Inspection on 12/09/05 for Arthur Court Residential Care Home

This inspection was carried out on 12th September 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

Arthur Court Residential Care... 23/01/07

Arthur Court Residential Care... 24/01/06

Arthur Court Residential Care... 21/12/04

Arthur Court Residential Care... 27/09/04

Arthur Court Residential Care... 10/02/04

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1 Marten Road

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Three Gables

Aldwick House

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The Springs Community

Crossways Community

Belle Vue Country House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Arthur Court 22/24 Christchurch Road Folkestone Kent CT20 2SL Lead Inspector Joseph Harris Unannounced 12/09/05 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. Arthur Court H56-H05 S23340 Arthur Court V244991 120905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Arthur Court Address 22/24 Christchurch Road, Folkestone, Kent CT20 2SL 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 254906 ACL Care Homes Limited Ms Pauline Joy Walledge Registered Care Home 20 Category(ies) of Mental Disability registration, with number of places Arthur Court H56-H05 S23340 Arthur Court V244991 120905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21/12/04 Brief Description of the Service: Arthur Court is a 20 bedded home set in a quiet residential road of Folkestone. The service provides support for people suffering with a range of mental health issues, with a focus on people with a history of forensic psychiatric needs. The home aims to work positively with service users facilitating greater independence and empowerment. The home is about ½ mile from the centre of Folkestone and a good range of facilities. The building is arranged over four floors and continues to undergo redevelopment and modernisation on an on going basis. There is a good range of communal spaces including two lounges and an internet café. There is a compact, yet attractive and functional garden to the rear of the home. The service is run by ACL care homes, with the sister home located on the opposite side of the road. The organisation has developed a website and online learning tools accessible to all. Arthur Court H56-H05 S23340 Arthur Court V244991 120905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection conducted on the 12th September 2005 that lasted for around 3.5 hours. During the course of the visit discussions were held with staff and service users and a tour of parts of the building was also undertaken. A range of documentation was viewed including service user plans, medication records and health and safety records. No requirements or recommendations have been made as a result of this inspection. What the service does well: What has improved since the last inspection? The directors continue to focus on the ongoing development of the service and have made additional improvements to the general environment including areas of redecoration and refurbishment. The registered manager and staff team have concentrated on improving the detail contained in service user plans, which now provide a good level of information to ensure that the staff can provide clear and consistent support. Improvements have also been made to the quality monitoring systems in the home, with the directors completing monthly monitoring reports, copies of which are sent to CSCI. Arthur Court H56-H05 S23340 Arthur Court V244991 120905 Stage 4.doc Version 1.40 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. Arthur Court H56-H05 S23340 Arthur Court V244991 120905 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 Arthur Court H56-H05 S23340 Arthur Court V244991 120905 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) 2, 3, 4 and 5. The needs and aspirations of prospective service users are assessed and they are aware that the home will be able to meet those needs. There are ample opportunities to visit the home prior to choosing whether to move in. All service users receive a statement of terms and conditions of residency. EVIDENCE: The home has developed strong assessment processes and links with the local community mental health services. A comprehensive assessment is carried out prior to the admission of any service user and background information is gathered from care managers and other significant professionals including Care Programme Approach documentation, assessments, history and risk factors. The home also employs a system of detailed, holistic assessment that is completed and updated over a period of time prior to admission. Any restrictions on choices and freedom are clearly documented and discussed with the individual and a plan of care is developed prior to admission. The home has clear criteria for admission to the service and can demonstrate an ability to meet the needs of service users. General healthcare and mental health professionals have good links with the service providing support and input as required. The needs of minority groups are catered for and the staff team are experienced and trained to a good standard in order to deliver appropriate care. Information about advocacy services are made available and service users are supported should this need arise. Arthur Court H56-H05 S23340 Arthur Court V244991 120905 Stage 4.doc Version 1.40 Page 9 An inclusive and individualised programme of trial visits and orientation to the service has been developed. The home ensures that prospective residents are introduced to key staff prior to visiting the home and, in close liaison with care managers, a series of visits are arranged ranging from short initial visits to overnight and longer stays based on needs and wishes. The home avoids emergency admissions wherever