Inspection on 04/09/07 for Anderida

This inspection was carried out on 4th September 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Anderida 16/08/06

Anderida 18/01/06

Anderida 31/08/05

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 Mrs Sue Gaskell Key Unannounced Inspection 4th September 2007 9:30 Anderida DS0000023151.V348411.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 Anderida DS0000023151.V348411.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. Anderida DS0000023151.V348411.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Anderida Address Church Road Mersham Ashford Kent TN25 6NT 01233 501581 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) anderida@counticare.co.uk Counticare Ltd Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Anderida DS0000023151.V348411.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th August 2006 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 bungalow set in approximately a quarter acre of ground. The home only has one WC and one bathroom for all of the residents and staff using the building and these are not accessible for people with mobility or sensory impairments. It also lacks separate laundry facilities and the washing machine is sited in the home’s kitchen. Therefore the home is unsuited to people who require a different type or level of care. 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. Fees range between £959.35 and £1503.88 per week with additional charges for magazines, papers, hairdresser, clothing and toiletries. Anderida DS0000023151.V348411.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 4th September 2007 between 9.30 and 13.00. There were 2 people living at the home and there is one vacancy. I spoke to the two residents and to the manager. The manager is in the process of applying for registration. I toured the building and looked at all communal areas. The two residents showed me their bedrooms. The inspection process also consisted of information collected before and during the visit to the home, and feedback from the care managers after the site visit finished. Other information seen included pre-admission assessments, various risk assessments, care plans, medication records, the duty rota and staff recruitment and training records. There were no outstanding requirements from the previous inspection and no requirements made following this inspection. Some recommendations have been made to improve basic facilities in the building and these should be considered prior to moving in any new clients. Anderida DS0000023151.V348411.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Provide residents with information in a pictorial format or one more easily understandable to them. Provide more toilet and bathing facilities. Provide a separate laundry. Provide a separate office facility which does not use the residents’ living space. Provide a separate sleeping in room which does not use the residents’ living space. Anderida DS0000023151.V348411.R01.S.doc Version 5.2 Page 7 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. Anderida DS0000023151.V348411.R01.S.doc Version 5.2 Page 8 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 Anderida DS0000023151.V348411.R01.S.doc Version 5.2 Page 9 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): 1&2 People who use the service experience good outcomes in this area. The statement of purpose, service user guide and individual statement of terms and conditions, clearly says what service will be offered. Prospective residents can be confident that their needs will be assessed and can be met This judgement has been made using available evidence including a visit to this service. Anderida DS0000023151.V348411.R01.S.doc Version 5.2 Page 10 EVIDENCE: The statement of purpose and contracts have been reviewed regularly to include details of the services used by the residents. All residents are issued with a service user guide. Residents have been issued with individual agreements stating their terms and conditions of residence but they require updating to ensure that all information is current. None of this information is currently provided in a pictorial format or any other format which residents might find easier to understand. There have been no new residents admitted to the home since the last inspection visit but there is an admissions procedure. The manager said that a comprehensive pre-admission assessment would be carried out on any prospective residents and that they would be introduced to the home on a gradual basis. Anderida DS0000023151.V348411.R01.S.doc Version 5.2 Page 11 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 People who use the service experience excellent outcomes in this area. The care plans are easy to use and descriptive. Residents’ choices are respected and their decision-making is well supported. Residents are supported in taking risks in the daily and social activities that form part of an independent lifestyle. This judgement has been made using available evidence including a visit to this service. Anderida DS0000023151.V348411.R01.S.doc Version 5.2 Page 12 EVIDENCE: The two residents who live in the home showed me their rooms and said that they like them. They were both seen to be relaxed and comfortable interacting with the manager. Both residents have a care plan and these care plans were examined in detail. The files have been improved since the last inspection and include person centred profiles, assessments, likes and dislikes, and guidelines on how the home will assist both residents in achieving their short and longer term goals. Both residents have a key worker who monitors their individual needs and activities and help them understand, and contribute as much as possible to, the contents of their care plan. The manager said that the residents contribute as much as possible to their care plans. There is evidence of this in the files where residents have signed their care plans or individual agreements. Comprehensive risk assessments have been prepared for each resident’s needs or activities, and include specific guidelines on how to minimise any risk. The records showed that staff sign to acknowledge having read these guidelines. The manager said that although there is only generally one member of staff on a shift, extra staffing is provided whenever it is necessary. The care plans, daily records and risk assessments indicate that this is appropriate to the current residents’ needs. Issues relating to confidentiality are addressed during the induction