of which were seen. These meetings are mainly concerned with issues relating to the house. One resident said she finds the meetings useful. Residents also meet individually with a staff member of their choice every other month to discuss how things are going for them generally, and whether anything needs to change. Staff meetings are held on a three Anderida H56-H05 S23151 Anderida V240172 310805 Stage 4.doc Version 1.40 Page 19 monthly basis and the minutes of last meeting revealed a wide ranging agenda. The last three Regulation 26 reports received by the commission are dated February, April and June 2005. This is unsatisfactory. The Regulation states that there must be visits made to the home by the registered person on a monthly basis and that reports of the visits are sent to the commission. It is also of concern that residents and staff were not interviewed on any of these visits. As recommended at the last inspection, policies and procedures are being reviewed and signed by the manager. Records seen were in good order generally and no obvious health and safety hazards were noted. Anderida H56-H05 S23151 Anderida V240172 310805 Stage 4.doc Version 1.40 Page 20 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 3 2 x x 3 Standard No 22 23 ENVIRONMENT Score 2 3 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 3 3 3 3 x 2 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 3 x 3 3 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Anderida Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 x H56-H05 S23151 Anderida V240172 310805 Stage 4.doc Version 1.40 Page 21 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. Standard 2 22 23 Regulation 14 22 13 Requirement Needs Assessment pro-forma to be available. Complaints recordings to be made separately. Whistle blowing policy to reflect DOH paper No Secrets and give information in respect of whistle blowing outside the organisation. (Timescale of 31/03/05 not met). Wash hand basin to be fitted in the kitchen, as required by Environmental Health Officer. (Timescale of 31/03/05 not met.) staff to receive regular formal supervision. Unannounced Regulation 26 visits to be undertaken in accordance with regulation, and reports of visits sent to the commission each month. Visits to include discussion with residents and staff. Timescale for action 01/10/05 31/08/05 31/09/05 4. 30 13 31/09/05 5. 6. 36 39 18 26 31/09/05 31/08/05 Anderida H56-H05 S23151 Anderida V240172 310805 Stage 4.doc Version 1.40 Page 22 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. Refer to Standard 1 7 13 Good Practice Recommendations The Statement of Purpose to be reviewed on an annual basis. Guidelines and residents goals to be signed and dated. Counticare Ltd signage to be removed from house car. Anderida H56-H05 S23151 Anderida V240172 310805 Stage 4.doc Version 1.40 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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