possible. Following admission there is an initial settling in period followed by multi-disciplinary reviews involving the service user. All service users are provided with a clear statement of terms and conditions of residency covering all key aspects of the home. Arthur Court H56-H05 S23340 Arthur Court V244991 120905 Stage 4.doc Version 1.40 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9. Adequate service user plans are developed for all residents. Service users are enabled to make decisions affecting their day-to-day lives. The home has a robust risk management process. EVIDENCE: The home develops a service user plan for all residents, which set out in adequate detail the needs, aspirations and goals for each individual. The registered manager and staff team have made improvements to the care planning methods addressing all needs in good detail using summaries and more detailed plans. Current issues are highlighted with specific action plans generated. The plans are kept under constant review and are discussed with service users. The ethos of the home is to promote the independence and empowerment of the service users enabling choices and self-determination with guidance and support. Many of the service users are actively working towards an independent lifestyle and the staff work proactively with each individual to assist them in achieving their goals. Where restrictions are required they are clearly identified and documented following consultation with the multidisciplinary team and service user. Residents are supported to manage their Arthur Court H56-H05 S23340 Arthur Court V244991 120905 Stage 4.doc Version 1.40 Page 11 own finances where possible and the home does not take an appointee role in any cases. The home has a good process of risk assessment and management developing clear and consistent risk assessments providing good guidance to minimise perceived risks. It was noted in one case that a risk had been highlighted, but a detailed plan had not yet been developed, this was addressed with the deputy manager and was an isolated case. The home has a missing persons procedure. Arthur Court H56-H05 S23340 Arthur Court V244991 120905 Stage 4.doc Version 1.40 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12 and 17. Service users have opportunities for personal development and take part in appropriate activities. There is a healthy, and balanced diet provided. EVIDENCE: The staff in the home work closely with individual service users to ensure there are a range of opportunities for personal development. A central ethos of the service is to enable residents to develop their independent living skills and each service user is involved in formulating a specific plan related to their needs and aspirations. A number of groups and activities are available in and out of the home in order to promote independent living skills. There are regular opportunities for residents to develop practical life skills on a formal and informal basis. Service users are given adequate opportunities to fulfil their spiritual needs. There is a positive philosophy ensuring that all service users have the opportunity to participate in meaningful activities including educational and work experience. Residents are encouraged to maintain and develop interests and hobbies. The staff in the home assist service users appropriately with any benefit and financial issues that may occur. Therapeutic programmes are documented and reviewed on a regular basis. Arthur Court H56-H05 S23340 Arthur Court V244991 120905 Stage 4.doc Version 1.40 Page 13 There is a balanced and healthy diet offered to all service users ensuring that choices are offered. Mealtimes are relaxed and unhurried with service users able to choose when they wish to eat. A programme and facilities are in place to enable some residents to cook for themselves as preparation for independent living. Dietary needs are considered and appropriate advice is gained where necessary when a special diet is required. Arthur Court H56-H05 S23340 Arthur Court V244991 120905 Stage 4.doc Version 1.40 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 20. The physical and emotional health needs of service users are met. Medication systems are adequate. EVIDENCE: Staff in the home ensure that the healthcare needs of individuals are assessed and addressed appropriately. Residents are encouraged to be independent and take responsibility for their healthcare needs with support as appropriate. All service users are registered with a local GP and are enabled access to all other healthcare services as required. Health issues are closely monitored and recorded through the home’s care planning and assessment processes. The home has developed very good links with local and specialist mental health services that provide advice, input and support as necessary. All documentation relating to medication was up to date and well maintained. Administration records were clear and unambiguous. The home has robust policies and procedures in place relating to all aspects of medication. Service users ability to self-medicate is assessed and individuals are encouraged to take responsibility in this area where appropriate as preparation for more independent lifestyles. Storage facilities are adequate although there is still scope for some improvement in this area. Staff who administer medication have all received adequate, available training in medication administration, including an in-house questionnaire and competency assessment. Arthur Court H56-H05 S23340 Arthur Court V244991 120905 Stage 4.doc Version 1.40 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) 23 Serviced users are protected from forms of abuse. EVIDENCE: The service has comprehensive policies and procedures relating to the protection of vulnerable adults from abuse. This