period. Confidential records are stored in a lockable store room. The lack of office space in the home means that some files have to be left out and staff have to be aware that they should not leave out any files containing confidential or personal information. Anderida DS0000023151.V348411.R01.S.doc Version 5.2 Page 13 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 People who use the service experience excellent outcomes in this area. Daily life meets the residents’ lifestyle preferences and expectations. Residents have regular contact with their families and friends. Residents receive a nourishing and balanced diet. This judgement has been made using available evidence including a visit to this service. Anderida DS0000023151.V348411.R01.S.doc Version 5.2 Page 14 EVIDENCE: The two residents enjoy a wide range of social activities and attend the Martello day centre three days per week where they do art projects, numeracy and literacy. One resident does paid work at the centre one day per week and both residents attend a local college. The care plans contain a list of residents’ needs, likes and dislikes and preferences. Leisure and social activities or holidays are generally carried out on an individual basis. There is evidence in the residents’ daily records to show that families, and other visitors are encouraged and welcomed. Residents have individual bank accounts which are regularly audited, with appropriate receipts and records kept. Staff signatures are required for monies taken out when residents spend money on social activities such as going to the pub. Although the residents do not currently have independent financial appointees, this matter is being addressed. Residents choose their own menus, shop for produce and cook meals for each other. The manager said that meals provided are mainly based on residents’ choices, but staff also take into account the need for a reasonably balanced diet. The store cupboard contained a wide range of good quality food including fresh fruit and vegetables. Nutritional assessments are carried out and residents are assisted with any dietary needs. Neither of the current residents has particular ethnic, religious or cultural needs. Residents’ wishes over their personal relationships are respected and they are supported by staff. There are appropriate guidelines in place which have been prepared and agreed to by the residents and their care managers. The manager showed a good awareness of equality and diversity issues. Anderida DS0000023151.V348411.R01.S.doc Version 5.2 Page 15 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 People who use the service experience excellent outcomes in this area. Residents’ choices over their care are respected. Residents’ care plans are reviewed and their health care needs are met. Residents are protected by the home’s policies and procedures for dealing with their medication. This judgement has been made using available evidence including a visit to this service. Anderida DS0000023151.V348411.R01.S.doc Version 5.2 Page 16 EVIDENCE: Both residents said that they are looked after very well and that the staff are always there for them. Residents care plans and daily records refer to clear guidelines on providing support and monitoring health care and social care needs. There is regular input from a variety of healthcare professionals and residents regularly attend for dental, opticians and well woman checks. There is evidence to show that residents are also referred for specialist help if they have other health care needs such as diabetes. The home keeps good records of GP’s and district nurses’ visits etc, together with any subsequent advice. The manager showed a high level of awareness of residents’ needs and referred to a variety of issues, such as the importance of ensuring that residents’ needs are treated with sensitivity and that the care is consistent. Two care managers said that they are satisfied with the care provided and that the home has managed residents’ needs appropriately. The home has sound medication procedures. The manager confirmed that only trained staff may administer medication and that all staff are required to read the procedures stored in the medication file. The home has a risk assessment procedure for assessing whether residents are able to store and/or administer their own medication and this is currently being reviewed for one resident. Medication is stored securely and appropriately. The medication records are clear and current and there is a system for the receipt and disposal of medication. Anderida DS0000023151.V348411.R01.S.doc Version 5.2 Page 17 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 People who use the service experience excellent outcomes in this area. Residents can be confident their complaints will be listened to and dealt with appropriately and that they will be protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The two residents said that they would tell staff if they are not happy with something and said that they knew that they could go to any staff at any time. Although the home uses complaints forms, these have not yet been produced in a pictorial format or any other format which may be more understandable for the residents. Anderida DS0000023151.V348411.R01.S.doc Version 5.2 Page 18 The home has appropriate procedures in place and staff confirmed that they have received training on safeguarding adults. The training records show that staff have received training in when and how to intervene appropriately in order to safeguard and assist residents. Further training is planned. The staff induction process includes information for staff on policies and procedures concerning appropriate behaviour when assisting with personal care, the use of appropriate intervention techniques, and “whistle blowing”. Anderida DS0000023151.V348411.R01.S.doc Version 5.2 Page 19 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, 27, 28 & 30 People who use the service experience good outcomes in this area. Whilst the home lacks some facilities, residents live in a homely and comfortable environment. The home is clean and adequately maintained. This judgement has been made using available evidence including a visit to this service. Anderida DS0000023151.V348411.R01.S.doc Version 5.2 Page 20 EVIDENCE: Residents have single rooms where they can display their own effects such as pictures and ornaments, and have their own TV, DVD player etc. Both residents showed me their bedrooms and said that they like the colours and furnishings. All bedrooms