documentation is regularly reviewed and up dated as required. Staff are provided with training regarding issues of abuse and these topics are also addressed through the induction process. Staff demonstrate a good awareness of issues of abuse and the protocols and reporting procedures underpinning them. The home has a whistle-blowing policy in place. Arthur Court H56-H05 S23340 Arthur Court V244991 120905 Stage 4.doc Version 1.40 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 and 30. Service users live in a homely, safe and comfortable environment, which is clean and hygienic. EVIDENCE: The service is maintained in good repair, comfortable and homely. Significant amounts of work have been completed in environment over the past few years, providing improved kitchen space, bedrooms and work is ongoing in relocating the office to provide a double kitchenette to promote independent living skills. The providers continue to update the environment and make improvements to the premises. There is adequate living space for the individual and collective needs of the service users. There is a planned maintenance programme and CCTV cameras are restricted to entrances for security purposes only. Furnishings and fittings are of good quality and the home is bright and cheerful. The home was clean, hygienic and free from offensive odours. Good policies and procedures have been developed ensuring controls on the spread of infection and in accordance with relevant guidance. Some staff have undertaken infection control training. The laundry facilities are sited in a purpose built outhouse and are suitable for the needs of the home. The majority of service users are responsible for their own washing with support as Arthur Court H56-H05 S23340 Arthur Court V244991 120905 Stage 4.doc Version 1.40 Page 17 required. Adequate hand washing facilities are available in key areas of the home. The home has a contract for the disposal of any clinical waste. Arthur Court H56-H05 S23340 Arthur Court V244991 120905 Stage 4.doc Version 1.40 Page 18 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 and 33. Staff have clearly defined roles and responsibilities and there is an effective staff team on duty at all times. EVIDENCE: All staff have clear job descriptions and understand the aims and goals of the service. There is a strong induction process and collaborative ethos within the home, ensuring that staff are aware of the policies and procedures and have opportunities to contribute to the development of the service. It was evident through observation and discussion with service users that staff develop positive and consistent relationships with residents assisting them to work towards their goals and aspirations. Staff are familiar with and have copies of the GSCC code of conduct. The service operates with a minimum of three staff in the morning and two in the afternoon, with two staff on waking night duty. In addition to this the registered manager and Directors are available during office hours and remain on-call at all times. The sister home to Arthur Court is situated nearby should additional staff be required in an emergency. Additional staff are on duty if support is required for trips out, appointments and activities. Regular staff meetings take place. All staff are over 21 years of age. Arthur Court H56-H05 S23340 Arthur Court V244991 120905 Stage 4.doc Version 1.40 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, 39 and 42. There is a positive ethos in the home and good quality assurance procedures. The health, safety and welfare of the home is maintained. EVIDENCE: All staff, service users and stakeholders involved in the service are enabled to contribute to the development of the home and the registered manager and providers value the opinions and input. Staff are encouraged to contribute to the development of the service and innovation and creativity are encouraged. The management of the home provides a clear sense of leadership with open and transparent decision-making. The organisation is committed to equal opportunities and has policies and procedures in place to underpin this. The organisation ensures that there is good and proactive quality monitoring, with the Directors taking a ‘hands on’ role in the service. This has been further enhanced since the last inspection with detailed monthly monitoring reports. The home has developed methods for monitoring the satisfaction of the service users, acting upon feedback where appropriate. Policies and procedures are regularly reviewed and updated. Arthur Court H56-H05 S23340 Arthur Court V244991 120905 Stage 4.doc Version 1.40 Page 20 Documentation relating to health and safety issues were viewed all of which was up to date and well maintained. The registered manager ensures safe working practices underpinned by good staff training and relevant policies and procedures. All maintenance work is carried out in a timely fashion and the home meets all legislative requirements in this regard. The fire safety logs and accident books were up to date. Arthur Court H56-H05 S23340 Arthur Court V244991 120905 Stage 4.doc Version 1.40 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 4 4 4 3 Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 3 3 x x x x 3 Standard No 31 32 33 34 35 36 Score 3 x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Arthur Court Score x x x x Standard No 37 38 39 40 41 42 43 Score x 4 3 x x x 3 H56-H05 S23340 Arthur Court V244991 120905 Stage 4.doc Version 1.40 Page 22 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. 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. Refer to Standard Good Practice Recommendations Arthur Court H56-H05 S23340 Arthur Court V244991 120905 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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