and living areas are furnished and decorated to a reasonable standard but some areas and items of furniture, eg the sofas, some walls and the windows, require attention or replacement. Although the lounge provides a comfortable environment., it is also used for the storage of a folding bed and for a desk and large filing cabinets containing office equipment, files and documents. There are no separate bedroom or other facilities for staff who are on sleeping in duty. There are no facilities for quiet time or meetings with care managers etc as there is no quiet room or office and the dining table is in the kitchen. All main rooms are wheelchair accessible but there is only one WC and one bathroom in the home to meet the needs of three residents and whatever staff are on duty. Both of these rooms have very limited access and are not suitable for people with impaired mobility. Also although there are disposable hand drying towels and a soap dispenser in the bathroom, there is no hand basin in the WC. There is a well-maintained garden and with garden furniture which is used by the residents. The home has no separate laundry room and the washing machine and tumbler drier are stored in the kitchen. The manager said that there is a procedure for bringing laundry into the kitchen but soiled laundry still has to be carried through what is a food preparation and dining area. Maintenance certificates are current and there are no outstanding health and safety requirements. Anderida DS0000023151.V348411.R01.S.doc Version 5.2 Page 21 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 & 36 People who use the service experience excellent outcomes in this area. Staffing, in terms of both numbers and competency, is appropriate to the current needs of the residents. Residents are protected by the Home’s sound recruitment procedures. Staff are well trained and supported and morale is high This judgement has been made using available evidence including a visit to this service. Anderida DS0000023151.V348411.R01.S.doc Version 5.2 Page 22 EVIDENCE: The manager said that the current staffing arrangement is sufficient to ensure that residents are safe and can participate in their chosen activities. Night staffing also appears appropriate and there are emergency on call systems. The staff files include CRB checks on all staff, references and evidence of verbal references. The files also include evidence of induction training, further training and regular recorded supervision. The records show that there is a good level of training and since the last inspection staff have completed NVQ training, and training in empowerment, diabetes awareness, mental health awareness, first aid, epilepsy, safe handling, risk assessments, diet and nutrition, supervision, fire safety and the administering of medication for epilepsy. Further training is planned for the coming months. The staff group has remained stable in the past twelve months and the manager said that residents have benefited from this, eg in providing a stable and consistent environment. Anderida DS0000023151.V348411.R01.S.doc Version 5.2 Page 23 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 People who use the service experience excellent outcomes in this area. The home is well run in a manner that encourages the development of clients. There are regular quality assurance and safety checks to ensure that the home is run in the best interests of the clients and their safety and welfare is protected and promoted. All areas are clean, and well maintained This judgement has been made using available evidence including a visit to this service. Anderida DS0000023151.V348411.R01.S.doc Version 5.2 Page 24 EVIDENCE: The manager has extensive experience and recognised care and management qualifications. The manager works shifts in the home and there is no specific time allocated within her rota for management or administration tasks. However, the management of the home and completion of records are generally of a good standard with daily records regularly checked by the registered manager. The residents said that they are regularly asked for their views and feelings about activities, meals and how things are done. This is either through group meetings or through the individual talk time for residents. The manager said that any suggestions or feedback from residents, staff, care managers or anyone else involved in the care of the residents is taken seriously and acted upon. There are regular checks by the owning company’s area manager as part of the monthly regulation 26 reports. Other quality assurance methods include regular audits and an annual business plan. The manager praised the staff team. There were no obvious hazards around the home and there was evidence to show that health and safety issues are taken seriously eg staff ensuring that personal items were appropriately disposed of and warning signs in place for wet floors. Risk assessments on the environment, and for activities off site involving residents, have also been prepared. The maintenance file contains current certificates to show that regular checks on the gas and electricity supply and appliances are carried out. A new fire alarm panel has been installed since the last inspection. Anderida DS0000023151.V348411.R01.S.doc Version 5.2 Page 25 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 3 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 4 23 4 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 2 28 2 29 X 30 2 STAFFING Standard No Score 31 X 32 4 33 X 34 4 35 4 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 2 LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 X 4 X 4 X X 4 X Anderida DS0000023151.V348411.R01.S.doc Version 5.2 Page 26 no 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. 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 5 Refer to Standard YA1 YA27 YA28 YA28 YA30 Good Practice Recommendations Provide residents with information in a pictorial format or one more easily understandable to them. Provide more toilet and bathing facilities. Provide a separate office facility which does not use the residents’ living space. Provide a separate sleeping in room which does not use the residents’ living space. Provide a separate laundry. Anderida DS0000023151.V348411.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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. Extracts may not be used or reproduced without the express permission of CSCI Anderida DS0000023151.V348411.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!